"We Tried to Borrow Money, but No One Helped." Assessing the Three-Delay Model Factors Affecting the Healthcare Service Delivery among Dengue Patients during COVID-19 Surge in a Public Tertiary Hospital: A Convergent Parallel Mixed Methods Study.
Antonio D LigsayMaurice Lee B SantosEpifania S SimbulKristan Jela M TambioMichelle Joyce M AytonaGrecebio Jonathan D AlejandroRichard Edward L PaulZypher Jude G RegenciaEmmanuel S BajaPublished in: International journal of environmental research and public health (2021)
Identification of delay barriers to care is essential for an effective and efficient healthcare service delivery. In this study, we described the delay in care among parents of the patients seeking treatment for dengue. We also examined the factors affecting the severity of dengue (dengue with warning signs; severe dengue). A convergent parallel design mixed-method approach using Key Informant Interviews (KII) and a survey guided by the Three-Delay Model were conducted among 24 respondents at the National Children's Hospital (NCH). Coding and thematic analysis using NVIVO and bivariable generalized linear models with a Poisson distribution and robust variance were utilized to analyze the KII transcripts and survey data, respectively. Results showed that financial constraints and previous dengue infection (first delay), mode of transportation, traffic density, and location (second delay), and hospital capacity (third delay) influenced the overall delay uncertainty in seeking care treatment for dengue infection. Furthermore, our bivariable analysis showed that travel time to NCH and place of residency, service given from previous health facilities, and parents' educational background were associated and played a role in the severity of dengue infection. Interventions focused on the identified factors contributing to delayed care should be made to avoid unwanted clinical outcomes.
Keyphrases
- healthcare
- zika virus
- dengue virus
- aedes aegypti
- mental health
- end stage renal disease
- chronic kidney disease
- ejection fraction
- newly diagnosed
- quality improvement
- palliative care
- young adults
- affordable care act
- randomized controlled trial
- peritoneal dialysis
- clinical trial
- machine learning
- public health
- early onset
- chronic pain
- adverse drug
- smoking cessation
- combination therapy
- data analysis