From the Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
Anesth Analg. 2019 Jul;129(1):294-300. doi: 10.1213/ANE.0000000000004083.
Inadequate access to anesthesia and surgical services is often considered to be a problem of low- and middle-income countries. However, affluent nations, including Canada, Australia, and the United States, also face shortages of anesthesia and surgical care in rural and remote communities. Inadequate services often disproportionately affect indigenous populations. A lack of anesthesia care providers has been identified as a major contributing factor to the shortfall of surgical and obstetrical care in rural and remote areas of these countries. This report summarizes the challenges facing the provision of anesthesia services in rural and remote regions. The current landscape of anesthesia providers and their training is described. We also explore innovative strategies and emerging technologies that could better support physician-led anesthesia care teams working in rural and remote areas. Ultimately, we believe that it is the responsibility of specialist anesthesiologists and academic health sciences centers to facilitate access to high-quality care through partnership with other stakeholders. Professional medical organizations also play an important role in ensuring the quality of care and continuing professional development. Enhanced collaboration between academic anesthesiologists and other stakeholders is required to meet the challenge issued by the World Health Organization to ensure access to essential anesthesia and surgical services for all.
麻醉和手术服务的获取不足通常被认为是中低收入国家的问题。然而,包括加拿大、澳大利亚和美国在内的富裕国家,在农村和偏远社区也面临着麻醉和手术护理的短缺。服务不足往往不成比例地影响到土著居民。麻醉护理提供者的缺乏已被确定为导致这些国家农村和偏远地区外科和产科护理短缺的一个主要因素。本报告总结了在农村和偏远地区提供麻醉服务所面临的挑战。描述了当前麻醉提供者及其培训的现状。我们还探讨了创新战略和新兴技术,这些战略和技术可以更好地支持在农村和偏远地区工作的以医生为主导的麻醉护理团队。最终,我们认为,通过与其他利益攸关方合作,为农村和偏远地区的人们提供高质量的医疗服务是专科麻醉师和学术卫生科学中心的责任。专业医疗组织在确保医疗质量和持续专业发展方面也发挥着重要作用。需要加强学术麻醉师和其他利益攸关方之间的合作,以应对世界卫生组织确保所有人都能获得基本麻醉和外科服务的挑战。