PRE-HOSPITAL CARE UTILIZATION AND ASSOCIATED FACTORS AMONG PATIENTS AT ADULT EMERGENCY DEPARTMENT OF PUBLIC HOSPITALS IN JIMMA CITY, SOUTHWEST OF ETHIOPIA, 2022

Abstract

Abstract Introduction: In developing countries, including Ethiopia, pre-hospital emergency care is rapidly expanding, targeted to handle the current burden of emergency conditions. However, there is inadequate evidence to show proportion of patients utilizing pre-hospital care in Jimma, southwest of Ethiopia. Objective: The aim of this study was to assess utilization of pre-hospital care and associated factors among patients at adult emergency departments of public hospitals in Jimma City. Method: An institutional-based cross-sectional study was conducted, from June 6-26, 2022, in Jimma city. A systematic sampling technique was used to select 468-sample size. Data were collected by using interview-based method. Data were coded and entered into Epi-data version 4.6 and exported to SPSS version 26 for analysis. Table, figures and texts were used to describe the results. Independent variables having p-value<0.2 in the binary logistic regression were entered into a multivariable regression analysis to control the confounders.The variables having p < 0.05 in multivariable logistic regression analysis were declared as statistically significant associated factors with pre-hospital care utilization. Results: A total of 451 participants with 96.4% response rate were included. Only 39.5% of the patients utilized pre-hospital care. Presentation time at night (AOR, 2.36, 95%CI, 1.3-4.4), and morning (AOR, 0.35, 95%CI, 0.2-0.6), self-referral (AOR, 0.2, 95%CI, 0.1-0.4), altered level of consciousness (AOR, 1.9, 95%CI, 1-3.5), first responder by polices (AOR, 6.3 95%CI, 1.5-26), bystander (AOR, 3.4, 95%C1, 1.7-6.6), distances ?15km (AOR,0.37, 95%CI, 0.2-0.7), and prior experience use (AOR, 4.1,95%CI, 2.4-7) were significantly associated with prehospital care utilization. Conclusion: The utilization of pre-hospital care services in Jimma City is relatively high. There was a favorable perception of prehospital care. Presentation time to ED, level of consciousness, referral link, first responder, distance, and experience of the services were identified as factors associated with prehospital care utilization. Community targeted prehospital care with improved knowledge with improved knowledge to improve pre-hospital care utilization Keywords: Pre-hospital care, Ambulance, utilization, Adult, Emergency Department, Jimma City