What is the importance of pre-hospital care in improving outcomes for patients especially for those with acute life-threatening conditions and in improving access to health care?
It is unfortunate, but nonetheless the reality, that a vast majority of Filipinos lack access to adequate healthcare. This is a result of many factors present in our country. Among these is the geography of the country, which is primarily archipelagic causing much of the population to be divided by seas into thousands of islands. Next is the volcanic nature of our archipelago, which in turn produces a high density of difficult to traverse mountain ranges, valleys, and rivers. Finally, you have the societal distribution of the Philippine population, which tends to have a large concentration of resources, people, and consequently medical personnel in a handful of large urban centers with a huge but spread-out rural population. This causes a mismatch in the distribution of medical facilities and trained medical service providers requiring patients or doctors to travel great distances over difficult terrain with a lack of infrastructure in order to access treatment or to reach underserved areas. This was demonstrated in the documentary we watched. This problem is even more acutely felt in emergency cases that cannot afford the wait or the travel time necessary to reach appropriate medical care. While the simplest answer is to make specialized services more available to the underserved, we are met with the equally unfortunate reality that resources in our country are finite. As much as it would be ideal to make to have tertiary centers within easy access to all Filipinos, we simply do not have the resources to accomplish this due to our position as a developing country and the previously mentioned limitations of geography. However, this does not mean that there is nothing we can do. We can reduce mortality and morbidity in these underserved areas by improving pre-hospital care and access to pre-hospital care in the form of more rural/local health units, more training for the personnel manning these, and better policies regarding the provision of initial treatment and stabilization before patients in emergencies are brought to larger hospitals. This requires relatively fewer resources than building more specialized hospitals for all underserved rural areas and is likely a more feasible compromise in improving outcomes for otherwise inaccessible areas. Although the ideal scenario would be to accomplish both better pre-hospital care and more even distributed tertiary hospitals, in the uniquely Philippine context of complicated geography and widespread poverty, improving pre-hospital care is an efficient way to maximize limited resources.