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Study on Prehospital Emergency Medical Service System of Urban Based on Community Health Institutions

Author: LiuJun
Tutor: FangPengZuo
School: Huazhong University of Science and Technology
Course: Social Medicine and Health Management
Keywords: Word Community Health Services Pre-hospital emergency System
CLC: R197.2
Type: Master's thesis
Year: 2011
Downloads: 77
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Abstract

First aid equipment and facilities the status quo of our community health agencies hospital, community health workers pre-hospital emergency care skills self-assessment to grasp the extent of research purpose of this study, community patients pre-hospital care to know, pre-hospital emergency services and first aid knowledge and skills needs of the status quo , as well as the important role of community health institutions in the city pre-hospital emergency care system to understand the needs of the community health agencies ability and community of pre-hospital emergency patients on pre-hospital emergency services is proposed to improve the emergency medical service system of pre-hospital emergency feasible way that is to build community health agencies relying city pre-hospital emergency care system, and to make policy recommendations for the system, in order to protect the lives and safety of the masses at the same time, strengthen grassroots health institutions reactive, but also for the sudden health emergencies perfect health emergency system providing certain conditions. Research content and methods (1) through the literature search and intelligence analysis, collection of domestic and foreign literature about the system of pre-hospital emergency care and community health agencies as the basis of pre-hospital emergency system to understand the main city hospital, pre-hospital emergency medical service status, community health agencies to participate in the pre-hospital emergency situation and existing problems, provide the basis for the present study follow-up study. (2) mainly in the form of a survey, Hubei Province, Guangdong Province, eight community health service centers, first aid equipment and facilities with the status quo, health technical personnel structure, pre-hospital emergency care knowledge and skills to master status survey to understand sampling regional urban community health service institutions hardware facilities of pre-hospital emergency care, health workforce, pre-hospital emergency Abilities and the problems and difficulties; community patients with pre-hospital emergency cognitive demand investigation; Hospital prehospital emergency disease Hubei Province, Guangdong Province, four samples Hospital emergency department director interviews species, call location, emergency response time, emergency patient death situation. (3) the use of quantitative descriptive analysis, including chi-square test (Fisher's test), corresponding analysis of the status of our urban community health service institutions hospital before the first aid hardware equipped, health technical personnel structure, the hospital before the first aid skills of self-assessment and to grasp the degree, etc., and Logistic regression analysis of influencing factors of community health service organizations, health technicians working competence of pre-hospital emergency; (4) the use of a SWOT analysis, pointed out the advantages of building a system of community health agencies as the basis of pre-hospital emergency, weaknesses, opportunities and threats to build to support conditions framework of the system, and make policy recommendations to improve our city pre-hospital emergency care system. Research results (1) through the study of the literature found relatively sound development of foreign pre-hospital emergency mode, respectively, the Anglo-American model and the Franco-German model; domestic pre-hospital emergency late start, the relatively slow development of pre-hospital emergency types of organizational forms more, but it is far from perfect combination of community health services. 8 (2) survey of community health service institutions, two community health agencies have separate emergency department; 2 separate emergency department of community health agencies but emergency duty; 4 separate emergency department of community health agencies, but there are relatively independent Emergency workspace. First aid basic instrument of eight community health agencies with not complete, were not equipped ambulance. (3) sampling regional community health service centers investigating a total of 230 health workers, accounting for 57.6% of the total number of health workers in community health service centers surveyed. Survey of health technicians, education level, health technicians, college-based, accounting for 60.9%; titles mainly primary and below, 66.4%; accounted for only 1.3% of the proportion of the subtropical high and above the title; average age was 34.3 years old, 25-35 years old health technicians up to 53.3%. Visible, community health workers, education level, titles are relatively low, the younger age structure. (4) Survey of 230 health workers in eight community health agencies, the sampling area community health agencies and health technicians prehospital first aid awareness rate was 99.1%. 92.6% of the health workers Community health agencies necessary to carry out the the prehospital emergency work, only 3.0% of the health workers saw no need to. After Fisher's test that health workers gender (χ ~~ 2 = 23.156, P = 0.004), educational level (of χ ~~ 2 = 22.538, P = 0.006), titles (χ to 2 = 19.087, P = 0.025), age (χ ~ 2 = 19.852, P = 0.023) on the attitude of health workers, community health agencies to participate in the pre-hospital emergency work, there is a significant difference, statistically significant. (5) in the pre-hospital first aid skills to master aspects better grasp of the detection of vital signs, cardiopulmonary resuscitation and hemostasis cleaning and dressing of general wound, respectively accounted for 60.0%, 56.1% and 50.9%; mastered the poor fracture fixation techniques, treatment of acute poisoning with the use of first aid equipment, accounted for only 29.1%, 19.6% and 8.7%, respectively. An average of 71.7% of the health workers training needs of the basic pre-hospital first aid knowledge and skills, the more intense the training needs of the community health technicians on the basic knowledge and skills of pre-hospital emergency. (6) community health agencies surveyed patients, 58.0% of patients with community heard of pre-hospital care, 58.0% of patients with community do not understand the pre-hospital emergency services, only 2.5% of patients to understand the pre-hospital emergency services ; 60.5% of patients with community community health agencies can play a role in the pre-hospital care, 38.3% of patients with community is very important that the community health agency's role in the pre-hospital emergency, only 1.2% of patients believe that the role of ; 55.5% of patients with community to acknowledge the level of first aid skills of community health agencies. (7) in community health technicians prehospital emergency work competence, capable work of the pre-hospital emergency health technicians accounted for 28.3%, and that the pre-hospital emergency work competence in general accounted for 60.4% of that incompetent hospital before first aid accounted for 11.3%. Logistic regression analysis of influencing factors of community health agencies and health technicians prehospital emergency work competence, and found that the attitude of the health workers of gender, work experience, education level, and posts, pre-hospital emergency services tend to their pre-hospital emergency competence influential. (8) qualitative analysis of influencing factors of community health agencies rely on pre-hospital emergency system built the main factor to influence the system build the attention of the government with the support of the policy can be summarized as reasonable funding compensation mechanism, the hospital construction of first aid personnel, a higher level of support and guidance of the hospital, first-aid equipment and facilities with community health agencies, community health agencies pre-hospital emergency function of positioning and community residents recognized the emergency services community health agencies and seven aspects. Discussion and proposed to discuss: (1) the relative lack of community health service institutions Emergency hardware facilities: (2) community health workers age structure is irrational, low education level and titles; relatively low level of knowledge and skills of pre-hospital care; (3 ) need to enhance the awareness and recognition of community patients with community emergency services; (4) functional orientation of the community health service centers to be further clarified or extended; pay enough attention to (5) of the leadership and the lack of appropriate policy support; (6) financing for the compensation mechanism is imperfect; (7) community health service centers, pre-hospital emergency service concept is not clear; (8) of the current city pre-hospital emergency care system needs to be further improved. Recommendation: (1) The government should attach great importance to the urban community emergency work; (2) the establishment of reasonable funding compensation mechanism; (3) optimize community health agencies and health technical personnel structure, the establishment of a high-quality community emergency personnel; (4) to carry out community knowledge of first aid and universal education; (5) community health agencies, first aid equipment and facilities should be equipped; (6) establish community health workers pre-hospital emergency service concept; (7) the establishment of career development mechanisms of pre-hospital emergency health technicians; (8) promoting the building of a unified city of pre-hospital emergency care system. Innovation and lack of innovation: current research is mostly limited to research Hospital, rarely involved in the community of pre-hospital emergency related content, emphasis on community health service institutions to participate in the pre-hospital emergency necessity of exploring and establishing community health agencies to rely idea of ??pre-hospital emergency care system in urban hospitals, and major departure angle from community health agencies, to conduct field research, analysis of the conditions, problems and difficulties encountered in build community health agencies relying city pre-hospital emergency care system process provide references and suggestions for improving the city emergency medical service system as well as the health emergency response mechanism. Inadequate study Scene Investigation: Because of the limitations of time and money, only to the eight community health service centers in Hubei and Guangdong provinces and four hospital emergency department to investigate the representativeness of the results may be insufficient; During the investigation, did not adequately The result of the interviews may not fully reflect all of the influencing factors of community health service institutions prehospital emergency; due to the on-site investigation is carried out in the community health service institutions or hospitals, some of the data may not fully reflect the real idea of ??the personnel.

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