Abstract:
BACKGROUND:Out-of-hospital emergency care (OHEC), also known as prehospital care, has been shown to reduce morbidity and mortality from serious illness. We sought to summarize literature for low and low-middle income countries to identify barriers to and key interventions for OHEC delivery. METHODS:We performed a systematic review of the peer reviewed literature from January 2005 to March 2015 in PubMed, Embase, Cochrane, and Web of Science. All articles referencing research from low and low-middle income countries addressing OHEC, emergency medical services, or transport/transfer of patients were included. We identified themes in the literature to form six categories of OHEC barriers. Data were collected using an electronic form and results were aggregated to produce a descriptive summary. RESULTS:A total 1927 titles were identified, 31 of which met inclusion criteria. Barriers to OHEC were divided into six categories that included: culture/community, infrastructure, communication/coordination, transport, equipment and personnel. Lack of transportation was a common problem, with 55% (17/31) of articles reporting this as a hindrance to OHEC. Ambulances were the most commonly mentioned (71%, 22/31) mode of transporting patients. However, many patients still relied on alternative means of transportation such as hired cars, and animal drawn carts. Sixty-one percent (19/31) of articles identified a lack of skilled personnel as a key barrier, with 32% (10/31) of OHEC being delivered by laypersons without formal training. Forty percent (12/31) of the systems identified in the review described a uniform access phone number for emergency medical service activation. CONCLUSIONS:Policy makers and researchers seeking to improve OHEC in low and low-middle income countries should focus on increasing the availability of transport and trained providers while improving patient access to the OHEC system. The review yielded articles with a primary focus in Africa, highlighting a need for future research in diverse geographic areas.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Kironji AG,Hodkinson P,de Ramirez SS,Anest T,Wallis L,Razzak J,Jenson A,Hansoti Bdoi
10.1186/s12913-018-3091-0subject
Has Abstractpub_date
2018-04-19 00:00:00pages
291issue
1issn
1472-6963pii
10.1186/s12913-018-3091-0journal_volume
18pub_type
杂志文章,评审abstract:BACKGROUND:Continuous medical education strategies, including academic detailing (AD), have mixed effects on the quality of prescribing in general practice. Alongside a cluster-randomized controlled trial (cRCT) to assess the effectiveness of AD visits (on appropriate prescribing of analgesics for chronic pain in osteo...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2797-8
更新日期:2017-12-21 00:00:00
abstract:BACKGROUND:Early diagnosis is crucial for the treatment of childhood cancer as it in some cases can prevent progression of disease and improve prognoses. However, childhood cancer can be difficult to diagnose and barriers to early diagnosis are multifactorial. New knowledge about factors influencing the pathway to diag...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05821-2
更新日期:2020-10-22 00:00:00
abstract:BACKGROUND:Many health systems in Africa are funded primarily through out-of-pocket payments. Out-of-pocket payments prevent people from seeking care, can result to catastrophic health spending and lead to impoverishment. This paper estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-413
更新日期:2012-11-21 00:00:00
abstract:BACKGROUND:Geographical variation in health care services challenges the basic principle of fair allocation of health care resources. This study aimed to investigate geographical variation in the use of X-ray, CT, MRI and Ultrasound examinations in Norway, the contribution from public and private institutions, and the ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-21
更新日期:2007-02-15 00:00:00
abstract:BACKGROUND:P.Re.Val.E. is the most comprehensive comparative evaluation program of healthcare outcomes in Lazio, an Italian region, and the first Italian study to make health provider performance data available to the public. The aim of this study is to describe the P.Re.Val.E. and the impact of releasing performance d...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-25
更新日期:2012-01-27 00:00:00
abstract:BACKGROUND:International studies have shown a contribution of psychiatric comorbidity to high utilization rates in out-of-hour primary care (OOHC). Up to now, the impact of psychiatric comorbidity in German OOHC remains unclear. Therefore, we aimed to investigate reasons for encounter (RFE), possible psychiatric comorb...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2749-3
更新日期:2017-11-28 00:00:00
abstract:BACKGROUND:As a result of the previous part of this trial, many patients with cardiovascular disease were expected to receive a statin for the first time. In order to provide these patients with comprehensive information on statins, as recommended by professional guidance, education at first and second dispensing of st...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-11-313
更新日期:2011-11-16 00:00:00
abstract:BACKGROUND:An estimated 65,000 abortions occurred in Zimbabwe in 2016, and 40 % resulted in complications that required treatment. Quality post-abortion care (PAC) services are essential to treat abortion complications and prevent future unintended pregnancies, and there have been recent national efforts to improve PAC...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05110-y
更新日期:2020-03-24 00:00:00
abstract:BACKGROUND:Electronic medical records contain valuable clinical information not readily available elsewhere. Accordingly, they hold important potential for contributing to and enhancing chronic disease registries with the goal of improving chronic disease management; however a standard for diagnoses of conditions such ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-347
更新日期:2010-12-23 00:00:00
abstract:BACKGROUND:Concerted quality improvement (QI) efforts have been taken to discourage the practice of early elective deliveries (EEDs), but few studies have robustly examined the impact of directed QI interventions in reducing EED practices. Using quasi-experimental methods, we sought to evaluate the impact of a statewid...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4033-1
更新日期:2019-04-02 00:00:00
abstract:BACKGROUND:In contrast to the acute hospital sector, there have been relatively few implementations of integrated electronic health record (EHR) systems into specialist mental health settings. The National Programme for Information Technology (NPfIT) in England was the most expensive IT-based transformation of public s...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-484
更新日期:2012-12-31 00:00:00
abstract:BACKGROUND:Fever is a common reason for attending primary health facilities in Vietnam. Response of health care providers to patients with fever commonly consists of making a presumptive diagnosis and proposing corresponding treatment. In Vietnam, where malaria was brought under control, viral infections, notably dengu...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-10-275
更新日期:2010-09-21 00:00:00
abstract:BACKGROUND:General practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such fact...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-3-8
更新日期:2003-03-24 00:00:00
abstract:BACKGROUND:Assessment of the availability of essential medicines, in rural areas of countries with free state health care system, is scarce. Dependence on essential medicines among the population in rural sector is considered to be high. Assessing the availability of essential medicines in selected state owned primary ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1969-2
更新日期:2017-01-05 00:00:00
abstract:BACKGROUND:Parents of children with food allergy, primary care physicians, and members of the general public play a critical role in the health and well-being of food-allergic children, though little is known about their knowledge and perceptions of food allergy. The purpose of this paper is to detail the development o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-142
更新日期:2009-08-07 00:00:00
abstract:BACKGROUND:Few studies have estimated planned home deaths compared to actual place of death in a general population or the longitudinal course of home nursing services and associations with place of death. We aimed to investigate trajectories of nursing services, potentially planned home deaths regardless of place of d...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4536-9
更新日期:2019-10-15 00:00:00
abstract:BACKGROUND:Substantial government funding has been invested to support the training of General Practitioners (GPs) in Australia to serve rural communities. However, there is little data on the impact of this expanded training on smaller communities, particularly for smaller rural and more remote communities. Improved u...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05684-7
更新日期:2020-08-31 00:00:00
abstract:BACKGROUND:A key constraint to saturating coverage of interventions for reducing the burden of childhood illnesses in Low and Middle Income Countries (LMIC) is the lack of human resources. Community health workers (CHW) are potentially important actors in bridging this gap. Evidence exists on effectiveness of CHW in ma...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-10-286
更新日期:2010-10-13 00:00:00
abstract:BACKGROUND:Health worker motivation can potentially affect the provision of health services. The HIV pandemic has placed additional strain on health service provision through the extra burden of increased testing and counselling, treating opportunistic infections and providing antiretroviral treatment. The aim of this ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-266
更新日期:2011-10-12 00:00:00
abstract:BACKGROUND:Evidence-based clinical algorithms (EBCA) are knowledge tools to promote evidence use by codifying evidence into action plans to facilitate appropriate care. However, their impact on process and outcomes of care varies considerably across practice settings and providers, highlighting the need for tailoring o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4008-2
更新日期:2019-03-20 00:00:00
abstract:BACKGROUND:Despite substantial research on pediatric pain assessment and management, health care professionals do not adequately incorporate this knowledge into clinical practice. Organizational context (work environment) is a significant factor in influencing outcomes; however, the nature of the mechanisms are relativ...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-017-2029-2
更新日期:2017-01-23 00:00:00
abstract:BACKGROUND:The Plan-Do-Study-Act (PDSA) method is widely used in quality improvement (QI) strategies. However, previous studies have indicated that methodological problems are frequent in PDSA-based QI projects. Furthermore, it has been difficult to establish an association between the use of PDSA and improvements in c...
journal_title:BMC health services research
pub_type: 杂志文章,meta分析
doi:10.1186/s12913-019-4482-6
更新日期:2019-10-04 00:00:00
abstract:BACKGROUND:There is consistent evidence highlighting the mal-distribution of the health workforce between urban and rural and remote regions. To date, addressing this mal-distribution has focused on medicine and nursing with limited initiatives targeted at allied health. Therefore, the aim of this research was to explo...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-4954-8
更新日期:2020-02-10 00:00:00
abstract:BACKGROUND:'Failure to rescue' of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2288-y
更新日期:2017-05-08 00:00:00
abstract:BACKGROUND:The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hos...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-019-4491-5
更新日期:2019-09-11 00:00:00
abstract:BACKGROUND:The purpose of this study is to understand health care provider barriers to referring patients to Medical Fitness Center Facilities within an affiliated teaching hospital system using referral of diabetic services as an example. The aims of this study include: (1) to assess health care providers' awareness a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2474-y
更新日期:2017-08-03 00:00:00
abstract:BACKGROUND:India has the distinction of financing its healthcare mainly through out-of-pocket expenses by individual families contributing to catastrophic health expenditure and impoverishment. Nearly 70 % of the expenditure is on medicines purchased at private pharmacies. Patients with chronic ailments are especially ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1680-3
更新日期:2016-08-22 00:00:00
abstract:BACKGROUND:Potentially avoidable hospitalizations represent an indirect measure of access to effective primary care. However many approaches have been proposed to measure them and results may differ considerably. This work aimed at examining the agreement between the Weissman and Ansari approaches in order to measure p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-014-0661-7
更新日期:2015-01-22 00:00:00
abstract:BACKGROUND:Screening programs for colorectal cancer (CRC) exist in many countries, and with varying participation rates. The present study aimed at identifying socio-demographic factors for accepting a cost-free screening offer for CRC in Denmark, and to study if more people would accept the screening offer if the pres...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-06023-6
更新日期:2021-01-07 00:00:00
abstract:BACKGROUND:Armenians very rarely seek healthcare services and, consequently experience more serious health conditions. With its ongoing reforms, Armenia is focusing on linking health system financing to the quality and volume of care provided. We examine the relationship between the perceived health status of the popul...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1309-6
更新日期:2016-02-19 00:00:00