Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 22;11(1):53.
doi: 10.1186/s12245-018-0207-6.

Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach

Amber Mehmood  1 , Armaan Ahmed Rowther  2 , Olive Kobusingye  3 , Adnan A Hyder  2
Affiliations

Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach

Amber Mehmood et al. Int J Emerg Med. .

Abstract

Emergency medical services (EMS) is defined as the system that organizes all aspects of care provided to patients in the pre-hospital or out-of-hospital environment. Hence, EMS is a critical component of the health systems and is necessary to improve outcomes of injuries and other time-sensitive illnesses. Still there exists a substantial need for evidence to improve our understanding of the capacity of such systems as well as their strengths, weaknesses, and priority areas for improvement in low-resource environments. The aim was to develop a tool for assessment of the pre-hospital EMS system using the World Health Organization (WHO) health system framework. Relevant literature search and expert consultation helped identify variables describing system capacity, outputs, and goals of pre-hospital EMS. Those were organized according to the health systems framework, and a multipronged approach is proposed for data collection including use of qualitative and quantitative methods with triangulation of information from important stakeholders, direct observation, and policy document review. The resultant information is expected to provide a holistic picture of the pre-hospital emergency medical services and develop key recommendations for PEMS systems strengthening.

Keywords: Assessment; Emergency medical services; Health services; Health system framework; Instruments; Pre-hospital care.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
WHO emergency care system framework. This framework captures essential emergency care functions at the scene of injury or illness, during transport, and through to emergency unit and early inpatient care. Orange text and images represent human resources, blue represents system functions, and green represents equipment, supplies, and information technologies
Fig. 2
Fig. 2
a WHO health systems framework. b Pre-hospital EMS framework. Using WHO health systems framework, pre-hospital care components are organized into building blocks of the EMS system to provide an evaluative framework for the assessment tool
Fig. 3
Fig. 3
Domains of the prehospital framework. This figure outlines potential variables of the assessment tool to evaluate overall EMS system capacity and performance according to a health systems framework. Blue cells in the table represent system inputs, yellow represents system outputs, and green represents goals and outcomes
See this image and copyright information in PMC

References

    1. Mock CN, Jurkovich GJ, Arreola-Risa C, et al. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma Acute Care Surg. 1998;44:804–814. doi: 10.1097/00005373-199805000-00011. - DOI - PubMed
    1. Kobusingye OC, Guwatudde D, Owor G, et al. Citywide trauma experience in Kampala, Uganda: a call for intervention. Inj Prev. 2002;8:133–136. doi: 10.1136/ip.8.2.133. - DOI - PMC - PubMed
    1. Levine AC, Presser DZ, Rosborough S, et al. Understanding barriers to emergency care in low-income countries: view from the front line. Prehosp Disaster Med. 2007;22:467. doi: 10.1017/S1049023X00005240. - DOI - PubMed
    1. Mistovich JJ, Hafen BQ, Karren KJ. Prehospital emergency care. USA: 8th ed: Brady Prentice Hall Health; 2007.
    1. Canto JG, Zalenski RJ, Ornato JP, et al. Use of emergency medical services in acute myocardial infarction and subsequent quality of care. Circulation. 2002;106:3018–3023. doi: 10.1161/01.CIR.0000041246.20352.03. - DOI - PubMed

LinkOut - more resources