title: Changing models of care for emergency surgical and trauma patients in Singapore.
abstract: The last 15 years have seen changing patterns of injury in emergency surgery and trauma patients. The ability to diagnose, treat and manage these patients nonoperatively has led to a decline in interest in trauma surgery as a career. In addition, healthcare systems face multiple challenges, including limited resources, an ageing population and increasing subspecialisation of medical care, while maintaining government-directed standards and managing public expectations. In the West, these challenges have led to the emergence of a new subspecialty, 'acute care surgery', with some models of care providing dedicated acute surgical units or separating acute and elective streams with the existing manpower resources. The outcomes for emergency surgery patients and efficiency gains are promising. In Singapore, Khoo Teck Puat Hospital has implemented its first dedicated acute surgical unit. This article outlines the evolution of acute care surgery and its relevance to Asia.
authors.affiliation: Department of Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Sachin
authors.initials: S
authors.lastname: Mathur
authors.affiliation: Department of Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Tiong Thye
authors.initials: TT
authors.lastname: Goo
authors.affiliation: Department of Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: T'zu Jen
authors.initials: TJ
authors.lastname: Tan
authors.affiliation: Department of Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Kok Yang
authors.initials: KY
authors.lastname: Tan
authors.affiliation: Department of Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Kenneth Seck Wai
authors.initials: KS
authors.lastname: Mak
mesh_terms: D003422:Critical Care / Q000639:trends*; D004635:Emergency Medicine / Q000639:trends*; D006284:Health Plan Implementation; D006302:Health Services Research; D006761:Hospitals; D006801:Humans; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D010820:Physicians; D012846:Singapore; D014193:Trauma Centers / Q000458:organization & administration; D014947:Wounds and Injuries / Q000601:surgery*
keywords: acute care surgery; emergency surgery; models of care; trauma