417 Accessibility determinants of post-crash medical care utilization in Delhi, India

<h3>Background</h3> Road traffic crashes are a significant public health problem in Low and MiddleIncome Countries (LMICs) such as India. The definitive care and post-crash response services in them are resource constrained. Prehospital care in India, is typically provisioned through multiple unstructured channels. The access to care is thus an outcome of decisions, decisionmakers, and the availability of resources in the post-crash situation. <h3>Objective</h3> This study investigates post-crash access to the medical care utilization in Delhi, India. The study aims to identify factors contributing to post-crash access to government and privately funded care facilities in Delhi. <h3>Methods</h3> A multilevel cross-sectional telephonic survey was conducted for data collection. The respondents included crash victims or their associates who were instrumental in the victims’ post-crash utilization of medical care and hospital services. A hierarchical multi-step modelling approach was used to assess the responses of 325 survey participants. <h3>Results</h3> Analysis reveals that bystanders and police are key enablers of utilizing medical care after road traffic crashes in Delhi, India. Private hospitals were preferred when patients were accompanied by their relatives rather than other responders. Financial resources emerged as an important determinant of the type of medical care utilized. <h3>Conclusion</h3> Key differences were observed in the respondents towards utilizing a government or a privately financed medical care facility after crash. These factors help us identify the areas for improving health systems for post-crash care in India. The insights from this study would be helpful in policy development for improving health systems for tacking road safety challenges in LMICs.