Kırsal hastanede sınırlı fizibilite ile genel cerrahi uygulamaları; Retrospektif kohort çalışma

Öz

Amaç: Kırsal alanda yaşayan birçok sakin, sağlık hizmetlerine erişimleri, kent dışı bölgelerde yaşayanlara göre daha zordur. ABD nüfusunun %20'sinin kırsal bölgelerde yaşıyor olmasına rağmen, hekimlerin sadece %9'u bu alanlarda çalışıyor ve özellikle genel cerrahlar küçük kırsal kasabalarda yetersiz kalmış gibi görünüyor. Bu çalışma ilçe devlet hastanesinde genel cerrahi açıdan yapılan uygulamaların tespiti amacıyla planlandı. 

Yöntemler: Çalışma Konya il merkezinden yaklaşık 150 km uzakta bulunan 25 yataklı Bozkır Devlet Hastanesinde gerçekleştirildi. 2009 yılında genel cerrahi polikliniğine başvuran hasta dosyaları incelendi. Elektif ve acil uygulanan major ve minor ameliyatlar kayıt edildi ve sonuçları irdelendi.

Bulgular: Çalışma süresince 4312 hasta poliklinikte görüldü. 2009 yılı toplam çalışılan gün sayısı 224 olup ortalama gün başına 22 hasta düşmektedir. Çalışma süresi içerisinde 35 adet major ameliyat yapıldı. On iki apendektomi, 15 adet kasık fıtığı, altı adet pilonidal sinus, bir guatr ve bir adet boğulmuş herni vakasında barsak rezeksiyonu ve herni onarımı ameliyatı yapıldı.

Sonuç: Hastanemizde edindiğimiz deneyim, bölgemizin sosyal yapısı ve ihtiyaçları ile ilgili olabilir. Kırsal kesimde çalışan cerrah, üçüncü basamak hastane hizmetleri gibi, hastalarla yüzleşmek ve gereksinimleri karşılamak için deneyimli ekiplere ve yeterli altyapıya ihtiyaç duyabilmektedir.

Anahtar Kelimeler

• Kırsal hastane,Cerrahi uygulamalar,Kohort

General surgery service with limited feasibility in a rural hospital; Retrospective cohort study

Abstract

Aim: Many residents living in rural areas have access to health services more difficult than those living in urban areas. Although 20% of the US population lives in rural areas, only 9% of physicians work in these areas, and in particular general surgeons appear to be inadequate in small rural towns. This study was planned in order to determine the applications made from the general surgery in the district state hospital.

Methods: The study was carried out at the Bozkır State Hospital with 25 beds located approximately 150 km away from the center of Konya. In 2009, patient files were reviewed for general surgery polyclinic. Elective and urgent (major and minor) operations were recorded. The results are examined.

Results: During the study period, 4312 patients were seen in the outpatient clinic. The total number of working days in 2009 is 224 and the average number of patients per day is 22. During the study period, 35 major operations were performed. Twelve appendectomies, 15 inguinal hernias, six pilonidal sinus, one goiter and one intestinal resection in a case with strangulated inguinal hernia were performed.

Conclusion: The experience we have in our hospital may be related to the social structure and needs of our region. A rural surgeon, like third-line hospital services, may need experienced teams and adequate infrastructure to confront patients and meet their needs.

Keywords

• Rural hospital,Surgery service,Cohort

Kaynakça

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