Evaluation of the Efficiency of Work and Prospects for the Development of Ambulance Aviation in the Conditions of a Megapolis on the Example of the City of Moscow

Abstract. The objectives of the study are to develop a structural and functional model, principles and algorithms of organizational and methodological support of helicopter evacuation of patients to specialized medical organizations of megapolis; to evaluate their effectiveness analysing the results of treatment of patients with significant urgent pathology.

Materials and research methods. The results of treatment of 241 patients with urgent pathology at the treatment facilities of the Moscow Health Department — City Clinical Hospital No.15 named after O.M. Filatov, S.S. Yudin State Clinical Hospital  and N.S. Sklifosovskiy Research Institute of Emergency Medicine in 2016-2019 — were analyzed. Inclusion criteria: patients with bleeding (isolated or in combination with acute trauma) requiring surgical intervention; with acute coronary syndrome (unstable angina pectoris, myocardial infarction with and without ST-segment elevation); with vascular pathology of central nervous system or craniocerebral trauma, requiring emergency hospitalization of the patient in a specialized medical institution — provided that the time of delivery of all these patients to the hospital was at least 30 minutes from the time of call.

Exclusion criteria: patients with mental illness, infectious-inflammatory processes, severe comorbid somatic diseases in decompensation stage (established by anamnesis, examination or autopsy reports); incurable cancer patients and any urgent patients whose delivery time to the specialized hospital was less than 30 minutes from the time of call.

All patients included in the study were divided into 2 groups:

The main — 1st group — included 112 patients delivered to the profile medical institution of the megapolis on a medical helicopter.

The comparison group — 2nd group — consisted of 129 patients with similar urgent pathology, hospitalized to the specialized hospitals of the city by ground ambulance transport.

Research results and their analysis. The analysis of the study results showed:

– performance of air medical teams is comparable to or exceeds that of ground ambulance teams;

– number of total bed-days in the group hospitalized by air ambulance was higher than in the comparison group;

– inpatient outcomes and long-term outcomes were comparable in both groups;

– pilot study of the use of mobile diagnostic ultrasound in providing emergency and urgent medical care allows us to consider this method as a promising one, but it requires further evidence accumulation.

Thus, the performance of medical aviation is not inferior to the performance of ground ambulance teams, and in some aspects, even exceed them, which confirms the high potential of its use in megapolis conditions and in remote and hard-to-reach areas.