“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. Ligsay, Maurice Lee B. Santos, Epifania S. Simbul, Kristan Jela M. Tambio, Michelle Joyce M. Aytona, Grecebio Jonathan D. Alejandro, Richard Edward L. Paul, Zypher Jude G. Regencia and Emmanuel S. Baja
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Antonio D. Ligsay: The Graduate School & College of Science, University of Santo Tomas, Manila 1008, Philippines
Maurice Lee B. Santos: National Children’s Hospital, New Manila, Quezon City 1113, Philippines
Epifania S. Simbul: National Children’s Hospital, New Manila, Quezon City 1113, Philippines
Kristan Jela M. Tambio: National Children’s Hospital, New Manila, Quezon City 1113, Philippines
Michelle Joyce M. Aytona: National Children’s Hospital, New Manila, Quezon City 1113, Philippines
Grecebio Jonathan D. Alejandro: The Graduate School & College of Science, University of Santo Tomas, Manila 1008, Philippines
Richard Edward L. Paul: Functional Genetics of Infectious Diseases Unit, Institut Pasteur, UMR 2000 (CNRS), 75015 Paris, France
Zypher Jude G. Regencia: Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Ermita, Manila 1000, Philippines
Emmanuel S. Baja: Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Ermita, Manila 1000, Philippines

IJERPH, 2021, vol. 18, issue 22, 1-15

Abstract: 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.

Keywords: delay to care; dengue; healthcare service delivery; Philippines; three-delay model (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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