Trauma Care in Mongolia: INTACT Evaluation and Recommendations for Improvement

Area of Science:

• Trauma care systems
• Public health
• Emergency medicine

Background:

• Injury is a leading cause of death in Mongolia, with rising motor vehicle fatalities.
• Limited access to care exists for the 50% of the population outside the capital, Ulaanbaatar.
• The Mongolian trauma system's capacity and adherence to standards require evaluation.

Purpose of the Study:

• To evaluate and describe the current Mongolian trauma system.
• To identify areas for improvement in trauma care delivery.
• To make recommendations for enhancing the national trauma system.

Main Methods:

• Collected hospital-level data from 10 rural and urban hospitals.
• Calculated International Assessment of Capacity for Trauma (INTACT) scores (0-10) for each hospital.
• Compared INTACT scores to World Health Organization Guidelines for Essential Trauma Care (GETC) standards.

Main Results:

• Ulaanbaatar has centralized prehospital services and well-resourced tertiary hospitals.
• Secondary and some primary facilities did not meet GETC minimums.
• No national standards exist for prehospital care, triage, or transfer; no rehabilitation facilities are available.

Conclusions:

• The Mongolian trauma system relies on regionalized care, with 60% of surveyed hospitals meeting GETC standards.
• Key areas for improvement include resourcing primary/secondary facilities, developing rural prehospital systems, and establishing rehabilitation services.
• Adoption of universal patient care standards is recommended to enhance the national trauma system.