The growing and aging global population has led to an increased demand for urgent, high-quality healthcare services capable of addressing life-threatening emergencies, sudden exacerbations of chronic illnesses, and various routine health issues that require immediate attention. Integrating emergency interventions with primary health care and public health strategies is essential to building resilient and comprehensive health systems. This discussion explores the critical function of acute care within that framework, emphasizing the importance of clear definitions, system integration, and strategic development to improve health outcomes worldwide.
Defining Acute Care
Establishing precise definitions for health systems and services is fundamental to fostering effective communication and guiding system enhancement efforts. A health system encompasses all organizations, institutions, and resources primarily dedicated to promoting, restoring, and maintaining health.1 Health services, in turn, are activities aimed at improving health outcomes, including diagnosis, treatment, and rehabilitation of the sick. These services can be viewed from multiple perspectives: as the organization of inputs for effective interventions; as encompassing promotion, prevention, cure, rehabilitation, and palliative care; and as targeted either toward individuals or populations.1,2
Clarifying the concept of acute care is equally vital. Medical definitions of acuity highlight the importance of time sensitivity.3 Consequently, acute services include all actions—be they promotive, preventive, curative, rehabilitative, or palliative—that are primarily designed to enhance health and whose success depends heavily on rapid, often urgent, intervention. Many services tailored for individuals have optimal delivery windows, with acute curative services being the most time-critical, regardless of disease type. Unfortunately, in many developing health systems, acute care remains poorly defined and under-resourced. A working definition of acute care would encompass the most urgent, time-sensitive diagnostic and therapeutic actions aimed at improving health outcomes. Specifically, it involves health system components or care delivery platforms responsible for managing sudden, unexpected episodes of injury or illness that could result in death or disability without swift intervention. The term acute care spans a spectrum of clinical functions, including emergency medicine, trauma management, pre-hospital emergency response, acute surgical interventions, critical care, urgent care, and short-term inpatient stabilization (see Fig. 1).
Fig. 1. Domains in Acute Care
a. Treatment for individuals with urgent surgical needs, such as severe injuries, appendicitis, or hernias strangulation.
b. Management of acute medical conditions that threaten life or limbs, including heart attacks, strokes, or severe abdominal pain evaluations.
c. Outpatient care delivered outside hospital emergency departments, often on a walk-in basis, such as evaluating a sprained ankle or a child’s fever.
d. Pre-treatment stabilization, like administering intravenous fluids to critically injured patients before surgical transfer.
e. Community-based care until patients reach facilities capable of providing definitive treatment, such as ambulance services or local health provider assessments.
f. Intensive care units offering comprehensive, continuous monitoring for patients with life-threatening conditions like respiratory failure or cerebral malaria seizures.
Fragmented Health Systems and Services
In 2007, the World Health Organization emphasized the need to strengthen health systems, but precise definitions and targeted objectives, especially regarding service delivery, often remain vague.4 Countries typically focus on addressing prioritized health issues identified through international consensus; however, the influence of time on the success of interventions is frequently overlooked. Preventive measures aim to reduce disease incidence by acting early, while curative strategies focus on decreasing disability or death among existing cases. The effectiveness of curative interventions is highly dependent on timely access and delivery, yet many health systems fail to coordinate care effectively. This results in fragmentation—delays or gaps in treatment, such as late antibiotic administration in sepsis cases—leading to preventable disability and death. Such disjointed care diminishes the potential to reduce disability-adjusted life years (DALYs) and undermines efficient resource utilization.
The Contribution of Acute Care
As a vital component of clinical services, acute care addresses health crises that pose immediate threats to life or limbs, regardless of underlying causes. By doing so, it underpins the development of robust, horizontal health systems rather than isolated, disease-specific vertical programs. Interestingly, many resources—material, consumables, and skilled personnel—used in acute care overlap with those in traditional disease-focused programs. It is crucial to dispel misconceptions that equate acute care solely with ambulance services or high-tech procedures; instead, its core principle relies on timely, life-saving responses. Effective acute care involves resource redistribution aimed at preventing death and disability promptly. When integrated with primary and preventive care, acute care completes a comprehensive health system model that addresses all essential health needs.
The global health discourse often categorizes health issues into communicable diseases, noncommunicable diseases, and injuries. The current focus on noncommunicable diseases highlights how neglecting the urgency of timely interventions can fragment care delivery. For example, out of 57 million global deaths in 2008, 36 million resulted from noncommunicable conditions—many of which require urgent responses.6 Despite this, strategies targeting these diseases tend to prioritize prevention and primary care, with less emphasis on the critical role of emergency interventions. Conditions such as diabetic ketoacidosis exemplify situations where immediate, time-sensitive treatment can be life-saving, illustrating how the undervaluation of acute care hampers efforts to reduce disease burden effectively.
Acute care plays an indispensable role in preventing death and long-term disability. Primary care alone often cannot fulfill this function, especially during emergencies. Moreover, acute care serves as an entry point for individuals experiencing urgent health issues, making it a cornerstone of accessible, responsive health systems. Developing clear metrics to evaluate the quality and reach of acute services, along with understanding the disease burden they address, is necessary for progress—particularly in low- and middle-income countries. Recognizing acute care as an integrated platform enables the various specialized fields involved to collaborate more effectively, creating a unified agenda for advancing health outcomes globally. For further insights into health system functioning, see how does the American healthcare system work.
Key Next Steps
Numerous straightforward, cost-effective, and life-saving interventions can be provided within the first 24 hours of care. These include basic surgical procedures at district hospitals for trauma, high-risk pregnancies, and common surgical conditions. Progress is being made through initiatives such as the 2009 establishment of the African Federation for Emergency Medicine and the upcoming global research agendas on emergency care. However, several strategic actions are essential to advance acute care systems:
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Developing tailored acute care service models suitable for low- and middle-income settings, functioning alongside preventive and primary health services to address both life-threatening and limb-threatening conditions, as well as exacerbations of chronic diseases.
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Enhancing coordination among providers of acute services—such as emergency physicians, surgeons, and obstetricians—to deliver rapid, effective care.
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Creating research frameworks to quantify the burden of acute health conditions, incorporating health economics and cost-effectiveness analyses to justify integrating these services into existing health systems.
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Facilitating national and international dialogues to promote better integration of acute care within broader health strategies.
This call to action urges policymakers, health leaders, and researchers to recognize the fundamental contribution of acute care systems in managing both communicable diseases and injuries, alongside chronic illnesses. Building robust, resource-efficient acute care platforms should not divert attention or resources from primary prevention efforts. Instead, aligning stakeholders across regions to develop the optimal mix of acute and preventative services is paramount for addressing the escalating global disease burden. For a comprehensive understanding of healthcare resource allocations, see how much do healthcare data analysts make.
References are available for further exploration, emphasizing the importance of systematic health system strengthening and the pivotal role of acute care in achieving better health outcomes worldwide.