CC BY
10https://doi.org/10.32921/2225-9929-2020-4-39-54-58
Short Communication
The Results of Analysis of Emergency Care Travels in Nur-Sultan city in 2016-2019
Chayakova Akerke 1, Utegenova Aigul 2, Ausra Berzanskyté3
1 Chief Specialist of the Research Center, Astana Medical University, Nur-Sultan, Kazakhstan. E-mail: Chayakova.a@amu.kz
2 Chief Specialist of the Research Center, Astana Medical University, Nur-Sultan, Kazakhstan. E-mail: Utegenova.a@amu.kz
3 Assistant of the Faculty of Public Health, Institute of Public Health, Vilnius University, Lithuania. E-mail: ausra.berzanskyte@mf.vu.lt
Abstract
The aim of the study is to analyze trends in the structure of emergency medical services in Nur-Sultan city in 2016-2019.
Methods. We took the data from electronic resources of various state medical institutions of the Republic of Kazakhstan. We conducted an analysis of trends in the structure of emergency medical services in Nur-Sultan (2016-2019). We applied a statistical method for calculating a number of dynamics.
Results. Analysis of the data obtained showed that more than 4% of calls to Nur-Sultan emergency medical services are unsuccessful, which is higher than the indicator for the Republic of Kazakhstan (3%). The maximum number of rejected calls for unjustified reasons was recorded in 2018 (73 units) compared to 2017 and the growth rate was 82%.
Conclusions. The problem of unsuccessful emergency medical services is relevant and can cause significant financial costs.
Keywords: ambulance, visits, requests for emergency medical care, Kazakhstan.
2016-2019 жылдар аралыгында Нур-Султан каласында жедел медициналык кемектщ шыгуын
талдау нэтижеЫ
Чаякова А.М.1, Утегенова А.М.2, Ausra Berzanskyte 3
1 FbrnbiMU-3epmmey орталыгыныц бас маманы, Астана медициналынyHueepcumemi, Нур-Султан, Цазанстан
2 FbWbiMU-3epmmey орталыгыныц бас маманы, Астана медициналын yHueepcumemi, Нур-Султан, Цазанстан
3 Цогамдын денсаулын институтыныц ногамдын денсаулын сантау факyльmemiнih| аccucmeнmi, Вильнюс
yнuвepcumemi, Литва
Тушндеме
Зерттеудщ мацсаты: 2016-2019 жылдарга арналган Нур-Султан наласына жедел медициналын жэрдем шыгуларыныц нуурылымына натысты Ypдicmepдi талдау болып табылады.
ddicmepi. Деректер Цазанстан Республикасы эpmYpлi мeмлeкemmiк медициналын мекемеле^^ц электрондын ресурстарынан алынды. Бiз Нур-Султан наласы жедел медициналын жэрдем шыгуларыныц нуурылымына натысты Ypдicmepдi талдауды ЖYpгiздiк (2016 - 2019 жж.). Бipнаmаp динамиканы eceпmeyдiц статистикалын эдici нолданылды.
Нэтижелер. Алынган дepeкmepдi талдау Нур-Султан наласына жедел медициналын жэрдем шаныруларыныц 4%-дан астамы нэтижеаз eкeнiн Kepcemmi, бул Республика бойынша керсетюштен жогары (3%). Нeгiзciз себептермен набылданбаган ноцыраулардыц ец жогары децгей 2018 жылы (73 бipлiк) байналды жэне 2017 жылмен салыстыргандагы есу нарныны 82% нурады.
Цорытынды. Жедел медициналын кемек^ц нэтижеаз шыгу проблемасы езет жэне eлeyлi наржылын шыгындардыц себе& болып табылады.
Туйн свздер: жедел медициналын кемек, жедел жэрдем шаныру саны, жедел медициналын кемекке жс/^ну, Цазанстан.
О результатах анализа выездов скорой медицинской помощи в г. Нурсултан за 2016-2019 гг.
Чаякова А.М.1 , Утегенова А.М.2, Ausra Berzanskyte 3
1 Главный специалист исследовательского центра, Медицинский университет Астана, Нур-Султан, Казахстан
2 Главный специалист исследовательского центра, Медицинский университет Астана, Нур-Султан, Казахстан
3 Ассистент факультета общественного здравоохранения Института общественного здравоохранения,
Вильнюсский университет, Литва
Резюме
Целью исследования является анализ тенденций в отношении структуры выездов скорой медицинской помощи в г. Нур-Султан за 2016-2019 гг.
Методы. Данные были взяты из электронных ресурсов различных государственных медицинских учреждений РК. Нами был проведен анализ тенденций в отношении структуры выездов скорой медицинской помощи г. Нур-Султан (2016 - 2019 гг.). Был применен статистический метод расчета ряда динамики.
Результаты. Анализ полученных данных показал, что более 4% вызовов в г. Нур-Султан скорой медицинской помощи являются безрезультатными, что выше показателя по Республике Казахстан (3%). Максимальный уровень отклоненных звонков по необоснованным причинам был отмечен в 2018 году (73 единицы) по сравнению с 2017 годом и темп роста составил 82%.
Выводы. Проблема безрезультатных выездов скорой медицинской помощи актуальна и могут является причиной ощутимых финансовых затрат.
Ключевые слова: скорая медицинская помощь, выезды, обращения за скорой медицинской помощи, Казахстан.
Corresponding author: Chayakova Akerke, Chief Specialist of the Research Center, Astana Medical University, Nur-Sultan,
Kazakhstan.
Postal code: Z01C1E7
Address: Beybitshilik Str, 49 / A
Phone: +7 7172 539424
E-mail: Chayakova.a@amu.kz
J Health Dev 2020; 4 (39):54-58 UDC 614.88:004-047.58 Recieved: 02-12-2020 Accepted: 15-12-2020
This work is licensed under a Creative Commons Attribution 4.0 International License
Introduction
WHO, at the seventy-second world health Assembly, emphasized that the effectiveness of the emergency care system ensures prompt care for patients with urgent conditions even before diagnosis, ensuring continuity of medical care and a safe transition for the patient's health from the primary to the secondary level of the health system [1].
Emergency medical services are a special type of activity of the national health care system. The prospect of changes in the main socio-demographic and health indicators of the population depends on the effectiveness of emergency medical services. However, the functioning of the emergency medical service is associated with a number of problems [2]. In recent years, the number of calls has increased significantly and their structure has changed, which significantly affects the quality of medical care.
Nowadays 18 independent ambulance stations provided emergency medical care to the population of the Republic of Kazakhstan (RK), 261 units - emergency departments that are part of other organizations.
In the system of emergency medical care (EMC) of the Republic of Kazakhstan, 168 units are medical teams, 52 pediatric ones. Paramedic brigades prevail in 1817 units, which occupy 89% of the total share of general field brigades.
Of particular interest in the structure of emergency medical care, we are concerned with unsuccessful visits and rejected for unsubstantiated calls, which affect the quality of EMC services and slow down the work of the service.
Unsuccessful trips are cases when the patient was not on the spot, the call was false (the address specified during the call was not found, the patient was practically healthy and did not need help) or when the victim died before the arrival of the ambulance team, etc.
An unjustified call is considered one in which, in addition to diagnostic methods of examination, the EMC team did not provide significant assistance [3].
Currently, the activity of emergency medical services is regulated by the order of the Minister of health of the Republic of Kazakhstan dated in July 3, 2017 No. 450 «On approval of the rules for providing emergency medical care in the Republic of Kazakhstan» (as amended on 08.01.2018).
Emergency medical care is one of the most expensive types of care [4].
In the structure of financial expenditures for the main types of medical care, emergency medical care accounts for 4%, outpatient care - 26.7%, inpatient care-22%, inpatient replacement forms - 2.4%.
The presence of unsuccessful visits indicates that emergency medical teams perform unusual functions, which undoubtedly reduces economic efficiency and increases the load on staff.
In accordance with the regulations of the Ministry of health the ambulance service works round the clock, providing emergency care for adults and children, both on scene and route to the hospital for conditions that threaten the health or life caused by sudden diseases, accidents, poisonings and injuries requiring emergency or urgent medical intervention [5]. Accordingly, in this way, unsuccessful departures is a call that is made to a patient who does not actually need assistance in the emergency, urgent or urgent care defined in the decree.
Thus, it is necessary to carry out targeted work to reduce the number of unsuccessful trips and rejected for unsubstantiated calls.
The aim of the study. Analysis of trends in the structure of emergency medical services in Nur-Sultan city in 2016-2019.
Material and Methods
We conducted a retrospective analysis of emergency medical services in Nur-Sultan for 2016-2019. We used a statistical method to calculate a number of dynamics. The sources were the reports the MH of the RK on «Health of population of the Republic of Kazakhstan
and activity of healthcare organizations in 2019». Also data from the National Health Account of the Republic of Kazakhstan: Review of healthcare expenditures for 2018, Republican center for health development, Nur-Sultan.
Results and Discussion
In the city of Nur-Sultan, unsuccessful trips are on average twice as much as in the Akmola region. In both cases, the maximum increase in unsuccessful departures calculated in 2018. However, the number of rejected calls in Nur-Sultan is much lower, which shows the effectiveness of the dispatcher service on the spot.
The collected factual material is presented in tables 1,2,3.
Totally in RK for 2016 year realized 7 583 959 visits, in 2017 - 7 439 092 visits in 2018 - 7 524 062 and 2019 - 7 838 544 visits, respectively. Of these, unsuccessful departures in 2016 amounted to 178.546 visits, in 2017165.475 visits were completed, in 2018 - 156.614 and in 2019 - 201.888 visits. In the Republic of Kazakhstan, the maximum number of unsuccessful visits executed in 2019.
Thus, more than 4% of calls to Nur-Sultan emergency medical services are unsuccessful, which is higher than in the Republic (RK-3%).
Table 1. Number of emergency medical service calls in Nur-Sultan for 2016-2019
Calls Amount % of the total number
2016 2017 2018 2019 2016 2017 2018 2019
Total
Akmola region 246878 264006 241 535 255 734 3.3 3.5 3.2 3.3
Nur-Sultan city 433851 506160 552 173 583 561 5.7 6.8 7.3 7.4
Denied for unsubstantiated calls
Akmola region 569 484 276 565 0.2 0.2 0.1 0.2
Nur-Sultan city 99 89 162 77 0.02 0.02 0.03 0.01
Unsuccessful visits
Akmola region 5223 4406 5 346 5 262 2.1 1.7 2.2 2.1
Nur-Sultan city 23856 22317 26 840 27 486 5.5 4.4 4.9 4.7
The maximum rate of rejected calls for unfounded this figure was 77, which shows a minimal increase and reasons was noted in 2018. It increased by 73 units a downward trend. compared to 2017 and the growth rate was 82%. In 2019,
99
+33351 23355 23356
HTotal C Denied for unsubstantiated ca s Unsuccessfu visfe
Figure 1. Comparative indicators of Denied for unsubstantiated calls and Unsuccessful visits in Nur-Sultan city
for 2016-2019
Table 2-Chain indicators of a number of dynamics of rejected calls for unjustified emergency medical services in Nur-Sultan for 2017-2018
Year Refused for unsubstantiated calls Absolute increase Growth rate, % Growth pace, % Absolute content of 1% increase Build-up rate, %
2016 99 0 0 100 0.99 0
2017 89 -10 -10 90 0.99 -10
2018 162 73 82 182 0.89 82
2019 77 -85 -52 48 1.62 -52
Unsuccessful visits in 2016 amounted to 23.856, growth rate was not observed. in 2017 this figure decreased to 22,317, respectively, the
Table 3. Chain indicators of a number of dynamics of unsuccessful emergency medical services in Nur-Sultan for 2017-2018
Year Unsuccessful visits Absolute increase Growth rate, % Growth pace, % Absolute content of 1% increase Build-up rate, %
2016 23 856 0 0 100 238.56 0
2017 22 317 -1 539 -6 94 238.56 -6
2018 26 840 4 523 20 120 223.17 20
2019 27 486 646 2 102 268.4 2
In 2018 compared to 2017, the number of unsuccessful departures increased by 4.523 and the growth rate was 20%. In 2019, unsuccessful visits amounted to 27.486, which shows the maximum increase, and over the past period increased by 646. The growth rate was 2%.
The growth rate shows that the maximum increase in unsuccessful departures was in 2018, and then there is a downward trend, which indicates a slowdown in growth.
The problem of unsuccessful emergency medical services is relevant and can cause significant financial costs.
Conclusion
Thus, in order to optimize the work of the EMC service, we concluded that it is necessary to conduct preventive conversations with the population about moral and legal issues related to medical care, as well as about
the rules for calling an ambulance, which could reduce the total number of unsuccessful visits by ambulance teams and refused calls for unreasonableness.
References
1. Seventy-second World Health Assembly. World Health Organization, 2020. Website. [Cited 30 Oct 2020]. Available from URL: https://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_JOUR1-en.pdf.
2. Moskvicheva M.G., Krermlev S.L., Schepilina E.S. The Development of Emergency Medical Care in the Russian Federation: Analysis of Normative Legal Regulation. Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny, 2018; 26(4): 226-229.
3. Приказ Министра здравоохранения Республики Казахстан. Об утверждении форм, предназначенных для сбора административных данных субъектов здравоохранения: утв. 6 марта 2013 года, № 128.
Prikaz Ministra zdravookhraneniia Respubliki Kazakhstan. Ob utverzhdenii form, prednaznachennykh dlia sbora administrativnykh dannykh sub»ektov zdravookhraneniia (Order of the Minister of Health of the Republic of Kazakhstan. On the approval of forms intended for the collection of administrative data of healthcare entities) [in Russian]: utv. 6 marta 2013 goda, № 128.
4. Шляфер С.И. Организация работы скорой медицинской помощи в Российской Федерации, результаты приема годовых статистических отчетов за 2008 год // Социальные аспекты здоровья населения. - 2009. -Т. 11. - №3.- C.1-6.
Shliafer S.I. Organizatsiia raboty skoroi meditsinskoi pomoshchi v Rossiiskoi Federatsii, rezul'taty priema godovykh statisticheskikh otchetov za 2008 god (Organization of emergency medical care in the Russian Federation// Results of receiving annual statistical reports for 2008) [in Russian]. Sotsial'nye aspekty zdorov'ia naseleniia, 2009; 11(3):1-6.
5. Приказ Министра здравоохранения и социального развития Республики Казахстан. Об утверждении Правил оказания стационарной помощи в Республике Казахстан: утв. 29 сентября 2015 года, № 761.
Prikaz Ministra zdravookhraneniia i sotsial'nogo razvitiia Respubliki Kazakhstan. Ob utverzhdenii Pravil okazaniia statsionarnoi pomoshchi v Respublike Kazakhstan (Order of the Minister of Health and Social Development of the Republic of Kazakhstan. On approval of the Rules for the provision of inpatient care in the Republic of Kazakhstan) [in Russian]: utv. 29 sentiabria 2015 goda, № 761.
