Challenges in the organization of the emergency care units in Skopje
Date Issued
2019
Author(s)
Pangovski, Ivan
Mehmedoviкј, Zlate
Hasani, Shpresa
Abstract
Background: Emergency ambulance care is regulated at national level, where services are
provided manly at the public health centers with free access to all, as integrated care consists
of ambulance services, home visits and night shifts services.
Aim: This study provides an evaluation of emergency medicine preparedness, national
response plan to manage health threads and outlines the current demands on the health care
system. Methods: Retrospective analysis on patient's medical records was conducted to
review emergency care, including ambulance services provided on the territory of the capital
city, Skopje. Operational, human resources capacity, availability and time response were the
assessed outcome measures, compared with community needs and national operational
minimum standards for care, equipment and qualifications.
Results: In our study we have analyzed 181785 medical records of provided integrated
ambulance services per 700,000 inhabitants in 2018, recorded by the Health Center. The
average rate of emergency calls per day was 88, out of which 22 were level 1 emergency,
with response time of 36 minutes. The delay in time response is the result of lack of
operational and human resources. According to the population there should be minimum of
100 teams, but the public emergency units have only 28 teams with total of 57 medical
doctors and 11 emergency vehicles, out of which, two type A for patient transport and nine
emergency ambulances type B. Conclusion: Enhancing the capacity of emergency and
ambulance care is an important demand on the health care system in order to meet
community and local needs. Introducing a paramedic workforce in the ambulance services
and collaboration with social and mental health teams to improve access and quality of
services are proposed interventions.
provided manly at the public health centers with free access to all, as integrated care consists
of ambulance services, home visits and night shifts services.
Aim: This study provides an evaluation of emergency medicine preparedness, national
response plan to manage health threads and outlines the current demands on the health care
system. Methods: Retrospective analysis on patient's medical records was conducted to
review emergency care, including ambulance services provided on the territory of the capital
city, Skopje. Operational, human resources capacity, availability and time response were the
assessed outcome measures, compared with community needs and national operational
minimum standards for care, equipment and qualifications.
Results: In our study we have analyzed 181785 medical records of provided integrated
ambulance services per 700,000 inhabitants in 2018, recorded by the Health Center. The
average rate of emergency calls per day was 88, out of which 22 were level 1 emergency,
with response time of 36 minutes. The delay in time response is the result of lack of
operational and human resources. According to the population there should be minimum of
100 teams, but the public emergency units have only 28 teams with total of 57 medical
doctors and 11 emergency vehicles, out of which, two type A for patient transport and nine
emergency ambulances type B. Conclusion: Enhancing the capacity of emergency and
ambulance care is an important demand on the health care system in order to meet
community and local needs. Introducing a paramedic workforce in the ambulance services
and collaboration with social and mental health teams to improve access and quality of
services are proposed interventions.
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