Mowafi Hani, Ngaruiya Christine, O'Reilly Gerard, Kobusingye Olive, Kapil Vikas, Rubiano Andres, Ong Marcus, Puyana Juan Carlos, Rahman Akm Fazlur, Jooma Rashid, Beecroft Blythe, Razzak Junaid
Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Department of Epidemiology & Preventative Medicine, Monash University, Clayton, Victoria, Australia.
BMJ Glob Health. 2019 Jul 29;4(Suppl 6):e001442. doi: 10.1136/bmjgh-2019-001442. eCollection 2019.
Despite the fact that the 15 leading causes of global deaths and disability-adjusted life years are from conditions amenable to emergency care, and that this burden is highest in low-income and middle-income countries (LMICs), there is a paucity of research on LMIC emergency care to guide policy making, resource allocation and service provision. A literature review of the 550 articles on LMIC emergency care published in the 10-year period from 2007 to 2016 yielded 106 articles for LMIC emergency care surveillance and registry research. Few articles were from established longitudinal surveillance or registries and primarily composed of short-term data collection. Using these articles, a working group was convened by the US National Institutes of Health Fogarty International Center to discuss challenges and potential solutions for established systems to better understand global emergency care in LMICs. The working group focused on potential uses for emergency care surveillance and registry data to improve the quality of services provided to patients. Challenges included a lack of dedicated resources for such research in LMIC settings as well as over-reliance on facility-based data collection without known correlation to the overall burden of emergency conditions in the broader community. The group outlined potential solutions including incorporating data from sources beyond traditional health records, use of standard clinical forms that embed data needed for research and policy making and structured population-based research to establish clear linkages between what is seen in emergency units and the wider community. The group then identified current gaps in LMIC emergency care surveillance and registry research to form a research agenda for the future.
尽管全球15个主要的死亡原因和伤残调整生命年来自于适合急诊护理的疾病，而且这种负担在低收入和中等收入国家（LMICs）最为严重，但针对LMICs急诊护理以指导政策制定、资源分配和服务提供的研究却很少。对2007年至2016年这十年间发表的550篇关于LMICs急诊护理的文章进行文献综述，得出了106篇关于LMICs急诊护理监测和登记研究的文章。很少有文章来自已建立的纵向监测或登记处，且主要由短期数据收集组成。利用这些文章，美国国立卫生研究院福格蒂国际中心召集了一个工作组，讨论现有系统在更好地了解LMICs全球急诊护理方面所面临的挑战和潜在解决方案。该工作组专注于急诊护理监测和登记数据的潜在用途，以提高为患者提供的服务质量。挑战包括在LMIC环境中缺乏此类研究的专用资源，以及过度依赖基于机构的数据收集，而这些数据与更广泛社区中急诊情况的总体负担并无已知关联。该小组概述了潜在的解决方案，包括纳入传统健康记录以外来源的数据，使用嵌入研究和政策制定所需数据的标准临床表格，以及开展基于结构化人群的研究，以在急诊室所见情况与更广泛社区之间建立明确联系。然后，该小组确定了LMIC急诊护理监测和登记研究当前存在的差距，以形成未来的研究议程。
