Emergency Department Characteristics and Capabilities in Quito, Ecuador

Background: Emergency care is an essential part of a health system. Ecuador has recognized emergency medicine as a specialty and has two emergency medicine residency training programs. However, little has been published about emergency department characteristics and capabilities in Ecuador. Objectiv...

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Autores principales:	Augusto Maldonado, Andrés M. Patiño, Alexis S. Kearney, Diana Tipán, Valerie Chavez-Flores, Michaela Banks, Krislyn M. Boggs, Carlos A. Camargo, Jr.
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2021
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/9d3409d4971d453c8a01f02cfb5eb018
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spelling	oai:doaj.org-article:9d3409d4971d453c8a01f02cfb5eb0182021-12-02T16:51:34ZEmergency Department Characteristics and Capabilities in Quito, Ecuador2214-999610.5334/aogh.3129https://doaj.org/article/9d3409d4971d453c8a01f02cfb5eb0182021-04-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/3129https://doaj.org/toc/2214-9996Background: Emergency care is an essential part of a health system. Ecuador has recognized emergency medicine as a specialty and has two emergency medicine residency training programs. However, little has been published about emergency department characteristics and capabilities in Ecuador. Objective: We described the characteristics and capabilities of emergency departments (EDs) in Quito, Ecuador, in 2017, using the National Emergency Department Inventory (NEDI) survey. Methods: The 23-item survey included questions pertaining to ED characteristics, including: visit volume, physical and administrative structure, clinical capabilities, technological resources, and consult personnel availability. This study included all EDs in Quito operating 24 hours/day, 7 days/week, and serving all patients seeking care. One representative from each ED was asked to complete the survey based on calendar year 2017. Findings: Thirty EDs met the inclusion criteria, and 26 completed the survey (87% response). The median number of ED beds was 17 (range 2–61). Median annual visit volume was 22,580 (range 1,680 to 129,676). All but two EDs provided care for both children and adults. Cardiac monitors were available in 88% of EDs, CT scanners in 68%, and rooms for respiratory isolation in 31%. Most EDs could manage patients with general medicine (92%), general surgery (92%), and gynecology (88%) emergencies 24/7. Fewer were able to provide hand surgery (45%) and dental (28%) care 24/7. Typical length of stay was 1–6 hours in 65% and >6 hours in 31% of EDs. Half of EDs reported operating at full capacity and 27% reported operating over their capacity. When compared to private EDs, government EDs (public and social security) had a higher mean number of visits per year (50,090 government vs. 13,968 private, p < 0.001), higher mean number of ED beds (36 government vs. 9 private, p = 0.002), and higher length of stay (58% of patient stays > 6 hours in government EDs vs. 86% of patient stays 1–6 hours in private EDs, p = 0.009). Conclusions: EDs in Quito varied widely with respect to annual visit volume, ability to treat different pathologies 24/7, and resources. Most EDs are functioning at or over capacity, and a substantial number have long lengths of stay. Further research and investment in emergency care could help increase the capacity and efficiency of EDs in Ecuador.Augusto MaldonadoAndrés M. PatiñoAlexis S. KearneyDiana TipánValerie Chavez-FloresMichaela BanksKrislyn M. BoggsCarlos A. Camargo, Jr.Ubiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 87, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Augusto Maldonado Andrés M. Patiño Alexis S. Kearney Diana Tipán Valerie Chavez-Flores Michaela Banks Krislyn M. Boggs Carlos A. Camargo, Jr. Emergency Department Characteristics and Capabilities in Quito, Ecuador
description	Background: Emergency care is an essential part of a health system. Ecuador has recognized emergency medicine as a specialty and has two emergency medicine residency training programs. However, little has been published about emergency department characteristics and capabilities in Ecuador. Objective: We described the characteristics and capabilities of emergency departments (EDs) in Quito, Ecuador, in 2017, using the National Emergency Department Inventory (NEDI) survey. Methods: The 23-item survey included questions pertaining to ED characteristics, including: visit volume, physical and administrative structure, clinical capabilities, technological resources, and consult personnel availability. This study included all EDs in Quito operating 24 hours/day, 7 days/week, and serving all patients seeking care. One representative from each ED was asked to complete the survey based on calendar year 2017. Findings: Thirty EDs met the inclusion criteria, and 26 completed the survey (87% response). The median number of ED beds was 17 (range 2–61). Median annual visit volume was 22,580 (range 1,680 to 129,676). All but two EDs provided care for both children and adults. Cardiac monitors were available in 88% of EDs, CT scanners in 68%, and rooms for respiratory isolation in 31%. Most EDs could manage patients with general medicine (92%), general surgery (92%), and gynecology (88%) emergencies 24/7. Fewer were able to provide hand surgery (45%) and dental (28%) care 24/7. Typical length of stay was 1–6 hours in 65% and >6 hours in 31% of EDs. Half of EDs reported operating at full capacity and 27% reported operating over their capacity. When compared to private EDs, government EDs (public and social security) had a higher mean number of visits per year (50,090 government vs. 13,968 private, p < 0.001), higher mean number of ED beds (36 government vs. 9 private, p = 0.002), and higher length of stay (58% of patient stays > 6 hours in government EDs vs. 86% of patient stays 1–6 hours in private EDs, p = 0.009). Conclusions: EDs in Quito varied widely with respect to annual visit volume, ability to treat different pathologies 24/7, and resources. Most EDs are functioning at or over capacity, and a substantial number have long lengths of stay. Further research and investment in emergency care could help increase the capacity and efficiency of EDs in Ecuador.
format	article
author	Augusto Maldonado Andrés M. Patiño Alexis S. Kearney Diana Tipán Valerie Chavez-Flores Michaela Banks Krislyn M. Boggs Carlos A. Camargo, Jr.
author_facet	Augusto Maldonado Andrés M. Patiño Alexis S. Kearney Diana Tipán Valerie Chavez-Flores Michaela Banks Krislyn M. Boggs Carlos A. Camargo, Jr.
author_sort	Augusto Maldonado
title	Emergency Department Characteristics and Capabilities in Quito, Ecuador
title_short	Emergency Department Characteristics and Capabilities in Quito, Ecuador
title_full	Emergency Department Characteristics and Capabilities in Quito, Ecuador
title_fullStr	Emergency Department Characteristics and Capabilities in Quito, Ecuador
title_full_unstemmed	Emergency Department Characteristics and Capabilities in Quito, Ecuador
title_sort	emergency department characteristics and capabilities in quito, ecuador
publisher	Ubiquity Press
publishDate	2021
url	https://doaj.org/article/9d3409d4971d453c8a01f02cfb5eb018
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Emergency Department Characteristics and Capabilities in Quito, Ecuador

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