Analysis On The Current Situation And Countermeasures Of The Pre-hospital Emergency System In Guangzhou City

1.ObjectiveThis study mainly analyzed the present situation of the pre-hospital emergency system in Guangzhou,found its existing problems and put forward some reasonable and effective countermeasures.And which provide certain basis and reference for construction planning and further development of the pre-hospital emergency system in Guangzhou.2.Methods(1)Literature study: Collecting the literatures,books,research reports,laws and regulations,which relate to the study and as a reference for it.(2)Analysis of the raw data: Extract the related data of pre-hospital emergency from 2012 to 2014 from 120 Dispatching System database in each emergency medical command agency.And to analyze the current situation of pre-hospital emergency service,disease spectrum and so on in Guangzhou.(3)Cross-sectional investigation: The questionnaire survey was conducted to investigate the emergency medical command institutions in Guangzhou.At the same time,some pre-hospital emergency doctors and some citizens who had called “120”emergency telephone were selected for questionnaires.(4)Qualitative research: In the form of a forum to interview with each emergency medical command agency in Guangzhou,in order to realize the present status and existing problems of the pre-hospital emergency system,and discuss the corresponding countermeasures.3.Results(1)The emergency medical network had 136 first-aid stations in Guangzhou 2015.And Guangzhou configured with a total of 285 ambulances used for pre-hospital care.(2)The average radius of emergency medical network in the urban areas was about 4 km,and the longest emergency radius was 9.15 km in Guangzhou.The average emergency response time in urban areas was 15.8 minutes,and first aid available for an average 46.3 minutes.(3)The top three reason for calling an ambulance followed by trauma,traffic accident and syncope.The top three of the disease spectrum were trauma,diseases of the nervous system,and circulatory system disease in pre-hospital emergency.(4)From the point of resource allocation fairness,the Gini coefficient of the first aid station and the ambulance of the population allocation was 0.241 and 0.151 respectively,and according to the geographic configuration of the Gini coefficient was 0.451 and 0.613 respectively.(5)The main results of the panel interview with the emergency medical command staff as follow.First,the construction of the command agencies was with weak basis,which need to be strongly supported by the higher authorities.Second,the related financial compensation was not in place,it was necessary to increase financial investment in pre-hospital emergency.Third,there was the shortage of pre-hospital emergency personnel,and it was urgent need to increase staff and stability the first aid team.Four,the number of first-aid stations were insufficient and needs to be appropriately increased and reasonable layout.Five,the ambulances updated slowly and on-board emergency equipments were not complete,which need to be further improved.Six,Prehospital emergency-related identification need to be further standardized.(6)Average daily working hours of Pre-hospital emergency physicians was(9.33±1.82)Hours.49.7% of pre-hospital emergency physicians said that working under a lot of pressure.44.3% of pre-hospital emergency physicians had turnover intention.Job interests and the working pressure,which were the influencing factors of turnover intentions.The problems in the training of medical staff were mainly the single training items,the lack of coherent training content and the single training methods.(7)Satisfaction score of 120 telephone services was(8.91±1.39),and its satisfaction rate was 98.1%.Satisfaction score of 120 ambulance services was(8.56±1.54),and its satisfaction rate was 96.8%.Satisfaction score of on-site emergency services was(8.54±1.64),and its satisfaction rate was 96.5%.According to the citizens,the main problems existing in pre-hospital services were that ambulance arrived at the scene time-consuming,service charge price was too high,and the driver was not familiar with the location of the street.4.Conclusion(1)There were some problems in the construction of pre-hospital emergency care system in Guangzhou.It needed to be further strengthened in terms of capital investment,the construction of command organizations,the configuration of emergency personnel,the configuration of emergency vehicles,and the construction of pre-hospital emergency network.(2)The regional development of pre-hospital emergency in Guangzhou was unbalanced.The urban area in city had a relatively short radius of emergency.The emergency resources were relatively abundant and the construction of emergency medical network was more perfect.(3)Guangzhou pre-hospital emergency resource was in a relatively fair state of the population configuration,but there was much room for improvement in the fairness of geographical distribution.(4)The pre-hospital emergency physician had a heavy work with great pressure.The Pre-hospital emergency personnel were mobile and unstable.(5)Public satisfaction with 120 telephone service,120 ambulance services and on-site emergency services and so on were higher.(6)Countermeasures: The government should increase financial investment to ensure that subsidies were in place.It was suggested to further strengthen the construction of emergency medical command organizations,and to improve the pre-hospital emergency network.Strengthening hardware equipment which related to pre-hospital emergency and regulating the management of ambulances.Besides,set up a specialization team which served for pre-hospital emergency.