World Journal of Surgery

, Volume 39, Issue 9, pp 2161–2167 | Cite as

Prehospital and Emergency Care: Updates from the Disease Control Priorities, Version 3

  • Renee Y. Hsia
  • Amardeep Thind
  • Ahmed Zakariah
  • Eduardo Romero Hicks
  • Charles Mock
Original Scientific Report



It is increasingly understood that emergency care systems can be cost-effective in low- and middle-income countries (LMICs). The development of such systems, however, is still a work in progress. This article updates previous work in providing the most recent estimates of the burden of disease sensitive to emergency care, the current state of knowledge on the feasibility of emergency care, effect on outcomes, and cost-effectiveness in LMICs, and future directions for research, policy, and implementation.


We calculated the potential impact of prehospital and emergency care systems using updated and revised data based on the global burden of disease study. We then assessed the state of current knowledge and potential future directions for research and policy by conducting a review of the literature on current systems in LMICs.


According to these newest updates, 24 million deaths related to emergency medical conditions occur in LMICs annually, accounting for an estimated 932 million years of life lost. Evidence shows that multiple emergency care models can function in different local settings, depending on resources and urbanicity. Emergency care can significantly improve mortality rates from emergent conditions and be highly cost-effective. Further research is needed on implementation of emergency care systems as they become a necessary reality in developing nations worldwide.


Emergency care implementation in LMICs presents both challenges and opportunities. Investment in evidence-based emergency care, research on implementation, and system coordination in LMICs could lead to a more cost- and outcome-effective emergency care system than exists in advanced economies.


Emergency Care Basic Life Support Advanced Life Support Prehospital Care Emergency Medical System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This article was prepared as a contribution to the Disease Control Priorities, third edition, which is sponsored by a grant from the Bill & Melinda Gates Foundation to the University of Washington. The sponsor had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Conflict of interest

Charles Mock is an associate editor for WJS. He will be recusing himself from handling this manuscript for the journal so as to avoid any potential conflicts of interest. We have no financial interests or conflicts to report.


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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Renee Y. Hsia
    • 1
  • Amardeep Thind
    • 2
  • Ahmed Zakariah
    • 3
  • Eduardo Romero Hicks
    • 4
  • Charles Mock
    • 5
  1. 1.UCSF Department of Emergency MedicineSan Francisco General HospitalSan FranciscoUSA
  2. 2.Department of Epidemiology & Biostatistics, Schulich School of Medicine and DentistryWestern UniversityLondonCanada
  3. 3.Ghana National Ambulance Service, MinistriesAccraGhana
  4. 4.Director del Sistema de Urgencias del Estado de GuanajuatoGuanajuatoMexico
  5. 5.Department of SurgeryUniversity of Washington, Harborview Injury Prevention & Research CenterSeattleUSA

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