THE OPINION OF MANAGERS OF DISTRICT AND MUNICIPAL HOSPITALS REGARDING THE RELATIONSHIP BETWEEN THE ORGANIZATION AND PERFORMANCE OF THE AVIASAN SERVICE. QUANTITATIVE-QUALITATIVE, CROSS-SECTIONAL STUDY

Abstract

In the Republic of Moldova, the medical institutions in the regions are struggling to cope with the challenges posed by patients with complex pathologies or critical conditions. In this context, there is a necessity for a consultancy and inter-hospital transfer service for patients – the republican AVIASAN Service. Through this service, specialized consultants provide remotely or on-site clinical advices and facilitate the transportation of patients to specialized tertiary institutions, according to medical indications. Several aspects related to the AVIASAN’s activity remain unclear. This study was proposed to analyze some of these aspects related to the AVIASAN service. Material and Methods. Quantitative-qualitative, cross-sectional study of the opinions of managers of regional and municipal hospitals regarding the relationship between the organization and performance of the AVIASAN service. The study was conducted based on an dedicated online questionnaire design for the purpose to this study. Results. In total, 27 out of 41 invited institutions participated in the study (65.85%) completed the questionnaire. The respondents (80%) believe that the range of medical specialties represented by AVIASAN service is sufficient. The activity of the medical teams involved in AVIASAN missions is highly appreciated (collaboration with doctors 60%, support provided in decision-making 80%). However, respondents (69%) reported that AVIASAN intervenes with delays in resolving some cases. The following barriers to the AVIASAN functioning were identified: human resources (insufficient and unqualified staff, lack of specialized narrow-profile experts), equipment (lack of equipment and specialized vehicles), infrastructure (road conditions), organization (lack of legal framework, national protocol, transport/ transfer criteria, poorly defined patient route, bureaucracy), and other factors (lack of responsiveness, reluctance, lack of cooperation). The proposed solutions are focused on: human resources (hiring, remuneration, training, decision-making authority); equipment (procurement of equipment and specialized vehicles); organization (establishing a legal framework, regionalization of efficient services, medical system reform); and quality control. Conclusion. Our aim was to analyze the opinions of AVIASAN service consumers from the perspective of organization, structure, and functionality. The study results suggests that there is room for improvement in the AVIASAN service. It is essential to transfer some of its functions to other healthcare institutions to enhance its effectiveness. Regionalizing specialized hospital services and medical care can lead to better coordination and allocation of resources. Additionally, investing in professional training will ensure that the medical teams involved in AVIASAN missions are well-prepared and capable of providing high-quality care. These proposed measures aim to improve the overall performance and efficiency of the AVIASAN service and ultimately enhance the quality of medical assistance provided to patients in critical conditions.