Time Intervals in the Treatment of Fractured Femurs as Indicators of the Quality of Trauma systems/Intervalles De Temps Dans le Traitement Des Femurs Fractures Comme Indicateurs De la Qualite Des Systemes De Prise En Charge Des traumatismes/Intervalos De Tiempo En El Tratamiento De la Fractura De Femur Como Indicadores De la Calidad De Los Sistemas Traumatologicos

By Matityahu, Amir; Elliott, Iain et al. | Bulletin of the World Health Organization, January 2014 | Go to article overview

Time Intervals in the Treatment of Fractured Femurs as Indicators of the Quality of Trauma systems/Intervalles De Temps Dans le Traitement Des Femurs Fractures Comme Indicateurs De la Qualite Des Systemes De Prise En Charge Des traumatismes/Intervalos De Tiempo En El Tratamiento De la Fractura De Femur Como Indicadores De la Calidad De Los Sistemas Traumatologicos


Matityahu, Amir, Elliott, Iain, Marmor, Meir, Caldwell, Amber, Coughlin, Richard, Gosselin, Richard A., Bulletin of the World Health Organization


Objective To investigate the use of time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems.

Methods Time intervals from injury to admission, admission to surgery and surgery to discharge for patients with isolated femur fractures in four low- and middle-income countries were compared with the corresponding values from one German hospital, an Israeli hospital and the National Trauma Data Bank of the United States of America by means of Student's t- tests. The correlations between the time intervals recorded in a country and that country's expenditure on health and gross domestic product (GDP) were also evaluated using Pearson's product moment correlation coefficient.

Findings Relative to patients from high-income countries, those from low- and middle- income countries were significantly more likely to be male and to have been treated by open femoral nailing, and their intervals from injury to admission, admission to surgery and surgery to discharge were significantly longer. Strong negative correlations were detected between the interval from injury to admission and government expenditure on health, and between the interval from admission to surgery and the per capita values for total expenditure on health, government expenditure on health and GDP. Strong positive correlations were detected between the interval from surgery to discharge and general government expenditure on health.

Conclusion The time intervals for the treatment of femur fractures are relatively long in low- and middle-income countries, can easily be measured, and are highly correlated with accessible and quantifiable country data on health and economics.

Resume

Objectif Examiner l'utilisation des intervalles de temps dans le traitement des femurs fractures comme indicateurs de la qualite des systemes de prise en charge des traumatismes

Methodes Les intervalles de temps de la blessure a l'admission, de l'admission a la chirurgie et de la chirurgie a la sortie des patients presentant des fractures du femur isolees dans quatre pays a revenu faible et intermediaire ont ete compares aux valeurs correspondantes d'un hopital allemand, d'un hopital israelien et de la Banque nationale des Donnees des Traumatismes des Etats-Unis d'Amerique a l'aide de tests t de Student. Les correlations entre les intervalles de temps enregistres dans un pays et les depenses de sante et le produit interieur brut (PIB) de ce pays ont egalement ete evaluees a l'aide du coefficient de correlation de Pearson.

Resultats Par rapport aux patients des pays a revenu eleve, les patients des pays a revenu faible et intermediaire etaient significativement plus susceptibles d'etre des hommes et d'avoir ete traites par enclouage ouvert du femur, et leurs intervalles de temps entre la blessure et l'admission, l'admission et la chirurgie et la chirurgie et la sortie etaient considerablement plus longs. De fortes correlations negatives ont ete detectees entre l'intervalle de temps entre la blessure et l'admission et les depenses publiques de sante, et entre l'intervalle de temps entre l'admission et la chirurgie et les valeurs par habitant pour les depenses totales de sante, les depenses publiques de sante et le PIB. De fortes correlations positives ont ete detectees entre l'intervalle de temps entre la chirurgie et la sortie et les depenses publiques generales de sante.

Conclusion Les intervalles de temps pour le traitement des fractures du femur sont relativement longs dans les pays a revenu faible et intermediaire. Ils peuvent etre facilement mesures et sont fortement correles aux donnees nationales accessibles et quantifiables sur la sante et l'economie.

Resumen

Objetivo Investigar el uso de intervalos de tiempo en el tratamiento de la fractura de femur como indicadores de la calidad de los sistemas traumatologicos.

Metodos Por medio de pruebas t-Student se compararon los intervalos de tiempo desde la lesion al ingreso, del ingreso a la cirugia y de la cirugia al alta hospitalaria de pacientes con fractura de femur aislada en cuatro paises de ingresos bajos y medianos con los valores correspondientes de un hospital en Alemania, un hospital israeli y el National Trauma Data Bank de Estados Unidos de America. …

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Time Intervals in the Treatment of Fractured Femurs as Indicators of the Quality of Trauma systems/Intervalles De Temps Dans le Traitement Des Femurs Fractures Comme Indicateurs De la Qualite Des Systemes De Prise En Charge Des traumatismes/Intervalos De Tiempo En El Tratamiento De la Fractura De Femur Como Indicadores De la Calidad De Los Sistemas Traumatologicos
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