Health systems and services: the role of acute care

TLDR

Growing aging populations will increase demand for acute curative services, and emergency care must be integrated with primary and public health to strengthen health systems. The study seeks to define acute care, highlight its fragmentation, show its role in reducing all‑cause morbidity and mortality, and outline steps for strengthening it within integrated health systems. Using WHO terminology, the authors propose working definitions for acute care and outline key steps for its development. They find that failure to adopt a common definition leads to fragmented service delivery, while a clear definition can enhance integrated care and reduce morbidity and mortality.

Abstract

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.