Military and Civilian Trauma System Integration: A Global Case Series

Introduction: Traumatic injury is a leading cause of morbidity globally, particularly in low-income and middle-income countries (LMICs). In high-income countries (HICs), it is well documented that military and civilian integration can positively impact trauma care in both healthcare systems, but it is unknown if this synergy could benefit LMICs. This case series examines the variety of integration between the civilian and military systems of various countries and inter-national partnerships to elucidate if there are commonalities in facilitators and barriers.Methods: A convenience sampling method was utilized to identify subject matter experts on civilian and military trauma system integration. Data were collected and coded through an iterative process, focusing on the historical impetuses and subsequent outcomes of civilian and military trauma care collaboration.Results: Eight total case studies were completed, five addressing specific countries and three addressing international partnerships. Themes which emerged as drivers for inte-gration included history of conflict, geography, and skill maintenance for military physi-cians. High-level government support was a central theme for successful integration, and financial issues were often seen as the greatest barrier.Conclusions: Various approaches in civilian-military integration exist throughout the world, and the studied nations and international partnerships demonstrated similar motivators and barriers to integration. This study highlights the need for further investigation, particularly in LMICs, where less is known about integration strategies.Published by Elsevier Inc.

Automated summary

Traumatic injury is a major cause of disability worldwide, especially in low and middle income countries (LMICs). The integration of civilian and military systems has been shown to have positive impact on trauma care in high-income countries (HICs), but it is unclear if this synergy could benefit LMICs. This study examines the integration between civilian and military systems in various countries and international partnerships to identify common facilitators and barriers.