Proposals for improvement of emergency rural health care

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Universal healthcare coverage is a right, and that includes emergency health care. The community expects such requirements to be within their reach, including all human and technological resources necessary for rapid and high-quality health assistance in an emergency. Access to and delivery of emergency care in rural areas is recognized as more difficult than that in urban areas. This paper summarizes the discussion that took place during the EURIPA Day Meeting (Belgrade, June 2004).

EURIPA declaration and some barriers to effective rural emergency care

Despite the fact that EURIPA has its own 'Declaration on Rural and Emergency Care' (Fig 1), the authors have submitted some additional proposals to assist in overcoming the major barriers to emergency healthcare in rural areas (Fig 2), in order to complete the Declaration.



Figure 1: The EURIPA Declaration on Rural Emergency Care



Figure 2: Barriers to effective rural emergency practice (vs urban)

Future of emergency health care in rural areas

The 20% of the European population that comprises the rural community needs special management of emergency health care, different from what is available in urban areas. Due to long distances to hospitals and other specific barriers (Fig 2), special primary care consideration and health promotion is needed.

To show the way ahead, the authors believe that more is needed than the previous recommendations. For that purpose, we have now completed the EURIPA Declaration by adding the following 'problems and proposals for improvement'^1-12 (Table 1):

Table 1: Problems and proposals for improvement



Conclusions

One in five persons dwell or work in a rural environment in the new European Union Region. The European rural community has its own characteristics: older patients, a lower socioeconomical status, isolation, and others factors. These facts reinforce the notion that rural health care - and specifically emergency care - needs its own management, and that this must be improved.

Due to the barriers to access and delivery in rural areas, investment in resources of all kinds (human, material, social) is needed in order to provide the same efficient care as in urban areas.

Primary health care has been demonstrated to be the most cost-effective system for rural care. Even though some hospitals are located in rural areas, emergency care policies should foster delivery of emergency care in primary care centers. Policies for emergency care should also foster specific medical emergency care education for health professionals.

Acknowledgements

The authors would like to thank all the participants in the EURIPA Day 2004 for their agreement with this presentation, and especially Dr John Wynn-Jones (President of EURIPA).

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