Qualitative evaluation of trauma delays in road traffic injury patients in Maringa, Brazil

• Type of Material: Article
• Authors: Anjni Patel, Emory University; João Ricardo Nickenig Vissoci, Duke University; Michael Hocker, Duke University; Enio Molina, Faculdade Inga; Nelly Moraes Gil, Faculdade Inga; Catherine Staton, Duke University
• Language: English
• Date: 2017-12-02
• Publisher: BMC (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © 2017 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12913-017-2762-6
• Title of Journal or Parent Work: BMC Health Services Research
• ISSN: 1472-6963
• Volume: 17
• Issue: 1
• Start Page: 804
• End Page: 804
• Grant/Funding Information: This work was partially funded from Emory University's Open Access Publishing Fund.
• Keywords: Health Care Sciences & Services; GOLDEN HOUR; SURVIVAL; TIMES; EMERGENCY MEDICAL-SERVICES; PRIORITIES; Life Sciences & Biomedicine; IMPROVEMENTS; MORTALITY; PREHOSPITAL CARE; Science & Technology
• Research Categories: Health Sciences, General; Health Sciences, Medicine and Surgery

Abstract

Background: Road traffic injuries (RTIs) are the eighth leading cause of death worldwide, with an estimated 90% of RTIs occurring in low- and middle-income countries (LMICs) like Brazil. There has been minimal research in evaluation of delays in transport of RTI patients to trauma centers in LMICs. The objective of this study is to determine specific causes of delays in prehospital transport of road traffic injury patients to designated trauma centers in Maringá, Brazil. Methods: A qualitative method was used based on the Consolidated Criteria for Reporting Qualitative Research (COREQ) approach. Eleven health care providers employed at prehospital or hospital settings were interviewed with questions specific to delays in care for RTI patients. A thematic analysis was conducted. Results: Responses to primary causes of delay in treatment to RTI patients fell into the following categories: 1) lack of public education, 2) traffic, 3) insufficient personnel/ambulances, 4) bureaucracy, and 5) poor location of stations. Suggestions for improvement in delays fell into the categories of 1) need for centralized station/avoid traffic, 2) improving public education, 3) Increase personnel, 4) increase ambulances, 5) proper extrication/rapid treatment. Conclusion: Our study found varied responses between hospital and SAMU providers regarding specific causes of delay for RTI patients; SAMU providers cited primarily traffic, bureaucracy, and poor location as primary factors while hospital employees focused more on public health aspects. These results mirror prehospital system challenges in other developing countries, but also provide solutions for improvement with better infrastructure and public health campaigns.