EU-based care.

The overwhelming burden of morbidity and mortality from injury and medical conditions requiring acute care are borne by low- and middle-income countries lacking accessible, quality care systems. Current evidence suggests the lack of prehospital care systems likely contributes to this disproportionate burden. As an initial step in a longitudinal, collaborative effort to strengthen the chain of survival for emergency conditions in Liberia, baseline attitudes and behaviors in accessing and utilizing emergency care were characterized. A multistage, proportional, cluster sampling frame was employed to conduct a cross-sectional, community-based survey of 800 households across rural Lofa County and the greater capital (Monrovia) metropolitan area. The primary outcome was facility-based utilization of emergency care within the 12 months prior to survey administration. 43.9% of individuals surveyed reported a visit to an emergency unit in the last year. Multivariable logistic regression revealed increased adjusted odds of facility-based emergency care utilization in households that were low-income, non-English-speaking, lacking electricity, or had a non-durable roof. Among these individuals, 23.6% had sought care from a community health worker, family/friend, clinic, pharmacy, or traditional healer prior. The majority of persons seeking care do so without ambulance services. 34.8% of all households have called a community member for a medical emergency, but 88.9% of survey respondents report no first aid training and cite barriers to rendering aid. This represents the first household survey to assess the perceptions and utilization of emergency care in Liberia. Formal pre-hospital care provision is limited and substantial barriers to emergency care access exist. First aid training and acceptance is lacking, despite frequent reliance on community-based aid during emergencies.

创伤及需急诊处置的疾病所导致的发病与死亡的沉重负担，多由缺乏可及性高质量医疗体系的中低收入国家承担。现有研究证据表明，院前急救（prehospital care）体系的缺失可能是这一不均衡疾病负担的重要驱动因素。作为强化利比里亚急诊救治生存链的纵向协作项目的初始阶段，本研究对当地居民获取与使用急诊医疗服务的基线态度与行为特征进行了系统刻画。研究采用多阶段分层整群抽样框架，在洛法县农村地区及首都蒙罗维亚大都市区完成了共计800户家庭的社区横断面调查。本次调查的主要结局指标为调查开展前12个月内的医疗机构急诊服务使用率。43.9%的受访对象报告称过去一年曾前往急诊科室就诊。多变量logistic回归分析显示，低收入、非英语使用者家庭、无电力供应家庭或屋顶不耐用家庭的医疗机构急诊服务使用校正后优势比显著升高。在上述曾就诊的受访对象中，23.6%的人此前曾向社区卫生工作者、家人/朋友、诊所、药房或传统治疗师寻求过医疗救助。绝大多数寻求急诊救治的人群并未使用救护车服务。34.8%的受访家庭曾在医疗紧急情况下求助社区成员，但88.9%的受访者表示未接受过急救培训，且提及了实施急救所面临的多重障碍。本研究为利比里亚首个评估居民急诊医疗服务认知与使用情况的家庭调查。该国正式院前急救服务供给有限，急诊医疗服务可及性存在显著障碍。尽管紧急情况下民众常依赖社区互助，但当地急救培训普及率与急救接受度均存在明显不足。