Time-to-Treatment and Patient Survival in Ghana: A Kaplan Meier Evaluation of Delays in Clinical Intervention

Abstract

In Ghana’s healthcare system, treatment delays continue to be a major problem that negatively impacts clinical results in a variety of illness categories. There are still few thorough survival analyses looking at the connection between time-to-treatment and mortality risk in the Ghanaian context, despite mounting data worldwide. The purpose of this study is to assess the relationship between treatment delay categories and patient survival outcomes at tertiary health facilities in Ghana using the Kaplan-Meier (K-M) estimator and log-rank test. A retrospective cohort of 1,240 patients who were admitted between 2018 and 2022 to Komfo Anokye Teaching Hospital and Korle-Bu Teaching Hospital was examined. Three delay groups were created by stratifying patients into early intervention (< 6 hours), moderate delay (6 to 24 hours), and late intervention (> 24 hours). Kaplan-Meier survival curves were constructed and pairwise comparisons performed using the log-rank test (significance level: p<0.05). Adjusted Cox proportional hazards models controlled for age, sex, disease severity, comorbidities, and socioeconomic status. Significant survival differences were observed across delay categories (log-rank χ²=47.3, p<0.001). The 30-day survival probability was 91.4% for early intervention, 78.6% for moderate delay, and 61.2% for late intervention groups. Cox regression confirmed that late intervention conferred a 2.8-fold increase in hazard of death (HR=2.81, 95% CI: 2.03-3.89, p<0.001) compared to early treatment, after controlling for covariates. In Ghana, treatment delays longer than 24 hours are significantly linked to lower survival rates for hospitalized patients. There is an urgent need for policy initiatives that focus on community health literacy, emergency triage procedures, and referral system efficiency.