Abstract
Background Wide use of hospital-replacing technologies (HRT) helps reduce urgent hospitalization, reduce ambulance calls, increase number of planned hospitalization. Methods We made time series on emergency medical service indicators to analyze HRT development dynamics. Cross-sectional, full study was carried out in 76 medical organizations providing hospital-replacing care (HRC) and 312 teams providing EMC in Almaty. Results Number of EMC teams in 2014-312(2011-320), pediatric-92(2011-96), appealibility per 1000 of population-481,8 (2011-451,7). Calls at PHC working hours-36%(2011-57,55), number of ineffectual departures per 1000 population-18,4(2011-19,8). Specific weight of repeated calls-4,4%. Number of people who received medical care during departures per 1000 of population - 468,7 (RoK-390,3). Death frequency before team arrival per 1000 of call-4,67(2011-5,33). Emergency hospitalization in RoK is 61% in 2014 (2011-65,4%), planned hospitalization-39% (2011-35%). To day and night care hospitals (DNCH) 35,78% patients were assigned from PHC, 33,8% delivered by an ambulance, 12,5%-on their own accord, 12,5%-other types, 5,51%-from diagnostic centres. Average duration of patient’s stay in DNCH is 9,5 days (2014) (2010-11,1 days). Growth rate of treated patients in RoK-34%. In Almaty, HRC was provided to 58,1% of patients in day care facilities of polyclinics, less than 20% were provided home care, 24,1% - treated in day care facilities of hospitals. On HRT hospitalization level - 54,5 per 1000 of population. HRT bed support of population - 9,1 per 10 000 of population, HRT coverage of population - 57,3 per 1000 of population, the average stay of patient in day care hospital - 7,6 bed-days. Conclusions Implementation of UNHS in RoK increased availability and quality of medical care provided to population. Development trend and efficient use of HRT show favorable results as the number of calls during PHC working hours decreased to 36% in 2014 (2012-45,6%, 2011-57,5%). Key messages: We comprehensively studied development of hospital-replacing technologies and identified relationship between the quality of hospital replacing care and reduction of ambulance calls HRT is an effective form for providing medical care. Improving quality of treatment in day care hospital of polyclinics has the effect of reducing number of ambulance calls