Vera-López Juan Daniel, Pérez-Núñez Ricardo, Gómez-García Lourdes, Hidalgo-Solórzano Elisa, Fraga-Sastrías Juan Manuel
Escuela de Salud Pública de México, Instituto Nacional de Salud Pública, Cuernavaca, México.
Secretariado Técnico, Consejo Nacional para la Prevención de Accidentes, Ciudad de México, México.
Cad Saude Publica. 2018 Oct 22;34(10):e00144916. doi: 10.1590/0102-311X00144916.
The aim of this article was to analyze the timeliness of emergency medical care (time transpired between the injury and the first contact with the Emergency Medical System) and its assocation with different negative health outcome in traffic accident victims treated at two Mexican hospitals, one in Guadalajara, Jalisco, and the other in León, Guanajuato, based on data from the Motor Vehicle Accident Epidemiological Surveillance System of the Bloomberg Philanthropies' Global Road Safety Program. Information was obtained on all patients treated for motor vehicle injuries in referral hospitals from May 2012 to November 2014. Multinomial logistic regression was used to model the health outcomes, categorized as short stay, prolonged hospitalization, disability, and death, compared to timeliness of care, adjusted by different target variables. A total of 2,575 patients were analyzed. Time from injury to care was 103.74 minutes (± 231.36) in León and 75.37 minutes (± 156.87) in Guadalajara; it was 38.02 and 36.23 minutes, respectively, in patients that received prehospital medical care. Timely care was associated with less prolonged hospital stay, but not with lower incidence of disability or death. Receiving prehospital medical care was associated statistically with negative health consequences. Timely care was associated with lower probability of prolonged hospitalization. Strategies are needed to evaluate and in turn improve the technical quality of prehospital medical care, including timeliness of care and adequate regulation.
本文旨在根据彭博慈善基金会全球道路安全项目机动车事故流行病学监测系统的数据,分析墨西哥两家医院(一家位于哈利斯科州瓜达拉哈拉,另一家位于瓜纳华托州莱昂)收治的交通事故受害者的紧急医疗护理及时性(从受伤到首次接触紧急医疗系统之间的时间间隔)及其与不同负面健康结果的关联。获取了2012年5月至2014年11月在转诊医院接受机动车伤害治疗的所有患者的信息。使用多项逻辑回归对健康结果进行建模,与护理及时性相比,健康结果分为短期住院、长期住院、残疾和死亡,并根据不同的目标变量进行调整。共分析了2575名患者。莱昂从受伤到接受护理的时间为103.74分钟(±231.36),瓜达拉哈拉为75.37分钟(±156.87);接受院前医疗护理的患者分别为38.02分钟和36.23分钟。及时护理与缩短住院时间相关,但与残疾或死亡发生率降低无关。接受院前医疗护理与负面健康后果在统计学上相关。及时护理与长期住院的可能性较低相关。需要采取策略来评估并进而提高院前医疗护理的技术质量,包括护理及时性和适当监管。