Pre-hospital care is often an individual’s entry point into the health care system, and it plays a vital role in acute life-threatening conditions which require timely, coordinated, and comprehensive care. Often, these injuries and illnesses demand immediate assessment and administration of life-saving interventions, and pre-hospital care buys time for these patients before receiving definitive treatment in a more advanced care setting, usually in hospitals and advanced specialty centers. In identifying, prioritizing, and addressing problems first outside of the hospital, pre-hospital care therefore becomes a course-altering factor in the trajectory of these patients by preventing further morbidity and improving prognosis and survival outcomes.
As we acknowledge the indispensable role of pre-hospital care as a door into the health care system, we also identify many diverse social, economic, and political factors that hinder the development of appropriate, responsive pre-hospital care. As highlighted in the documentary Ambulansyang de Paa, we saw how poverty, devolution of health care, geographical isolation, lack of health care personnel, and government neglect of building stronger health systems using the primary health care approach all contributed to the problems of the sitios in Bansud, Oriental Mindoro. These glaring inequalities that all undermine pre-hospital care inevitably create a tall barrier to free, comprehensive health care, and chances of improving health outcomes for everyone all the more becomes nil.
Therefore, it is only just and necessary to call for a whole-of-society approach in improving not only pre-hospital care in the country but the entire health care system as well. After all, we are not only concerned with admitting the patient into our care settings—it is imperative that as the patient navigates through the various levels of care, our referral systems are able to accommodate and respond to their needs while anchoring on the concepts of accessibility, continuity, justice, and quality comprehensive care.