TY - JOUR T1 - Achieving affordable critical care in low-income and middle-income countries JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2019-001675 VL - 4 IS - 3 SP - e001675 AU - Hugo C Turner AU - Nguyen Van Hao AU - Sophie Yacoub AU - Van Minh Tu Hoang AU - David A Clifton AU - Guy E Thwaites AU - Arjen M Dondorp AU - C Louise Thwaites AU - Nguyen Van Vinh Chau Y1 - 2019/06/01 UR - http://gh.bmj.com/content/4/3/e001675.abstract N2 - Summary boxImproving the quality and availability of critical care is essential for reducing the burden of preventable deaths in low-income and middle-income countries.The conventional high-income country model, based on resource-intensive intensive care units with expensive monitoring and supportive equipment and large numbers of highly trained staff, is unlikely to be suitable for these settings.Currently, costs severely restrict access to critical care in low-income and middle-income countries, and there is an urgent need to develop an alternative affordable critical care model for these settings.Innovative technology and digital health may offer part of the solution and enable the development of an affordable, sustainable and scalable model of critical care in resource-limited settings.In 2016, an estimated 8.6 million premature deaths occurred in low-income and middle-income countries (LMICs) from causes that ‘should not occur in the presence of timely and effective healthcare’. Improving the quality and availability of critical illness care in LMICs is essential if this burden is to be reduced,1 2 and even more important over the coming years as populations age and the prevalence of comorbidities, such as cardiovascular disease and diabetes, increase.1Currently, capacity for critical illness care in many LMICs3–5 is limited. In high-income countries, there are generally between 5 and 30 intensive care unit (ICU) beds per 100 000 people.2 3 The limited data available indicate that in LMICs, there are between 0.1 and 2.5 ICU beds per 100 000 people. Many countries are also transitioning from low to lower–middle income status, receiving less international healthcare aid6 which may limit resources available for expanding capacity. While, the expansion of private healthcare systems in LMICs may partly meet the increased demand, the quality of care delivered by such providers is variable and will be unaffordable for many.2 7Careful physiological … ER -