4B.001 Qualitative assessment of trauma care in Hanoi, Vietnam

Background Injury is a great contributor to the Vietnamese disease burden. Road traffic injuries were the leading cause of injury mortality from 2005 to 2013. Our objective was to understand the intricacies of the trauma care system in Hanoi, Vietnam. Methods We aimed to elucidate the trauma care continuum (pre-hospital, hospital and post hospital care) and identify perceptions of system functioning. This was done via in-depth interviews and focus group discussions. Results Ten interviews and two focus groups were conducted. Participants were: community stakeholders, hospital leadership, the Ministry of Health, National Traffic Safety Committee and Hanoi Emergency Response Centre. 59% of respondents were male and there was variation in education level and employment status. Thematic analysis was conducted using the NVivo 12 software. The major theme identified was prehospital care with the relevant issues being communication, transportation and human resources deficits. The minor themes were around hospital care, community education and governance. A common barrier to effective care across multiple themes was the lack of coordination and integration between various institutions. Conclusion The trauma care landscape is multifaceted but there are areas which could potentially benefit with the major one being prehospital care. Specific policies that can arise as a result of this work include improving the logistical coordination of prehospital transportation, a legal framework to protect bystanders providing first aid, and bolstering a non-physician prehospital care workforce. Learning Outcomes The results provide a direction to guide governmental (both local and national) and organizational efforts toward prehospital trauma care.