Delays in hospital admissions in patients with fractures across 18 low-income and middle-income countries (INORMUS): a prospective observational study
Authors: Panthea Pouramin, Chuan Silvia Li, Jason W Busse, Sheila Sprague, P J Devereaux, Jagnoor Jagnoor, Rebecca Ivers, Mohit Bhandari, Mohit Bhandari, PJ Devereaux, Gordon Guyatt, Brad Petrisor, Lehana Thabane, Respicious L. Boniface, Bruce Browner, Fernando de la Huerta, Rebecca Q Ivers, Theodore Miclau, Paul Moroz, Andrew Pollak, Gerard Slobogean, Parag Sancheti, Emil Schemitsch, Junlin Zhou, Sheila Sprague, Paula McKay, Chuan Silvia Li, Raman Mundi, Nathan O'Hara, Diane Heels-Ansdell, Lisa Buckingham, Nicole Simunovic, Jagnoor Jagnoor, Robyn Norton, Jing Zhang, Maoyi Tian, Soumyadeep Bhaumik, Samina Parveen, Saam Morshed, Madeline C. MacKechnie, Junlin Zhou, Yang Liu, Yanrui Zhao, Junfei Li, Haoran Zhang, Zhentao Zhang, Wei Zhang, Tao Guo, Guang Chen, Zichao Jia, Jianzhong Yang, Lixing Kang, Peng Zhang, Haoqing Ma, Donghai Liu, Yinghua Ma, Yanguo Qin, Jincheng Wang, He Liu, Xinlong Ma, Jianxiong Ma, Haobo Jia, Shuangshuang Cui, Zhihu Zhao, Lin Fu, Hongqiang Jiang, Jianwei Lv, Sanbao Hu, Yongwei Wang, Mingyao Sun, Shuqing Tao, Baochang Qi, Ming Gao, Bo Wu, Chunsheng Zhi, Ben Xing, Jun Yang, Wenjie Dai, Duo Lu, Shisheng He, Xinyu Cai, Gejun Liu, Gang Rui, Baoshan Hu, Pingfang Shi, Hua Chen, Te Wang, Qingqing Wang, Linzhen Xie, Huanguang Xie, Tony Mutanda, Juliet Ntuulo, Flavia Lubega, Gayita Teddy Tracy, Kayondo Zaitun, Sylvester Ndayisaba, Titus Amone, Samuel Remmy Odong, Mark Lutomia, Caesar Okatch, Thomas Bitok, Alexander Kiambuthi, Fred Mathew Toboso Otsyeno, Pankaj G Jani, Vincent Muoki Mutiso, John EO Ating'a, Peter Kavoo Kilonzo, James Muoki, Makena Mbogori, Joan Wambui Wambugu, Dorothy Torutt, Christopher Odok, Elisha Ngetich, Dean Otsyeno, Juma Wakhayanga, Desmond Nzioka, Deogracia Owende, Ruth Lucinde, Brian Ngure Kariuki, Dennis Kinyua, Maureen Kamau, Maureen Mwancha, Mellany Murgor, Marilyn Nyabuti, Rita Njoki, Patricia Wanza, Abraham Odongo, Paul Marealle, Athman Wanini, Marwa Elisha, Damas Zumbulu, Pariyo Bonane Godfrey, Benjamin Mukulu Ndeleva, Murila Johnson, Moses Kimani, Kinuthia Gichui, Rogers Joachin Temu, Angela Neofitus Mselle, Ancelimu Rafael Kimario, Mmampapatla Thomas Ramokgopa, Gregory Firth, Anna Grisillo Biscardi, Machuene Ananias Poopedi, Johan Moolman, Brenda Milner, Matimba Maluleke, Maxwell Jingo, Susan van Deventer, Timothy Pikor, Ravi Bhaga, Michael Mara, Geoffrey Chege Mwangi, Anthony Muchiri Maina, David Wamae Gicheru, Carol Mwangi, Isaac Kingori Wangai, Peter Watson Maina, Ezra Mitei Kiptoo, Olufemi Olukemi Temiloluwa, Adeyeye Adeolu Ikechukwu, Ige Oluwole Olugbenga, Ojodu Ishaq Bamidele, Oladimeji Oladipupo Akanbi, Panchu Subramanian, Olivia L Mosweu, Samuel Hailu, Geletaw Tessema, Bahiru Bezabih, Birhanu Ayana, Hiwot Hailu, Betelhem Zewdneh, Hana Tesfaye, Sosena Tadesse, Dominic Konadu-Yeboah, Vincent Ativor, Peter Konadu, Dominic Awariyah, Raphael Quartey, Raphael Kumah-Ametepey, Osman Saani, Robert Ekow Quansah, Paa Kwesi Baidoo, Peter Trafton, David Anyitey-Korkor, Michael Leat, Johnny Sobotie, Godwin Opuni, Kwasi Kusi, Twimasi Baah, Paul Okyere, Bernice Mensah, Doris Akuoko Sarpong, Felicia Agbenorwu, Phyllis Osei-Donkor, Priscilla Opoku, Michael Segbefia, Gerald Chukwuemeka Oguzie, Emmanuel Chino Iyidobi, Cajetan Uwatoronye Nwadinigwe, Sharon Amarachi Uloma Oguzie, Emina Bami Kesiena, Henry Tanyi Ndasi, Nietiayurk Aminake Ghislain, Mala Irine Shey, Ikose John Nanje, Parag Sancheti, Ashok Shyam, Madhav Borate, Sampat Dumbre Patil, Sachin Karkamakar, Shailesh Patil, Abhijeet Ranaware, Shadab Tamboli, Manish Gandhalikar, Rohini Tupe, Vishal Chaudhari, Avanti Joshi, Sanjay Patil, Mohit Madhukar Dalwekar, Tejas Gandhi, Chintamani Latkar, Gopal Pundkare, Sandeep Shrivastava, Pradeep K Singh, Sanjay Deshpande, Sumit Baheti, Ravi Mittal, Vijay Sharma, Vinoo Mathew Cherian, Thilak Samuel Jepegnanam, Vijay T K Titus, Manasseh Nithyananth, Palapattu R J V C Boopalan, Viju Daniel Varghese, Justin Arockiaraj, Anupam Mahajan, Bobby John, Ritesh Pandey, Jeewan S Prakash, Valsamma Abraham, Arti Rajkumar, Harvinder Singh Chhabra, Rajesh Sharawat, Ritabh Kumar, Pushkar Chawla, Rashmi Yadav, Rajagopalan N Iyer, Naveen Nair, Rajkumar S Amaravathi, Srinivasalu Santhanagopa, Anoop Pilar, Keith Behram Tamboowala, Mandeep S Dhillon, Sarvdeep S Dhatt, Asolie Chase, Neel M Bhavsar, Rameez Musa, Darshan Shah, Sunil Chodavadiyah, Pankaj G Patel, Raja Irfan Qadir, Syed Imran Bukhari, Khushnood Ali Baz, Subin Byanjankar, Ruban Raj Joshi, Rajeev Dwivedi, Jay Raj Sharma, La Ngoc Quang, Nguyen Duc Chinh, Vu Bao Hong, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Wanjak Pongsamakthai, Irewin Alagar Tabu, Paula Veronica Reyes, Iardinne Caiquep, Joni Mitchell Robles Bituin, Jenna González, Mohammadreza Golbakhsh, Mashyaneh Haddadi, Soheil Saadat, Mohammadreza Zafarghandi, Clotilde Fuentes Orozco, José de Jesús Martínez Ruíz, Gustavo Armando Tafoya Arreguin, César Eduardo Pinedo Flores, Irydia Guadalupe Pellegrini Verduzco, Miguel Oscar Hernandez Camacho, Diego Abraham Estrada Téllez, Rodrigo Salcedo López, Ileana Guadalupe Canales Navarro, Mizael Dennis Pérez, Daniel de Jesús Enciso Carrillo, Paola Alejandra Álvarez López, Adán Cervantes Gómez, Fátima Nohemí Franco Bravo, Eugenia de los Ángeles Reyes Arias, Igor A. Escalante Elguezabal, Ennio Antonio Rizzo, Jean Michel Hovsepian, Victor Rodriguez, Manuel Malaret Baldo, Andres Serrano, Carlos G. Sanchez Valenciano, Edgar Efren Mercado Salcedo, Fryda Medina, Fernando Bidolegui, Sebastian Pereira, Gerardo Aguilar, Jorge Rubio-Avila, William Dias Belangero, José Ricardo Lenzi Mariolani, Bruno Livani, André Lugnani, Felipe Rossi, Angela Katayama, Fernando Baldy, Vinícius Ynoe de Moraes, Fabricio Fogagnolo, Kodi Edson Kojima, Jorge dos Santos Silva, Marco Kawamura Demange, Fernando Brandão de Andrade-Silva, Adriana Carvalho Gomes da Silva, Nelson Elias, Dino Aguilar Martinez, Fernando Contreras, Mario Garuz, Jose Eduardo Quintero, Gavino Merchan, Christian M. Lozano Lurita, Aturo D. Torres Manrique, Jorge Hurtado Fernandez, Sergio Iriarte Vincenti, Alfredo Pozzo Bobarin, Dalton Salinas Sanchez, Julio Segovia Altieri, Diego Almada, Derlis Bogado, Carlos Coronel, Cristian Boveda, Victor del Valle, Carlos Montiel, Nelson Marin, Antonio Barquet, Daniel Rienzi, Carlos Amanquez, Georges Beauvoir, Iván J Salce Cutipa, José Eduardo Grandi Ribeiro, José María Jiménez Avila, Luis Padilla, Hernando Cuevas Ochoa, Hernando Cuevas Cano, Adriana Vaca González, Nubia Itzel Gonzalez Gutierrez, José Eduardo Grandi Ribeiro, Victor Espinola, Cristian Boveda
Journal: The Lancet Global Health (2020)

The Lancet Commission on Global Surgery established the Three Delays framework, categorising delays in accessing timely surgical care into delays in seeking care (First Delay), reaching care (Second Delay), and receiving care (Third Delay). Globally, knowledge gaps regarding delays for fracture care, and the lack of large prospective studies informed the rationale for our international observational study. We investigated delays in hospital admission as a surrogate for accessing timely fracture care and explored factors associated with delayed hospital admission.