Medico-socio-economic perspective of congenital hydrocephalus patients treatment in dr. Soetomo Academic General hospital, Surabaya, Indonesia

Background: Hydrocephalus is a brain disease that requires prompt treatment. The outcome of hydrocephalus is dependent on early detection and treatment. This study was conducted to analyze the medico-socio-economic perspective on the delayed treatment of hydrocephalus patients, which aimed to advance the practice of neurosurgery in the socio-neurosurgery field, including both preventive and therapeutic aspects.
Method: This was an observational analysis study. The study subjects were all patients with congenital hydrocephalus treated in dr. Soetomo Academic General Hospital between January 2017 and December 2019. The study was carried out on January 2017 to December 2019 at the Inpatient Surgery ward, dr Soetomo Academic General Hospital, neurosurgery outpatient unit, and home visits. Research data consists of both primary and medical record data. Data on patient characteristics were obtained through direct interviews with the sample using prepared questionnaires, medical record data, and radiological data of both patients examined at dr. Soetomo Academic General Hospital and other health services. Bivariate correlation analysis was performed to assess the effect of each risk factor on the incidence of delay in treatment, and multivariate logistic regression analysis was performed to assess the magnitude of the effect of risk factors.
Result: The number of cases was 101 subjects. A total of 101 patients included as research samples were congenital hydrocephalus patients who received the first treatment at dr. Soetomo Academic General Hospital from January 2017 to December 2019. Up to 50 individuals (49.5%) were delayed in treatment. The data analysis with Chi-square did not reveal a statistically significant correlation between delay in treatment and level of parent's education (p=0.0951), delay in treatment and economic status ((p=0.4955). Delays in the treatment of congenital hydrocephalus were statistically significant and correlated with Posyandu's role (p=0.0012), health insurance ownership (p=0.0001), family support (p=0.0130), and professional medical decisions (p=0.0001). Health insurance ownership has the smallest p-value (0.000) and largest wald (16.545) in the multivariate logistic regression analysis calculation using the enter method. The insurance ownership variable has the most significant and largest partial influence on the delay in treating congenital hydrocephalus.
Conclusion: There were 101 patients included, and up to 50 individuals (49.5%) were delayed in treatment. Parents' education level and socioeconomic status were not associated with delayed treatment of congenital hydrocephalus. Delays in managing congenital hydrocephalus were influenced by Posyandu's role, health insurance ownership, family support, and professional medical decisions.           