# The five-link theory for improving the integrated and balanced development of emergency medical care in urban and rural areas

## TL;DR

This paper introduces a five-link emergency care chain to reduce urban-rural disparities in emergency medical services in China.

## Contribution

The five-link theory provides a novel conceptual framework for integrated and balanced emergency care development.

## Key findings

- The five-link emergency care chain includes primary care points, township units, prehospital, in-hospital, and critical care.
- The framework aims to optimize structural coherence, response efficacy, and service equity in emergency medical systems.
- The model offers insights for global emergency medicine modernization and rural EMSS advancement.

## Abstract

Over the past decades, considerable advancements have been made in China's emergency medical service system (EMSS). The disparity in EMSS development between urban and rural areas in China continues to be a significant public health concern. It also represents a pressing challenge on a global scale. Implementing strategies to narrow the urban-rural gap in emergency care and achieve balanced EMSS development holds critical significance. Therefore, this viewpoint presents the conceptual framework of the five-link theory and the five-link emergency care chain. The five-link emergency care chain constitutes the ground-breaking conceptual framework systematically addressing persistent challenges in achieving urban-rural health care integration and equitable advancement of emergency medical services. This framework constitutes a comprehensive EMSS, encompassing five core operational components: village (community) primary emergency care points, township emergency care units, prehospital emergency care, in-hospital emergency care, and critical care. It is engineered to optimise structural coherence, response efficacy, and service equity within EMSS. With the advancement of the five-link emergency care chain model implementation, its theoretical framework continues to evolve. This integrated theory-practice paradigm offers Chinese insights and experience in advancing global emergency medicine modernisation. Establishing comprehensive theoretical frameworks guiding emergency care service optimisation at township and village levels is imperative to facilitate the advancement of rural EMSS and mitigate urban-rural disparities in emergency medical services capacity. The five-link theory, grounded in five-link emergency care chain practices, offers a valuable framework for advancing urban-rural coordination of emergency care and ensuring equitable distribution of emergency response resources.