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Economics

Concern for prehospital care/ambulance services

10 Aug, 15 | by jmagoola

I spent last week travelling in Adjumani district (located in Northern Uganda) as part of an exercise in improving the quality of immunization data through support supervision and mentor-ship. This required us as a team to visit as many of the health facilities in the district as possible. Due to the limited sources of our country, we had to make do with one of the hospital ambulances as a means of transport. In between ferrying us from one health facility to another, the driver would get calls to go pick up emergency cases that required urgent transportation to hospital.

In this scenario, all the ambulance is manned by only a driver (no paramedic, no nurse) whose role is to pick you up and drop you at the nearest health facility. One of 2 ambulanes currently used by the district to transport patients during emergencies.No triage, no first aid, no prehospital care until arrival. This could contribute to the trauma mortality rates, which are already higher in rural areas before victims reach the hospital. It is known that travel time is a predictor of the outcome of an injury and as such many fatal injuries or their severity may be reduced by adequate prehospital trauma care. A previous study in Uganda found that fewer than 5% of injured patients are transported by ambulance to hospital  most of which ambulances are privately run and expensive. In neighboring Tanzania, a study evaluating access to prehospital care found there was no prehospital care in the region.

The interior of the ambulance, lacking paramedic supplies for first aid.

The interior of the ambulance, lacking paramedic supplies for first aid.

This highlights a major need to prioritize the development of prehospital trauma care if we are to address the issue of injuries. In addition, while the presence of an ambulance will reduce the travel time to hospital and thus increase the chance of survival, the ambulances themselves should be equipped with materials to offer some basic first aid during the course of transportation. They key policy and clinical practice questions we should ask ourselves should include; how equipped are the ambulances?; what should be the minimum standards a vehicle should attain before it is designated as an ambulance?

 

Are cost of injury studies cost-effective?

13 May, 15 | by Barry Pless

This appeared in my email so I am sharing it with blog readers but I do have a comment to add. I cannot help but wonder why we still think that publicizing cost of injury studies, or, indeed doing them, is likely to help prevent injuries in the long run. All injury prevention professionals are well aware of how much could be saved even if we only applied what we already know. It is even likely, almost certain, that most policy makers including those directly involved in health care at each local, state or provincial, and federal level, also know that injuries are extremely costly and that their prevention is a good investment. Yet, every since such studies have been popular, I see little substantial change in the resources policy makers are providing for prevention. So, I have to wonder. Perhaps some readers will see things differently. I especially invite the leading experts listed below to respond to this question.  Or, perhaps even more germane, perhaps someone from the Economic Club of Canada, will share their reactions on this blog and tell us, what specifically, they intend to do in response to what they have learned. 

“Parachute is revealing a new report The Cost of Injury In Canada at the Economic Club of Canada on June 3, 2015. Through the perspectives of leading experts — including Louis Thériault, Vice-President, Public Policy for the Conference Board of Canada, Dr. Louis Francescutti, immediate past President, Canadian Medical Association, and Dr. Ian Pike, Director of BC Research and Prevention Unit — this discussion panel will explore the societal burdens and cost pressures of preventable injuries. The panel will be moderated by Louise Logan, Parachute President & CEO. Leading Canadian franchise expert and lawyer, Ned Levitt, joins the panel to inform and inspire all with his daughter Stacey’s story, who died suddenly at age 18.”

Latest from Injury Prevention

Latest from Injury Prevention