Factors associated with access to physical rehabilitation for victims of traffic accidents

Abstract

OBJECTIVE Evaluate the level of access to physical rehabilitation for survivors of traffic accidents and the associated factors.METHODS A cross-sectional study performed in Natal, Northeastern Brazil, through a telephone survey of 155 victims of traffic accidents admitted to an emergency hospital between January and August of 2013, with a diagnosis of fracture, traumatic brain injury or amputation. Participants were identified in the database of the reference hospital for care of traffic accident victims. We calculated point estimates and confidence interval (95%CI) for the frequency of subjects who had access, in addition to multivariate analysis (logistic regression) between access (dependent variable) and sociodemographic, clinical, and assistance variables.RESULTS Among the 155 respondents, the majority were adolescents and adults between 15–29 years of age (47.7%), men (82.6%), education up to high school (92.3%), income of up to two minimum wages (78.0%) and bikers (75.5%). Although 85.8% of traffic accident survivors reported the need for physical rehabilitation, there was little access (51.6%; 95%CI 43.7–59.4) and a delay to start the physical rehabilitation (average = 67 days). We classified factors associated with access to physical rehabilitation as: (i) unmodifiable individuals in the short term – family income greater than two minimum wages (OR = 3.7), informal worker (OR = 0.11) or unemployed (OR = 0.15) and possession of a private health care plan (OR = 0.07); and (ii) assistance modifiable by service management – written referral for physical rehabilitation (OR = 27.5) and perceived need of physical rehabilitation (OR = 10).CONCLUSIONS This study found a low and slow access to physical rehabilitation for individuals potentially in need. The associated factors were the organizational processes of health care (health information and referral) and social determinants (income, occupation and private health care plan).

Acolhimento de enfermagem à pessoa vítima de acidente de motocicleta e ao familiar acompanhante

“…27 In the emergency services, many professionals work exclusively in the search for results and not for quality. The individual who is a victim of a traffic accident requires integral health care; 12 however, the exclusivity of the biomedical model can dehumanize the care, as well as the lack of accountability and bond production. 28 Similarly to the findings of the present study's observation, in Colombia a study on the rights of the patients in relation to the services offered, revealed insufficient quality in the care provided, the patients being seen as sick and isolated organisms, bodies devoid of their singularity and restricted to technical-scientific knowledge that involves clinical experience, which increasingly distances them from their fundamental rights.…”

“…9 The abrupt change in the health and routine of accident victims and their families can cause emotional stress to all of them, with pain and suffering, as well as expenses and loss of working time that impact on the family budget. 10 Traffic accidents are considered worldwide as a serious problem and difficult to solve, and it is responsible for deaths and disabilities, physical and psychosocial harms to the victims and their families, 11,12 combined with reduced worker productivity. 13 Therefore, the consequences of traffic accidents are not limited to high mortality but have an impact on the lives of those involved due to their high social and economic cost.…”