Public Health and Preventive Medicine

doi: 10.25005/2074-0581-2018-20-1-42-46
CURRENT PROBLEMS OF INTEGRATION WORK OF THE DUSHANBE AMBULANCE SERVICE WITH CITY HEALTH CENTERS, NURSING CARE HOSPITAL AND OTHER PROFILE SERVICES

B.G. Muminzoda1, F.Kh. Mirzoev2

1Department of Public Health, Economics and Health Management with the Course of Medical Statistics, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
2Central Substation, Dushanbe Emergency Care Center

Objective: Examining issues of continuity of the ambulance service (AS) with primary health care, Nursing Care Hospital and other profile services.

Methods: An analysis of the activities of the AS station, Nursing Care Hospital, city health centers, large hospitals were carried out. The materials of the Traffic Police Department of Dushanbe were used in the victims of road accidents, as well as the existing normative legal acts and regulating the activities of the Ambulance Medical Care.

Results: The need for medical social assistance (hospital stage) increased 4 times. Number of AS calls in the working hours health centers increased by 45.3%. The number of patients, who died in an accident before the arrival of AS, due to the lost "golden hour", was 13.9%.

Conclusion: Rational use of the possibilities of the Nursing Care Hospital, Health Centers, the extension of the bed fund for medico-social care, and the adoption of a number of integrated measures a legislatively and organized nature, including measures at reducing fragmentation of health care can significantly reduce the load on the ambulance.

Keywords: Ambulance service, integration of ambulance service, Nursing Care Hospital, city health centers, profile services.

Download file:


References
  1. Bagnenko SF, Miroshnichenko AG, Alimov RR, Barsukova IM, Bumay AO, Korbut DL, i dr. Normativno-pravovoe regulirovanie okazaniya skoroy meditsinskoy pomoshchi [Regulatory and legal regulation of emergency medical care]. Skoraya meditsinskaya pomoshch. 2013;1:19-23.
  2. Muminov BG, Mirzoeva ZA. Sostoyanie i perespektiva integratsionnykh rabot vrachey skoroy meditsinskoy pomoshchi i semeynykh vrachey v Respublike Tadzhikistan [Status and perspective of the integration work of emergency medical doctors and family doctors in the Republic of Tajikistan]. Vestnik Avitsenny [Avicenna Bulletin]. 2011;4:144-7.
  3. Bondarenko NB, Krasilnikova DN, Chirikov AE, Sheyman IM, Shishkin SV. Rasshirenie potrebitel’skogo vybora v zdravookhranenii: teoriya, praktika, perspektivy [Extension of consumer choice in health care: theory, practice, prospects]. Moscow, RF: ID VshE; 2012. 262 p.
  4. Sharabchiev YuT, Dudina TV. Dostupnost’ i kachestvo meditsiskoy pomoshchi: slagaemye uspekha [Availability and quality of medical care: components of success]. Klinicheskaya praktika i zdorov’e. 2013;4:16-34.
  5. Mikhalevich PN, Sheshko VF. Preemstvennost’ raboty vracha obshchey praktiki v sel’skoy mestnosti s sel’skimi meditsinskimi organizatsiyami [Continuity of the GP practice in rural areas with rural medical organizations]. Vestnik VGMU. 2008;7(3):1-6.
  6. Gress S, Baan CA, Calnan M, Dedeu T, Groenewegen P, Howson H, et al. Coordination and management of chronic conditions in Europe: the role of primary care – position paper of the European Forum of Primary Care. Qual Prim Care. 2009;17(1):75-86.
  7. Magnussen J, Vrankbæk K, Saltman RB. (eds) Nordic health care systems. Recent reforms and current policy challenges. Berkshire, UK: Open University Press; 2009. 339 p.
  8. Bodenheimer T, Pham H. Primary care: current problems and proposed solutions. Health Affairs. 2010;29:799-805.
  9. Bitran R, Escoba L, Gassibe P. After Chile's health reform: increase in coverage and access, decline in hospitalization and death rates. Health Affairs. 2010; 29:2161-70.
  10. Boult C, Counsell S, Leipzig R, Berenson R. The urgency of preparing primary care physicians to care for older people with chronic condi-tions. Health Affair. 2010;29:811-8.
  11. Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: conver-gence of two epidemics. Lancet Infect Dis. 2009;9:737-46.
  12. Sbornik pokazateley lechebno-profilakticheskikh uchrezhdeniy g. Dushanbe za period 2011-2016 g.g. [Compendium of indicators of treat-ment and prevention institutions in Dushanbe for the period 2011-2016]. Dushanbe, RT: MZ RT; 2017. 71 p.
  13. Sbornik pokazateley lechebno-profilakticheskikh uchrezhdeniy g. Dushanbe za period 1998-2010 g.g. [Compendium of indicators of treat-ment and prevention institutions in Dushanbe for the period 1998-2010]. Dushanbe, RT: MZ RT; 2011. 112 p.
  14. Badirov ShSh. Neobosnovannye vyzovy skoroy meditsinskoy pomoshchi [Unreasonable calls for emergency medical care]. Vestnik Almatinskogo gosudarstvennogo instituta usovershenstvovaniya vrachey. 2013;2:86-8.
  15. Barsukova IM, Miroshenko AG, Kiselgof OG, Bumay OA. Statistika dorozhno-transportnykh proisshestviy v rabote skoroy meditsinskoy pomoshchi v Rossiyskoy Fedratsii [Statistics of road and transport incidents in the work of emergency medical care in the Russian Federation]. Skoraya meditsinskaya pomoshch. 2014;2:4-13
  16. Kodeks zdravookhraneniya Respubliki Tadzhikistan [Health Code of the Republic of Tajikistan]. Dushanbe, RT: MZ RT; 2017. 191 p.

Authors' information:


Muminzoda Bobodzhon Gafor,
Candidate of Medical Sciences, Doctoral Candidate of the Department of Public Health, Economics and Health Management with the Course of Medical Statistics, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan

Mirzoev Fatkhullo Khayrulloevich,
Head of the Central Substation, Center for Emergency Medical Care of Dushanbe

Conflicts of interest: No conflict

Address for correspondence:


Muminzoda Bobodzhon Gafor

Candidate of Medical Sciences, Doctoral Candidate of the Department of Public Health, Economics and Health Management with the Course of Medical Statistics, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan

734026, Republic of Tajikistan, Dushanbe, Somoni Ave., 59/1

Tel.: (+992) 918 632252

E-mail: muminov_bobokul@inbox.ru

Materials on the topic: