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{
    "pk": 16502,
    "title": "Emergency Services Capacity of a Rural Community in Guatemala",
    "subtitle": null,
    "abstract": "Introduction: \nAccess to emergency care is an essential part of the health system. Improving access to emergency services in low- and middle-income countries (LMIC) decreases mortality and reduces global disparities; however, few studies have assessed emergency services resources in LMICs. To guide future improvements in care, we performed a comprehensive assessment of the emergency services capacity of a rural community in Guatemala serving a mostly indigenous population.\nMethods:\n We performed an exhaustively sampled cross-sectional survey of all healthcare facilities providing urgent and emergent care in the four largest cities surrounding Lake Atitlán using the Emergency Services Resource Assessment Tool (ESRAT).\nResults:\n Of 17 identified facilities, 16 agreed to participate and were surveyed: nine private hospitals; four public clinics; and three public hospitals, including the region’s public departmental hospital. All facilities provided emergency services 24/7, and a dedicated emergency unit was available at 67% of hospitals and 75% of clinics. A dedicated physician was present in the emergency unit during the day at 67% of hospitals and 75% of clinics. Hospitals had a significantly higher percentage of available equipment compared to clinics (85% vs 54%, mean difference 31%; 95% confidence interval (CI) 23-37%; P = 0.004). There was no difference in availability of laboratory tests between public and private hospitals or between cities. Private hospitals had access to a significantly higher percentage of medications compared to clinics (56% vs 27%, mean difference 29%; 95% CI 9-49%; P = 0.024).\nConclusion:\n We found a high availability of emergency services and universal availability of personal protective equipment but a severe shortage of critical medications in clinics, and widespread shortage of pediatric equipment.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Global Health"
        },
        {
            "word": "Capacity"
        },
        {
            "word": "Guatemala"
        },
        {
            "word": "ESRAT"
        },
        {
            "word": "health systems"
        }
    ],
    "section": "International Medicine",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/8k85q733",
    "frozenauthors": [
        {
            "first_name": "Matthew",
            "middle_name": "",
            "last_name": "Hughes",
            "name_suffix": "",
            "institution": "University of Wisconsin School of Medicine and Public Health Department of Emergency Medicine, Madison, Wisconsin",
            "department": "None"
        },
        {
            "first_name": "Jessica",
            "middle_name": "",
            "last_name": "Schmidt",
            "name_suffix": "",
            "institution": "University of Wisconsin School of Medicine and Public Health Department of Emergency Medicine, Madison, Wisconsin",
            "department": "None"
        },
        {
            "first_name": "James",
            "middle_name": "",
            "last_name": "Svenson",
            "name_suffix": "",
            "institution": "University of Wisconsin School of Medicine and Public Health Department of Emergency Medicine, Madison, Wisconsin",
            "department": "None"
        }
    ],
    "date_submitted": "2022-01-28T13:52:44-05:00",
    "date_accepted": "2022-01-28T13:52:44-05:00",
    "date_published": "2022-09-12T22:15:12-04:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/16502/galley/8349/download/"
        }
    ]
}