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SUMMARY
Chile is uniquely situated to be a leader in South
American development of the specialty of Emergency
Medicine. Chilean emergency medicine has successfully
transitioned from a novelty training idea to a nationally
and internationally recognized entity with serious
public health goals. There are more residency training
programs in Chile than in any other South American or
Latin American country, and the specialty is formally
recognized by the Ministry of Health. Chilean emergency
medicine thought leaders have networked internationally
with multiple groups, intelligently used outside resources,
and created durable academic relationships. While
focusing on locally important issues and patient care they
have successfully advanced their agenda. Despite this, the
specialty faces many new challenges and remains fragile
but sustainable. Policy makers and the Chilean MOH
need to be acutely aware of this fragility to preserve the
progress achieved so far, and support ongoing maturation
of the specialty of Emergency Medicine.
Key words: Emergency medicine, history, residency
programs.
BACKGROUND AND OVERVIEW
The Republic of Chile is a country of over 17 million people
with 85% of the population living in urban settings.
Almost half of the population lives in the greater Santiago
metropolitan region and the area around Viña del Mar directly
west of Santiago. The country is a democratic republic,
economically stable, and resource rich (copper, agriculture,
viticulture and wine production, fisheries, and tourism) (1).
The population of Chile is aging rapidly and growing at a rela-
tively slow pace with geriatric considerations prominent in
long term medical and economic planning for the country.
Fifteen percent of the country is age 60 or greater (2). Cathol-
icism is the main religion with relatively small groups of other
Christians, Mormons, Jews, and Muslims. While private hospi-
tals exist that accept private insurance, most Chileans use the
public hospital system for emergent care.
Chile hosts a national public health care program called
FONASA (National Health Fund) which has four levels of fund,
according to the affiliate’s economic level and which serves
over 80% of the population. Private insurance, which is more
comprehensive, is available for those who can afford it. It is
called ISAPRES and covers about 15% of Chileans. Workers’
compensation insurance is also nearly universal, and all
employers make contributions to public healthcare funding.
A military health care system with hospitals also exists. Thus,
there is near universal coverage of the Chilean population,
but it is not a single payor system. The nation spends less
than 10% of its GDP on health and yet it has maintained
excellent WHO health statistics (ranks number 33 in the
year 2000) all of which is a tribute to the general overall
[REV. MED. CLIN. CONDES - 2017; 28(2) 163-169]
THE SPECIALTY OF EMERGENCY
MEDICINE IN CHILE:
20 YEARS OF HISTORY
MALLON WK (1), VALENZUELA R (1), SALWAY RJ (1), SHOENBERGER JM (2), SWADRON SP (2)
(1) Professor of Emergency Medicine, Stony Brook University School of Medicine. Director, Division of International Emergency Medicine
Department of Emergency Medicine. New York, USA.
(2) Keck School of Medicine of University of Southern California, Department of Emergency Medicine, Los Angeles, CA. USA.
Email:
wkmallonmd@gmail.comArtículo recibido: 02-01-2017
Artículo aprobado para publicación: 03-03-2017