Availability and distribution of hemostasis and thrombosis resources in Argentina in 2022

Abstract

Introduction. In Argentina, information regarding the availability of resources in hemostasis and thrombosis is very scarce. The “Grupo Promoción del Acceso” del grupo CAHT (Cooperativo Argentino de Hemostasia y trombosis) conducted an extensive survey of resources in Argentina to understand the current state of the specialty. Objectives. To describe the availability of human and physical resources (diagnostic and therapeutic) in hemostasis and thrombosis in healthcare centers across Argentina in 2022 and to identify regional differences or disparities between the private and public sectors. Materials and methods. Cross-sectional cohort study. Healthcare centers from the Argentine Republic were included: institutions with inpatient services, outpatient centers, and laboratories. Data regarding the availability of human, diagnostic, and therapeutic resources in hemostasis and thrombosis were obtained at some point during the year 2022 through surveys conducted among healthcare professionals. Availability in analytical resources was defined when the test was performed within the institution or when the sample/patient was referred elsewhere for testing. Results. The study included 215 centers from 77 cities across Argentina. 85.5% of the centers had inpatient services. The median number of hematologists per institution was 3 (IQR 1-5). Differences were found among the median numbers across regions: CABA-Ciudad Autónoma de Buenos Aires-(5), Centro/Cuyo (3.5), GBA/LP-Gran Buenos Aires/La Plata-(2), NOA-Noroeste Argentino-(2), NEA-Nordeste Argentino-(1), and SUR (1). 27% of the centers had 1 or no hematologist. 59% of the centers reported employing specialized biochemists in hemostasis/hematology. The region with the lowest percentage of centers with specialists was GBA/LP (37%). There was a high availability of basic coagulation tests observed. Conversely, for more complex tests, availability was suboptimal and marked regional asymmetries were detected (GBA/LP, NOA, and NEA presented the lowest proportion of centers with resources). Some tests, such as platelet aggregation or anti-platelet factor 4/heparin, were not available in wide areas of the country. In most therapeutic resources, greater availability was detected in the private sector. Conclusions. We identified suboptimal availability of high-complexity physical resources and public-private and regional disparities. We believe that the establishment of integrated networks is a strategy that will help reduce access inequities. Scientific societies, from their position, can make valuable contributions to achieve this goal.