International Journal of Public Health
Volume 63, Issue 5, 2018, Pages 577-588

eHealth as a facilitator of equitable access to primary healthcare: the case of caring for non-communicable diseases in rural and refugee settings in Lebanon (Article)

Saleh S. , Alameddine M.* , Farah A. , El Arnaout N. , Dimassi H. , Muntaner C. , El Morr C.
  • a Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon, Global Health Institute, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
  • b Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health Care City, Dubai, United Arab Emirates
  • c Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
  • d Global Health Institute, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
  • e School of Pharmacy, Lebanese American University, Beirut, Lebanon
  • f Bloomberg Faculty of Nursing, Dalla Lana School of Public Health and Department of Psychiatry, School of Medicine University of Toronto, Suite 381, HSB, 155 College Street, Toronto, ON M5T 1P8, Canada
  • g Health Informatics, School of Health Policy and Management, Faculty of Health, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada

Abstract

Objectives: Assess the effect of selected low-cost eHealth tools on diabetes/hypertension detection and referrals rates in rural settings and refugee camps in Lebanon and explore the barriers to showing-up to scheduled appointments at Primary Healthcare Centers (PHC). Methods: Community-based screening for diabetes and hypertension was conducted in five rural and three refugee camp PHCs using an eHealth netbook application. Remote referrals were generated based on pre-set criteria. A phone survey was subsequently conducted to assess the rate and causes of no-shows to scheduled appointments. Associations between the independent variables and the outcome of referrals were then tested. Results: Among 3481 screened individuals, diabetes, hypertension, and comorbidity were detected in 184,356 and 113 per 1000 individuals, respectively. 37.1% of referred individuals reported not showing-up to scheduled appointments, owing to feeling better/symptoms resolved (36.9%) and having another obligation (26.1%). The knowledge of referral reasons and the employment status were significantly associated with appointment show-ups. Conclusions: Low-cost eHealth netbook application was deemed effective in identifying new cases of NCDs and establishing appropriate referrals in underserved communities. © 2018, Swiss School of Public Health (SSPH+).

Author Keywords

eHealth Appointment no-show Referrals Hypertension Primary healthcare diabetes

Index Keywords

refugee human Refugees middle aged statistics and numerical data diabetes mellitus hypertension Aged Lebanon Humans male female patient referral Socioeconomic Factors Referral and Consultation socioeconomics organization and management adult non communicable disease Telemedicine rural health care Health Services Accessibility primary health care Noncommunicable Diseases health care delivery Rural Health Services
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85044093223&doi=10.1007%2fs00038-018-1092-8&partnerID=40&md5=18b440ec3c93b2678f3ba879c6232011
DOI: 10.1007/s00038-018-1092-8
ISSN: 16618556
Cited by: 2
Original Language: English