Obtaining quality information about emergency care in low- and middle-income countries (LMIC) is challenging. Data is sparse and often of low quality and the number of peer reviewed publications is limited.
In order to address this, Obermeyer et. al. just published in the WHO Bulletin a systematic review of emergency care in 59 low- and middle-income countries. In this article, the authors systematically reviewed 195 reports related to 192 facilities. The search included English or French articles from 1990 found within PubMed, CINAHL and World Health Organization (WHO) databases.
Burden of Emergency Care
Most articles were from emeregncy departments (EDs) in academically-affiliated hospitals in urban areas. Median mortality in the EDs was 1.8% (interquartile range, IQR: 0.2–5.1%), though in sub-Saharan Africa it was 3.4% (IQR: 0.5–6.3%). The median number of patients seen per year was 30,000 (IQR: 10 296–60 000). The facilities were staffed primarily by physicians-in-training or by physicians whose level of training was unspecified. There were very few providers specialized in emergency care.
Bottom Line
Based upon available data, there are high patient loads and mortality in LMIC- particularly in sub-Saharan Africa. This report highlights the importance of emergency care and the opportunity for systematic improvement to reduce mortality in these countries.
