Impact of Regional Health Facilities Planning Disparity on Patient Health: A Comparative Study on Bogura and Joypurhat Districts of Bangladesh

Abstract

Regional healthcare planning significantly shapes patient health outcomes, particularly within district hospitals in developing countries such as Bangladesh. This study investigates the impact of regional healthcare planning disparities on patient health outcomes in Bangladesh through a comparative analysis of two 250-bed district hospitals—Bogura Mohammad Ali District Hospital (BMADH) and Joypurhat District Hospital (JDH). Data were collected from 60 inpatients (n = 30 per hospital) selected from only medicine ward patients, representing approximately 50% of the ward population. A mixed-methods approach of both qualitative and quantitative methods was employed for the data analysis. The qualitative data were analyzed thematically from regional healthcare infrastructure assessment and hospital environmental evaluation. The quantitative data were analyzed using descriptive statistics from the patient-reported health indicators. The findings indicate that patients at BMADH, despite better environmental and architectural conditions, experienced longer hospital stays, higher medication use, and lower perceived physical improvement compared to patients at JDH. The observed differences appear to be associated with variations in regional healthcare systems, whereby BMADH operates within a four-tier referral structure that accommodates more severe and complex cases, while JDH functions within a two-tier system that handles comparatively less severe patients and refers critical patients elsewhere. The study contributes to the literature by highlighting the potential influence of regional healthcare planning and referral structures over hospital design on observed patient outcomes in district hospitals. However, the findings should be interpreted with caution because the study relied on a relatively small sample and involved only medicine ward patients. It used descriptive rather than inferential statistical analysis and did not take into consideration clinical variables, including disease severity, comorbidities, and referral source. As a result, the findings show associations rather than causal relationships between patient health outcomes and regional healthcare planning.