Preparation to provide healthcare in disasters in public hospitals in the district of Lima, Peru
DOI:
https://doi.org/10.5055/ajdm.0494Keywords:
disasters, safety, hospital, business continuity, emergency operationAbstract
Objective: To assess the safety and degree of preparation of public hospitals in the district of Lima to provide healthcare in the event of disaster by studying their structural and nonstructural safety and their compliance with the established standards for the organization of the hospital’s Emergency Operations Centers (EOCs).
Design: A cross-sectional observational study of 20 out of the 38 public hospitals in the district of Lima was conducted. The hospitals were selected based on the criteria of being state-run, having complete information on open access safety indicators, and belonging to Categories II and III according to the Peruvian Ministry of Health classification, equivalent to the usual secondary and tertiary levels of specialization hospitals. A multivariate regression analysis was performed to study the determining elements of vulnerability.
Results: Only with the existence of a formally established EOC emergency committee and up-to-date and available telephone directory does the average compliance reach 65 percent among all government hospitals. Only in four of the criteria did the hospitals achieve 50 percent good compliance, indicating that they have a plan, have trained the responsible personnel, and have the necessary resources to implement them. Fifty percent of hospitals in the district of Lima do not have a plan for psychosocial care for patients, family members, and health personnel in the event of a disaster; and that only 55 percent have a plan, trained personnel, and resources available for attention in the case of a disaster. In the multivariant analysis of the vulnerability determinants, the statistically significant (p < 0.05) elements were the year in which the emergency plan was drawn up and the year in which the hospital was built.
Conclusions: Public hospitals in Lima have varying levels of hospital security and vulnerability. Several of them do not have adequate capacity and security to provide medical care to patients and protect health personnel in the event of a disaster. Security is compromised by several factors, with the main significant (p < 0.05) determinants of vulnerability being the year the hospitals were built and the time since the hospitals’ emergency plan was drawn up. Emergency plans will need to be updated, and the dimensions that are most deficient in them corrected.
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