Suchergebnisse

Primary health care is important item of political agendas since Alma Ata conference in 1978. West Balkans share common history in development of primary care since 1920' when Andrija Stampar introduced social and community based primary care concepts. The first known specialist training in general practice in the world started in former Yugoslavia in the early 1960'. Since then, much has been done in the field of general practice and family medicine and this is reflected in The European Academy of Teachers in General Practice and Family Medicine (EURACT), which is a network organisation within World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians Region Europe (WONCA Europe). Its aim is to foster and maintain high standards of care in European general practice by promoting general practice as a discipline by learning and teaching. EURACT developed several documents and teachers' courses which can serve the development of family medicine curricula in new established departments of medical schools. This is also the case at Maribor Medical School, where learning outcomes and teaching methods are in concordance with EURACT teaching agenda, but also some innovative approaches are used, such as art and e-learning environment as teaching methods.

Background: The outcome of severely injured or ill patients can be time dependent. Short activation and approach times for emergency medical service (EMS) units are widely recognized to be important quality indicators. The use of a helicopter emergency medical service (HEMS) can significantly shorten rescue missions especially in mountainous areas. We aimed to analyze the HEMS characteristics that influence the activation and approach times. Methods: In a multi-centre retrospective study, we analyzed 6121 rescue missions from nineHEMS bases situated in mountainous regions of four European countries. Results: We found large differences in mean activation and approach times among HEMS bases. The shortest mean activation time was 2.9 minutes ; the longest 17.0 minutes. The shortest mean approach time was 10.4 minutes ; the longest 45.0 minutes. Short times are linked (p < 0.001) to the following conditions: helicopter operator is not state owned ; HEMS is integrated in EMS ; all crew members are at the same location ; doctors come from state or private health institutions ; organization performing HEMS is privately owned ; helicopters are only for HEMS ; operation area is around 10.000 km2 ; HEMS activation is by a dispatching centre of regional government who is in charge of making decisions ; there is only one intermediator in the emergency call ; helicopter is equipped with hoist or fixed line ; HEMS has more than one base with helicopters, and one team per base ; closest neighboring base is 90 km away ; HEMS is about 20 years old and has more than 650 missions per year ; and modern helicopters are used. Conclusions: An improvement in HEMS activation and approach times is possible. We found 17 factors associated with shorter times.