Evaluation of demands, usage and unmet needs for emergency care in Yaoundé, Cameroon: a cross-sectional study
Identifieur interne : 000231 ( Pmc/Checkpoint ); précédent : 000230; suivant : 000232Evaluation of demands, usage and unmet needs for emergency care in Yaoundé, Cameroon: a cross-sectional study
Auteurs : Young Sun Ro [Corée du Sud] ; Sang Do Shin [Corée du Sud] ; Joongsik Jeong [Corée du Sud, Cameroun] ; Min Jung Kim [Corée du Sud] ; Young Hee Jung [Corée du Sud] ; Joseph Kamgno [Cameroun] ; Etoundi Mballa Georges Alain [Cameroun] ; Bonaventure Hollong [Cameroun]Source :
- BMJ Open [ 2044-6055 ] ; 2017.
Abstract
To assess the burden of emergent illnesses and emergency care system usage by Yaoundé residents and to evaluate unmet needs for emergency care and associated barriers.
A cross-sectional study using a community-based survey.
Yaoundé, Cameroon.
All residents living in Yaoundé were selected as the target population to investigate the needs and usage of emergency care in Yaoundé. 14 households in every health area (47 in total) were selected using 2-stage sampling.
Unmet needs for emergency care.
Among the 3201 participants from 619 households who completed the survey, 1113 (34.8%) with median age of 22 experienced 1 or more emergency conditions in the previous year. Respondents who experienced emergency conditions used emergency units (7.0%), outpatient clinics (46.5%) or hospitalisation (13.0%), and in overall, 68.8% of them reported unmet needs for emergency care. The primary reasons for not seeking healthcare were economic issues (37.2%) and use of complementary medicine (22.2%). Young age (adjusted OR (95% CI) 1.80 (1.23 to 2.62)), rental housing (1.50 (1.11 to 2.03)) and moderate household income (0.60 (0.36 to 0.99)) were associated with unmet needs for emergency care.
Residents of Yaoundé had a high demand for emergency care, and high unmet needs were observed due to low emergency care usage. Development of a cost-effective, universal emergency care system is urgently needed in Cameroon.
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DOI: 10.1136/bmjopen-2016-014573
PubMed: 28167749
PubMed Central: 5293974
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Evaluation of demands, usage and unmet needs for emergency care in Yaoundé, Cameroon: a cross-sectional study</title><author><name sortKey="Ro, Young Sun" sort="Ro, Young Sun" uniqKey="Ro Y" first="Young Sun" last="Ro">Young Sun Ro</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Laboratory of Emergency Medical Services</addr-line>,<institution>Seoul National University Hospital Biomedical Research Institute</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Shin, Sang Do" sort="Shin, Sang Do" uniqKey="Shin S" first="Sang Do" last="Shin">Sang Do Shin</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Emergency Medicine</addr-line>,<institution>Seoul National University College of Medicine</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jeong, Joongsik" sort="Jeong, Joongsik" uniqKey="Jeong J" first="Joongsik" last="Jeong">Joongsik Jeong</name><affiliation wicri:level="1"><nlm:aff id="af3"><institution>Korea International Cooperation Agency</institution>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Emergency Medicine</addr-line>,<institution>Centre des Urgences de Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Min Jung" sort="Kim, Min Jung" uniqKey="Kim M" first="Min Jung" last="Kim">Min Jung Kim</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Laboratory of Emergency Medical Services</addr-line>,<institution>Seoul National University Hospital Biomedical Research Institute</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jung, Young Hee" sort="Jung, Young Hee" uniqKey="Jung Y" first="Young Hee" last="Jung">Young Hee Jung</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Laboratory of Emergency Medical Services</addr-line>,<institution>Seoul National University Hospital Biomedical Research Institute</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kamgno, Joseph" sort="Kamgno, Joseph" uniqKey="Kamgno J" first="Joseph" last="Kamgno">Joseph Kamgno</name><affiliation wicri:level="1"><nlm:aff id="af5"><addr-line>Faculty of Medicine and Biomedical Services, Department of Epidemiology</addr-line>,<institution>University of Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Alain, Etoundi Mballa Georges" sort="Alain, Etoundi Mballa Georges" uniqKey="Alain E" first="Etoundi Mballa Georges" last="Alain">Etoundi Mballa Georges Alain</name><affiliation wicri:level="1"><nlm:aff id="af6"><addr-line>Department of Disease Control, Epidemics and Pandemics</addr-line>,<institution>Ministry of Public Health</institution>,<country>Cameroon</country></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hollong, Bonaventure" sort="Hollong, Bonaventure" uniqKey="Hollong B" first="Bonaventure" last="Hollong">Bonaventure Hollong</name><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Department of Emergency Medicine</addr-line>,<institution>Centre des Urgences de Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28167749</idno><idno type="pmc">5293974</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293974</idno><idno type="RBID">PMC:5293974</idno><idno type="doi">10.1136/bmjopen-2016-014573</idno><date when="2017">2017</date><idno 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Institute</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Shin, Sang Do" sort="Shin, Sang Do" uniqKey="Shin S" first="Sang Do" last="Shin">Sang Do Shin</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Emergency Medicine</addr-line>,<institution>Seoul National University College of Medicine</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jeong, Joongsik" sort="Jeong, Joongsik" uniqKey="Jeong J" first="Joongsik" last="Jeong">Joongsik Jeong</name><affiliation wicri:level="1"><nlm:aff id="af3"><institution>Korea International Cooperation Agency</institution>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Emergency Medicine</addr-line>,<institution>Centre des Urgences de Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Min Jung" sort="Kim, Min Jung" uniqKey="Kim M" first="Min Jung" last="Kim">Min Jung Kim</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Laboratory of Emergency Medical Services</addr-line>,<institution>Seoul National University Hospital Biomedical Research Institute</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jung, Young Hee" sort="Jung, Young Hee" uniqKey="Jung Y" first="Young Hee" last="Jung">Young Hee Jung</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Laboratory of Emergency Medical Services</addr-line>,<institution>Seoul National University Hospital Biomedical Research Institute</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kamgno, Joseph" sort="Kamgno, Joseph" uniqKey="Kamgno J" first="Joseph" last="Kamgno">Joseph Kamgno</name><affiliation wicri:level="1"><nlm:aff id="af5"><addr-line>Faculty of Medicine and Biomedical Services, Department of Epidemiology</addr-line>,<institution>University of Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Alain, Etoundi Mballa Georges" sort="Alain, Etoundi Mballa Georges" uniqKey="Alain E" first="Etoundi Mballa Georges" last="Alain">Etoundi Mballa Georges Alain</name><affiliation wicri:level="1"><nlm:aff id="af6"><addr-line>Department of Disease Control, Epidemics and Pandemics</addr-line>,<institution>Ministry of Public Health</institution>,<country>Cameroon</country></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hollong, Bonaventure" sort="Hollong, Bonaventure" uniqKey="Hollong B" first="Bonaventure" last="Hollong">Bonaventure Hollong</name><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Department of Emergency Medicine</addr-line>,<institution>Centre des Urgences de Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>To assess the burden of emergent illnesses and emergency care system usage by Yaoundé residents and to evaluate unmet needs for emergency care and associated barriers.</p></sec><sec><title>Design</title><p>A cross-sectional study using a community-based survey.</p></sec><sec><title>Setting</title><p>Yaoundé, Cameroon.</p></sec><sec><title>Participants</title><p>All residents living in Yaoundé were selected as the target population to investigate the needs and usage of emergency care in Yaoundé. 14 households in every health area (47 in total) were selected using 2-stage sampling.</p></sec><sec><title>Primary outcome measures</title><p>Unmet needs for emergency care.</p></sec><sec><title>Results</title><p>Among the 3201 participants from 619 households who completed the survey, 1113 (34.8%) with median age of 22 experienced 1 or more emergency conditions in the previous year. Respondents who experienced emergency conditions used emergency units (7.0%), outpatient clinics (46.5%) or hospitalisation (13.0%), and in overall, 68.8% of them reported unmet needs for emergency care. The primary reasons for not seeking healthcare were economic issues (37.2%) and use of complementary medicine (22.2%). Young age (adjusted OR (95% CI) 1.80 (1.23 to 2.62)), rental housing (1.50 (1.11 to 2.03)) and moderate household income (0.60 (0.36 to 0.99)) were associated with unmet needs for emergency care.</p></sec><sec><title>Conclusions</title><p>Residents of Yaoundé had a high demand for emergency care, and high unmet needs were observed due to low emergency care usage. Development of a cost-effective, universal emergency care system is urgently needed in Cameroon.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Razzak, Ja" uniqKey="Razzak J">JA Razzak</name></author><author><name sortKey="Kellermann, Al" uniqKey="Kellermann A">AL Kellermann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Levine, Ac" uniqKey="Levine A">AC Levine</name></author><author><name sortKey="Presser, Dz" uniqKey="Presser D">DZ Presser</name></author><author><name sortKey="Rosborough, S" uniqKey="Rosborough S">S Rosborough</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hofman, K" uniqKey="Hofman K">K Hofman</name></author><author><name sortKey="Primack, A" uniqKey="Primack A">A Primack</name></author><author><name sortKey="Keusch, G" uniqKey="Keusch G">G Keusch</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ Open</journal-id><journal-id journal-id-type="iso-abbrev">BMJ Open</journal-id><journal-id journal-id-type="hwp">bmjopen</journal-id><journal-id journal-id-type="publisher-id">bmjopen</journal-id><journal-title-group><journal-title>BMJ Open</journal-title></journal-title-group><issn pub-type="epub">2044-6055</issn><publisher><publisher-name>BMJ Publishing Group</publisher-name><publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28167749</article-id><article-id pub-id-type="pmc">5293974</article-id><article-id pub-id-type="publisher-id">bmjopen-2016-014573</article-id><article-id pub-id-type="doi">10.1136/bmjopen-2016-014573</article-id><article-categories><subj-group subj-group-type="heading"><subject>Emergency Medicine</subject><subj-group><subject>Research</subject></subj-group></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject><subject>1691</subject><subject>1692</subject></subj-group></article-categories><title-group><article-title>Evaluation of demands, usage and unmet needs for emergency care in Yaoundé, Cameroon: a cross-sectional study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Ro</surname><given-names>Young Sun</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Shin</surname><given-names>Sang Do</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Jeong</surname><given-names>Joongsik</given-names></name><xref ref-type="aff" rid="af3">3</xref><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Min Jung</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Jung</surname><given-names>Young Hee</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kamgno</surname><given-names>Joseph</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Alain</surname><given-names>Etoundi Mballa Georges</given-names></name><xref ref-type="aff" rid="af6">6</xref></contrib><contrib contrib-type="author"><name><surname>Hollong</surname><given-names>Bonaventure</given-names></name><xref ref-type="aff" rid="af7">7</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Laboratory of Emergency Medical Services</addr-line>,<institution>Seoul National University Hospital Biomedical Research Institute</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></aff><aff id="af2"><label>2</label><addr-line>Department of Emergency Medicine</addr-line>,<institution>Seoul National University College of Medicine</institution>,<addr-line>Seoul</addr-line>,<country>Korea</country></aff><aff id="af3"><label>3</label><institution>Korea International Cooperation Agency</institution>,<country>Korea</country></aff><aff id="af4"><label>4</label><addr-line>Department of Emergency Medicine</addr-line>,<institution>Centre des Urgences de Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></aff><aff id="af5"><label>5</label><addr-line>Faculty of Medicine and Biomedical Services, Department of Epidemiology</addr-line>,<institution>University of Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></aff><aff id="af6"><label>6</label><addr-line>Department of Disease Control, Epidemics and Pandemics</addr-line>,<institution>Ministry of Public Health</institution>,<country>Cameroon</country></aff><aff id="af7"><label>7</label><addr-line>Department of Emergency Medicine</addr-line>,<institution>Centre des Urgences de Yaoundé</institution>,<addr-line>Yaoundé</addr-line>,<country>Cameroon</country></aff><author-notes><corresp><label>Correspondence to</label> Dr Sang Do Shin; <email>shinsangdo@gmail.com</email></corresp></author-notes><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>6</day><month>2</month><year>2017</year></pub-date><volume>7</volume><issue>2</issue><elocation-id>e014573</elocation-id><history><date date-type="received"><day>4</day><month>10</month><year>2016</year></date><date date-type="rev-recd"><day>8</day><month>12</month><year>2016</year></date><date date-type="accepted"><day>6</day><month>1</month><year>2017</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/</copyright-statement><copyright-year>2017</copyright-year><license license-type="open-access"><license-p>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link></license-p></license></permissions><self-uri xlink:title="pdf" xlink:href="bmjopen-2016-014573.pdf"></self-uri><abstract><sec><title>Objectives</title><p>To assess the burden of emergent illnesses and emergency care system usage by Yaoundé residents and to evaluate unmet needs for emergency care and associated barriers.</p></sec><sec><title>Design</title><p>A cross-sectional study using a community-based survey.</p></sec><sec><title>Setting</title><p>Yaoundé, Cameroon.</p></sec><sec><title>Participants</title><p>All residents living in Yaoundé were selected as the target population to investigate the needs and usage of emergency care in Yaoundé. 14 households in every health area (47 in total) were selected using 2-stage sampling.</p></sec><sec><title>Primary outcome measures</title><p>Unmet needs for emergency care.</p></sec><sec><title>Results</title><p>Among the 3201 participants from 619 households who completed the survey, 1113 (34.8%) with median age of 22 experienced 1 or more emergency conditions in the previous year. Respondents who experienced emergency conditions used emergency units (7.0%), outpatient clinics (46.5%) or hospitalisation (13.0%), and in overall, 68.8% of them reported unmet needs for emergency care. The primary reasons for not seeking healthcare were economic issues (37.2%) and use of complementary medicine (22.2%). Young age (adjusted OR (95% CI) 1.80 (1.23 to 2.62)), rental housing (1.50 (1.11 to 2.03)) and moderate household income (0.60 (0.36 to 0.99)) were associated with unmet needs for emergency care.</p></sec><sec><title>Conclusions</title><p>Residents of Yaoundé had a high demand for emergency care, and high unmet needs were observed due to low emergency care usage. Development of a cost-effective, universal emergency care system is urgently needed in Cameroon.</p></sec></abstract><kwd-group><kwd>Emergency Medical Services</kwd><kwd>Needs Assessment</kwd><kwd>Cameroon</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Cameroun</li><li>Corée du Sud</li></country></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Ro, Young Sun" sort="Ro, Young Sun" uniqKey="Ro Y" first="Young Sun" last="Ro">Young Sun Ro</name></noRegion><name sortKey="Jeong, Joongsik" sort="Jeong, Joongsik" uniqKey="Jeong J" first="Joongsik" last="Jeong">Joongsik Jeong</name><name sortKey="Jung, Young Hee" sort="Jung, Young Hee" uniqKey="Jung Y" first="Young Hee" last="Jung">Young Hee Jung</name><name sortKey="Kim, Min Jung" sort="Kim, Min Jung" uniqKey="Kim M" first="Min Jung" last="Kim">Min Jung Kim</name><name sortKey="Shin, Sang Do" sort="Shin, Sang Do" uniqKey="Shin S" first="Sang Do" last="Shin">Sang Do Shin</name></country><country name="Cameroun"><noRegion><name sortKey="Jeong, Joongsik" sort="Jeong, Joongsik" uniqKey="Jeong J" first="Joongsik" last="Jeong">Joongsik Jeong</name></noRegion><name sortKey="Alain, Etoundi Mballa Georges" sort="Alain, Etoundi Mballa Georges" uniqKey="Alain E" first="Etoundi Mballa Georges" last="Alain">Etoundi Mballa Georges Alain</name><name sortKey="Hollong, Bonaventure" sort="Hollong, Bonaventure" uniqKey="Hollong B" first="Bonaventure" last="Hollong">Bonaventure Hollong</name><name sortKey="Kamgno, Joseph" sort="Kamgno, Joseph" uniqKey="Kamgno J" first="Joseph" last="Kamgno">Joseph Kamgno</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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