Shen Weifeng
J Glob Health. 2025 Jul 1;15:03023. doi: 10.7189/jogh.15.03023.
Over the past decades, considerable advancements have been made in China's emergency medical service system (EMSS). The disparity in EMSS development between urban and rural areas in China continues to be a significant public health concern. It also represents a pressing challenge on a global scale. Implementing strategies to narrow the urban-rural gap in emergency care and achieve balanced EMSS development holds critical significance. Therefore, this viewpoint presents the conceptual framework of the five-link theory and the five-link emergency care chain. The five-link emergency care chain constitutes the ground-breaking conceptual framework systematically addressing persistent challenges in achieving urban-rural health care integration and equitable advancement of emergency medical services. This framework constitutes a comprehensive EMSS, encompassing five core operational components: village (community) primary emergency care points, township emergency care units, prehospital emergency care, in-hospital emergency care, and critical care. It is engineered to optimise structural coherence, response efficacy, and service equity within EMSS. With the advancement of the five-link emergency care chain model implementation, its theoretical framework continues to evolve. This integrated theory-practice paradigm offers Chinese insights and experience in advancing global emergency medicine modernisation. Establishing comprehensive theoretical frameworks guiding emergency care service optimisation at township and village levels is imperative to facilitate the advancement of rural EMSS and mitigate urban-rural disparities in emergency medical services capacity. The five-link theory, grounded in five-link emergency care chain practices, offers a valuable framework for advancing urban-rural coordination of emergency care and ensuring equitable distribution of emergency response resources.
在过去几十年里，中国的紧急医疗服务体系（EMSS）取得了长足进步。中国城乡紧急医疗服务体系发展的差距仍然是一个重大的公共卫生问题。在全球范围内，这也是一项紧迫的挑战。实施缩小城乡紧急医疗差距、实现紧急医疗服务体系均衡发展的战略具有至关重要的意义。因此，本观点提出了五环节理论和五环节紧急医疗链的概念框架。五环节紧急医疗链构成了一个开创性的概念框架，系统地应对了在实现城乡医疗一体化和紧急医疗服务公平发展方面持续存在的挑战。该框架构成了一个全面的紧急医疗服务体系，涵盖五个核心运作组成部分：村（社区）基层急救点、乡镇急救单元、院前急救、院内急救和重症监护。它旨在优化紧急医疗服务体系内的结构连贯性、反应效能和服务公平性。随着五环节紧急医疗链模型实施的推进，其理论框架也在不断演变。这种理论与实践相结合的范式为推动全球急诊医学现代化提供了中国的见解和经验。建立指导乡镇和村级紧急医疗服务优化的综合理论框架对于促进农村紧急医疗服务体系的发展和缩小城乡紧急医疗服务能力差距至关重要。基于五环节紧急医疗链实践的五环节理论为推进城乡紧急医疗协调和确保应急资源公平分配提供了一个有价值的框架。
