Show simple item record

dc.contributor.authorGuzman, IB
dc.contributor.authorCuesta, JG
dc.contributor.authorTrelles, M
dc.contributor.authorJaweed, O
dc.contributor.authorCherestal, S
dc.contributor.authorvan Loenhout, JAF
dc.contributor.authorGuha-Sapir, D
dc.date.accessioned2019-03-26T13:46:03Z
dc.date.available2019-03-26T13:46:03Z
dc.date.issued2019-03-05
dc.date.submitted2019-03-14
dc.identifier.urihttp://hdl.handle.net/10144/619352
dc.description.abstractIntroduction Delays in arrival and treatment at health facilities lead to negative health outcomes. Individual and external factors could be associated with these delays. This study aimed to assess common factors associated with arrival and treatment delays in the emergency departments (ED) of three hospitals in humanitarian settings. Methodology This was a cross-sectional study based on routine data collected from three MSF-supported hospitals in Afghanistan, Haiti and Sierra Leone. We calculated the proportion of consultations with delay in arrival (>24 hours) and in treatment (based on target time according to triage categories). We used a multinomial logistic regression model (MLR) to analyse the association between age, sex, hospital and diagnosis (trauma and non-trauma) with these delays. Results We included 95,025 consultations. Males represented 65.2%, Delay in arrival was present in 27.8% of cases and delay in treatment in 27.2%. The MLR showed higher risk of delay in arrival for females (OR 1.2, 95% CI 1.2–1.3), children <5 (OR 1.4, 95% CI 1.4–1.5), patients attending to Gondama (OR 30.0, 95% CI 25.6–35.3) and non-trauma cases (OR 4.7, 95% CI 4.4–4.8). A higher risk of delay in treatment was observed for females (OR 1.1, 95% CI 1.0–1.1), children <5 (OR 2.0, 95% CI 1.9–2.1), patients attending to Martissant (OR 14.6, 95% CI 13.9–15.4) and non-trauma cases (OR 1.6, 95% CI 1.5–1.7). Conclusions Women, children <5 and non-trauma cases suffered most from delays. These delays could relate to educational and cultural barriers, and severity perception of the disease. Treatment delay could be due to insufficient resources with consequent overcrowding, and severity perception from medical staff for non-trauma patients. Extended community outreach, health promotion and support to community health workers could improve emergency care in humanitarian settings.en_US
dc.language.isoenen_US
dc.publisherPublic Library of Scienceen_US
dc.rightsWith thanks to Public Library of Scienceen_US
dc.titleDelays in arrival and treatment in emergency departments: Women, children and non-trauma consultations the most at risk in humanitarian settingsen_US
dc.identifier.journalPLoS ONEen_US
refterms.dateFOA2019-03-26T13:46:03Z


Files in this item

Thumbnail
Name:
Guzman et al - 2019 - Delays in ...
Size:
522.8Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record