1. Prehospital Emergency Medicine in Argentina
Silvio Aguilera MD, MBA
Medical Director EMS Vittal
Past President “Sociedad Argentina de Emergencias”

2. Statistics Population Surface: 2.780.000 sq km
Total population: 40 millions
Annual population growth rate: 1.3 %
Percentage of population aged 60+ years: 13.6%

3. Statistics Socials indicators Literacy rate: 97.4 %
Rate of unmet needs: 17.7 %
Precarious housing situation
Houses with 3 or more people per room
Children between 6 to 12 years not in school
4 or more people per family that work

4. Health indicators Statistics Life expectancy at birth: 74 years
Child mortality males/females (per 1000): 19/16
(probability of dying under age 5 years)

5. National health accounts indicators
Statistics
National health accounts indicators
Total GDP: U$S millions (Rank: 33th)
Total health expenditure: 10.2 % of GDP (Rank: 14th)
Public health expenditure: %
Private health expenditure: 45%

6. Physicians 5.000 physicians graduated each year
One doctor per 313 inhabitants
5.000 physicians graduated each year
Residencies are not mandatory
10-15% obtain a residency training programs
No equivalent to board certification

7. Hospitals Hospitals 3.311 Hospitals (Public and Private)
Public Hospital: 38%
Private Hospital: 64%
hospital beds(4/1.000 inhabitants)
Public Hospital: 51%
Private Hospital: 49%
No equivalent to JCAHO, accreditation is not mandatory for hospitals

8. Emergency Medicine Is not an specialty
Thirteen residency training programs (public and private)
100 residents
More than physicians in ED and EMS
Two National Emergency Medicine Societies

9. Emergency Medical Services
Franco-German model
Always there are a physician in the ambulance
Not paramedic or EMT
Driver and Nurse in ambulances
Different kind of ambulances

10. Emergency Medical Services
Publics and privates companies
Privates companies more important than publics
More than 400 private companies in Argentina
Some privates companies are big ( calls each years)

11. Emergency Medical Services
Many EMS in the same city (public and private)
Private EMS only for associated (50%)
Public EMS for all people
Public EMS of different quality from city to city
Not only one Telephone number for EMS publics (107)
Private EMS: different telephone number

12. Emergency Medical Services
Model of “dispatch priorities”:
code: red or 1 or emergency
yellow or 2 or urgency
green or 3 or non-urgent visit (only in private EMS)

13. Emergency Medical Services
Doctors works or 24 hours
Bill: session fees (fixed hourly rate of pay), or salary

14. Emergency Medical Services

15. Emergency Medical Services
Founded in 1987
The biggest EMS company in Argentina
Annual Income: U$S
Market share (Buenos Aires City): 20%
Employees: (880 physicians)
In 12 city in different province of Argentina

16. Emergency Medical Services
Physicians

17. Emergency Medical Services
Physicians
880
MICU
Transport
Pediatricians
188
Visits
339
MICU
Transport
MICU
NEO
MICU
Car
Car
250
103 10 96 82
339

18. Emergency Medical Services
Dispatch Center

19. Emergency Medical Services
Dispatch Center

20. Emergency Medical Services
Buenos Aires City and surrounding districts: population:

21. Emergency Medical Services

22. Emergency Medical Services
Ambulance units
Mobile Intensive Care Unit (MICUs)
Cars for non urgent visit

23. Emergency Medical Services

24. Emergency Medical Services
Principal reason for call
Triage: red and yellow
Shortness of breath
Chest pain
Mental Status Altered
Abdominal Pain
Upper extremity injury
Hypertension
Triage: green
Fever
Cough
Nausea/Vomiting
Abdominal Pain
Diarrhea
Acute Sore Throat

25. Emergency Medical Services
Final diagnosis
Triage: red and yellow
Cardiovascular disorders
Injury
Respiratory disorders
Abdominal disorders
Mental disorders
Nervous System disorders
Triage: green
Infectious disorders
Abdominal disorders
Respiratory disorders
Injury
Cardiovascular disorders
Musculoskeletal disorders

26. Emergency Medical Services

27. Emergency Medical Services

28. Emergency Medical Services

29. Emergency Medical Services

30. Emergency Medical Services

31. Emergency Medical Services

32. Emergency Medical Services

33. Emergency Medical Services

34. Training
International Training Center

38. National Planification to Disaster Response
National Ministery of Health
National Ministery of Interior
DINESA
Emergency Disaster Direction
SIFEM
Federal Emergency System

39. National Planification to Disaster Response

41. Injury
patients
Minor Trauma: (83%)
Mild trauma: (15%)
Severe trauma: (2%)