Integrated Management Model for Pre-hospital and Hospital Emergency Rooms in Iran

摘要

Background and Objective: The need for medical emergencies is a shadow that accompanies humans and may occur for any individual under any circumstances. Emergency care services systems in different countries are completely different and very complex and dispersed, have false financial incentives, and waiting times are rising and are among the most important emergency challenges. In this regard, by identifying the pre-hospital and hospital emergency systems in the countries of the world and Iran, factors related to the integrated management of pre-hospital and hospital emergency wards are identified and solutions are provided to provide a model for management. Methods: The present research is based on the nature, exploratory, descriptive and comparative, and from the perspective of classification, based on objective, review, applied and analytical. Developed countries in different parts of the world have been selected based on acceptable patterns of service delivery and availability of information. Based on the results of comparative studies, a conceptual model was designed. In the first stage, five components including policy making, emergency management, structure, financing, and control were identified to gain insight into the components of the integrated emergency management model. Finally, Friedman test and exploratory and confirmatory factor analysis were used. To validate the proposed conceptual model of the research, the method was to determine the validity of the content and through the judgment of several experts and experts in pre-hospital and hospital emergencies. In this research, quantitative, mean, standard deviation and domain variables were calculated and presented for qualitative variables, abundance and percentages. Results: In order to explore the exploratory factor and to evaluate the structural validity, the criteria were loaded in the relevant factors and the KMO values for each extractive factor were higher than 0.6. The percentage of variance expressed for extraction factors was calculated to be between 38.78 to 54.26. In addition, the results of the Bartlett test confirmed the adequacy of exploratory factor analysis for all extraction factors. Factor loads above 0.3 which were also observed in most items of this factor confirmed the maintenance of these items, but in some cases factor load factors were less than 0.3, which were eliminated by these candidates and after The study was deleted and, as expected, the existence of the five components derived from the variables of the study was confirmed. Meanwhile, the amount of results indicated that, firstly, the "amount of variables sharing" and "correlation of the variables with the relevant component" are adequately fitted, and second, there is a good correlation between each variable with the component. Conclusion: In order to meet the expectations of patients in need of emergency care, we need to improve the emergency services and this requires reorganization of pre-hospital emergency services and promotion of emergency department inside the hospital by employing effective approaches to improving services in pre-hospital and hospital emergency rooms in Iran. Integrated management template.