HEMS, yadda ceton helikwafta ke aiki a Rasha: bincike shekaru biyar bayan ƙirƙirar Squadron Medical Aviation na Rasha duka.
Ayyukan HEMS suna da mahimmanci kuma suna da mahimmanci a kowane kusurwar duniya, ciki har da Rasha, inda aka yanke shawarar daidaita ayyukan jiragen sama na likita shekaru biyar da suka wuce.
A cikin 2021, jirgin saman National Air Ambulance Sabis (NSSA), wanda ƙoƙarin Rostec State Corporation ya ƙirƙira, bayan kammala ayyuka sama da 5,000, ya taimaka ceton rayuka da lafiyar marasa lafiya sama da 6,000.
A cikin shekaru uku da suka gabata, kasuwar helikwafta ta ninka darajarta sau biyar, daga 3,886 rubles a 2018 zuwa rikodin 16,672 biliyan a 2021.
Yuro ɗaya yana da daraja yayin da muke rubuta wannan labarin game da 60 rubles.
Amma tsari ne wanda ba ya tafiya daidai, kuma aikin da za a daidaita sabis na motar daukar marasa lafiya na iska yana fuskantar juriya na gida.
MAFI KYAUTA KAYAN AIKI NA HEMS? ZIYARAR BOOTH NA AREWA A BIKIN GAGGAWA
HEMS a Rasha, ƙirƙirar Squadron Likitan Jirgin Sama na Rasha duka
Farkon aikin don ƙirƙirar Squadron Medical Aviation Squadron na Rasha na iya zama kusan kwanan wata zuwa 2011-2012, lokacin da aka tsara ƙungiyar ma'aikata ta musamman a ƙarƙashin Ma'aikatar Lafiya ta Tarayyar Rasha.
Manufar da aka bayyana ita ce aiwatarwa da ƙwarewar sabis na helikwafta.
A watan Oktoba 2013, Veronika Skvortsova, sa'an nan shugaban ma'aikatar kiwon lafiya, gabatar da thematic matukin jirgi aikin tare da kasafin kudin zuba jari na 2.2 rubles.
An yi zaton cewa nan da shekaru biyu za a aiwatar da tsarin gudanar da aikin kula da zirga-zirgar jiragen sama na likitanci tare da samar da tsarin doka, kuma idan tulun ya tashi daga kasa, za a fara aikin jigilar magunguna sama da kasa a kasar nan. 2016.
Ganin girman al'ummar, aikin da ya daidaita HEMS da MEDEVAC: Rasha tana da yankuna masu girman gaske.
Don zirga-zirgar jiragen sama na gida, aikin shine amfani da jirage masu saukar ungulu da ƙananan jiragen sama, da na zirga-zirgar yankuna da na kasa da kasa - matsakaici da jirgin sama mai tsayi.
Dole ne a yi la'akari da cewa dangane da girman, Italiya ya ninka girman Rasha sau 57.
A wancan lokacin, tushen Zashchita VTsMK, jirgin sama na likita yana aiki har abada a cikin yankuna 40, duk da haka, a cikin uku daga cikinsu, kawai tare da aikace-aikacen kashewa ɗaya kawai.
A cikin yankuna bakwai, aikin motar asibiti na iska ya taka rawar da helikofta na Ma'aikatar Harkokin Gaggawa ta Rasha, a cikin shida ta hanyar sufurin jiragen sama na yau da kullum.
Abubuwa sun ɗan yi kyau tare da wuraren tashi: daga cikin jimillar raka'a 234, ana iya kwatanta 118 a matsayin kayan aiki, waɗanda 19 kawai ke kusa da asibitoci.
Yankunan matukin jirgi na aikin tsakiya sune Khabarovsk Territory, Sakha Republic (Yakutia), Arkhangelsk da Amur yankuna.
A cikin 2016, Ma'aikatar Lafiya ta Tarayyar Rasha ta amince da shirin fifiko na bayanan martaba, bisa ga abin da yankuna 34 da ke da yankuna masu wahala zasu iya samun tallafin tarayya don siyan sabis na jirgin sama na likita.
Don wannan dalili, mai gudanarwa ya ware fiye da biliyan 10 rubles a cikin kasafin kuɗi har zuwa 2020.
A watan Yulin 2017, a wasan kwaikwayon iska na MAKS a Zhukovsky (kusa da Moscow), ƙungiyar likitocin Heli-Drive sun gabatar wa Shugaba Putin sabon sabon Ansat tare da tsarin likitanci a matsayin samfuri ga babban. hukumar na gaba NSSA.
Rasha, da ra'ayin tsakiya na HEMS da MEDEVAC sabis na kiwon lafiya a ƙarshe sun sami yanayin aikin sa a cikin kaka 2017
Anatoly Serdyukov, shugaban kungiyar jiragen sama na Rostec State Corporation, ya zama jakadan ta.
Ma'auni na aikin sun yi la'akari da ƙungiyar ma'aikacin tarayya guda ɗaya na sabis na jiragen sama na likita - tare da nasa jiragen ruwa, wanda ya ƙunshi yawancin jirage masu saukar ungulu na gida tare da kayan aikin likitanci, cibiyar aikawa ta gama gari da kuma ƙayyadaddun ƙa'idodi dangane da mafi kyawun ayyuka na duniya.
An fara aiwatar da tsarin aiwatar da aikin a matsayin 'kayan aikin haɗin gwiwa': samar da jiragen sama zuwa yankuna don samun tabbacin shigar da kuɗin fitar da likita a cikin tsarin inshorar likita na tilas.
A lokaci guda, an kafa JSC National Air Ambulance Service, 25% na wanda aka samu daga JSC Rychag, mallakar Rostec, da kuma sauran 75% daga Asusun don bunkasa Air Ambulance.
An ƙaddamar da shi tare da amincewar Vladimir Putin a cikin Janairu 2018, NSSA watanni shida bayan haka ta sami matsayin mai ba da kayayyaki guda ɗaya daga gwamnati, wanda ke ba ta damar yin kwangila da yankuna idan suna so.
Har ila yau, ma'aikacin ya sami haɗin kai na duk sa'o'i na jirgin sama na Rasha: 295,000 rubles na dogon lokaci Mi-8s da 195,000 rubles na haske Ansats.
Akwai matsala guda ɗaya: kayan aikin jiragen ruwa na HEMS a Rasha
A cikin Satumba 2018, rassan Rostec Group of Companies - Rasha Helicopters JSC, NSSA JSC da Aviacapital-Service LLC - sun sanya hannu kan kwangilar samar da 104 Ansats da 46 Mi-8AMT helicopters tare da kayan aikin likita.
An kiyasta kudin yarjejeniyar a kan 40 biliyan rubles.
A karkashin garantin kwangilar, Rostec ya yi niyyar haɓaka 30 biliyan rubles ta hannun reshenta na JSC RT-Finance gabaɗaya ta hanyar ba da lamuni na musanya tare da balaga har zuwa shekaru 15.
Helikwafta takwas na farko - Ansats hudu da Mi-8AMTs hudu a cikin jan hankali na musamman na ja da rawaya - an tura su zuwa ma'aikacin a watan Fabrairun 2019.
Da alama babu wani abu da zai iya kawo cikas ga yanayin jirgin na NSSA har sai lokacin da aka shirya rage girman, musamman tun lokacin da aka ba da fifikon aikin ci gaban tsaftar jiragen sama a cikin aikin kiwon lafiya na ƙasa, kuma matsayin mai ba da sabis na ma'aikacin ya tsawaita. gwamnati har zuwa 2021.
Bugu da ƙari, NCSA na iya zaɓin yin amfani da haƙƙin babban ɗan kwangila-aggregator: dole ne kamfanin ya cika aƙalla kashi 30 na odar jihar da kanta, kuma don cika sauran odar, hayar ƴan kwangila.
HEMS a Rasha, nazarin ci gaba a cikin lokacin 2017 - 2021
Don gano yadda kasuwar motar motar asibiti ta canza tare da zuwan HCSA, Cibiyar Nazarin ta bincikar kwangilar siyan kayan EIS don sabis na fitarwa na likita da aka kammala a cikin shekaru biyar da suka gabata.
Don yin wannan, ta amfani da sabis na zakupki360.ru, an sanar da kwangilar siyan kuɗi daga 1 Janairu 2017 zuwa 31 Disamba 2021 tare da OKPD 62.20.10.111 (sabis na jigilar fasinjoji ta jirgin sama a kan jiragen haya) da 51.10.20. 000 (sabis na hayar jirgin sama tare da ma'aikatan jirgin), wanda ya ambaci kalmomi masu mahimmanci 'kulawa' ko 'aero-ambulance' a kowane bambance-bambancen, da kuma babban tsari - 86.90.14.000 (sabis na motar asibiti) da 52.23.19.115 (aiki) don samar da kulawar likita), a cikin kwangilolin da ke dauke da kalmar 'jirgin sama'.
Kasuwanci na musamman na umarni na jihohi an ba da kuɗi ta hanyoyi biyu: daga kasafin kudin tarayya (a cikin 2021, an tanadar da biliyan 5.2 don waɗannan dalilai, a cikin 2022, an tsara wani 5.4 biliyan rubles) kuma daga yankuna.
HEMS, darajar sabis na helikwafta a Rasha ya karu zuwa 43.641 biliyan rubles a cikin shekaru biyar da suka gabata.
Ya zuwa shekarar 2018, karuwar ta yi yawa: daga biliyan 3,886 rubles a shekarar 2018 zuwa biliyan 7,552 a shekarar 2019, sannan daga biliyan 11,657 a shekarar 2020 zuwa biliyan 16,672 a shekarar 2021.
Masu ba da kayayyaki 74 ne kawai suka bayyana a kasuwa tsawon shekaru, yayin da kamfanonin TOP25 ke ba da 92% na ayyukan kwangila.
Adadin sayayya a ƙarƙashin Dokar Tarayya ta 223, wacce ba ta ba da izinin buga yarjejeniya da ƴan kwangila ba don haka ba ta ba da izinin kafa ikon mallakar su ba, ya kai biliyan 2.554.
Shugaban TOP25 da alama NSSA JSC (kasuwar kuma tana da NSSA LLC mai suna, wanda aka sake masa suna daga Heli-Drive Medspas LLC), wanda a hankali ya ƙara girman kwangilarsa daga 10.7 rubles a 2018 zuwa 4.342 biliyan rubles a 2021.
Duk da haka, fadada NSSA, wanda ke tasowa a karkashin jagorancin abokin tarayya mai karfi a cikin tsarin mulkin kasa, ba za a iya kiran shi wasan yara ba.
Ga ‘yan misalai kaɗan.
A cikin Janairu 2021, NSSA ta sami kwangila da Asibitin Nenets mai suna NI RI Batmanova, kuma a zahiri washegari, a ƙarshen yarjejeniyar, an gano cewa NSSA ba za ta iya samar da jiragen ba.
Sakamakon haka? “Ba a ƙyale sabon ma’aikacin ya sauka da jirage masu saukar ungulu a filin jirgin saman yankin ba. Don haka, a zahiri, an hana wanda ya lashe gasar damar yin aiki,' in ji wata majiya daga Rukunin Kamfanoni na Rostec.
An warware rikicin ta hanyar dakatar da kwangilar a matakin NSSA.
Irin wannan labari, ko da yake yana da wani sakamako na daban, ya faru a Tyumen: a can, a cikin Nuwamba 2021, NSCA ta yi nasara tare da dillalan gargajiya na yankin, JSC UTair - Sabis na Helicopter, tare da farashin farashi na 139.9 rubles.
Duk da haka, Asibitin Clinical na Yanki No. 1, wanda ya yi aiki a matsayin abokin ciniki, ya sanya hannu kan kwangila tare da UTair, yana tabbatar da yanke shawara tare da shaida cewa NCSA ba za ta iya cika kwangilar ba saboda ba ta da damar yin amfani da wuraren saukowa.
Hukumar ta NCSA, ta yi nuni da cewa, a nata ra’ayi matsalar wata matsala ce ta daban, wato aljihu na juriya ga yadda ake gudanar da aikin, ya samo asali ne daga matsayin kamfanonin jiragen sama na cikin gida da ba su taba kware a harkar jiragen sama ba, amma suna jin dadin tallafin. na abokan ciniki na jihohi waɗanda ke da'awar ka'idar 'kudi ya kamata ya tsaya a yankin'.
NCSA tana ƙoƙarin magance ƙayyadaddun yanayin gasa na yanki kawai tare da hanyoyin doka, kamfanin ya tabbatar.
A cikin Afrilu 2019, a cikin Order No. 236n, Ma'aikatar Lafiya ta Tarayyar Rasha ta gabatar da ma'auni don motar asibiti ta iska. kayan aiki a cikin Tsarin Bayar da Kula da Kiwon Lafiyar Gaggawa: jerin da ake buƙata sun haɗa da na'urorin motsa jiki, numfashi da kayan aikin farfadowa, marufi da tsarin likita tare da shimfiɗa.
Dokar ta ba da damar cire masu fasaha da sassan da ba su da kayan aiki daga tsarin jihar.
Kuma a cikin watan Satumba na 2019, masu gudanarwa sun amince da daidaitaccen kwangila don aiwatar da aikin iska don samar da kulawar likita, wanda ya zama nau'i na tilas daga Fabrairu 2022, yana nuna shirye-shiryen sharuɗɗan sayan jama'a.
Koyaya, tsawon shekaru biyar akan hanyar NSSA zuwa jimillar cin kasuwa, matsaloli masu tsanani sun taso fiye da fafatawar da masu fafatawa da ɗaiɗaikun masu fafatawa ko abokan ciniki mara kyau.
Tambaya ce ta gina jirgin ruwa na mutum. Shirin farko na sayen jirage masu saukar ungulu 150, wanda nan take zai mayar da HCSA zuwa daya daga cikin manyan masu samar da dukkan jiragen sama na kasar, ya tsaya kusan nan take: cibiyoyin hada-hadar kudi ba su shirya ba da lamuni ga sabon kamfani ba tare da garanti da garanti ba.
Sakamakon haka, maimakon jirage 50 da aka tsara don 2019, ma'aikacin tarayya ya karɓi takwas kawai.
Lamarin ya inganta ne kawai a farkon 2021.
Bayan samun garanti daga Gwamnatin Tarayyar Rasha da Kamfanin Rostec State Corporation, NSSA ta sanya hannu kan kwangiloli biyu tare da JSC PSB Avialeasing don samar da jirage masu saukar ungulu 66 - 29 Mi-8MTV-1s da 37 Ansats - don jimlar 21.4 biliyan rubles.
Har ila yau, akwai gazawa a masana'anta - KVZ, wanda tsarin NSCA ya kasance mafi girma a cikin shekaru 30.
Isar da kayayyaki kawai ya inganta a tsakiyar 2021, lokacin da aka aika sabbin jirage masu saukar ungulu guda 14 zuwa kamfanin.
Tun daga ranar 1 ga Fabrairu 2022, rundunar NSSA ta riga ta ƙunshi motoci 22: 11 Ansats da 11 Mi-8 kowanne.
HEMS a Rasha, ƙarancin jirage masu saukar ungulu ya tilasta NSSA don ƙara yawan rabon kwangilar
A cikin 2020-2021, kamfanin ya sanya hannu kan kwangilar da ya kai 2.2-2.7 biliyan rubles a kowace shekara.
An samu ci gaba da samun bunkasuwa mai tushe guda a shekarar 2021 musamman ta hanyar jawo kamfanonin jiragen sama da ke aiki a yankuna kafin zuwan NCSA a matsayin abokin tarayya.
A cikin Novgorod yankin, alal misali, RVS JSC sanya hannu a subcontract, a cikin Altai - AltaiAvia yankin (22nd wuri, 0.323 biliyan rubles), da kuma kudin da jirgin awa a sakandare kwangila ne sau da yawa 10-20 dubu rubles kasa da babban. farashin.
NCSA ta bayyana bambanci, ko da yake ba shi da mahimmanci, ta hanyar farashin su don samar da ababen more rayuwa da kuma gabatar da ka'idojin motar asibiti na iska a cikin yankuna, yayin da masu kwangila kawai ke tashi kuma an keɓe su daga irin wannan farashin.
ƙwararrun 'yan wasa suna ramawa ga raguwar fa'ida a cikin kasuwar oda ta jihar ta hanyar haɓaka sabbin abubuwan more rayuwa.
Misali, RVS JSC, daya daga cikin manyan masu fafatawa na NSSA a jirgin sama na likitanci, ya ha]a hannu da Medsi Group a watan Mayu 2021 don ƙirƙirar sabis na korar likita ga marasa lafiya a cibiyoyin sadarwa na Moscow.
Yarjejeniyar ta ƙunshi shirya jigilar jiragen sama daga yankin Moscow da sauran yankuna zuwa wurin asibitin asibiti na Otradnoye ko kuma cibiyar RVS a Odintsovo, inda za a aika da marasa lafiya ta hanyar motar asibiti zuwa asibitocin kungiyar.
Ana tsammanin cewa farashin sabis ɗin zai fara daga 15 dubu rubles, dangane da wurin da lokacin jirgin.
A cewar Sergey Khomyakov, mataimakin babban darektan RVS, haɗin gwiwar zai dauki sabis na motar asibiti na iska a Rasha 'zuwa sabon matakin inganci'.
Bukatar haɓaka guda ɗaya, cibiyar sadarwa ta IT don daidaita ayyukan HEMS a Rasha
Daga cikin ainihin ayyukan NSSA da aka yi amfani da su shine haɓaka dandamalin IT wanda aka daidaita shi HEMS za a gina tsarin jigilar jiragen sama.
A watan Fabrairun 2019, a wani taro a Ma'aikatar Lafiya ta Tarayyar Rasha, an tsara umarnin don haɗa tsarin tsarin '' Gaggawa da Kula da Kiwon Lafiyar Gaggawa 'a cikin Tsarin Bayanai na Lafiya na Jiha Uniform, gami da na'urar motar daukar marasa lafiya ta iska a ciki.
Dan kwangila don haɓaka Tsarin Bayanan Lafiya na Jiha Uniform har zuwa 2021 ya kasance Rostec iri ɗaya ne.
Haka kuma, a lokacin bazara na 2019, bisa ga majiyoyin sufurin jiragen sama na Kommersant, Rostec ya ƙarfafa gungumen azaba a cikin NCSA.
Ya zuwa yanzu, ba a tsawaita matsayin mai ba da kayayyaki ga NSSA ba.
A cewar hukumar, har yanzu babu wani shiri na dakatar da tallafin da gwamnatin tarayya ke ba wa jiragen sama na likitanci: ci gaban hidimar na kunshe ne a cikin jerin manufofin kasa har zuwa shekarar 2030, duk da haka, har yanzu nauyin da ake kashewa wajen gina jiragen sama masu saukar ungulu zai ci gaba da daukar nauyi. yankin.
Koyaya, ana yin la'akari da yuwuwar ba da tallafin kuɗin waɗannan wurare a ƙarƙashin wani aikin tarayya - 'Safe and High-Quality Routes' -.
Sabbin yanayin takunkumi sun kara haɗarin NSSA a cikin layin samar da jiragen ruwa: a cikin Maris 2022, an gano cewa sashin Kanada na Pratt & Whitney na Amurka ya dakatar da samar da injunan PW207K zuwa KVZ, wanda Ansat ya tashi.
Analogin cikin gida - Injin VK-650V wanda ODK-Klimov ya haɓaka - yana wanzu ne kawai a cikin sigar gwaji, kuma ba a tsammanin takaddun shaida har zuwa 2023.
Ɗaya daga cikin zaɓuɓɓukan da aka yi la'akari da su a cikin masana'antu, ban da haɓaka hanyoyin don VK-650V, shine haɗin gwiwar tashar wutar lantarki ta VK-800V don bukatun Ansat.
Koyaya, injin helikwafta na Kazan yana da niyyar samar da helikofta 44 na Ansat a cikin 2022 - mai yuwuwa, wasu daga cikinsu za a taru daga hannun jari.
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