Strengthening Health Systems to Provide Emergency Care

Reynolds, Teri; Sawe, Hendry R.; Rubiano, Andrés M.; Shin, Sang Do; Wallis, Lynne; Mock, Charles

doi:10.1596/978-1-4648-0527-1_ch13

Cited by 94 publications

(126 citation statements)

References 45 publications

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“…Implicit in the WHO framework is an acknowledgment that EC systems enable time‐sensitive interventions and effective service delivery across the continuum of healthcare. They also promote equity and improve health system resilience for disasters, outbreaks and mass casualty events . In LMICs, EC might be the only access point to healthcare for vulnerable populations, including migrants, refugees, women, children and people with disabilities.…”

Section: Global Ecmentioning

confidence: 99%

See 1 more Smart Citation

World Health Assembly Resolution 72.16: What are the implications for the Australasian College for Emergency Medicine and emergency care development in the Indo‐Pacific?

Mitchell

Phillips

O’Reilly

et al. 2019

Emerg Medicine Australasia

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Section: Global Ecmentioning

confidence: 99%

“…In addition, the post‐2015 Sustainable Development Goals (SDGs) provide a more suitable platform for progressing global EC development . With explicit references to non‐communicable diseases, road trauma and health security, there are opportunities to leverage SDG priorities to promote investment in EC systems …”

Section: What Has Happened So Far?mentioning

confidence: 99%

World Health Assembly Resolution 72.16: What are the implications for the Australasian College for Emergency Medicine and emergency care development in the Indo‐Pacific?

Mitchell

Phillips

O’Reilly

et al. 2019

Emerg Medicine Australasia

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“…Urgent interventions, which include a large fraction of essential surgical interventions, are ideally available at all times and close to where patients live, with important implications for dispersal of relevant platforms and integration of different services. 27 Non-urgent but continuing interventions to address chronic conditions (eg, secondary prevention of vascular disease or antiretroviral therapy for HIV-positive individuals) is a big and quite distinct challenge. One new product of DCP3 has been to explicitly categorise all essential interventions into one of these three temporal categories and to draw relevant lessons, including concerning cost, for health systems.…”

Section: Packages Platforms and Policiesmentioning

confidence: 99%

“…Urgent interventions (eg, for trauma or obstructed labour) require that first-level hospitals be accessible quickly. 27 About a quarter to a third of incremental costs are required to provide this capacity. Time-bound but non-urgent interventions (eg, cataract extraction) allow patients to be accumulated over space and time with concomitant potential for efficiency and quality resulting from high volume.…”

Section: Essential Universal Health Coveragementioning

confidence: 99%

Universal health coverage and intersectoral action for health: key messages from Disease Control Priorities, 3rd edition

et al. 2018

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The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1% of (current) gross national income (GNI) in low-income countries and 5·2% of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected.

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“…Increasingly, there is evidence and recognition of the value of EC in RL settings. Modelling from the World Bank Disease Control Priorities Project estimates that effective EC could save more than one billion disability‐adjusted life years each year, and address up to 54% of all deaths . In the setting of an escalating global burden of non‐communicable disease and injury, the World Health Assembly has nominated EC as a critical tool to achieve universal health coverage …”

Section: Introductionmentioning

confidence: 99%

Demand for global health training and experiences among emergency medicine trainees in Australia and New Zealand

Mitchell

Phillips

et al. 2020

Emerg Medicine Australasia

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Objective Demand for global health (GH) training and experiences among emergency medicine trainees is unknown. The primary objective of the Trainee Interest in Global Health Training (TIGHT) study was to quantify the number of trainees interested in completing a rotation in a resource‐limited environment within a low‐ or middle‐income country during their specialty training. Methods A cross‐sectional study of trainees in seven specialty training programmes was conducted between August and October 2018. Data were collected using a voluntary, anonymous, self‐reporting, web‐based survey. This study describes the results of a planned sub‐group analysis of ACEM trainees. Results There were 203 respondents among 2525 ACEM trainees. Although only a small number (36/198, 18.2%) had undertaken a GH experience as a specialty trainee, 85.6% (167/195) were keen to do so. The vast majority of respondents (179/194, 87.1%) were interested or very interested in having their GH experience accredited for training, but 68.9% (133/193) reported that accessing a suitable placement was a barrier. More than 79% (147/186) expressed interest in undertaking an integrated GH training or fellowship programme as an adjunct to specialty training. Conclusions Notwithstanding the limitations of a self‐reporting survey with a sub‐optimal response rate, there is significant demand for GH training and experiences among ACEM trainees. These findings should inform the development of safe and effective global emergency care training pathways, underpinned by mutually beneficial, international partnerships with educational and development objectives.

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Strengthening Health Systems to Provide Emergency Care

Cited by 94 publications

References 45 publications

World Health Assembly Resolution 72.16: What are the implications for the Australasian College for Emergency Medicine and emergency care development in the Indo‐Pacific?

World Health Assembly Resolution 72.16: What are the implications for the Australasian College for Emergency Medicine and emergency care development in the Indo‐Pacific?

Universal health coverage and intersectoral action for health: key messages from Disease Control Priorities, 3rd edition

Demand for global health training and experiences among emergency medicine trainees in Australia and New Zealand

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