Critical care service delivery across healthcare systems in low-income and low-middle-income countries: protocol for a systematic review
Srinivas Murthy,
Teri Reynolds,
Richard Lowsby,
Neill KJ Adhikari,
Andrew George Lim,
Lia Ilona Losonczy,
Michael S Jaung,
Sojung Yi,
Sean Kivlehan,
Enrico Dippenaar,
Marc Li Chuan L C Yang,
P Andrew Stephens,
Nicole Benzoni,
Nana Sefa,
Emily Suzanne Bartlett,
Brandon Alexander Chaffay,
Naeha Haridasa,
Bernadett Pua Velasco,
Caitlin A Contag,
Amir Lotfy Rashed,
Patrick McCarville,
Paul D Sonenthal,
Nebiyu Shukur,
Abdelouahab Bellou,
Carl Mickman,
Adhiti Ghatak-Roy,
Allison Ferreira
Affiliations
Srinivas Murthy
Faculty of Medicine, BC Children’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
Teri Reynolds
Integrated Health Services, World Health Organization, Geneva, Switzerland
Richard Lowsby
Department of Critical Care Medicine, Department of Emergency Medicine, Mid Cheshire Hospitals NHS Foundation Trust, Cheshire, Cheshire, UK
Neill KJ Adhikari
Interdepartmental Division of Critical Care Medicine and Institute of Health Policy, Managament, and Evaluation, University of Toronto, Toronto, Ontario, Canada
Andrew George Lim
Section of Critical Care Medicine, Virginia Mason Medical Center, Seattle, Washington, USA
Lia Ilona Losonczy
Department of Emergency Medicine, Department of Anaesthesia & Critical Care Medicine, The George Washington University Medical Center, Washington, District of Columbia, USA
Michael S Jaung
Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA
Sojung Yi
Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
Sean Kivlehan
Department of Emergency Medicine, Brigham and Women`s Hospital, Boston, Massachusetts, USA
Enrico Dippenaar
Emergency Medicine Research Group, Anglia Ruskin University, Chelmsford, Essex, UK
Marc Li Chuan L C Yang
Accident and Emergency Medicine, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong
P Andrew Stephens
Department of Emergency Medicine, Intensive Care & Resuscitation, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Nicole Benzoni
Division of Pulmonary & Critical Care Medicine, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
Nana Sefa
Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
Emily Suzanne Bartlett
Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
Brandon Alexander Chaffay
Department of Emergency Medicine, The George Washington University Hospital, Washington, District of Columbia, USA
Naeha Haridasa
The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
Bernadett Pua Velasco
Department of Emergency Medicine, East Avenue Medical Center, Quezon City, National Capital Region, Philippines
Caitlin A Contag
Department of Medicine, Stanford University, Palo Alto, California, USA
Amir Lotfy Rashed
Department of Emergency Medicine, Jacobi Medical Center, Bronx, New York, USA
Patrick McCarville
Department of Emergency Medicine, The George Washington University Hospital, Washington, District of Columbia, USA
Paul D Sonenthal
Division of Pulmonary & Critical Care Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
Nebiyu Shukur
Department of Emergency Medicine, The George Washington University Hospital, Washington, District of Columbia, USA
Abdelouahab Bellou
Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA
Carl Mickman
Department of Emergency Medicine, Mount Sinai Hospital, New York, New York, USA
Adhiti Ghatak-Roy
Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
Allison Ferreira
Department of Emergency Medicine, University of California Los Angeles, Los Angeles, California, USA
Introduction Critical care in low-income and low-middle income countries (LLMICs) is an underdeveloped component of the healthcare system. Given the increasing growth in demand for critical care services in LLMICs, understanding the current capacity to provide critical care is imperative to inform policy on service expansion. Thus, our aim is to describe the provision of critical care in LLMICs with respect to patients, providers, location of care and services and interventions delivered.Methods and analysis We will search PubMed/MEDLINE, Web of Science and EMBASE for full-text original research articles available in English describing critical care services that specify the location of service delivery and describe patients and interventions. We will restrict our review to populations from LLMICs (using 2016 World Bank classifications) and published from 1 January 2008 to 1 January 2020. Two-reviewer agreement will be required for both title/abstract and full text review stages, and rate of agreement will be calculated for each stage. We will extract data regarding the location of critical care service delivery, the training of the healthcare professionals providing services, and the illnesses treated according to classification by the WHO Universal Health Coverage Compendium.Ethics and dissemination Reviewed and exempted by the Stanford University Office for Human Subjects Research and IRB on 20 May 2020. The results of this review will be disseminated through scholarly publication and presentation at regional and international conferences. This review is designed to inform broader WHO, International Federation for Emergency Medicine and partner efforts to strengthen critical care globally.PROSPERO registration number CRD42019146802.
