Abstract

Millions of children in low- and middle-income countries (LMICs) experience illness or trauma amenable to emergency medical interventions, but local resources are not sufficient to treat them. Emergency medical services (EMS), including ambulance transport, bridge the gap between local services and higher-level hospital care, and data collected by EMS could be used to elucidate patterns of paediatric health care need and use. Here we conducted a retrospective observational study of patterns of paediatric use of EMS services by children who used EMS in India, a leader in maternal and child EMS development, to inform public health needs and system interventions to improve EMS effectiveness.We analysed three years (2013-2015) of data from patients <18 years of age from a large prehospital EMS system in India, including 1?101?970 prehospital care records across 11 states and a union territory.Overall, 38.3% of calls were for girls (n?=?422?370), 40.5% were for adolescents (n?=?445?753), 65.9% were from rural areas (n?=?726?154), and most families were from a socially disadvantaged caste or lower economic status (n?=?834?973, 75.8%). The most common chief complaints were fever (n?=?247?594, 22.5%), trauma (n?=?231?533, 21.0%), and respiratory difficulty (n?=?161?120, 14.6%). However, transport patterns, including patient sex and age and type of destination hospital, varied by state, as did data collection.EMS in India widely transports children with symptoms of the leading causes of child mortality and provides access to higher levels of care for geographically and socioeconomically vulnerable populations, including care for critically ill neonates, mental health and burn care for girls, and trauma care for adolescents. EMS in India is an important mechanism for overcoming transport and cost as barriers to access, and for reducing the urban-rural gap found across causes of child mortality. Further standardisation of data collection will provide the foundation for assessing disparities and identifying targets for quality improvement of paediatric care.

View details for DOI 10.7189/jogh.12.04080

View details for PubMedID 36243953