Organization of a three-level system of emergency, including emergency specialized, medical care in the constituent entities of the Russian Federation

Introduction. The article presents an analysis of the problem, justification of the concept and formulates the basic principles of the functioning of a three-level system for organizing the provision of emergency specialized medical care in the constituent entities of the Russian Federation, and also demonstrates the experience of using computer modeling to create it on the example of three constituent entities of the country.  Target. Determination of possible ways to optimize the three-level system in the regions through virtual experiments.Methods. A retrospective analysis of data on the current activities of the region was carried out, on the basis of which, with the help of computer simulation, a model of a three-level system was created and experiments aimed at its optimization were carried out.  Results. On the basis of data on emergency patients admitted to various hospitals, a simulation model was created, a number of experiments were carried out aimed at determining the optimal redistribution of the flow of patients in need of emergency care in hospitals of the 3rd level, including in emergency situations of a biological and social nature at example of the COVID‑19 pandemic. The effectiveness of the proposed system was demonstrated, in the model it was possible to ensure the timely hospitalization of all patients in the subject to the place of providing them with comprehensive medical care.  Conclusion. For the organization of a three-level system of emergency care, including specialized medical care, it is advisable to conduct organizational experiments using simulation modeling, which allows you to correctly plan the redistribution of patient flows, identify possible errors in the virtual model.

three-level system, emergency medicine, healthcare organization, simulation modeling