Mapping of pathways of care, assessment of delays and gap analysis in provision of care following road traffic injury among patients in selected tertiary hospitals in urban Karnataka, South India

Published

2021-12-31

DOI:

https://doi.org/10.47203/IJCH.2021.v33i04.015

Keywords:

Pathways of Care, Road Traffic Injury, Golden Hour

Dimensions Badge

Issue

Section

Original Article

Authors

Abstract

Background: Evidence-based public health advocates decision making based on best available scientific evidence, hence it is important to gather evidence of current scenario of trauma care. Aim & Objective: To determine pathways of care and delays among Road Traffic Injury patients and assess gaps in resources. Settings and Design: This cross-sectional study was conducted in selected tertiary care hospitals in Mangaluru taluk, Karnataka. Methods and Material: Participants were administered validated proformas on prehospital and hospital care. WHO trauma care checklist was used for capacity assessment and gap analysis. Statistical analysis used: Time intervals are expressed as measures of central tendency and dispersion. Descriptive analysis is given as percentages and proportions. Results: Median pre-hospital time was 30 minutes. Overall, 67.5% of the patients reached within golden hour. Majority (64.1%) were directly transported to current hospital. All patients received first aid, but only 0.8% received it at the RTI site. First aid was mostly administered by doctors (68.7%) or nursing staff (31.1%) and none by bystander. Insurance coverage was 32.8% and 87.9% incurred out of pocket expenditures. Scores were low in GP level hospital. Conclusions: Although transport was within the golden hour, pre-hospital care was poor. Out of pocket expenditures were high.

How to Cite

1.
Prabhu SH, Rashmi A, Kundapur R, Sathyanath SM. Mapping of pathways of care, assessment of delays and gap analysis in provision of care following road traffic injury among patients in selected tertiary hospitals in urban Karnataka, South India. Indian J Community Health [Internet]. 2021 Dec. 31 [cited 2022 Aug. 19];33(4):627-33. Available from: https://iapsmupuk.org/journal/index.php/IJCH/article/view/2156

Downloads

Download data is not yet available.

References

Global status report on road safety 2015. Available from: https://www.who.int/violence_injury_prevention/road_safety_status/2015 /en/ [Accessed 25/12/2021]

World Health Organization. Country profiles. Available from: https://www.who.int/violence_injury_prevention/road_safety_status/ country_profiles/en/ [Accessed 25/12/2021]

World report on road traffic injury prevention 2004. [Internet]. [cited]. Available from: https://www.who.int/violence_injury_prevention/publications/road_traffi c/world_report/en/ [Accessed 25/12/2021]

Newgard CD, Meier EN, Bulger EM, Buick J, Sheehan K, Lin S, et al. Revisiting the “Golden Hour”: An evaluation of out-of-hospital time in shock and traumatic brain injury. Ann Emerg Med. 2015; 66(1):30 – 41

Koyner JL. The Golden Hours of AKI: Is Oxygen Delivery the Key? Clin J Am Soc Nephrol. 2015;10(8):1311-3.

Reducing the severity of road injuries through post-impact care. Brussels, European Transport Safety Council, Post Impact Care Working Party, 1999.Eur J Emerg Med 1999;6(3):271-4

Lerner EB, Moscati RM. The golden hour: scientific fact or medical “urban legend”. Academic Emergency Medicine. 2001; 8:758–760.

Amit Gupta, Ekta Gupta. Challenges in Organizing Trauma Care Systems in India. Indian J Community Med. 2009; 34(1): 75–76

Centre for Homeland Defence and Security, US Department of Health and Human Services. Model Trauma System Planning and Evaluation. 2006; Available from https://www.hsdl.org/?abstract&did=463554 [Accessed 25/12/2021]

Mitra S, Sarkar AP, Saren AB, Haldar D, Saha I, Sarkar GN. Road Traffic Injuries: A Study on Severity and Outcome among Inpatients of a Tertiary Care Level Hospital of West Bengal, India. J Emerg Trauma Shock. 2018;11(4):247–52

OpenEpi - Toolkit Shell for Developing New Applications [Internet]. Available from http://www.openepi.com/SampleSize/SSPropor.html [Accessed 25/12/2021]

Carr BG, Caplan JM, Pryor JP, Branas CC. A meta-analysis of prehospital care times for trauma. PrehospEmerg Care. 2006;10(2):198?206

Bigdeli M, Khorasani-Zavareh D, Mohammadi R. Pre-hospital care time intervals among victims of road traffic injuries in Iran- A cross-sectional study. BMC Public Health. 2010; 10:406

Lahiri SK, Mandal P, Mandi P, Mitra SP, Chatterjee T. A study on cases contracting road traffic accidents in rural area and attending the Tarakeswar rural hospital, West Bengal. Indian J Prev Soc Med. 2005; 36:94–101

Ministry of Road Transport and Highways. Government of India. Report of the Working Group on Emergency Care in India. Available from: http://healthmarketinnovations.org/sites/. Accessed 25/12/2021

Dharap S, Kamath S, Kumar V. Does prehospital time affect the survival of major trauma patients where there is no prehospital care? J Postgrad Med. 2017;63(3):169–75

Misra P, Majumdar A, Misra MC, Kant S, Gupta SK, Gupta A, et al. Epidemiological Study of Patients of Road Traffic Injuries Attending Emergency Department of a Trauma Centre in New Delhi. Indian J Crit Care Med. 2017;21(10):678–83

Chandrasekharan A, Nanavati AJ, Prabhakar S, Prabhakar S. Factors Impacting Mortality in the Pre-Hospital Period After Road Traffic Accidents in Urban India. Trauma Mon. 2016;21(3): e22456

Shrivastava SR, Pandian P, Shrivastava PS. Pre-hospital care among victims of road traffic accident in a rural area of Tamil Nadu: A cross-sectional descriptive study. J Neurosci Rural Pract. 2014;5 (Suppl 1): S33–8

Singh R, Kumar A, Singh G K, Kumar S, Singh N. An evaluation of association between pre-hospital care with injury severity scores among survivors of road traffic accidents in a north Indian setting. IOSR Journal of Dental and Medical Sciences. 2014;13(6): 05-08

Prakashy C, Tiwari V K, Raj T.P & Nair, K S. Pattern of road accidents system response and quality of services in emergency ward of a tertiary hospital in Delhi. Health and population; perspectives and issues. 2013;36 (3): 133-151

Chauhan A, Ahmed N, Singh JV, Singh VK, Singh A, Kumar S. Disability and mortality following road traffic injury: a follow-up study from a tertiary care centre of India. International Journal of Community Medicine and Public Health. 2017;4(12):4712–7

Elango S, Ramya AB, Renita A, Ramana M, Revathy S, Rajajeyakumar M. An Analysis of Road Traffic Injuries in India from 2013 to 2016: A Review Article. Journal of Community Medicine & Health Education. 2018;8(2):1–8

Kumar GA, Dilip TR, Dandona L, Dandona R. Burden of out-of-pocket expenditure for road traffic injuries in urban India. BMC Health Serv Res. 2012; 12:285

Prinja S, Jagnoor J, Sharma D, Aggarwal S, Katoch S, Lakshmi PVM, et al. Out-of-pocket expenditure and catastrophic health expenditure for hospitalization due to injuries in public sector hospitals in North India. PLoS ONE 2019; 14 (11): e0224721

Asheel BM, Soman B, Kuriakose VG, Francis S, Mathew T. Health system preparedness for road traffic accidents in a rural district in Kerala, India. Injury Prevention. 2010;16(Suppl 1): A32–A32

Razzak JA, Baqir SM, Khan UR, Heller D, Bhatti J, Hyder AA. Emergency and trauma care in Pakistan: a cross-sectional study of healthcare levels. Emerg Med J. 2015;32(3):207–13

Most read articles by the same author(s)

1 2 > >>