Barriers facing primary health care physicians in Jeddah when dealing with emergency cases

Dr. Majed Abdullah Aloufi

Joint Program Family & Community Medicine, Jeddah – 2013

Background: Medical emergencies that arise in the PHC centres are a great source of concern for practitioners and PHC centres staff. Proper planning for the unexpected medical emergencies can help alleviate some of this anxiety and improve patient safety within PHC centres.

Objectives: To estimate the prevalence of emergency cases reported to PHC centres, MOH, Jeddah as well as to explore the barriers facing primary care physicians when dealing with such emergency cases.

Subjects and Methods: A cross-sectional descriptive study was adopted. All primary health care physicians who are working in the PHC centres of the Ministry of Health in Jeddah city at the period of the study were invited to participate (n=247). Regarding centres, all PHCCs were included (n=42). Data were collected through two sources; self-administered questionnaire consists of three main parts: socio-demographic data, questions to identify level of training, previous experience and emergency courses and questions to determine their perceived competence when dealing with emergency cases. The second source was a structured observation sheet used to evaluate availability of equipments, drugs, ambulance and other supporting facilities which are needed to deal with emergency cases.

Results: Out of 247 PHC physicians recruited for the study, 206 responded by returning back completed questionnaires. Thus, the response rate was 83.4%. Their age ranged between 25 and 60 years with a mean±SD of 34.4±7.5 years. Majority of PHC physicians (83.5%) did not attend ATLS courses at all whereas 60.7% never attended ACLS courses. Vast majority of them (97.1%) attended BLS courses. Physicians in the age group 36-45 years (p value=0.001), non-Saudi (p value=0.009), those who had SBFM (p value<0.001), those who reported experience in working in emergency departments (p value=0.002) and physicians who reported more working years (>5 years) in PHCCs (p value=0.001) had significant higher score of perceived level of competence in performing emergency skill scale than others. The prevalence of emergency cases attending PHCCs in Jeddah (1434 H) was 5.2%. Laboratory was available in 97.6% of PHCCs whereas x-ray and equipped ambulance cars were available in 45.2% and 28.6% of PHCCs, respectively.

Conclusion: The present study showed that emergency services at PHC level in Jeddah were functioning reasonably well in some terms. Yet, the services need to be fine-tuned, and defects revealed by the present study should be taken into consideration hand-in-hand with available resources in order to upgrade the quality of the emergency services provided at PHCCs in Jeddah.

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