Recursos y capacidades de servicios de emergencia para atención de lesiones por traumas en Perú

Rosales-Mayor, Edmundo; Miranda, J. Jaime; Lema, Claudia Patricia Henao; López, Luis Alejandro Valdés; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Piat, Equipo

doi:10.1590/s0102-311x2011000900017

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…There are also, however, victim, vehicle, and environmental factors that, together with opportunity and quality of care, can influence the fatality rate. These factors are difficult to document and measure, and for example, adequate human resources [51] and insurance coverage for RTIs [52]remain a challenge to be addressed in the Peruvian setting.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Road Traffic Incidents in Peru 1973–2008: Incidence, Mortality, and Fatality

et al. 2014

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BackgroundThe epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973–2008, as well as their relationship to population trends such as economic growth.Methods and FindingsSecondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43–5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15–0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09–1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capitaConclusionsThe significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Road Traffic Incidents in Peru 1973–2008: Incidence, Mortality, and Fatality

et al. 2014

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“…One method to improve the quality of hospital care that has demonstrated cost-effectiveness is the implementation of improvement programs for trauma and emergency services laid out in the Guidelines for Essential Trauma Care, published by the WHO 4 . Their application to our health system has been insufficient at present 29 .…”

Section: Discussionmentioning

confidence: 99%

Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study

Miranda¹,

Rosales-Mayor²,

Quistberg

et al. 2013

F1000Res

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Background: Road injuries are the second-leading cause of disease and injury in the Andean region of South America. Adequate management of road traffic crash victims is important to prevent and reduce deaths and serious long-term injuries. Objective: To evaluate the promptness of health care services provided to those injured in road traffic incidents (RTIs) and the satisfaction with those services during the pre-hospital and hospital periods. Methods: We conducted a cross-sectional study with active surveillance to recruit participants in emergency departments at eight health care facilities in three Peruvian cities: a large metropolitan city (Lima) and two provincial cities (an urban center in the southern Andes and an urban center in the rainforest region), between August and September 2009. The main outcomes of interest were promptness of care, measured by time between injury and each service offered, as well as patient satisfaction measured by the Service Quality (SERVQUAL) survey. We explored the association between outcomes and city, type of health care facility (HCF), and type of provider. Results: We recruited 644 adults seeking care for RTIs. This active surveillance strategy yielded 34% more events than anticipated, suggesting under-reporting in traditional registries. Median response time between a RTI and any care at a HCF was 33 minutes overall and only 62% of participants received professional care during the initial “golden” hour after the RTI. After adjustment for various factors, there was strong evidence of higher global dissatisfaction levels among those receiving care at public HCFs compared to private ones (odds ratio (OR) 5.05, 95% confidence interval (CI) 1.88-13.54). This difference was not observed when provincial sites were compared to Lima (OR 1.41, 95% CI 0.42-4.70). Conclusions: Response time to RTIs was adequate overall, though a large proportion of RTI victims could have received more prompt care. Overall, dissatisfaction was high, mainly at public institutions indicating much need for improvements in service provision.

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“…Previous work was limited to one study of emergency services in an urban area in El Salvador 10 and other studies in South America with limited scopes of assessment such as trauma or surgery. [11][12][13][14][15] In our study we found some areas of adequate capacity including in supplies such as PPE and staffing infrastructure. However, there were also major deficiencies including a severe shortage of critical medications in clinics, and a widespread shortage of pediatric equipment.…”

Section: Discussionmentioning

confidence: 54%

“…There are few organized prehospital services and most people have to rely on public or self-transport to access emergency care. 9 Although previous work has evaluated hospitals in urban areas, 10 and focused studies on limited scopes of service such as trauma or surgery have been done, [11][12][13][14][15] the ability to provide a standardized set of emergency services, or "emergency services capacity" in rural areas of Central and South America has not been systematically studied.…”

Section: How Does This Improve Population Health?mentioning

confidence: 99%

Emergency Services Capacity of a Rural Community in Guatemala

Hughes¹,

Schmidt²,

Svenson³

2022

WestJEM

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Introduction: Access to emergency care is an essential part of the health system. Improving access to emergency services in low- and middle-income countries (LMIC) decreases mortality and reduces global disparities; however, few studies have assessed emergency services resources in LMICs. To guide future improvements in care, we performed a comprehensive assessment of the emergency services capacity of a rural community in Guatemala serving a mostly indigenous population. Methods: We performed an exhaustively sampled cross-sectional survey of all healthcare facilities providing urgent and emergent care in the four largest cities surrounding Lake Atitlán using the Emergency Services Resource Assessment Tool (ESRAT). Results: Of 17 identified facilities, 16 agreed to participate and were surveyed: nine private hospitals; four public clinics; and three public hospitals, including the region’s public departmental hospital. All facilities provided emergency services 24/7, and a dedicated emergency unit was available at 67% of hospitals and 75% of clinics. A dedicated physician was present in the emergency unit during the day at 67% of hospitals and 75% of clinics. Hospitals had a significantly higher percentage of available equipment compared to clinics (85% vs 54%, mean difference 31%; 95% confidence interval (CI) 23-37%; P = 0.004). There was no difference in availability of laboratory tests between public and private hospitals or between cities. Private hospitals had access to a significantly higher percentage of medications compared to clinics (56% vs 27%, mean difference 29%; 95% CI 9-49%; P = 0.024). Conclusion: We found a high availability of emergency services and universal availability of personal protective equipment but a severe shortage of critical medications in clinics, and widespread shortage of pediatric equipment.

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Recursos y capacidades de servicios de emergencia para atención de lesiones por traumas en Perú

Cited by 7 publications

References 15 publications

Epidemiology of Road Traffic Incidents in Peru 1973–2008: Incidence, Mortality, and Fatality

Epidemiology of Road Traffic Incidents in Peru 1973–2008: Incidence, Mortality, and Fatality

Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study

Emergency Services Capacity of a Rural Community in Guatemala

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