Indicadores de Atención Pre Hospitalaria para incidentes viales en Colombia / Prehospital care indicators for road incidents in Colombia / Indicadores de Assistência Pré-Hospitalar para incidentes viários na Colômbia

Resumen La Atención Pre Hospitalaria (APH) reduce la letalidad, minimiza la morbilidad y sus secuelas en situaciones de urgencia y emergencia. Evaluar su grado de desarrollo es relevante. Metodología: Revisión sistemática de literatura, consulta a expertos y prueba piloto de un sistema de indicadores de APH para incidentes viales en Colombia implementado en 6 ciudades, un departamento y una concesión vial. Resultados: Según lineamientos políticos, normativos, conceptuales y metodológicos, internacionales y nacionales, se propuso un sistema de indicadores para ser aplicado según el desarrollo territorial de la APH; hubo diversas dificultades para implementarlo. Conclusión: Es necesario fortalecer los servicios de APH y estandarizar un sistema de información para su monitoreo en el país.

Abstract Prehospital care (PHC) reduces lethality and minimizes morbidity and its effects in urgency and emergency situations. Assessing its degree of development is thus relevant. Methodology: the authors used a systematic review of the literature, inquiries to experts and a pilot test with a system of PHC indicators for road incidents in Colombia which was implemented in 6 cities, one department and one highway concession. Results: according to political, regulatory, conceptual, methodological, international and national guidelines, a system of indicators was proposed to be applied in accordance with the territorial development of PHC. However, there were a number of difficulties to implement it. Conclusion: it is necessary to strengthen PHC and standardize an information system for monitoring it in Colombia.

Resumo A Assistência Pré-Hospitalar (APH) reduz a letalidade, minimiza a morbidade e as suas sequelas em situações de urgência e emergência. Avaliar seu grau de desenvolvimento é relevante. Metodologia: Revisão sistemática de literatura, consulta a especialistas e teste piloto de um sistema de indicadores de APH para incidentes viários na Colômbia implantado em 6 cidades, um estado do país e uma concessão viária. Resultados: De acordo com diretrizes políticas, normativas, conceituais e metodológicas, internacionais e nacionais, propôs-se um sistema de indicadores para ser aplicado segundo o desenvolvimento territorial da APH; houve diferentes dificuldades para a sua implantação. Conclusão: É preciso fortalecer os serviços de APH e padronizar um sistema de informação para seu monitoramento no país.

Latin American Clinical Epidemiology Network Series - Paper 6: The influence of alcohol in traffic accidents and health care costs of it in Bogotá-Colombia.

OBJECTIVES: In Colombia, some studies have estimated medical costs associated to traffic accidents. It is required to assess results by city or region and determine the influence of variables such as alcohol consumption. The main objective of this study was to identify health care costs associated to traffic accidents in Bogota and determine whether alcohol consumption can increase them. STUDY DESIGN AND SETTING: Cross-sectional costs study conducted in patients over 18 years treated in the emergency rooms of six different hospitals in Bogota, Colombia. RESULTS: The average total cost of medical care per patient was 628 USD, in Bogota-Colombia. The average cost per accident was estimated at 1,349 USD. On average, the total cost for health care for patients with positive blood alcohol level was 1.8 times higher than those who did not consume alcohol. The indirect costs were on average 115.3 USD per injured person. Numbers are expressed in 2011 U.S. dollars. CONCLUSION: Alcohol consumption increases the risk of traffic accidents and direct medical health costs.

Driving under the influence of alcohol in Cali, Colombia: prevalence and consumption patterns, 2013.

This study's goal was to establish the prevalence of driving under the influence of alcohol (DUI) and alcohol consumption patterns among drivers in Cali, Colombia, in 2013. A cross-sectional study based on a roadside survey using a stratified and multi-stage sampling design was developed. Thirty-two sites were chosen randomly for the selection of drivers who were then tested for blood alcohol concentration (BAC) and asked to participate in the survey. The prevalence of DUI was 0.88% (95% confidence intervals [95% CI] 0.26%-1.49%) with a lower prevalence when BAC was increasing. In addition, a higher prevalence was found during non-typical checkpoint hours (1.28, 95% CI -0.001%-0.03%). The overall prevalence is considered high, given the low alcohol consumption and vehicles per capita. Prevention measures are needed to reduce DUI during non-typical checkpoints and ongoing studies are required to monitor the trends and enable the assessment of interventions.

Beber y conducir en Medellín: prevalencia y caracterización de patrones de consumo, 2014 / Drinking and driving in Medellín: prevalence and consumption patterns, 2014

Incidentes viales causan al año 1,3 millones de muertes, lesiones a 50 millones y pérdida de 40 millones de años de vida saludable; según la Organización Mundial de la Salud el 25% de incidentes viales se asocian con embriaguez. METODOLOGIA:para estimar la prevalencia y caracterizar patrones de consumo de alcohol en conductores de Medellín se hizo una medición aleatoria, transversal y estratificada en enero de 2014. En 32 puestos de control se aforaron 23.856 vehículos y se detuvieron 1.611: 845 (52,4%) autos y 766 (47,6%) motos. RESULTADOS: positivo con alcoholemia de 24 a 300 mg de etanol/100 ml; 7 clasificaron en grado cero, 8 en primero, ninguno en segundo y uno en tercero; expandida a conductores de la ciudad esto equivale aproximadamente a 4.985 personas conduciendo bajo efectos del alcohol, cada día. Un tercio de conductores fue detenido antes en algún puesto de control; entre éstos, uno de cuatro en el último mes; 36% perciben alta y 26% media la probabilidad de detención. La mayoría (60%) reportó no beber y conducir, pero 19% consideró que beber un trago es compatible con conducción segura; aunque 45% afirmó nunca beber y conducir, 48% condujo bebido alguna vez en la vida, un 7% muchas veces y 25% en el último año: 26% con un trago, 13% con dos, tres o cuatro tragos y 30% con cinco o más tragos. CONCLUSION: la prevalencia y patrones identificados señalan pertinente monitorear aleatoria y sistemáticamente este comportamiento en Medellín.

Every year road incidents kill 1.3 million people, cause severe injuries to 20 million and are the reason behind the loss of 40 million years of healthy life all over the world. The World Health Organization estimates that 25% of road incidents and their effects are associated with drunkenness. METHODOLOGY: to estimate the prevalence and characterize the consumption patterns of the drivers in Medellín, a random, cross-sectional and stratified measurement was taken in January 2014. During the 32 control checks 23,856 vehicles were tested; 1,611 were arrrested. A total of 845 (52,4%) were cars, while 766 (47,6%) were motorcycles. RESULTS :of the 1,569 individuals tested for alcohol in their breath, 16 (1%) tested positive and their blood alcohol level varied from 0,24 to 3 mg of ethanol. Similarly, 7 individuals showed degree 0, 8 first degree, 0 second degree and 1 third degree. One third of the individuals had been arrested before and one in four of them had been arrested in the last month. Additionally, 36% considered they had a high probability of being arrested and 26% considered to have a moderate probability. Most drivers (60%) reported not drinking and driving, but one fifth (19%) considered that having one drink is compatible with safe driving and, even though 45% stated never drinking and driving, the other half (48%) had driven while drunk at least once in their lives. Similarly, 7% had done so several times and 25% of them did it in the last year. Finally, 26% of the individuals drove while drunk after one drink, 13% after two, three or four and remaining 30% after 5 or more drinks. CONCLUSION: the prevalence and patterns identified make evident the need to monitor and control the drink-and-drive behavior.

Costos directos de atención médica de accidentes de tránsito en Bogotá D. C / Direct costs involved in providing medical attention associated with traffic accidents in Bogotá

Objetivo Determinar los costos de atención médica generados por la accidentalidad vial en Bogotá. Metodología Estudio observacional prospectivo con datos de pacientes mayores de edad atendidos en la central de urgencias de 6 instituciones hospitalarias. Resultados El promedio del costo totalde atención por paciente fue de $1'112.000 El costo promedio día de paciente hospitalizado fue de $1'200.000. Pacientes con atención ambulatoria tuvieron un costo promedio de $247.400. El costo promedio por accidente se calculó en $2'333.700. Los costos médicos por accidentes en el periodo de análisis en Bogotá fueron aproximadamente $2.301'028.200. Cifras en pesos de 2011. Conclusiones Los costos de la atención médica de los accidentes de tránsito constituyen una carga económica considerable.

Objective To determine the cost of medical attention associated with traffic accidents in Bogotá, Colombia. Methods Prospective observational study with data from adult patients attended to in the emergency centers of 6 hospitals. Results Average total cost per patient was $1'112.000 COP. Average daily cost of hospitalized patients was $1'200.000 COP. Average cost of ambulatory treated patients ascended to $247.400 COP. Cost per accident calculated was $2'333.700 COP. In the whole city during study period, total medical costs were around $2.301'028.200 COP. All data was expressed in 2011 Colombian pesos. Conclusion The medical cost of transit accidents is a significant economic burden.

[Direct costs involved in providing medical attention associated with traffic accidents in Bogotá]. / Costos directos de atención médica de accidentes de tránsito en Bogotá D.C.

OBJECTIVE: To determine the cost of medical attention associated with traffic accidents in Bogotá, Colombia. METHODS: Prospective observational study with data from adult patients attended to in the emergency centers of 6 hospitals. RESULTS: Average total cost per patient was $1'112.000 COP. Average daily cost of hospitalized patients was $1'200.000 COP. Average cost of ambulatory treated patients ascended to $247.400 COP. Cost per accident calculated was $2'333.700 COP. In the whole city during study period, total medical costs were around $2.301'028.200 COP. All data was expressed in 2011 Colombian pesos. CONCLUSION: The medical cost of transit accidents is a significant economic burden.