Military and Civilian Trauma System Integration: A Global Case Series

Area of Science:

• Trauma Care Systems
• Global Health Security
• Military Medicine

Background:

• Traumatic injury is a major global health burden, especially in low- and middle-income countries (LMICs).
• Integration of military and civilian trauma care systems in high-income countries (HICs) is known to improve outcomes.
• The potential benefits of such integration in LMICs remain largely unexplored.

Purpose of the Study:

• To examine diverse civilian and military trauma system integration models worldwide.
• To identify common facilitators and barriers to successful integration.
• To inform strategies for enhancing trauma care in LMICs.

Main Methods:

• A case series approach was employed.
• Subject matter experts were identified using convenience sampling.
• Data on historical context and outcomes of collaborations were collected and iteratively coded.

Main Results:

• Eight case studies (five country-specific, three international partnerships) were analyzed.
• Key integration drivers included history of conflict, geography, and military physician skill maintenance.
• Strong government support was crucial for success, while financial constraints posed the biggest obstacle.

Conclusions:

• Global approaches to civilian-military trauma system integration show consistent motivators and barriers.
• Successful integration requires high-level government backing and effective financial management.
• Further investigation into integration strategies is essential, particularly within LMICs.