Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
J Hand Surg Am. 2020 Sep;45(9):851-856.e2. doi: 10.1016/j.jhsa.2020.04.027. Epub 2020 Jul 14.
Trauma is the leading cause of mortality in patients aged 5 years and older. Globally, trauma kills more people than malaria, tuberculosis, and HIV/AIDs combined. As the number of surgical outreach trips to low- and middle-income countries and resources provided for such trips increase, hand surgeons are uniquely positioned to address this global burden. However, the delivery of surgical care alone is insufficient without effectively evaluating the quality of care delivered. It is critical that the care provided on outreach trips improves patient and population health, does not harm patients, and develops the local health care ecosystem. An estimated 8 million lives could be saved annually in low- and middle-income countries with higher-quality health systems. Currently, data collection systems for evaluating quality during outreach trips are lacking. Insight into current methods of quality assessment and improvement in both developing and developed countries can help inform future efforts to implement innovative data collection systems. Thoughtful and sustainable collaboration with host sites in low- and middle-income countries can ensure that care delivery is culturally competent and improves population health.
创伤是 5 岁及以上人群死亡的主要原因。在全球范围内，创伤导致的死亡人数超过疟疾、结核病和艾滋病的总和。随着外科外展服务前往中低收入国家的次数增加，以及为这些外展服务提供的资源增加，手外科医生有独特的优势来应对这一全球负担。然而，如果不有效评估所提供的护理质量，仅提供外科护理是不够的。至关重要的是，外展服务提供的护理能够改善患者和人群的健康，不会对患者造成伤害，并发展当地的医疗保健生态系统。在中低收入国家，如果拥有更高质量的卫生系统，估计每年可挽救 800 万人的生命。目前，外展服务期间评估质量的数据收集系统缺乏。了解发展中国家和发达国家当前质量评估和改进的方法，可以帮助为实施创新数据收集系统提供信息。与中低收入国家的主办机构进行深思熟虑和可持续的合作，可以确保提供的护理具有文化能力并改善人口健康。
