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20 n 0 O IMPROVING UZBEKISTAN'S POSITION IN INTERNATIONAL RATINGS L U L 0 AND INDEXES: THEORY, PRACTICE, AND STRATEGY
CONSIDERATION OF SYSTEMS FOR ORGANIZING THE PROVISION OF EMERGENCY MEDICAL CARE IN VARIOUS COUNTRIES Akhmedova Dilafruz Tashpulat qizi
Assistant, Tashkent medical academy https://doi.org/10.5281/zenodo.10143356
Annotation. This article provides a brief description of existing emergency medical care (EMS) systems using the example of several countries. Also ways to improve the possibility of digitalizing the system of recording and recording data on patients in need of emergency medical care.
Keywords: primary health care system, emergency medical care, "golden hour" principle, digitalization of the data system.
Annotatsiya. Ushbu maqolada bir nechta mamlakatlar misolida mavjud shoshilinch tibbiy yordam (ShTY) tizimlarining qisqacha tavsifikeltirilgan. Shuningdek, shoshilinch tibbiyyordamga muhtoj bemorlar to'g'risidagi ma'lumotlarni hisobga olish vaqaydetish tizimini raqamlashtirish imkoniyatlarini takomillashtirish yo'llari.
Kalit so'zlar: birlamchi sog'liqni saqlash tizimi, shoshilinch tibbiy yordam, "oltin soat" tamoyili, ma'lumotlar tizimini raqamlashtirish.
Аннотация. В данной статье проводится краткое описание существующих систем оказания скорой медицинской помощи (СМП) на примере нескольких стран. Также пути улучшения возможности цифровизации системы учета и регистрации данных о пациентах, нуждающихся в скорой медицинской помощи.
Ключевые слова: первичная система здравоохранения, скорая медицинская помощь, принцип «золотого часа», цифровизация системы данных.
The development of humanity, the processes of globalization taking place in all spheres, qualitative and structural changes not only raise international cooperation and connections to a new level, but also call on every independent country to move forward together. And this is determined by the country's position on a global scale, its position in international rankings and indicators.
Today, innovative and creative work is being carried out at an accelerated pace. Naturally, the results of such transformations are reflected not only in the life of our people, but also in international ratings and indices. It should be noted that this is a mirror of such important aspects as the quality of government, the standard of living of the population, the protection of human rights, business activities and a favorable environment for foreign investors, sustainable economic growth and competitiveness. This reflects the essence of the reforms being carried out in our country. The reforms carried out in these directions in our country acquire an even deeper meaning and ensure the well-being of the people and a decent life for people.
An important guide in increasing the efficiency of the work carried out in this area was the Presidential Decree "On improving the positions of the Republic of Uzbekistan in international ratings and indices, as well as introducing a new mechanism for systematic work with them in government bodies and organizations" dated June 2, 2020.
- International ratings and indices are a tool accepted by the world community as the main condition for economic development in assessing the quality of the institutional environment in the world. They are used not only by experts, but also by states as a criterion for reforms and socioeconomic policy.
0 n 0 O IMPROVING UZBEKISTAN'S POSITION IN INTERNATIONAL RATINGS L U L 0 AND INDEXES: THEORY, PRACTICE, AND STRATEGY
the 2023 SDG Index , published by the Sustainable Development Solutions Network (SDSN) and international experts, Uzbekistan ranked 69th among 166 countries with an index of 71.1.
Uzbekistan improved its indicator by 8 points compared to 2022 , which allowed the country to rise from 77th place (index 69.9) to 69th place in the overall ranking.
According to the SDG Index report for 2023, Uzbekistan recorded positive growth in the following 10 indicators of the sustainable development goals:
— reduction of poverty in the country;
— promoting health and well-being;
— providing quality education;
— achieving gender equality;
— clean water and sanitation;
— industrialization, innovation and infrastructure;
— sustainable development of cities and towns;
— combating climate change;
— peace, justice and good governance;
— cooperation for sustainable development.
Today, telemedicine is developing in our country, more precisely, online clinic and online hospital systems, which makes a patient's appointment with a doctor more convenient and this avoids long lines at the doctor's office, test results can be obtained in a timely manner, etc.
At the same time, it is interesting how the emergency medical service is organized in our country and in foreign countries.
Uzbekistan took 55th place in the ranking of countries in terms of sustainable development indicators related to medicine, life and health, compiled by the authoritative medical magazine The Lancet .
The rating is based on a total assessment of 33 indicators, each of which was rated from 0 (lowest result) to 100. Among the selection criteria are overweight, level of alcohol consumption and smoking, child and infant mortality, mortality in road accidents, incidence of HIV, tuberculosis and hepatitis B.
Let's look at how emergency medical care works using the example of other countries.
The main number for calling emergency medical services in Russia is number 103 (call from landline and mobile phones).
In addition, there is number 112 - calls from mobile phones; works when the SIM card is blocked, in the absence of a SIM card, and also in the absence of funds on the phone account. Operators respond in both Russian and English.
After the dispatcher checks the address and phone number again, he will then report which team has been sent (ambulance or emergency medical care team) or switch to the doctor at the advisory console to clarify the situation.
After receiving a call to Service 103 and instantly processing the request at the Unified City Dispatch Center, the call is transferred to the ambulance or emergency medical team closest to the patient.
For an emergency call, the regulated time of arrival of an ambulance does not exceed 20 minutes, while ambulances are dispatched to an emergency call if there are no emergency calls in the service area.
0 n 0 O IMPROVING UZBEKISTAN'S POSITION IN INTERNATIONAL RATINGS L U L 0 AND INDEXES: THEORY, PRACTICE, AND STRATEGY
For the arrival of emergency medical teams, the standard is 120 minutes, but it should be noted that this is the maximum waiting time for the team.
The problem of accessibility and access of the ambulance team to the patient is one of the most important in our work. Ambulances are equipped with blue flashing lights and a specialized sound signal, which allows them to have priority on city highways.
The responsibility for choosing the team that will be sent to the patient is the medical staff of the operational department, which receives and sorts calls according to the validity, urgency and profile of the teams. The main task of the operational department specialists is to understand where to send the ambulance team first. Thanks to callers' answers to questions, dispatchers also draw conclusions about the need to send a specialized team. As a result, the call may be assigned the status of emergency or urgent. If urgent assistance from the team is not needed, the caller is connected with a senior doctor who gives recommendations for treatment.
In cases where emergency assistance is required and a person's life depends on the provision of immediate assistance by others, the call is registered by the dispatcher, and the caller may be transferred to a senior doctor to provide assistance over the phone until the ambulance arrives.
To call an emergency medical service in the USA, just dial the well-known telephone number "911". The organization of the work of the American ambulance is fundamentally different from the Russian service "03". If Russian doctors, who often respond to calls for any, often not the most urgent, issue, should, if possible, provide qualified medical care at home, then their American colleagues perform mainly transportation functions - to stabilize the patient's condition and quickly take him to the nearest hospital.
As a rule, the medical team does not include a general practitioner and a paramedic. In the USA, a paramedic and a driver technician respond to a call. The tasks of the first include the practical provision of basic medical care, and the technician-driver is responsible for driving the carriage, loading and unloading the stretcher with the patient. At the same time, he must undergo special training to work in the emergency system, obtain the appropriate certificate and have a general understanding of medicine.
South Korea's emergency medical care system Korean ambulance has a three-level structure, each element of which performs specific functions. Regional Urgent Care Center, Tertiary (Level 1 Emergency Medical Care Institute) aims to treat critically ill patients in an optimal time frame when advanced medical technology and care are required. Currently, each region has one emergency medical care center. The local mid-level urgent care center (Level 2 Urgent Care Institute) is for emergency patients with moderate symptoms. The lowest level local urgent care center (Level 3 Emergency Medical Care Institute) oversees basic emergency and emergency medical care for minor patients. For such a system to operate effectively, all incoming patients must be evenly distributed according to the functions of a particular emergency medical care facility.
Now let's return to our country, consider what changes have taken place in recent years.
In the Republic of Uzbekistan, a unified system has been created to provide free emergency highly qualified medical care to the population, which includes the Republican Scientific Center for Emergency Medical Care, its regional branches and departments of district medical associations, which meets the highest requirements and international standards of the emergency medical service (EMS).
0 n 0 O IMPROVING UZBEKISTAN'S POSITION IN INTERNATIONAL RATINGS L U L 0 AND INDEXES: THEORY, PRACTICE, AND STRATEGY
Emergency medical care is provided to citizens free of charge in case of illnesses, accidents, injuries , poisoning and other conditions that require urgent medical intervention at the pre-hospital stage, and is an expensive type of care.
An important element of the operational work of emergency medical care is equipping emergency medical services stations with an automated control system for receiving and processing calls. From April 1, 2019, a pilot project in the city of Tashkent is expected to introduce an automated management system for receiving and processing EMS calls. Order of the Ministry of Health of the Republic of Uzbekistan No. 131 dated March 31, 2017 determined that the arrival time should not exceed 25 minutes. In 2018, 97.2% of departures were completed with a travel time of up to 20 minutes. The EMS service has developed and applied standards for the provision of emergency medical care.
In accordance with international requirements, the main indicators of the effectiveness of the EMS service are the availability, timeliness and rationality of its activities. In the world, the development of this service as a whole is characterized by the reform of all classical models in order to achieve a timely response to an emergency call, immediate medical care for patients and effective interaction between mobile ambulance teams and hospitals.
The indicator of timeliness or response of the EMS service according to international requirements must comply with the principles of the "golden hour" when the time before the arrival of the mobile team to the patient or victim should be less than 20 minutes.
In order to further improve the organization and provision of emergency medical care to the population of the republic, the formation of an organizational structure of the EMS service that meets modern requirements, provision of specialized vehicles and equipment, increasing the level of provision of visiting teams with medicines and medical products, as well as staffing with qualified medical personnel, a Decree was adopted (No.UP-4985 dated March 16, 2017) and resolutions (No.PP-2838 dated March 16, 2017, No.PP-3494 dated January 25, 2018 and No.PP-3973 dated October 16, 2018) of the President of the Republic of Uzbekistan .
The emergency medical service received 13 million 22 thousand 162 calls during 2022, the press service of the Ministry of Health of Uzbekistan reported. The number of hospitalizations during the year amounted to 1 million 180 thousand 416 people.
The most requests were received in Fergana region - 1,520,448, in Andijan - 1,415,023, in Tashkent - 1,280,242, in Tashkent region - 1,262,187, in Namangan - 1,227,318.
It is noted that there are many factors that negatively affect the activities of the emergency medical service. In particular, in most cases, medical teams cannot get to the place of the call on time, as it takes doctors time to find out the address and purpose of the call. This clearly puts the lives of seriously ill patients at risk.
Taking into account all these facts and the accelerated development of modern information technologies throughout the world, there are opportunities to digitalize the system for recording and recording patient data, in particular, creating a mobile application for online calling emergency medical care. Using such an application will reduce the time it takes to transfer patient data and the time it takes to organize the dispatch of an emergency medical team, which in turn can save the lives of many people.
Also, given today's congested roads, it is necessary to increase the priority movement of emergency medical vehicles, which helps reduce the time of arrival to the destination.
We assume that the application of the above proposals makes it possible to find the exact address and location of the patient and arrive promptly to provide emergency medical care, obtain
0 n 0 O IMPROVING UZBEKISTAN'S POSITION IN INTERNATIONAL RATINGS L U L 0 AND INDEXES: THEORY, PRACTICE, AND STRATEGY
more complete information about the patient, and also quickly hospitalize the patient in severe
cases and life-threatening conditions .
REFERENCES
1. Modern aspects of the development of emergency medical services in the Republic of Uzbekistan A.M. Khadzhibaev1, A.M. Sharipov2, D.T. S ultanov1, K.A. Khamzaev2, I.N. Aslonov1 - Shoshilinch tibbiyot axborotnomasi , 2019, volume 12, no. 1
2. On measures to improve the emergency medical service in the Republic of Uzbekistan: Decree of the President of the Republic of Uzbekistan No. PP-3973 dated October 16, 2018.
3. On measures to accelerate the improvement of the emergency medical care system: Decree of the President of the Republic of Uzbekistan No. pp-3494 dated January 25, 2018.
4. On improving the activities of the emergency medical care system: Decree of the President of the Republic of Uzbekistan No. 1114 of May 21, 2009.
5. https://ssv.uz/
