Emergency care in cross-border settings: a scoping review

Abstract

Emergency Medical Services (EMS) have developed from a war context into a complex scenario of rapid urbanization and great interconnectivity, which includes cross-border areas. Specificities of these areas are underrepresented in studies about EMS. The aim of this work is to provide a better comprehension of emergency care in cross-border settings. A qualitative scoping review was performed in three major databases of interest, where 29 works matched the inclusion strategy and underwent thematic analysis. Results show a consistent growing interest in this topic, even though the term ‘cross-border’ remains as a multidisciplinary approach with lack of clarity in its definition. These studies are more frequent in the European Union due to the ‘borderless’ discourse and practices, and in other specific cases, such as the US-Mexico border, building a dominant perspective from the Global North. Frequent challenges that cross-border EMS face are linguistic and sociocultural barriers, high complexity in the legal and institutional framework, financial issues, lack of standardization in recognition of professional skills, lack of interoperability of cross-border data, problems in emergency communication and missing consensus in concepts and practices. Despite all these difficulties, multiple advantages are perceived and documented, as better patient and social outcomes, increased efficiency on the utilization and management of resources, reduction on delayed responses and undertreatment, better quality of the provided services, higher patient satisfaction, creation of synergies of shared responsibilities in border areas which are usually perceived as peripheral and improvement in public health preparedness and emergency responses.