A Research Agenda for Acute Care Services Delivery in Low‐ and Middle‐income Countries

Abstract

Delivery of acute care services at every level of the health system is essential to ensure appropriate evaluation and management of emergent illness and injury in low-and middle-income countries (LMICs). The health services breakout group at the 2013 Academic Emergency Medicine consensus conference developed recommendations for a research agenda along the following themes: infrastructure, implementation, and sustainable provision of acute care services. Based on these recommendations, a set of priorities was created to promote and guide future research on acute care services.

Burden of emergency conditions and emergency care usage: new estimates from 40 countries

“…[4–6] There is increasing recognition that emergency care delivery is an essential part of health systems, [7–9] and this has been reflected in the dramatic rise in emergency department (ED) patient volumes over the last few decades in many parts of the world. [10] However, outside of a handful of high-income countries (HICs) with well-established emergency care systems, there is a dearth of information about the burden of emergency conditions, or how frequently patients seek emergency care.…”

“…[10] However, outside of a handful of high-income countries (HICs) with well-established emergency care systems, there is a dearth of information about the burden of emergency conditions, or how frequently patients seek emergency care. [2, 9, 11]…”

“…These constraints are particularly heightened in low- and middle- income countries (LMICs). [9, 11] Even where data are collected, systematic analysis is difficult because emergency care is frequently delivered across a variety of settings, including clinics and outpatient departments,[2, 7, 12] and formal EDs may not exist, even in some HICs. [12] This lack of basic information about emergency care delivery and the burden of emergency conditions has stalled attempts to understand and improve emergency care, particularly in LMICs.…”

Cardiopulmonary ultrasound for critically ill adults improves diagnostic accuracy in a resource‐limited setting: the AFRICA trial

“…The future direction of research in LMICs, including for ultrasound, should focus on obtaining baseline information about disease burden and patient outcome measures. There is a lack of information on disease burden in the acute care setting for LMICs , including for critical illness . Continued collaboration between institutions will be an important component of future research efforts .…”

The sixth vital sign: HIV status assessment and severe illness triage in Uganda

“…19,20 Improvements in hospital-based HIV care may also enhance confidence and engagement in HIV out-patient services. 16,21,22 In sub-Saharan African settings where HIV and tuberculosis (TB) co-infection is highly prevalent, the importance of HIV status assessment in severe illness management cannot be overemphasized. In line with evidence suggesting that survival for severely ill patients with HIV-associated TB is improved by early, empiric anti-tuberculosis treatment, the WHO currently recommends empiric treatment for HIV-infected possible TB patients with deranged physiologic parameters.…”