3Medicine / The organization of public health services

Ospanova D. A.

Institute of development of public health services, Kazakhstan

Some questions of rendering of fast and urgent medical aid to the population of elder age of large city

For a substantiation of need of persons of advanced age in the medical-social help parameters of illnesses, according to survey in the treatment-and-prophylactic organizations have the major value. As for pensioners, close dependence between their age and a level of illnesses of using medical help in the treatment-and-prophylactic organizations is characteristic. Materials of the present research show, that at a share of people of advanced age, components in structure of the population of city of 11,6 %, on them 40,2 % of all quantity of served calls are necessary. The general level of using medical help by people of advanced age behind the first help makes 826,3 references on 1000 person whereas the general level of using this help among adult population of city makes 274,6 references on 1000 person of corresponding age.

Some features of using medical services are revealed in different age groups of persons of advanced age. The level using medical services behind the first help raises with the years (Q=0,77), reaching a maximum at persons in age group 70-74 years (1212,3%о); at senile age the given parameter decreases in age group of 75-79 years on 9,5 %, and in age group of 80 years and is most senior on 1,7 %. At men and women the features and distinctions in parameters of using these services behind the first help, as general parameter and on separate age groups are established. Materials of research testify that pensioners address for the first help more often, than persons of able-bodied age. According to our data, the level of using health services by people of advanced age in 3 times above a similar level of all other population. Thus, the difference is more appreciable at men - in 3,6 times, than at women - in 2,7 times above. The using of these services with a sharp pathology makes 20,1 % from number of all references of aged citizens behind the first help, including at men - 23,6 %, at women - 17,9 %. In structure people who use medical services of advanced age for emergency without going to hospital medical aid on a share of sudden diseases 87,5-88,7 % of calls, accidents - 4,3-4,6 %, scheduled and urgent transportation - 7,0-7,9 % are necessary. More than half of pensioners (54,3 %) use the first help once, 20,6 more % - two times a year. At the same time, because of insufficient quality диспансерного supervision over the persons of advanced age having chronic diseases, absence of necessary continuity in rendering medical aid, concerning high the share of the chronic sick senior age groups causing the first help of 20 and more times within year (0,6 % from number of the addressed pensioners). By us are studied not only a level and features of using medical help by people of advanced age behind the first help, but also periodicity of receipt of calls on seasons of year, months, days of week and hours of day. Hospitalization is spent, mainly, in cardiological branches are studied not only a level and features of using these services by people of advanced age behind the first help, but also periodicity of receipt of calls on seasons of year, months, days of week and hours of day. Hospitalization is spent, mainly in cardiological branch (23,4 % from all (23,4 % from all hospitalized persons of advanced age); in surgical branch (19,5 %); in therapeutic branch (20,2 %); in neurologic branch (10,0 %). As a whole hospitalization are a subject 95,8 % from among the persons of advanced age delivered in hospitals, and men in 1,7 times more often, than women. It is necessary to note, that 4,2 % sick delivered in receptions of hospitals have not been hospitalized by brigades of the first help, that indirectly testifies to a professional standard of medical workers of stations of the first help and about a hardware of service. Actual there are questions of continuity and interrelation of station of the first help with other medical organizations and first of all with the out-patient-polyclinic organizations. As a result of the decision of these problems the service of first aid would be relieved of performance of functions unusual for it – from service of not profile (unreasonable) calls. As show results of our research not profile (unreasonable) using of health services makes 42,9 %. Among ways of essential reduction of a stream of not profile (unreasonable) calls from persons of advanced age it is necessary to note: drawing up in the out-patient-polyclinic organizations of lists of the chronic patients requiring active supervision of medical and social workers; the organization of hospitals in-home; duly hospitalization under medical and medical-social indications. The received results show that process of aging the population renders essential influence on a level and structure of using behind the first help. Therefore, studying of a condition and ways of perfection of the organization of service of the first help and volume of its activity are the important problem of health protection of people of advanced age.