Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA, USA.
Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Health Policy Plan. 2019 Feb 1;34(1):78-82. doi: 10.1093/heapol/czy111.
Since the adoption of the Sustainable Development Goals in 2015, innovation in global healthcare delivery has been recognized as a vital avenue for strengthening health systems and overcoming present implementation bottlenecks. In the recent rapid development of the science of global health-care delivery, emergency care-a critical element of the health system-has been widely overlooked. Emergency care plays a vital role in the health system through providing immediately responsive care and serving as one of the main entry points for those with symptomatic disease. We present a new perspective on emergency care's role in the health system within the context of global health-care delivery, and argue that, if properly integrated, emergency care has the potential to add significant value across the healthcare continuum. Capitalizing on emergency care as a shared delivery infrastructure presents opportunities to increase efficiency not only in treatment of time-sensitive conditions, but also for secondary prevention through its capacity to promote early disease detection and enhance coordination of care. We propose an integrated emergency care delivery value chain, demonstrating emergency care's critical position as a point of access to the greater health system and its key connections to longitudinal care delivery, which remain under-developed in low- and middle-income country health systems. As emergency care systems are created within emerging and established health systems, this role can be more effectively leveraged by policy makers and healthcare leaders globally to promote progress towards the Sustainable Development Goals.
自 2015 年通过可持续发展目标以来,全球医疗保健提供方面的创新已被视为加强卫生系统和克服当前实施瓶颈的重要途径。在全球医疗保健提供科学的快速发展中,急救护理——卫生系统的一个关键要素——一直被广泛忽视。急救护理通过提供即时响应的护理,并且是有症状疾病患者的主要进入点之一,在卫生系统中发挥着至关重要的作用。我们在全球医疗保健提供的背景下提出了急救护理在卫生系统中的作用的新观点,并认为,如果得到适当整合,急救护理有可能在整个医疗保健连续体中增加显著价值。利用急救护理作为共享的提供基础设施,不仅有机会提高对时间敏感条件的治疗效率,而且还可以通过促进早期疾病检测和加强护理协调来实现二级预防。我们提出了一个综合的急救护理提供价值链,展示了急救护理作为进入更大卫生系统的切入点的关键地位,以及其与纵向护理提供的关键联系,这些联系在中低收入国家的卫生系统中仍未得到充分发展。随着新兴和现有卫生系统中急救护理系统的建立,全球的政策制定者和医疗保健领导者可以更有效地利用这一角色,促进朝着可持续发展目标取得进展。