Tarighi Payam, Tabibi Seyed Jamaledin, Motevalian Seyed Abbas, Tofighi Shahram, Maleki Mohammad Reza, Delgoshaei Bahram, Panahi Farzad, Masoomi Gholam Reza
Department of Management, School of Management and Medical Informatics, Tehran University of Medical Sciences, Iran.
Acta Med Iran. 2012;50(1):9-17.
Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS) to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.
创伤是全球死亡和残疾的主要原因。伤害每年导致约600万人死亡，其中90%发生在发展中国家。在伊朗，伤害是50岁以下年龄组中最常见的死亡原因。创伤系统的发展是一种系统而全面的伤害预防和治疗方法，其有效性已得到证实。本研究旨在设计一个创伤系统管理模型，作为伊朗建立创伤系统的第一步。在这项定性研究中，基于公共卫生方法和三个著名的创伤系统模型开发了一个概念框架。我们使用基准、指标和评分（BIS）来分析伊朗创伤护理系统的现状。然后，利用公共卫生方法的政策制定阶段设计创伤系统管理。经专家小组验证的创伤系统管理模型，根据管理的四个主要功能：领导、规划、组织和控制，描述了牵头机构、创伤系统计划、决策委员会和基于数据的控制。该模型可分两个阶段实施：专注于资源整合的排他阶段和专注于系统发展的包容阶段。该模型可以通过试点研究作为公共卫生方法的保障阶段，促进伊朗创伤系统的发展。此外，该模型可以为国际层面的创伤系统管理提供一个实用框架。
