Strengthening Health Systems to Provide Emergency Care

Excerpt

All around the world, acutely ill and injured people of all ages seek care every day. They will call neighbors, the police, or universal emergency numbers for help. They will be assisted by family members, community members with first-aid training, or professional prehospital providers. They may travel to a health care facility by foot, motorcycle, taxi, or ambulance. On arrival, they may or may not find a designated emergency area and providers capable of delivering the care they need.

Emergency care systems (ECSs) address a wide range of acute conditions, including injuries, communicable and noncommunicable diseases, and complications of pregnancy. Especially when there are barriers to health care access, people may seek care only when acutely ill or injured. Emergency care is an essential component of universal health coverage—a critical mechanism for ensuring accessible, affordable, high-quality care—and for many people around the world, it is the primary point of access to the health system.

The World Health Organization (WHO) has defined a series of essential functions for an ECS that span from prehospital care and transport through facility-based emergency unit care to early operative and critical care (figure 13.1). Each of these functions can be achieved in many ways, depending on available resources, and each is essential to the delivery of effective emergency care.

Each of the previous eight volumes of this edition of Disease Control Priorities (third edition) (DCP3) presents a package of essential services and highlights urgent services for conditions likely to result in morbidity or mortality if not addressed rapidly. An ECS is an integrated mechanism to address these time-sensitive conditions, and this chapter integrates the urgent interventions from all the Disease Control Priorities packages with the WHO ECS framework to derive a package of essential emergency care services, including key policy strategies for system development. This effort is intended to identify ways in which national health care systems globally can be strengthened to provide emergency care more effectively.