Citation

Kinder F, Mehmood S, Hodgson H, Giannoudis P, Howard A. Eur. J. Orthop. Surg. Traumatol. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00590-021-03080-3

PMID

unavailable

Abstract

INTRODUCTION: Trauma is widespread in Central and South America and is a significant cause of morbidity and mortality. Providing high quality emergency trauma care is of great importance. Understanding the barriers to care is challenging; this systematic review aims to establish current the current challenges and barriers in providing high-quality trauma care within the 21 countries in the region.

METHODS: OVID Medline, Embase, EBM reviews and Global Health databases were systematically searched in October 2020. Records were screened by two independent researchers. Data were extracted according to a predetermined proforma. Studies of any type, published in the preceding decade were included, excluding grey literature and non-English records. Trauma was defined as blunt or penetrating injury from an external force. Studies were individually critically appraised and assessed for bias using the RTI item bank.

RESULTS: 57 records met the inclusion criteria. 20 countries were covered at least once. Nine key barriers were identified: training (37/57), resources and equipment (33/57), protocols (29/57), staffing (17/57), transport and logistics (16/57), finance (15/57), socio-cultural (13/57), capacity (9/57), public education (4/57).

CONCLUSION: Nine key barriers negatively impact on the provision of high-quality trauma care and highlight potential areas for improving care in Central & South America. Many countries in the region, along with rural areas, are under-represented by the current literature and future research is urgently required to assess barriers to trauma management in these countries. No funding was received.

CLINICAL TRIAL REGISTRATION: PROSPERO CRD42020220380.

Language: en

Keywords

Trauma; Barriers; Health Care Access; South America