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Lack of access to paediatric cardiology services in the public health system in four major urban centres in Perú

Published online by Cambridge University Press:  10 September 2018

Luis Altamirano-Diaz ,
Kambiz Norozi ,
Jaime A. Seabrook  and
Eva Welisch
Luis Altamirano-Diaz*
Affiliation:
Department of Paediatrics, Western University, London, Ontario, Canada Paediatric Cardiopulmonary Research Laboratory, London Health Sciences Centre, London, Ontario, Canada Children’s Health Research Institute, London, Ontario, Canada Lawson Health Research Institute, London, Ontario, Canada
Kambiz Norozi
Affiliation:
Department of Paediatrics, Western University, London, Ontario, Canada Paediatric Cardiopulmonary Research Laboratory, London Health Sciences Centre, London, Ontario, Canada Children’s Health Research Institute, London, Ontario, Canada Lawson Health Research Institute, London, Ontario, Canada
Jaime A. Seabrook
Affiliation:
Department of Paediatrics, Western University, London, Ontario, Canada Children’s Health Research Institute, London, Ontario, Canada Lawson Health Research Institute, London, Ontario, Canada School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
Eva Welisch
Affiliation:
Department of Paediatrics, Western University, London, Ontario, Canada
*
Author for correspondence: Luis Altamirano-Diaz, Department of Paediatrics, Division of Paediatric Cardiology, Western University, 800 Commissioners Rd E, PO Box 5010, London, Ontario, Canada N6A 5W9. Tel: +1 519 685 8500 ext. 56061; Fax: +1 519 685 8156; E-mail: [email protected]
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Abstract

For one-third of the Peruvian population living in large cities outside the capital city Lima, there is no access to paediatric cardiology services provided by the public health care system. Children with suspected CHD living in these areas are referred to the adult cardiologist working at the regional hospitals for care and treatment. This is a consequence of the universal health care system and the heavily skewed distribution of the health care workforce towards the capital city of Lima. This imbalance has resulted in a severe shortage of paediatric cardiologists practicing outside of Lima and the adult cardiologists that remain are left to make up for this deficit.

To gain a better understanding of the current model of care for children with suspected CHD within the public health care system in Peru, we surveyed adult cardiologists from four major urban centres that serve one-third of the Peruvian population outside of Lima. We determined that adult cardiologists spend a significant amount of time treating children, but lack the specialised training and equipment to provide model care. The cardiologists indicated that receiving additional training and appropriate equipment would help enable them to provide proper care for these children.

Keywords

PeruSouth AmericaCHDcardiologistmodel careechocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 12 , December 2018 , pp. 1452 - 1456
Copyright
© Cambridge University Press 2018 

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References

1. van der Linde, D, Konings, EEM, Slager, MA, et al. Birth prevalence of congenital heart disease worldwide. J Am Coll Cardiol 2011; 58: 2241–2247.Google Scholar
2. Murray, CJL, Vos, T, Lozano, R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet (London, England) 2012; 380: 2197–2223.Google Scholar
3. Musa, NL, Hjortdal, V, Zheleva, B, et al. The global burden of paediatric heart disease. Cardiol Young 2017; 27: S3–S8.Google Scholar
4. Dolk, H, Loane, M, Garne, E, European Surveillance of Congenital Anomalies (EUROCAT) Working Group. Congenital heart defects in Europe: prevalence and perinatal mortality, 2000 to 2005. Circulation 2011; 123: 841–849.Google Scholar
5. Bronicki, RA, Pollak, U, Argent, AC, et al. Global perspective on training and staffing for paediatric cardiac critical care. Cardiol Young 2017; 27: S9–S13.Google Scholar
6. Zheleva, B, Atwood, JB. The invisible child: childhood heart disease in global health. Lancet (London, England) 2017; 389: 16–18.Google Scholar
7. The invisible child a case for childhood heart disease and the global health agenda 1st in a series of 4 briefs from children’s HeartLink real children with an invisible disease.Google Scholar
8. The invisible child finding childhood heart disease and the global health agenda 2nd in a series of 4 briefs from children’s HeartLink.Google Scholar
9. Nava, AM. Inequality in Peru: reality and risks. Work Pap Peru 2015; 1: 12.Google Scholar
10. Instituto Nacional de Estadística e Informática (INEI). Perú:Estimaciones y Proyecciones de Población Económicamente Activa, Urbana y Rural por Sexo y Grupos de Edad, según Departamento, 2000-2015. Boletín Espec N o 20 2010; 21.Google Scholar
11. Instituto Nacional de Estadística e Informática (INEI). Estado de la Población Peruana 2015. 2015.Google Scholar
12. Población en situación de pobreza, según ámbitos geográficos. Retrieved February 8, 2018, from https://www.inei.gob.pe/estadisticas/indice-tematico/sociales/ Google Scholar
13. Población en situación de pobreza extrema, ámbitos geográficos. Retrieved February 8, 2018, from https://www.inei.gob.pe/estadisticas/indice-tematico/sociales/ Google Scholar
14. Instituto Nacional de Estadística e Informática (INEI). Perú: Perfil de la pobreza por dominios geográficos, 2007–2016; 2017.Google Scholar
15. Valdez Huarcaya, W, Omar Napanga Saldaña, E, Oyola García, A, et al. ANÁLISIS DE SITUACIÓN DE SALUD DEL PERÚ; 2013.Google Scholar
16. Ramírez Ramírez, R, Héctor, BR, Dávila Tanco, E. Perú: Estimaciones y Proyecciones de Población Total Por Sexo de Las Principales Ciudades, 2000-2015. Boletín Especial N 18. Lima; 2009.Google Scholar
17. Zevallos, L, Pastor, R, Moscoso, B. Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps. Rev Peru Med Exp Salud Publica 2011; 28: 177–185.Google Scholar
18. Instituto Nacional de Estadística e Informática (INEI). Perú: Evolución de Los Indicadores de Empleo e Ingresos Por Departamento, 2007–2016; 2017.Google Scholar
19. Anticona Huaynate, CF, Pajuelo Travezaño, MJ, Correa, M, et al. Diagnostics barriers and innovations in rural areas: insights from junior medical doctors on the frontlines of rural care in Peru. BMC Health Serv Res 2015; 15: 454.Google Scholar
20. Mocumbi, AO, Lameira, E, Yaksh, A, Paul, L, Ferreira, MB, Sidi, D. Challenges on the management of congenital heart disease in developing countries. Int J Cardiol 2011; 148: 285–288.Google Scholar
21. Rashid, U, Qureshi, AU, Hyder, SN, Sadiq, M. Pattern of congenital heart disease in a developing country tertiary care center: factors associated with delayed diagnosis. Ann Pediatr Cardiol 2016; 9: 210–215.Google Scholar
22. Hwang, I-C, Sisavanh, M, Billamay, S, et al. Congenital heart disease at Laos Children’s Hospital: two year experience. Pediatr Int 2017; 59: 271–279.Google Scholar
23. Brown, KL, Beke, DM, Cooper, DS, MacLaren, G. Pediatric Cardiac Intensive Care Society statement: caring for children with critical cardiac disease across the globe. Cardiol Young 2017; 27: S1–S2.Google Scholar
24. Vermeersch, C, Medici, A, Narvaez, R. Universal health coverage for inclusive and sustainable development: Country Summary Report for Peru; 2014.Google Scholar
25. Reich, MR, Harris, J, Ikegami, N, et al. Moving towards universal health coverage: lessons from 11 country studies. Lancet (London, England) 2016; 387: 811–816.Google Scholar
26. Maguiña, C, Galán-Rodas, E. Health situation in Peru: the pending agenda. Rev Peru Med Exp Salud Publica 2011; 28: 569–570.Google Scholar
27. Jimenez, MM, Bui, AL, Mantilla, E, Miranda, JJ. Human resources for health in Peru: recent trends (2007–2013) in the labour market for physicians, nurses and midwives. Hum Resour Health 2017; 15: 69.Google Scholar
28. Loh, LC, Ugarte-Gil, C, Darko, K. Private sector contributions and their effect on physician emigration in the developing world. Bull World Health Organ 2013; 91: 227–233.Google Scholar
29. Miranda, JJ, Diez-Canseco, F, Lema, C, et al. Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment. In: Fort AL (ed) PLoS One 2012; 7: e50567.Google Scholar
30. Ministerio de Salud. Experiencias de Planificacio´n de Los Recursos Humanos En Salud: Perú 2007-2010; 2011.Google Scholar
31. Huicho, L, Canseco, FD, Lema, C, Miranda, JJ, Lescano, AG. Incentives to attract and retain the health workforce in rural areas of Peru: a qualitative study. Cad Saude Publica 2012; 28 (4): 729–739.Google Scholar
32. Trucco, SM, Barnoya, J, Larrazabal, LA, Castañeda, A, Teitel, DF. Detection rates of congenital heart disease in Guatemala. Cardiol Young 2011; 21: 153–160.Google Scholar
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