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[*] posted on 14-3-2018 at 12:08 AM
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By Dr. Zulfikar BuxAssistant Professor of Emergency MedicineAfter reviewing an article from Dr Ziad Obermeyer of the Harvard University on the importance of emergency medical care in health systems, I had to share it to show the importance of emergency medicine in health care. Emergency care is often overlooked in budgets and in the agendas in healthcare systems but it easily provides the best value for money when it comes to the delivery of efficient and effective healthcare.When we think about health care in low and Middle-Income Countries (LMICs), we think about vaccines, maternal and child health and controlling epidemics of major infectious diseases, and perhaps improving nutrition and sanitation. There is a good reason these interventions come to mind: over the past few decades they have saved literally millions of lives. But it?s easy to forget that people in poor countries also get into car accidents. They get pneumonia, heart attacks, diarrheal illnesses, and asthma too. Not all these emergencies are preventable?even in high-income countries that have been investing in prevention and primary care for decades. So it?s no surprise that studies consistently put emergency conditions at the top of the list of causes of death and disability worldwide.Evidence showing importance of emergency medical careRecently an international group called the Acute Care Development Consortium, reviewed over 40,000 published and unpublished reports to generate a snapshot of emergency care in LMICs. They found that 10-15 percent of all deaths occurred in emergency facilities. And unlike high-income countries, where emergency facilities serve growing numbers of chronically ill elders, these patients are young, healthy, and economically productive.Dr. Zulfikar BuxThe volume of patients seeking emergency care in LMICs is enormous; facilities see on average 10 times the caseloads of primary care doctors in similar settings. And mortality rates are staggering?multiples of those in high-income countries, especially in paediatric facilities in central Africa. In some facilities,China Jerseys Wholesale, up to one in five children brought in for treatment died in the emergency setting, in front of a provider.They found that emergency care in LMICs is shockingly under-resourced. Conditions were often heartbreakingly rudimentary. Findings suggested that funding for emergency care is almost non-existent. This and the issues surrounding emergency care is usually absent from agendas of most donors,China NBA Jerseys, international organizations and Ministries of Health.But with so many competing priorities in global health, most of them under-resourced,China Jerseys Cheap, what makes emergency care different?What can be done?A key insight comes from the evolution of emergency care in high-income countries. Over the past few decades, focused efforts to improve quality?advances in clinical operations, protocolized care, provider training, and more?have translated into major reductions in mortality across several diseases and conditions. And for all the hand-wringing in policy circles about overuse,Cheap Jeseys NFL, emergency care accounts for a tiny fraction of national medical expenditures. It is a small price to pay for lives saved.Encouragingly,NBA Jerseys China, they found early indications from LMICs that similar improvements in emergency care?better triage, improved patient flow,Wholesale Authentic NFL Jerseys, supervision/training of junior providers?can also lead to dramatic reductions in mortality. These interventions did not require massive new investments in infrastructure; they simply tweaked the way existing health system resources are used, meaning that lives, limbs,Authentic Jerseys China, and discomfort were likely saved at very little cost.There is no question that disease and injury prevention are core functions of health systems everywhere. But parallel investments in emergency care could help promote innovative cost-effective interventions, break down disease-specific silos in health care delivery, and prepare us for the next epidemic of Ebola?or something worse. So, in a way, rethinking emergency care might actually get us closer to the original Alma Ata goals of primary care and health for all. Emergency care in Guyana is still in its infancy and has strong potential for growth. Continued support and nurturing will ensure its evolution into a force that tremendously benefit the health of all Guyanese.
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