Strengthening the Healthcare System in Low- and Middle-income Countries by Integrating Emergency Care Capacities.
Strengthening the Healthcare System in Low- and Middle-income Countries by Integrating Emergency Care Capacities.
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DOI：
10.31662/jmaj.2018-0041
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发表时间：
2019-09-04
期刊：
影响因子：
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通讯作者：
Sakamoto, Tetsuya
中科院分区：
文献类型：
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作者：
Nakahara, Shinji;Ichikawa, Masao;Sakamoto, Tetsuya
初级卫生保健原则为加强卫生保健系统提供了一个框架，以满足中低收入国家日益增长和多样化的卫生需求。目前，中低收入国家的初级保健系统需要扩大护理能力，以应对非传染性疾病和伤害，包括紧急情况。在这篇文章中，我们讨论了将初级保健原则应用于中低收入国家的紧急护理并将紧急护理纳入初级保健的可能性;这些原则包括通过靠近社区的非专业提供者提供与医疗保健的第一接触点，以提高可及性，提供高质量的（即，全面、协调和持续的初级保健，并通过社区赋权解决健康不良的主要原因。这些原则适用于急救护理，急救护理具有相同的属性：它还要求通过非专业人员急救和救护车系统增加第一接触点，它还为各种疾病和伤害提供全面护理，各种设施和人员参与协调和持续提供服务;集体社区行动还发展和加强紧急护理系统，特别是通过卫生部门以外的组成部分（例如，交通、通讯和互助）。将紧急护理纳入初级保健可以加强一般卫生系统，比单独的系统更有效。
Primary healthcare (PHC) principles provide a framework for strengthening the healthcare system to tackle increasing and diversifying health needs in low- and middle-income countries (LMICs). Currently, PHC systems in LMICs require expanded care capabilities in order to deal with noncommunicable diseases and injuries, including emergency conditions. In this article, we discuss the possibility of applying PHC principles to emergency care in LMICs and integrating emergency care into PHC; such principles include providing first points of contact with healthcare through nonprofessional providers close to communities in order to improve accessibility, providing high-quality (i.e., comprehensive, coordinated, and continuous) primary care, and addressing primary causes of ill-health through community empowerment. These principles are applicable to emergency care, which has the same attributes: it also requires increasing first points of contact through layperson first aid and the ambulance system, and it also provides comprehensive care for diverse diseases and injuries, with various facilities and personnel involved in its coordinated and continuous delivery; collective community actions also develop and strengthen the emergency care system, particularly through components outside the health sector (e.g., transport, communication, and mutual aid). Integrating emergency care into PHC could enhance the general health system and is more efficient than having separate systems.