Need for Specialist and Subspecialist Physicians at the "Juan José Ortega" National Hospital of Coatepeque

Abstract

Introduction: The availability of specialist physicians is a critical challenge for national hospitals in Guatemala. The "Juan José Ortega" National Hospital of Coatepeque faces high healthcare demand alongside limitations in its resolution capacity due to the absence of specialists in key areas. Objective: To determine the need for specialist and subspecialist physicians at the National Hospital of Coatepeque during June and July 2024. Method: An observational, descriptive, and cross-sectional study was conducted at the "Juan José Ortega" National Hospital of Coatepeque during June and July 2024. Official records from MSPAS, COLMEDEGUA, PAHO, WHO, and the hospital were analyzed. Indicators of availability, sufficiency, shift coverage, population and operational gaps, external referrals, and waiting times were calculated. Results: The hospital has 55 specialists across six basic areas, predominantly in pediatrics and internal medicine. However, there is an absolute absence in seven critical specialties: cardiology, neurosurgery, nephrology, pulmonology, infectiology, gastroenterology, and urology. Gaps compared to international standards exceed 70%, with waiting times of up to 32 days for internal services and 45 days in referred areas. A total of 156 external referrals were documented during the analyzed period. Conclusions: The findings demonstrate an urgent need to expand and redistribute specialists at the National Hospital of Coatepeque. The shortage in critical areas limits its role as a referral hospital, increases external referrals, and prolongs waiting times, thereby affecting the quality and equity of care.