Реформування системи екстреної медичної допомоги постраждалим на ранньому госпітальному етапі

Abstract

Objective. To determine the key trend of reformation of the system of the emergent medical help to the injured persons on early hospital stage. Маterials and methods. The systemic analysis, including a bibliographical one, semantic and economic methods of investigation, as well as organization of the medical help delivery to the injured persons in USA. Results. The system of the emergency medical help delivery to the injured persons is based on the trauma centers net. Treatment of the injured persons, suffering severe trauma in the centers of trauma is by 40 – 60% more effective and by 50 – 60% more cost – effective, than in surgical/traumatological departments of the national Medical Health Service. The system of Emergency Medical Help for injured persons on early hospital stage in Ukraine demands organization of no less than 30 Centers of Trauma of the level І on the base of the University Regional Hospitals and in the cities with more than 1 million of inhabitants; approximately 200 the Level II Centers of Trauma on the base of multidisciplinary hospitals for intensive treatment of the second level and 300 the Level III trauma centers on the base of multidisciplinary hospitals for intensive treatment of the first level. Complete need for Ukraine constitutes 530 Centers of Trauma. Conclusion. The system for the Emergency Medical Help Delivery to the injured persons must be based on the net of the Trauma Centers of a certain level. The trauma centers organization needs some preliminary work to do: to study the traumatism indices, analysis of the regional need in medical help delivery and depicting of the National Trauma Registry. Trauma Centers in Ukraine is expedient to create on the base of the university regional hospitals, multidisciplinary hospitals of intensive therapy and hospitals of urgent medical help. Possibility of inclusion to the medical help delivery of such specialists, as a surgeon, anesthesiologist, traumatologist and neurosurgeon, constitutes an obligatory element of the trauma center organization. Financial support for the medical help delivery to the injured persons, suffering severe combined trauma, demands additional input of the nonbudget resources. Кeywords: trauma; еmergency medical help; early hospital stage; the trauma centre; оrganization.