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Health systems and services: the role of acute care
Open accessAbstract
As populations continue to grow and age, there will be increasing demand for acute curative services responsive to life-threatening emergencies, acute exacerbation of chronic illnesses and many routine health problems that nevertheless require prompt action. Emergency interventions and services should be integrated with primary care and public health measures to complete and strengthen health systems. This paper focuses on acute care within that context. First, we draw on standard World Health Organization (WHO) terminology to propose working terms to define “acute care”. Second, we highlight the fragmentation of service delivery that results from not adopting the proposed definition. Third, we show the potential contribution of acute care to integrated health systems designed to reduce all-cause morbidity and mortality. Finally, we propose key steps to further the development of acute care that leaders, researchers and health workers, who are the people responsible for maintaining strong national health systems, should consider taking.
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Kewalramani, D., Choron, R. L., Whitley, D., Teichman, A. L., Raina, K., Singh, G., Piplani, C., Englert, Z. P., Hanna, J., Peck, G., et al. (2025) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000004525 · Cited by 9
Self-citation
Metadata
- Authors
- Hirshon, J. M., Risko, N., Calvello, E. J., Stewart de Ramirez, S., Narayan, M., Theodosis, C., O’Neill, J., & for the Acute Care Research Collaborative at the University of Maryland Global Health Initiative
- Affiliations
- University of Maryland, Baltimore (US)
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
- Venue
- Bulletin of the World Health Organization
- Publisher
- WHO Press
- Published
- 2013-01-31
- Volume
- 91
- Issue
- 5
- Pages
- 386-388
- ISSN
- 0042-9686 (ISSN-L)
- PMC
- PMC3646345
- OpenAlex
- W2038083257
- Cited by
- 270
- References
- 9
- Citations by year
- 2026: 22 · 2025: 31 · 2024: 15 · 2023: 22 · 2022: 28 · 2021: 34 · 2020: 23 · 2019: 21 · 2018: 17 · 2017: 19 · 2016: 11 · 2015: 17 · 2014: 4 · 2013: 4
- FWCI
- 11.85
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Bulletin of the World Health Organization (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health
- Fogarty International Center (D43TW007296)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Practices
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Keywords
- acute care, health system integration, primary care, emergency care, health system strengthening, morbidity and mortality reduction
- MeSH terms
- Delivery of Health Care, Emergency Medical Services, Humans, Primary Health Care, Quality of Health Care
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