The Bridge Between Need and Access: Distribution of Trauma Care Facilities at a Religious Mega Mass Gathering
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Abstract
Participating in mass gatherings puts people at risk of incidents. The distribution of resources should be based on need. The purpose of this study was to investigate the distribution of trauma care facilities based on need and access at a religious mass gathering in Iran. This national cross-sectional study is based on obtained data including the number of visits to health centers (NVHC) and the number of injuries visits health center (NIVHC) as needs and the number of physicians, paramedic, ambulance, and treatment center as access in border cities of Iran and Iraq in 2016. Gini coefficient, Lorenz curve and the Pearson correlation coefficient were applied to measure the level of equality in the distribution of trauma care and the correlation between access and need. The facilities were relatively distributed equally at the border towns in Iran; however, were not equally distributed in Iraq. There is no significant association between the paramedic for NIVHC and ambulance for NIVHC and NVHC. Moreover, there was a significant association between physician for NIVHC and NVHC, a paramedic for NVHC, and treatment centers for NIVHC and NVHC. The consequences of incidents could be reduced if distributing trauma care facilities equals at mass gatherings.
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2. Ganjeh M, Einollahi B. Mass Fatalities in Hajj in 2015. Trauma monthly. 2016;21(5). doi: 10.5812/traumamon.43253
PMCID: PMC5292036
3. Hajj and Pilgrimage Organization. Arbaeen pilgrims Statistics. 2018.
4. Arbon P. The development of conceptual models for mass-gathering health. Prehospital and Disaster Medicine. 2004;19(3):208-12. https://doi.org/10.1017/S1049023X00001795
5. Abubakar I, Gautret P, Brunette GW, Blumberg L, Johnson D, Poumerol G, et al. Global perspectives for prevention of infectious diseases associated with mass gatherings. The Lancet infectious diseases. 2012;12(1):66-74. https://doi.org/10.1016/S1473-3099(11)70246-8
6. Department IsE. 2016.
7. Hutton A, Ranse J, Verdonk N, Ullah S, Arbon P. Understanding the characteristics of patient presentations of young people at outdoor music festivals. Prehospital and disaster medicine. 2014;29(2):160-6. https://doi.org/10.1017/S1049023X14000156
8. Steffen R, Bouchama A, Johansson A, Dvorak J, Isla N, Smallwood C, et al. Non-communicable health risks during mass gatherings. The Lancet Infectious Diseases. 2012;12(2):142-9. https://doi.org/10.1016/S1473-3099(11)70293-6
9. David S, Roy N. Public health perspectives from the biggest human mass gathering on earth: Kumbh Mela, India. International Journal of Infectious Diseases. 2016;47:42-5. https://doi.org/10.1016/j.ijid.2016.01.010
10. Memish ZA, Stephens GM, Steffen R, Ahmed QA. Emergence of medicine for mass gatherings: lessons from the Hajj. The Lancet infectious diseases. 2012;12(1):56-65. https://doi.org/10.1016/S1473-3099(11)70337-1
11. Tsouros A, Efstathiou P. Mass gatherings and public health-the experience of the Athens 2004 Olympic Games. 2007. World Health Organization Regional Office for Europe: Copenhagen.
12. Soomaroo L, Murray V. Disasters at mass gatherings: lessons from history. PLoS currents. 2012;4. doi: [10.1371/currents.RRN1301]
13. Baird JN. Development of a conceptual model for mass gatherings. 1989.
14. Bidgoli HH, Bogg L, Hasselberg M. Pre-hospital trauma care resources for road traffic injuries in a middle-income country—A province based study on need and access in Iran. Injury. 2011;42(9):879-84. https://doi.org/10.1016/j.injury.2010.04.024
15. Davis DP, Poste JC, Hicks T, Polk D, Rymer TE, Jacoby I. Hospital bed surge capacity in the event of a mass-casualty incident. Prehospital and Disaster Medicine. 2005;20(3):169-76. https://doi.org/10.1017/S1049023X00002405
16. Boyle MF, De Lorenzo RA, Garrison R. Physician integration into mass gathering medical care. The United States Air Show. Prehospital and disaster medicine. 1993;8(2):165-8. https://doi.org/10.1017/S1049023X00040255
17. Lankarani KB, Sarikhani Y, Heydari ST, Joulaie H, Maharlouei N, Peimani P, et al. Traffic accidents in Iran, a decade of progress but still challenges ahead. Medical journal of the Islamic Republic of Iran. 2014;28:96.
18. Balikuddembe K, Ardalan A, Khorasani Z, Nejati A, Kasiima M. Road traffic incidents in Uganda: A systematic review study of five years trend. J Inj Violence Res. 2016;9(1).
19. Zeitz KM, Zeitz CJ, Arbon P. Forecasting medical work at mass-gathering events: predictive model versus retrospective review. Prehospital and disaster medicine. 2005;20(03):164-8. https://doi.org/10.1017/S1049023X00002399
20. Arbon P, Bridgewater FHG, Smith C. Mass gathering medicine: A predictive model for patient presentation and transport rates. Prehospital and disaster medicine. 2001;16(3):150-8. https://doi.org/10.1017/S1049023X00025905
21. Bowdish GE, Cordell WH, Bock HC, Vukov LF. Using regression analysis to predict emergency patient volume at the Indianapolis 500 mile race. Ann Emerg Med. 1992;21(10):1200-3. DOI: https://doi.org/10.1016/S0196-0644(05)81746-9
22. Chang R-KR, Halfon N. Geographic distribution of pediatricians in the United States: an analysis of the fifty states and Washington, DC. Pediatrics. 1997;100(2):172-9.
23. Gravelle H, Sutton M. Inequality in the geographical distribution of general practitioners in England and Wales 1974–1995. Journal of Health Services Research & Policy. 2001;6(1):6-13. https://doi.org/10.1258/1355819011927143
24. Theodorakis PN, Mantzavinis GD, Rrumbullaku L, Lionis C, Trell E. Measuring health inequalities in Albania: a focus on the distribution of general practitioners. Human Resources for Health. 2006;4(1):5. https://doi.org/10.1186/1478-4491-4-5
25. De Maio FG. Income inequality measures. Journal of Epidemiology & Community Health. 2007;61(10):849-52. http://dx.doi.org/10.1136/jech.2006.052969
26. Whitehead M. The concepts and principles of equity and health by Margaret Whitehead. Health promotion international. 1991;6(3):217-28. https://doi.org/10.1093/heapro/6.3.217
27. Tsouros A, Efstathiou P. Mass gatherings and public health-the experience of the Athens 2004 Olympic Games. 2007. World Health Organisation Europe, EU/07/5062470,[http://www euro who int/datapublications/Publications/Catalogue/20071001_1] Google Scholar.
28. Federal Emergency Management Agency. Special Events Contingency Planning 2005 [cited 2018 8 feb].
29. Koenig K, Schultz C. Disaster medicine: comprehensive principles and practices. Cambridge University Press; 2010.
30. Nacca K, Scott J, Grant W. Diagnosis According to Time of Arrival at ‘‘The Great New York State Fair’’. Prehospital and disaster medicine. 2014;29(1):47-9.
31. Morimura N, et al. Analysis of Patient Load Data From the 2002 FIFA World Cup Korea/Japan. Prehospital and disaster medicine. 2004;19(3):278-84. https://doi.org/10.1017/S1049023X00001874
32. Severi E, Heinsbroek E, Watson C, Catchpole M. Infectious disease surveillance for the London 2012 Olympic and Paralympic Games. Eurosurveillance. 2012;17(31):20232.
| Files | ||
| Issue | Vol 57, No 7 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v57i7.2332 | |
| Keywords | ||
| Trauma care facilities Trauma Religious mass gathering Pilgrim Arbaeen ceremony | ||
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How to Cite
1.
Karampouian A, Ghomian Z, Khorasani-Zavareh D. The Bridge Between Need and Access: Distribution of Trauma Care Facilities at a Religious Mega Mass Gathering. Acta Med Iran. 2020;57(7):442-447.
