BACKGROUND Emergency Medical Care is an important component of health care system. Unfortunately it is however, ignored in many low income countries. We assessed the availability and quality of facility-based emergency medical care in the government health care system at district level in a low income country - Pakistan. METHODS We did a quantitative pilot study of a convenience sample of 22 rural and 20 urban health facilities in 2 districts - Faisalabad and Peshawar - in Pakistan. The study consisted of three separate cross-sectional assessments of selected community leaders, health care providers, and health care facilities. Three data collection instruments were created with input from existing models for facility assessment such as those used by the Joint Commission of Accreditation of Hospitals and the National Center for Health Statistics in USA and the Medical Research Council in Pakistan. RESULTS The majority of respondents 43/44(98%), in community survey were not satisfied with the emergency care provided. Most participants 36/44(82%) mentioned that they will not call an ambulance in health related emergency because it does not function properly in the government system. The expenses on emergency care for the last experience were reported to be less than 5,000 Pakistani Rupees (equivalent to US$ 83) for 19/29(66%) respondents. Most health care providers 43/44(98%) were of the opinion that their facilities were inadequately equipped to treat emergencies. The majority of facilities 31/42(74%) had no budget allocated for emergency care. A review of medications and equipment available showed that many critical supplies needed in an emergency were not found in these facilities. CONCLUSION Assessment of emergency care should be part of health systems analysis in Pakistan. Multiple deficiencies in emergency care at the district level in Pakistan were noted in our study. Priority should be given to make emergency care responsive to needs in Pakistan. Specific efforts should be directed to equip emergency care at district facilities and to organize an ambulance network.

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评估低收入国家的紧急医疗护理：巴基斯坦的一项试点研究。

背景技术急救医疗是卫生保健系统的重要组成部分。然而不幸的是，它在许多低收入国家被忽视。我们评估了低收入国家巴基斯坦地区级政府医疗保健系统中基于设施的紧急医疗服务的可用性和质量。方法 我们对巴基斯坦费萨拉巴德和白沙瓦 2 个地区的 22 个农村和 20 个城市卫生设施的便利样本进行了定量试点研究。该研究包括对选定的社区领袖、医疗保健提供者和医疗保健机构进行的三个独立的横断面评估。三个数据收集工具是根据现有设施评估模型的输入创建的，例如美国医院认证联合委员会和国家卫生统计中心以及巴基斯坦医学研究委员会使用的模型。结果 在社区调查中，大多数受访者（43/44（98%））对所提供的紧急护理不满意。大多数参与者 36/44(82%) 提到他们不会在与健康相关的紧急情况下呼叫救护车，因为它在政府系统中无法正常运作。据报告，19/29（66%）受访者的最后一次体验的紧急护理费用不到 5,000 巴基斯坦卢比（相当于 83 美元）。大多数医疗保健提供者 43/44(98%) 认为他们的设施不足以处理紧急情况。大多数设施 31/42(74%) 没有为紧急护理分配预算。对可用药物和设备的审查表明，在这些设施中找不到紧急情况所需的许多关键用品。结论 紧急护理评估应成为巴基斯坦卫生系统分析的一部分。在我们的研究中，我们注意到巴基斯坦地区级紧急护理方面的多项缺陷。应优先考虑使紧急护理响应巴基斯坦的需求。应作出具体努力，在地区设施中配备紧急护理设备并组织救护车网络。结论 紧急护理评估应成为巴基斯坦卫生系统分析的一部分。在我们的研究中，我们注意到巴基斯坦地区级紧急护理方面的多项缺陷。应优先考虑使紧急护理响应巴基斯坦的需求。应作出具体努力，在地区设施中配备紧急护理设备并组织救护车网络。结论 紧急护理评估应成为巴基斯坦卫生系统分析的一部分。在我们的研究中，我们注意到巴基斯坦地区级紧急护理方面的多项缺陷。应优先考虑使紧急护理响应巴基斯坦的需求。应作出具体努力，在地区设施中配备紧急护理设备并组织救护车网络。