MEDICAL EMERGENCY SERVICE OF THE REPUBLIC OF UZBEKISTAN
– THE KEY TO LINK THE COUNTRY HEALTH SYSTEM

Emergency medical service (EMS) as an autonomous structure and as the largest of the country’s health system was established according to the Decree of the President of the Republic of Uzbekistan No. UP-2107 of 10 November 1998. It began operating in 2000. Today, at the end of its first decade of existence, the SMU is considered one of the most important players in the country’s social policy.

During the preparation of the National Reform Programme of the health system of the Republic of Uzbekistan, a concrete target was defined: create a structure capable of providing high quality medical emergency assistance available to the public on any the territory of Uzbekistan.

In Uzbekistan, during the period prior to the reform, emergency medicine had no independent status and autonomous structure within the organization and management of health in the country.

Given the state of the health system that prevailed in 1999, and the specifics of the transition in the economic field, it was decided to renew the previous model of emergency medicine. For purposes of accessibility and kind of get the maximum economic and medical efficiency, SMU was organized on the basis of multiple levels where all units were combined into a single service that combined organizational structures and vertical and horizontal management.

The main principles of the new service are organized around the following points:
• The opportunity and speed of medical help;
• The step therapy;
• Compliance with approved standards of care at every stage;
• High-tech medical care.

The structure of the EMS includes a leading center in Tashkent – National Center for Research for Emergency Medicine (CNRMU) and its regional offices (total 13). In addition, in 174 localities of Uzbekistan, emergency services – in CNRMU subsidiaries were created from medical associations districts (AMD). In addition to these fixed units, the structure also includes the “03” service with 194 stations and 2207 ambulance crews, the air ambulance service and medical units of the Ministry of Emergency Situations. Now, the organizational structure of SMU offers coverage from all regions and all categories of the population of Uzbekistan. Availability is 24 hours on 24, free services is ensured and an adequate and efficient support of inventory and personnel resources ensures total availability of emergency medical care.

In 2010, 7895 patients, 27.9% of all hospital admissions of adults (28 268 patients) received medical help in the intensive care unit and intensive care of the service and reception diagnosis CNRMU.

It was created to help in emergency situations and 39 specialized teams available around the clock (3 teams in the CNRMU and 12 in its subsidiaries), 182 emergency medical teams on the basis of medical associations districts (AMD) and municipal (AMM).

The original structure of the organization of SMU in Uzbekistan, dislocation of his stationary units, beds and medication reserves for emergencies, the possibility of a rapid conversion of therapeutic beds surgical beds and resuscitation allow a few hours to transform hospital services in complete evacuation hospitals.

UAS staff includes 53 794 25 units employing 55,659 people, including doctors – 8299 (15%), nurses, 29,328 (53%). The CNRMU as subsidiaries of Samarkand and Andijan also serve as training bases emergency physicians. The CNRMU and its subsidiaries also have the Departments of advanced medicine. Each year, more than 400 doctors are trained at the base of CNRMU. During the period 2000-2010, these are 4389 doctors were able to re-level qualifications.
The adoption of the Cabinet of Ministers of Uzbekistan №537 “On measures of further improvement of the emergency medical service” of 2 December 2003, became the key costs of training for EMS managers.

To implement the above decree, a series of measures have been adopted:

Foundation for the support and development of the EMS was created;

depth study of issues of SMU is included in the programs of higher medical training institutions;

the Master “SMU” was created;

funding from the Foundation for the Support and Development of SMU allow training, retraining and upgrading of emergency medical clinics in countries such as Russia, Ukraine, Moldova, Turkey, Austria, Japan , Korea, Lithuania, France, the United Kingdom, the United States. In total, more than 240 doctors who were able to improve their skills abroad.

The CNRMU is the largest scientific institution in the health system in which 17 projects are funded through the Center for Science and Technology Coordinating Council for scientific research and technological development with the Council of Ministers. The center employs 22 PhDs and 70 doctoral students. During the existence of the EMS of the Republic of Uzbekistan, 11 State doctoral theses and 56 university theses were defended. In 2010 the Centre’s specialists have published 386 scientific papers, including 84 journal articles, 16 of which in the editions of the IEC, 4 – abroad.

In accordance with the special decree of the President of the Republic of Uzbekistan Islam Karimov PP №1114 of 21.05.2009 “On the improvement of the EMS system,” the park service ambulances “03” has been renewed. His medical equipment as well as its Mobile communications have suckled updated. The Government has funded and distributed to all regions 110 cars “Hyundai” and 381 cars “Damas”.

More than 1,240 pieces of medical equipment for 73 sectors including computed tomography and angiography (valued at $ 23 million) were delivered and installed in regional subsidiaries. In addition, the government has weighed heavily to attract more bank credit lines from Kuwait in the amount of $ 25 million to equip the emergency services district medical associations (AMD) – in subsidiaries CNRMU.

The EMS system in the country is an original service. It combines the potential material, technical, scientific and human within a single structure. It is funded by the budget. Its task is to ensure timely free of highly trained emergency medical care to the population and in all conditions of possible emergencies.