Chandran Aruna, Ejaz Kiran, Karani Rabia, Baqir Muhammad, Razzak Junaid, Hyder Adnan A
International Injury Research Unit, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan.
Emerg Med J. 2014 Dec;31(12):990-3. doi: 10.1136/emermed-2013-202762. Epub 2013 Sep 10.
Prehospital care is a vital part of emergency medical care. Countries with decentralised ambulance systems, such as Pakistan, require patient knowledge as to when to call an ambulance and which service to call. Little is known about how patient perceptions of ambulance services affect ambulance usage in most low- and middle-income countries (LMIC). The purpose of our study was to analyse patient perspectives of the ambulance system in Karachi to understand how to improve ambulance use.
Indepth interviews were conducted with 30 individuals selected by convenience sampling representing patients who came to the emergency department by private transport versus one of two of the main ambulance service providers in Karachi.
Similar to what has been shown in some LMIC contexts, two of the major themes that emerged which affect patient decision making with regard to ambulance use were a mistrust of the ambulance system or providers and a sense of inadequacy of the local system as compared with international standards. In addition, which has not been shown in previous studies, there was a fundamental misunderstanding of the role of ambulance services in the healthcare infrastructure.
Insight into the main issues affecting patient decisions to use an ambulance service offers possible targets for patient education that could result in an increase in the proper usage of ambulances and thus optimise outcomes from serious injury and illness in an LMIC context.
院前护理是紧急医疗护理的重要组成部分。在巴基斯坦等拥有分散式救护车系统的国家，患者需要了解何时呼叫救护车以及呼叫哪家服务机构。在大多数低收入和中等收入国家（LMIC），关于患者对救护车服务的认知如何影响救护车使用情况，我们知之甚少。我们研究的目的是分析卡拉奇患者对救护车系统的看法，以了解如何改善救护车的使用。
通过便利抽样选取了30个人进行深入访谈，这些人分别代表乘坐私人交通工具前往急诊科的患者以及卡拉奇两家主要救护车服务提供商之一的患者。
与一些低收入和中等收入国家的情况类似，出现的影响患者使用救护车决策的两个主要主题是对救护车系统或服务提供商的不信任，以及与国际标准相比，认为当地系统存在不足。此外，与之前的研究不同，患者对救护车服务在医疗基础设施中的作用存在根本性误解。
深入了解影响患者使用救护车服务决策的主要问题，为患者教育提供了可能的目标，这可能会增加救护车的正确使用率，从而在低收入和中等收入国家背景下优化严重伤病的治疗效果。
