Reaching the right facility for emergency patients - destinations of patients transported by emergency medical services in Kigali, Rwanda

Reaching the right facility for emergency patients - destinations of patients transported by emergency medical services in Kigali, Rwanda

Ambulance, Emergency medical services (EMS), Service D’Aide Médicale Urgente (SAMU), Rwanda

Abstract
Background Ensuring that emergency patients reach the right healthcare facility at the right time is a key
component of providing quality emergency care. Rwanda’s prehospital emergency care system, Service D’Aide
Médicale Urgente (SAMU), was established in 2007 to provide prehospital emergency care services, but a formal
assessment of the receiving facilities has not been done. We explored the characteristics of patients transported by
SAMU to identify factors influencing the choice of destination health facilities.
Methods We retrospectively analyzed SAMU data documenting patients transported in Kigali in 2022. The main
dataset included patient sex, age, emergency condition, insurance status, and destination facility. For a subset of
patients, additional data were available on clinical variables such as Glasgow Coma Score (GCS), variables to permit
derivation of the Triage Early Warning Scores (TEWS), and an assessment of urgency made by the ambulance team.
Facilities receiving patients transported by SAMU were categorised into health centers, district hospitals, and tertiary
hospitals. Results are described for the main dataset, and associations between facility type and patient characteristics
were determined using multinomial logistic regression on the subset of patients with additional clinical variables.
Results Data was available for 7,221 patients. The majority were male (65%), with a mean age of 34 years (SD=16).
The leading three emergency conditions were trauma (66%), gynecological and obstetric conditions (9%), and
medical conditions (17%). Most patients were received by district hospitals (47%), followed by health centers (36%),
and tertiary hospitals (17%). We also found that patients with urgency classified as “extreme” had a 49%, 37%, and

Ephrem Daniel Sheferaw1*, Barnabas Alyande1

, Oda Munyura1

, Assuman Nuhu4

, Aurore Nishimwe2
,

Jeanne Nyinawankusi5

, Jean Marie Uwitonze5

, Jean Nepomuscene Sindikubwabo5

, Irene Bagahirwa5
,

Didier Hagumimana4

, Fabien Hagenimana4

, Collins Fred Inkotanyi1

, Jean Claude Semuto5

, Gilbert Rukundo5
,

Agnieszka Ignatowicz2

, Lucia D’Ambruoso3

, Philbert Muhire7

, Sudha Jayaraman8

, Emmy Agabe Nkusi6

, Laura Quinn2
,

Abebe Bekele1

, Jean Claude Byiringiro4† and Justine Davies2,9†

https://doi.org/10.1186/s12245-025-00853-z

2025

Peri Irawan

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