Emergency Care Research Funding in the Global Health Context: Trends, Priorities, and Future Directions

Vu, Alexander; Duber, Herbert C.; Sasser, Scott M.; Hansoti, Bhakti; Lynch, Catherine; Khan, Ayesha; Johnson, Tara; Modi, Payal; Clattenburg, Eben J.; Hargarten, Stephen W.

doi:10.1111/acem.12267

Cited by 8 publications

(3 citation statements)

References 22 publications

(22 reference statements)

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“…Moreover, obtaining grant funding for projects in developing countries can be far more difficult than obtaining funding for similar projects in developed countries. Funding issues are discussed in more detail in this issue …”

Section: Challenges To Conducting Research In Resource‐limited Settingsmentioning

confidence: 99%

Clinical and Translational Research in Global Health and Emergency Care: A Research Agenda

Runyon

Sawe

Levine

et al. 2013

Academic Emergency Medicine

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As policy-makers increasingly recognize emergency care to be a global health priority, the need for highquality clinical and translational research in this area continues to grow. As part of the proceedings of the 2013 Academic Emergency Medicine consensus conference, this article discusses the importance of: 1) including clinical and translational research in the initial emergency care development plan, 2) defining the burden of acute disease and the barriers to conducting research in resource-limited settings, 3) assessing the appropriateness and effectiveness of local and global acute care guidelines within the local context, 4) studying the local research infrastructure needs to understand the best methods to build a sustainable research infrastructure, and 5) studying the long-term effects of clinical research programs on health care systems.ACADEMIC EMERGENCY MEDICINE 2013; 20:1272-1277 by the Society for Academic Emergency Medicine A s policy-makers increasingly recognize emergency care to be a global health priority, the need for high-quality clinical and translational research in emergency care continues to grow. Often, when developing emergency care programs in resource-limited settings, the inclination is to focus on clinical and educational services given the relative lack of resources and personnel. However, clinical and translational research must also be seen as critical to the successful development of a sustainable emergency care infrastructure. 1 IMPORTANCE OF CLINICAL AND TRANSLATIONAL RESEARCH IN GLOBAL HEALTH AND EMERGENCY CAREConcurrent development of a research infrastructure within the emergency care system will serve to enhance care delivery and sustainability. As the initial focus is on improving emergency care, it is important to recognize that research is necessary to inform clinical care delivery. Just as the adult literature does not always translate to children, treatments or care delivery paradigms

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Section: Challenges To Conducting Research In Resource‐limited Settingsmentioning

confidence: 99%

Clinical and Translational Research in Global Health and Emergency Care: A Research Agenda

Runyon

Sawe

Levine

et al. 2013

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…The disconnect between emergency health burdens and support for clinical research and scholarly outputs in LMICs illustrates the need for increased funding 29. Emergency medicine is a new specialty in most LMICs; hence, it is difficult to identify local champions to engage in grant funding applications, further lowering the possibilities of securing research funding.…”

Section: Emergency Care Research In Lmics: Challenges and Strategiesmentioning

confidence: 99%

Clinical emergency care research in low-income and middle-income countries: opportunities and challenges

et al. 2019

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Disease processes that frequently require emergency care constitute approximately 50% of the total disease burden in low-income and middle-income countries (LMICs). Many LMICs continue to deal with emergencies caused by communicable disease states such as pneumonia, diarrhoea, malaria and meningitis, while also experiencing a marked increase in non-communicable diseases, such as cardiovascular diseases, diabetes mellitus and trauma. For many of these states, emergency care interventions have been developed through research in high-income countries (HICs) and advances in care have been achieved. However, in LMICs, clinical research, especially interventional trials, in emergency care are rare. Furthermore, there exists minimal research on the emergency management of diseases, which are rarely encountered in HICs but impact the majority of LMIC populations. This paper explores challenges in conducting clinical research in patients with emergency conditions in LMICs, identifies examples of successful clinical research and highlights the system, individual and study design characteristics that made such research possible in LMICs. Derived from the available literature, a focused list of high impact research considerations are put forth.

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“… 1 , 2 Lower income countries have restricted resources including limitations in infrastructure, technology, supplies, manpower, and access to further education. The burden of disease can vary between locations, as can the “cultural, political, and social aspects of delivery of care.” 3 , 4 A deeper understanding of acute care delivery systems and their patients is essential to providing better acute care. However, minimal data exist from emergency departments (EDs) in Latin America, and there is no information regarding acute care in Ecuador.…”

Section: Introductionmentioning

confidence: 99%

Emergency Department of a Rural Hospital in Ecuador

Johnson¹,

Gaus²,

Herrera³

2016

WestJEM

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IntroductionThere is a paucity of data studying patients and complaints presenting to emergency departments (EDs) in low- and middle-income countries. The town of Pedro Vicente Maldonado (PVM) is located in the northwestern highlands of Ecuador. Hospital PVM (HPVM) is a rural teaching hospital providing family medicine residency training. These physicians provide around-the-clock acute medical care in HPVM’s ED. This study provides a first look at a functioning ED in rural Latin America by reviewing one year of ED visits to HPVM.MethodsAll ED visits between April 14, 2013, and April 13, 2014, were included and analyzed, totaling 1,239 patient visits. Data were collected from their electronic medical record and exported into a de-identified Excel® database where it was sorted and categorized. Variables included age, gender, mode of arrival, insurance type, month and day of the week of the service, chief complaint, laboratory and imaging requests, and disposition. We performed descriptive statistics, and where possible, comparisons using Student’s T or chi-square, as appropriate.ResultsOf the 1239 total ED visits, 48% were males and 52% females; 93% of the visits were ambulatory, and 7% came by ambulance. Sixty-three percent of the patients had social security insurance. The top three chief complaints were abdominal pain (25.5%), fever (15.1%) and trauma (10.8%). Healthcare providers requested labs on 71.3% of patients and imaging on 43.2%. The most frequently requested imaging studies were chest radiograph (14.9%), upper extremity radiograph (9.4%), and electrocardiogram (9.0%). There was no seasonal or day-of-week variability to number of ED patients. The chief complaint of human or animal bite made it more likely the patient would be admitted, and the chief complaint of traumatic injury made it more likely the patient would be transferred.ConclusionAnalysis of patients presenting to a rural ED in Ecuador contributes to the global study of acute care in the developing world and also provides a self-analysis identifying disease patterns of the area, training topics for residents, areas for introducing protocols, and information to help planning for rural EDs in low- and middle-income countries.

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Emergency Care Research Funding in the Global Health Context: Trends, Priorities, and Future Directions

Cited by 8 publications

References 22 publications

Clinical and Translational Research in Global Health and Emergency Care: A Research Agenda

Clinical and Translational Research in Global Health and Emergency Care: A Research Agenda

Clinical emergency care research in low-income and middle-income countries: opportunities and challenges

Emergency Department of a Rural Hospital in Ecuador

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