Bhandari Deepak, Yadav Nabin Krishna
Department of Anesthesia, Critical care and Pain, Nepal Mediciti Hospital, Bhainsepati, Kathmandu, Nepal.
Department of Anesthesiology And Critical Care, Chitwan Medical College, Bharatpur-10, Chitwan, Nepal.
Int J Emerg Med. 2020 Feb 7;13(1):7. doi: 10.1186/s12245-020-0268-1.
The main aim of emergency medical services (EMS) should be to provide universal emergency medical care which is EMS system available to all those who need it. Most of the developed countries have an integrated EMS system that is accessible by a single dial number in the whole country. Nepal does not have a proper EMS system. We conducted a literature review regarding methods of developing an integrated EMS system in Nepal.
The fragmented system, high demand-low supply, inequity with the service, and inadequately trained responders are major problems associated with EMS in Nepal. Nepal too should develop an integrated single dial number EMS system to meet the current demand of EMS. Having a paramedic in ambulances as the first responders will prevent chaos and save critical time. Funding models have to be considered while developing an EMS considering the capital as well as operational cost.
Nepal can develop a public private partnership model of EMS where capital cost is provided by the government and operational cost by other methods. Community-based insurance system looks more feasible in a country like Nepal for generating operational cost.
紧急医疗服务(EMS)的主要目标应该是提供普遍的紧急医疗护理,即对所有有需要的人都可提供的紧急医疗服务系统。大多数发达国家都有一个综合的紧急医疗服务系统,在全国通过拨打一个号码即可接入。尼泊尔没有合适的紧急医疗服务系统。我们针对在尼泊尔建立综合紧急医疗服务系统的方法进行了文献综述。
零散的系统、高需求低供给、服务不公平以及急救人员培训不足是尼泊尔紧急医疗服务面临的主要问题。尼泊尔也应该建立一个综合的单号码紧急医疗服务系统,以满足当前紧急医疗服务的需求。在救护车上配备护理人员作为第一响应者将避免混乱并节省关键时间。在发展紧急医疗服务时,必须考虑资金模式,同时要考虑到资金成本和运营成本。
尼泊尔可以发展公私合营的紧急医疗服务模式,其中资金成本由政府提供,运营成本通过其他方式解决。在尼泊尔这样的国家,基于社区的保险系统在产生运营成本方面似乎更可行。