American journal of disaster medicine
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Despite an increasing reliance on outpatient clinics and other ambulatory care facilities, traditional hospitals play a crucial role in the US healthcare system. They provide emergency services on a walk-in basis and are staffed to address issues related to triage. In an era of heightened concern over bioterrorism and a potential influenza pandemic, hospital preparedness for responding to infectious disease outbreaks is essential. During such outbreaks, mental and behavioral health problems may constitute an important part of the demand placed on hospitals. There is now sufficient clinical experience regarding such problems, and tested recommendations are available for hospitals to implement in disaster planning and practice. ⋯ More research is needed to categorically examine the preparedness of hospitals for mental and behavioral health interventions during times of disaster.
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Emergency management of trauma in the developing world is at a nascent stage of development. Industrialized cities, rural towns, and villages coexist, with an almost complete lack of organized trauma care. There is no leading national agency to coordinate the various components of a trauma system, and no mechanism for accreditation of trauma centers and professionals exists. ⋯ However, communicable diseases, maternal and child health, and population control continue to be government priorities, far ahead of trauma care, in countries like India. New initiatives under the National Health Policy 2002 were expected to result in improvements in the systems, but grossly inadequate funding allocation made any significant impact on the outcome impossible. Strengthening in several areas is severely needed to achieve a reasonable level of efficiency, despite significant efforts on the part of the private sector to develop trauma care systems.