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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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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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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