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Defining measures of emergency care access in low-income and middle-income countries: a scoping review.
Hirner, Sarah; Dhakal, Jyotshila; Broccoli, Morgan Carol; Ross, Madeline; Calvello Hynes, Emilie J; Bills, Corey B.
  • Hirner S; School of Medicine, University of Colorado, Aurora, Colorado, USA.
  • Dhakal J; College Undergraduate Degree Programs & Studies, University of Colorado Denver, Denver, Colorado, USA.
  • Broccoli MC; Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Ross M; Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.
  • Calvello Hynes EJ; Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.
  • Bills CB; Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA corey.bills@cuanschutz.edu.
BMJ Open ; 13(4): e067884, 2023 04 17.
Article in English | MEDLINE | ID: covidwho-2296481
ABSTRACT

BACKGROUND:

Over 50% of annual deaths in low-income and middle-income countries (LMICs) could be averted through access to high-quality emergency care.

OBJECTIVES:

We performed a scoping review of the literature that described at least one measure of emergency care access in LMICs in order to understand relevant barriers to emergency care systems. ELIGIBILITY CRITERIA English language studies published between 1 January 1990 and 30 December 2020, with one or more discrete measure(s) of access to emergency health services in LMICs described. SOURCE OF EVIDENCE PubMed, Embase, Web of Science, CINAHL and the grey literature. CHARTING

METHODS:

A structured data extraction tool was used to identify and classify the number of 'unique' measures, and the number of times each unique measure was studied in the literature ('total' measures). Measures of access were categorised by access type, defined by Thomas and Penchansky, with further categorisation according to the 'Three Delay' model of seeking, reaching and receiving care, and the WHO's Emergency Care Systems Framework (ECSF).

RESULTS:

A total of 3103 articles were screened. 75 met full study inclusion. Articles were uniformly descriptive (n=75, 100%). 137 discrete measures of access were reported. Unique measures of accommodation (n=42, 30.7%) and availability (n=40, 29.2%) were most common. Measures of seeking, reaching and receiving care were 22 (16.0%), 46 (33.6%) and 69 (50.4%), respectively. According to the ECSF slightly more measures focused on prehospital care-inclusive of care at the scene and through transport to a facility (n=76, 55.4%) as compared with facility-based care (n=57, 41.6%).

CONCLUSIONS:

Numerous measures of emergency care access are described in the literature, but many measures are overaddressed. Development of a core set of access measures with associated minimum standards are necessary to aid in ensuring universal access to high-quality emergency care in all settings.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Developing Countries / Emergency Medical Services Type of study: Reviews Limits: Humans Language: English Journal: BMJ Open Year: 2023 Document Type: Article Affiliation country: Bmjopen-2022-067884

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Developing Countries / Emergency Medical Services Type of study: Reviews Limits: Humans Language: English Journal: BMJ Open Year: 2023 Document Type: Article Affiliation country: Bmjopen-2022-067884