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中低收入国家创伤登记处实施现状及实施障碍的促进因素:文献回顾与专家咨询。

Current status of implementation of trauma registries' in LMICs & facilitators to implementation barriers: A literature review & consultation.

机构信息

Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.

Programme in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Indian J Med Res. 2024;159(3 & 4):322-330. doi: 10.25259/IJMR_2420_23.

DOI:10.25259/IJMR_2420_23
PMID:39361796
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11413881/
Abstract

Background & objectives Many low- and middle- income countries (LMICs) have attempted to implement trauma registries with varying degrees of success. This study aimed to understand the registry implementation mechanism in LMICs better. Study objectives include assessment of the current use of trauma registries in LMICs, identification of barriers to the process and potential areas for intervention, and investigation of the registry implementation experience of key stakeholders in LMICs. Methods An initial narrative review of articles on trauma registry use in LMICs published in English between January 2017 and September 2023 was conducted. Key findings identified in this review were used to establish a theoretical framework from which an interview guide was subsequently developed. Expert consultation with key stakeholders in trauma registry implementation in two LMICs was conducted to assess the experience of registry implementation further. Results The presence of trauma registries in LMICs is limited. Key implementation barriers include funding concerns, uncoordinated administrative efforts, lack of human and physical resources (i.e., technology, equipment), and challenges in data management, analysis, and quality. Stakeholder interviews highlighted the importance of trauma registry development but echoed some obstacles, notably funding and data collection barriers. Interpretation & conclusions Barriers to registry implementation are ubiquitous and may contribute to the low uptake of registries in LMICs. One potential solution to these challenges is the application of the WHO International Registry for Trauma and Emergency Care. Future studies examining context-specific challenges to registry implementation and sustained utilization are required.

摘要

背景与目的

许多中低收入国家(LMICs)已经尝试实施创伤登记系统,但取得的成功程度各不相同。本研究旨在更深入地了解 LMICs 中登记系统的实施机制。研究目的包括评估创伤登记系统在 LMICs 中的当前使用情况、确定实施过程中的障碍和潜在的干预领域,以及调查 LMICs 中关键利益相关者的登记实施经验。

方法

对 2017 年 1 月至 2023 年 9 月期间发表的关于 LMICs 中创伤登记使用的英文文章进行了初步的叙述性综述。从这次综述中确定了关键发现,并用其建立了一个理论框架,随后据此制定了访谈指南。对两个 LMICs 中创伤登记实施的关键利益相关者进行了专家咨询,以进一步评估登记实施的经验。

结果

LMICs 中创伤登记系统的存在是有限的。关键的实施障碍包括资金问题、协调不力的行政工作、缺乏人力和物力资源(即技术、设备),以及数据管理、分析和质量方面的挑战。利益相关者访谈强调了创伤登记系统发展的重要性,但也反映了一些障碍,特别是资金和数据收集方面的障碍。

解释与结论

实施登记系统的障碍普遍存在,这可能是导致 LMICs 中登记系统采用率低的原因之一。解决这些挑战的一个潜在方法是应用世卫组织国际创伤和紧急护理登记处。需要进一步研究具体背景下的登记实施挑战和持续利用的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4cc/11413881/5421e84c403c/IJMR-159-3-4-322-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4cc/11413881/37a997c49db8/IJMR-159-3-4-322-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4cc/11413881/5421e84c403c/IJMR-159-3-4-322-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4cc/11413881/37a997c49db8/IJMR-159-3-4-322-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4cc/11413881/5421e84c403c/IJMR-159-3-4-322-g2.jpg

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