Emergency Cases and Primary Healthcare Physicians: Factors and Barriers in Al-Madinah City, 2021

Abstract

Introduction: Primary health care (PHC) centers are the first meeting line with health services, therefore, there is a significant number of emergency cases presenting to PHC centers with different levels of severity from mild to moderate and severe cases. This study aimed to assess primary health care physicians` competency regarding emergency cases, factors, and barriers.
Methods: A cross-sectional study among all primary health care physicians in Al-Madinah city was performed during 2021. Two tools were adopted for data collection; a self-administered questionnaire to assess physicians` competency in dealing with emergency cases and a structured observation sheet used to evaluate the availability of equipment, drugs, and other supporting facilities required to deal with emergency cases in PHC centers.
Results: The study included 200 primary healthcare physicians, out of the targeted 219 with a response rate of 91.3%. Their age ranged between 26 and 63 years with an arithmetic mean of 36.05 years and a standard deviation of (±) 8.16 years. More than one-third (39%) of the physicians had a poor level of competence in dealing with emergency cases. Saudi, more qualified physicians, those who attended BLS this year, and those who attended ATLS courses for more than two years were more competent in dealing with emergency cases than their peers. Overall, 40% of them had an insufficient level of competence and comfort in performing different emergency skills. Male physicians were more likely than females to have a sufficient level of competency and comfort in performing emergency skills, p=0.021. The most frequently reported barriers facing primary healthcare physicians in dealing with emergency cases were the availability of ER facilities (72%) and insufficient knowledge and practice related to emergency cases (61.5%). The commonest reported preferred methods for training in emergency medicine were practical training in PHC centers by qualified staff (81%), hospital rotation training (52%), and lectures (40%).
Conclusions: A considerable proportion of primary healthcare physicians in Al Madinah were not competent in dealing with emergency cases, and performing emergency skills. Most Emergency medications and services at the PHC level were available; however, shortages were observed in some items