Burget F, DouŠa P, Kloub M, KozÁk T, Pleva L, Rogalewicz V
Comparison of Hospital Preparedness to Deal with Crisis Situations in Mass Casualty Incidents According to the UN Human Development Index.
Acta Chir Orthop Traumatol Cech. 2020;87(6):438-446.
PURPOSE OF THE STUDY This thesis presents the very current topic of general hospital preparedness to deal with crisis situations in mass casualty incidents. MATERIAL AND METHODS The key part of the work consists in a questionnaire survey of 26 foreign and domestic respondents, which provides a very good description of this issue in various countries of the world. The group is divided into health facilities in developed and developing countries of the world according to the UN Human Development Index. Another sub-group consists of hospitals in areas with a higher frequency of terrorist attacks and a separate group is formed by 5 hospitals in the Czech Republic. Based on the results of the questionnaire survey, the preparedness of hospitals for dealing with mass casualty incidents is compared in both the groups according to the advancement of the country and also in the subgroup of hospitals in the Czech Republic and in countries with frequent terrorist attacks. The maximum achievable score evaluating the hospital readiness is 20 points. The data obtained by the questionnaire survey is evaluated using statistical methods. RESULTS Higher preparedness of hospitals was found in developed countries, with a hospital preparedness score of 12.9 points compared with 5.9 points in developing countries' hospitals. Hospitals in the Czech Republic show a similar readiness for mass casualties as the other hospitals in developed countries, with the mean score of 12.2 points. Hospitals in countries with a higher number of terrorist attacks did not show a higher readiness to deal with crisis situations associated with mass casualties - the mean score of 9.4 points. DISCUSSION The following discussions and evaluations, together with personal experience and thorough knowledge of real-life solutions, became the basis for recommendations of triage procedures, organization of surgery and traumatology departments and material equipment of medical facilities in the Czech Republic. CONCLUSIONS By applying the results of the habilitation thesis it is possible to achieve an optimal solution and increase the reliability in the preparedness of hospitals in dealing with crisis situations, especially to eliminate the discrepancy between theory and practice. Key words: mass casualty incidents, triage, hospital preparedness, disaster management response.
研究目的 本论文探讨了综合医院应对大规模伤亡事件危机情况的当前热门话题。材料与方法 研究的关键部分是对26位国内外受访者进行问卷调查，这能很好地描述世界各国在这个问题上的情况。根据联合国人类发展指数，该群体分为世界发达国家和发展中国家的卫生机构。另一个子群体由恐怖袭击频率较高地区的医院组成，还有一个单独的群体由捷克共和国的5家医院组成。根据问卷调查结果，按照国家发展程度比较两组医院应对大规模伤亡事件的准备情况，同时也比较捷克共和国医院子群体以及恐怖袭击频发国家医院子群体的情况。评估医院准备情况的最高可得分为20分。通过统计方法对问卷调查获得的数据进行评估。结果 发现发达国家的医院准备更充分，发达国家医院的准备得分是12.9分，而发展中国家医院为5.9分。捷克共和国的医院应对大规模伤亡的准备情况与发达国家的其他医院相似，平均分为12.2分。恐怖袭击次数较多国家的医院在应对与大规模伤亡相关的危机情况时，准备情况并未更高——平均分为9.4分。讨论 以下讨论和评估，结合个人经验以及对实际解决方案的深入了解，成为了捷克共和国分诊程序、外科和创伤科组织以及医疗设施物资设备建议的基础。结论 通过应用 habilititation 论文的结果，有可能实现最优解决方案，并提高医院应对危机情况准备工作的可靠性，特别是消除理论与实践之间的差距。关键词：大规模伤亡事件、分诊、医院准备、灾害管理应对
