加纳国家救护车服务:20 年来能力和利用率的变化

IF 1.4 4区 医学 Q3 EMERGENCY MEDICINE
Ahmed N. Zakariah , Edmund Boateng , Christiana Achena , Foster Ansong-Bridjan , Charles Mock
{"title":"加纳国家救护车服务:20 年来能力和利用率的变化","authors":"Ahmed N. Zakariah ,&nbsp;Edmund Boateng ,&nbsp;Christiana Achena ,&nbsp;Foster Ansong-Bridjan ,&nbsp;Charles Mock","doi":"10.1016/j.afjem.2024.06.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Emergency medical services (EMS) are minimally developed in many African countries. We sought to document the achievements and challenges faced by the National Ambulance Service (NAS) of Ghana during its 20-year nationwide expansion, and to understand how well it is providing access to previously unserved, remoter areas.</p></div><div><h3>Methods</h3><p>Data routinely collected by NAS from 2004 to 2023 were analyzed, including structure and capacity (number of stations, ambulances, employees) and utilization and process of care (number of patients served, demographics, medical conditions, response site). Per population indicators of capacity and utilization were compared across Ghana's 16 regions.</p></div><div><h3>Results</h3><p>From 64 emergency medical technicians (EMTs) and nine ambulances in 2004, NAS has grown to 3,473 EMTs and 356 ambulances. From covering three cities in 2004, NAS now has at least one station in each of Ghana's 261 districts. From transporting 205 patients in 2004, NAS transported 38,393 patients in 2022. There have been interruptions due to financial restrictions, with numbers of patients transported per year in 2017–2019 decreasing by over 50% from the prior peak (<em>n</em> = 20,236 in 2014). In 2022, there were 1.13 ambulances per 100,000 people and 0.33 transports/100,000/day. Most (81.3%) transports are inter-facility transfers. Among Ghana's 16 regions, there is moderate variation in utilization from 0.16 to 0.50 transports/100,000/day. However, the three lowest-income, remoter regions currently have utilizations of 0.16, 0.30, and 0.37 transports/100,000/day, mostly near the National average of 0.33.</p></div><div><h3>Conclusion</h3><p>Despite periodic limitations due to finances, the NAS has expanded to cover all of Ghana's 261 districts and has largely achieved geographic equity. Sustainability has been aided by having a training school directly under NAS's control, assuring a steady supply of EMTs. Challenges include assuring financial stability and increasing utilization for emergencies at the scene, in addition to the current high utilization for inter-facility transfer.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 3","pages":"Pages 172-178"},"PeriodicalIF":1.4000,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X24000260/pdfft?md5=af05056337f023485e2db89f16edd6bd&pid=1-s2.0-S2211419X24000260-main.pdf","citationCount":"0","resultStr":"{\"title\":\"The National Ambulance Service of Ghana: Changes in capacity and utilization over 20 years\",\"authors\":\"Ahmed N. Zakariah ,&nbsp;Edmund Boateng ,&nbsp;Christiana Achena ,&nbsp;Foster Ansong-Bridjan ,&nbsp;Charles Mock\",\"doi\":\"10.1016/j.afjem.2024.06.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Emergency medical services (EMS) are minimally developed in many African countries. We sought to document the achievements and challenges faced by the National Ambulance Service (NAS) of Ghana during its 20-year nationwide expansion, and to understand how well it is providing access to previously unserved, remoter areas.</p></div><div><h3>Methods</h3><p>Data routinely collected by NAS from 2004 to 2023 were analyzed, including structure and capacity (number of stations, ambulances, employees) and utilization and process of care (number of patients served, demographics, medical conditions, response site). Per population indicators of capacity and utilization were compared across Ghana's 16 regions.</p></div><div><h3>Results</h3><p>From 64 emergency medical technicians (EMTs) and nine ambulances in 2004, NAS has grown to 3,473 EMTs and 356 ambulances. From covering three cities in 2004, NAS now has at least one station in each of Ghana's 261 districts. From transporting 205 patients in 2004, NAS transported 38,393 patients in 2022. There have been interruptions due to financial restrictions, with numbers of patients transported per year in 2017–2019 decreasing by over 50% from the prior peak (<em>n</em> = 20,236 in 2014). In 2022, there were 1.13 ambulances per 100,000 people and 0.33 transports/100,000/day. Most (81.3%) transports are inter-facility transfers. Among Ghana's 16 regions, there is moderate variation in utilization from 0.16 to 0.50 transports/100,000/day. However, the three lowest-income, remoter regions currently have utilizations of 0.16, 0.30, and 0.37 transports/100,000/day, mostly near the National average of 0.33.</p></div><div><h3>Conclusion</h3><p>Despite periodic limitations due to finances, the NAS has expanded to cover all of Ghana's 261 districts and has largely achieved geographic equity. Sustainability has been aided by having a training school directly under NAS's control, assuring a steady supply of EMTs. Challenges include assuring financial stability and increasing utilization for emergencies at the scene, in addition to the current high utilization for inter-facility transfer.</p></div>\",\"PeriodicalId\":48515,\"journal\":{\"name\":\"African Journal of Emergency Medicine\",\"volume\":\"14 3\",\"pages\":\"Pages 172-178\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-07-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2211419X24000260/pdfft?md5=af05056337f023485e2db89f16edd6bd&pid=1-s2.0-S2211419X24000260-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"African Journal of Emergency Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2211419X24000260\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"African Journal of Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2211419X24000260","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0

摘要

导言许多非洲国家的紧急医疗服务(EMS)发展程度很低。我们试图记录加纳国家救护车服务局(NAS)在其 20 年的全国扩张过程中所取得的成就和面临的挑战,并了解其为以前未提供服务的偏远地区提供服务的情况。方法对 NAS 在 2004 年至 2023 年期间收集的常规数据进行分析,包括结构和能力(站点数量、救护车数量、员工数量)以及利用率和护理流程(服务的患者数量、人口统计、医疗条件、响应地点)。对加纳 16 个地区按人口计算的能力和利用率指标进行了比较。结果NAS 从 2004 年的 64 名紧急医疗技术人员(EMT)和 9 辆救护车发展到现在的 3473 名紧急医疗技术人员和 356 辆救护车。2004 年,NAS 的服务范围覆盖三个城市,而现在加纳 261 个地区中的每个地区都至少有一个服务站。从 2004 年运送 205 名病人,到 2022 年运送了 38 393 名病人。由于财政限制,运送工作曾一度中断,2017-2019 年每年运送的病人数量比之前的峰值(2014 年为 20 236 人)减少了 50%以上。2022 年,每 10 万人有 1.13 辆救护车,每天每 10 万人有 0.33 次转运。大多数(81.3%)转运是机构间转运。在加纳的 16 个地区中,救护车使用率差异不大,从 0.16 到 0.50 次/100,000 人/天不等。然而,收入最低的三个偏远地区目前的利用率分别为 0.16、0.30 和 0.37 次/100,000/天,大多接近 0.33 次/100,000/天的全国平均水平。由于培训学校直接受加纳国家医疗服务管理局控制,确保了急救医疗人员的稳定供应,这有助于该计划的可持续发展。面临的挑战包括确保财务稳定和提高现场紧急情况的利用率,以及目前设施间转运的高利用率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The National Ambulance Service of Ghana: Changes in capacity and utilization over 20 years

Introduction

Emergency medical services (EMS) are minimally developed in many African countries. We sought to document the achievements and challenges faced by the National Ambulance Service (NAS) of Ghana during its 20-year nationwide expansion, and to understand how well it is providing access to previously unserved, remoter areas.

Methods

Data routinely collected by NAS from 2004 to 2023 were analyzed, including structure and capacity (number of stations, ambulances, employees) and utilization and process of care (number of patients served, demographics, medical conditions, response site). Per population indicators of capacity and utilization were compared across Ghana's 16 regions.

Results

From 64 emergency medical technicians (EMTs) and nine ambulances in 2004, NAS has grown to 3,473 EMTs and 356 ambulances. From covering three cities in 2004, NAS now has at least one station in each of Ghana's 261 districts. From transporting 205 patients in 2004, NAS transported 38,393 patients in 2022. There have been interruptions due to financial restrictions, with numbers of patients transported per year in 2017–2019 decreasing by over 50% from the prior peak (n = 20,236 in 2014). In 2022, there were 1.13 ambulances per 100,000 people and 0.33 transports/100,000/day. Most (81.3%) transports are inter-facility transfers. Among Ghana's 16 regions, there is moderate variation in utilization from 0.16 to 0.50 transports/100,000/day. However, the three lowest-income, remoter regions currently have utilizations of 0.16, 0.30, and 0.37 transports/100,000/day, mostly near the National average of 0.33.

Conclusion

Despite periodic limitations due to finances, the NAS has expanded to cover all of Ghana's 261 districts and has largely achieved geographic equity. Sustainability has been aided by having a training school directly under NAS's control, assuring a steady supply of EMTs. Challenges include assuring financial stability and increasing utilization for emergencies at the scene, in addition to the current high utilization for inter-facility transfer.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
2.40
自引率
7.70%
发文量
78
审稿时长
85 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信