Commercial ambulance. Paid ambulance and transportation

Every person experiences various health problems from time to time. They can cause a lot of discomfort, but in general they are most often amenable to successful treatment at home under the supervision of a qualified therapist. However, in some cases, a person’s health is suddenly disrupted, which poses a serious threat to life. Similar conditions require immediate medical attention. The topic of our conversation today will be paid emergency medical care; we will discuss paid emergency medical services in a little more detail.

Paid ambulance services are especially actual topic for many patients of different ages and gender. Indeed, despite the level of development of medicine, free medical care today leaves much to be desired in terms of attitude towards the patient. And emergency medical care should generally be considered as an indicator of the attitude of doctors towards patients. Many people who have at least once had to call a free emergency room have had to draw rather disappointing conclusions.

a commercial ambulance does not have a clear standard for the time spent with each patient; this is one of the main differences from the eternally overloaded city structures. Paid ambulance doctors are in no hurry; they can provide assistance at home as long as there is a need for it.

Others distinctive features commercial medical services Ambulance

Paid ambulance doctors are interested in providing guaranteed quality service. This structure employs highly qualified doctors, as well as qualified personnel. To work in a paid ambulance, specialists are recruited who have many years of experience and have already served in hospital and intensive care units, as well as in medical institutions.

Paid ambulance service is offered to all patients individual approach, and the entire range of services they provide is quite wide.

Such commercial structures have modern control centers. They can simultaneously take several calls, make an instant assessment of the situation, give advice and quickly dispatch the right team to the call.

Also, paid medical structures have at their disposal their own air ambulance, for example, airplanes and helicopters.

In addition, commercial ambulance doctors treat their clients politely and attentively. And they do not need to provide any documents - no passport, no compulsory medical insurance policy, no registration.

Thanks to these qualities, paid ambulance services are popular among patients in many cities of Russia.

Paid ambulance services medical care

Commercial medical structures offer a number of services to their patients:

Emergency help;
- resuscitation;
- children's and adult ambulances;
- transportation of patients by car, plane (helicopter) and train;
- calling a doctor at home;
- duty at various public events.

The most popular paid ambulance services

Quite often, paid ambulances are called in cases where the patient’s life is at stake. After all, when there is an immediate threat to life, you cannot trust random people. Paid ambulance doctors have extensive experience working in emergency calls. And new, reliable imported commercial vehicles are equipped with everything necessary to stabilize and further maintain the vital functions of the injured person on the way to the hospital.

Ambulance crews resuscitation care usually consist of a resuscitator-anesthesiologist, a paramedic and a driver who has undergone special training in high-speed driving in urban conditions.

Paid ambulance services for pregnant women and women in labor are also especially popular among clients. Such patients are visited by a special obstetric team, usually consisting of an obstetrician-gynecologist, a paramedic and a driver. Doctors will quickly come to the rescue natural childbirth and different dangerous conditions, they will deliver the patient to the hospital in literally a matter of minutes. A paid ambulance can deliver a woman in labor to any maternity hospital (by agreement), while a government ambulance will only take her to her place of registration.

Paid ambulance doctors are often called to provide emergency psychiatric or drug treatment. The main difference between these services and similar actions public services consists of complete anonymity.

Paid ambulances are often used to transport bedridden, seated and stretchered patients. The state ambulance provides free transportation only to the inpatient department at the place of residence. And commercial structures can organize transportation throughout the city, country, or even beyond its borders. And for this, not only cars, but also air ambulances can be used.

Paid state ambulance services

In many Russian cities, state ambulance services also provide paid services. They mainly concern non-emergency and emergency care, but only additional capabilities of the medical institution.

Such services are provided after the conclusion of a contract, and they are described in detail in the documents of a specific department of the Ambulance and Emergency Aid Station.

Among paid services State ambulance services can be distinguished:

Medical care by ambulance for various mass entertainment and sporting events;
- medical service emergency medical technicians when transporting a patient;
- conducting medical examination drivers (pre-trip and post-trip).

Private ambulance: legal aspects, license, equipment, personnel, “kitchen”.

Private ambulance - 24-hour emergency structure medical care in case of emergency conditions en route to medical institution or directly at the scene of the disaster.

This service serves as a popular way to enter the medical business. The explanation is simple: the well-functioning system inherited from the USSR is falling into disrepair, and the emerging middle class and elite cannot satisfy their needs in the public sector. Private ambulance began to develop from the moment of the establishment of all private practice, approximately from 95-98 of the last century, but everything was legally formalized only in 2007, with the adoption of the law on licensing of medical services in the final reading.

There is no key difference from the state emergency medical service, but due to the presence of an excellent material and technical base, high motivation of employees and less workload on the average crew during the day, the patient can count on a more individual approach, and in case emergency conditions, gets access to modern resuscitation equipment, which is not always possible in a government structure. In addition, if the patient has funds, the ambulance can serve as a local or family doctor, as well as provide consulting services - in essence, the client receives a large package on one “hot phone”.

Legal points

Depending on the various situations the stage of formal creation of an ambulance can last up to six months. Most often, these are bureaucratic issues, for example, the license is signed personally by the head of Roszdravnadzor, and it requires decisions from Rospotrebnadzor, a sanitary and epidemiological conclusion on the strict compliance of work and services, tests, physical factors, water quality, washes for sterility - all this can take quite a long time.

The only option for the necessary tasks of an LLC is entity, society with limited liability. An LLC can recruit employees only after obtaining a license.

Optimal taxation - simplified tax system income minus expenses, 15%. OKVED - Healthcare and provision social services , activities in the field of health care, paragraph 85.14.4, activities of emergency medical care institutions.

The method of payment with patients is only receipts, cash desk is not possible in the conditions of an ambulance carriage, receipts must be registered in a special journal for forms strict reporting.

How to get a private ambulance license

Licensing takes place in accordance with the requirements of Resolution No. 30 “On approval of the Regulations on licensing of medical activities” dated January 22, 2007. Deals with permitting papers Roszdravnadzor, licensing is unlimited. It is necessary to collect a package of documents and pay the price for services and fees, in case positive decision.

• A copy of the LLC charter and registration certificate.
• A copy of the conclusion from Rospotrebnadzor.
• Lease agreement or property documents.
• Lists of medical equipment and certificates of conformity.
• Papers for each employee, excluding the driver and accountant - diploma, post-graduate training, internship or residency, certificate and category rating.
• Application for consideration of the case and a check for the services of consideration and work on your issue.

Room for machine base

SanPiN requirements for the size of the premises and a mandatory bathroom must be met already at the stage of renting the premises. SanPiN 2.1.3.1375-03 “Hygienic requirements for the placement, design, equipment and operation of hospitals, maternity hospitals and other medical hospitals”

We need a base that will combine the functions of a logistics center, a garage and a rest room; later you can expand the range of services, introduce several inpatient wards and a manipulation room, although it is optimal to do this at the opening stage in order to form a favorable opinion about the brand. There will also be help desk, which also needs to be highlighted separate office- she will work with clients and guide crews; these employees also need a place to rest.

Equipment

It is quite possible to start even with one special car, especially considering the prices, approximately 900,000 rubles for a Gazelle chassis and 2 million for a Mercedes chassis. You can transport patients and go out on single calls, building up a client base. But Desired minimum: three cars- two linear and pediatric, one specialized cardio and resuscitation.

Of the equipment they usually put on each resuscitation kit (oxygen, manual ventilator, perfuser, defibrillator and cardiac monitor- its cost may vary, depending on the manufacturer, but preferably German and Italian manufacturers, if the budget allows). This is necessary for logistics purposes; sometimes a specialized team may be on call, and resuscitation measures should be carried out by a regular linear one.

Technology and PBX with several channels, walkie-talkies for cars and the costs of their registration - also need to be taken into account. The initial costs for refrigerators for medications, safes for storing the A list, and, in fact, the medications themselves can be quite significant. Acquainted with necessary equipment and consumables can be found in the “List of equipment for the visiting team” ( Appendix 1.13 of the order of the Ministry of Health Russian Federation dated March 26, 1999 N 100).

Staff

• Drivers, who must have excellent knowledge of the city - best of all, with experience in a state ambulance or taxi.
• Accountant- he can be hired before licensing, there will be enough work, especially in terms of reporting.
• Chief physician - administrator, director and person who controls all operational issues, with experience in management work.
• Crews- usually a doctor and a paramedic, preference for men who can carry a patient and get him out of a car. Usually there must be an obstetrician, a surgeon and a cardiologist; a narcologist is also often included in the team; calls to relieve withdrawal symptoms are not uncommon. Crews are staffed on a daily basis - three for each ambulance.
• Dispatching service- usually junior medical staff who can adequately assess the situation and make a decision about the need to send a particular team and, in general, about the advisability of calling.
• Sales Manager- a person who works with private insurance companies, with a corporate client, negotiates with city authorities to conduct city holidays and sporting events, offers services to individuals for monitoring and managing patients.

To start work, you usually need a fairly large team - from 20 people, in the case of 3 cars, in addition, you will need a nurse and a mechanic who can fix any problem in the car in emergency mode.

Private ambulance services

Typically, following the letter of the law, a private ambulance provides the following services.

• Conducting remote consultation and monitoring of seriously ill patients.
• Providing emergency medical care when indicated.
• Transportation of bedridden patients and people who, according to indications, require constant medical supervision.
• Detoxification activities at home - withdrawal from binge drinking and various abstinence.
• Call any specialist to your home for guidance or consultation.
• Servicing corporate events and celebrations.
• Additional medical services at the station - massage, exercise therapy, various courses.
• Segment health insurance- a promising and broad topic that goes beyond the scope of this review.

The target audience services - wealthy people who are dissatisfied with the quality of public ambulance services, people who need supervision and monitoring (bedridden and chronically ill patients). These are also young people with drug or alcohol addiction who does not want publicity or feels the need for medical supervision, a corporate client who needs to provide adequate medical care for mass events, the middle class who uses insurance medicine.

How does the structure of private ambulance work?

To call a private ambulance, you need to make a call to the dispatcher - anyone who wants to can call it, not just the client private clinic and using an insurance policy. After receiving an incoming call on a landline phone with a conversation recording function, the dispatcher carries out initial work with the patient - interviews him about symptoms, writes down the address, enters it into a strict reporting journal and into a special computer program. Payment is made after medical care is provided, since the “check” can “float” depending on the drugs used. It is worth paying attention to the fact that the standard package usually includes diagnostics, including a cardiogram.

After assistance, the patient is sent to the hospital according to indications. Typically, urgent patients and people who are unconscious end up in emergency hospitals and specialized departments, while chronic patients have a choice between private medicine and state aid. If the client uses insurance medicine, the certificate usually indicates the desired place of hospitalization, even if the patient is in unconscious, you can easily navigate.

Reception department indicates in the crew route sheet the time of arrival, the preliminary diagnosis and signs that the patient has been admitted to the hospital. This is where all relationships between a private ambulance and a hospital institution end, the hospital is not responsible either to the private owner or to third parties, just as private owners are not responsible after they have admitted a patient.

IN modern society a person does not have to constantly worry about his safety. Development of socially significant public services has led to people relying on emergency services without a shadow of a doubt. At any time of the day and in any weather, in case of danger, you just need to make a call and firefighters, police and ambulance will arrive on call. For the average citizen, firefighters and police have virtually no alternative. But this does not apply to the emergency room. Today everyone can call a paid ambulance in Moscow. Its greater efficiency and better equipment increases the chances of everyone who contacts it for a favorable resolution of the emergency situation. The right to choose is an inalienable right of everyone. There is no need to deprive yourself of this right through banal ignorance at moments when timing is everything. Therefore, everyone should know how to call a paid ambulance. This knowledge can save lives or preserve health. Calling a paid ambulance is justified not only in emergency situations. Events planned in advance, such as transportation of sick or pregnant women, are best carried out using a commercial ambulance. Private ambulances are much better equipped than government ones. We should not forget about banal comfort, which plays an important role even for healthy people, and even more so for sick and pregnant women.

When people learn about the existence of a commercial ambulance service, many of them are first of all interested in how much it costs to call a paid ambulance. This interest is quite reasonable. But it should be noted that it arises only at moments when there is no need for help itself. When the unexpected happens and people’s lives and their health are in serious danger, doubts are dispelled. This happens because, in fact, everyone is well aware of the problems of modern state medicine. And of course, at the moment when loyalty and speed decisions made become more important than ever, the question of how much it costs to call an ambulance is losing its relevance. After all, no one will try to evaluate a person’s life, especially at the moment when this life is under immediate threat. Such a complex and multidisciplinary organization as emergency medical care on a commercial basis cannot survive on rare calls from wealthy clients. Services of this kind are massive by definition. Therefore, the cost of calling an ambulance cannot be high.

The state ambulance service suffers from staff shortages. This affects the number and composition of crews. Even the call center is often overloaded, and waiting for an operator to respond adds to the time the team will spend on the road. A private ambulance is devoid of these disadvantages due to its nature. As the number of calls increases, the organization’s income increases, and hence the number of staff. Thus, constant increase the quality and efficiency of the services provided is part of a natural process for private emergency medical care. Everyone who, in moments of crisis, did not become confused and preferred a paid ambulance service, appreciated the qualifications of the staff and the equipment of the teams receiving proper funding.

Private entrepreneurship in Russia is developing and conquering new sectors of the service market every year. It is no longer new to use a private bank, security agency or ambulance. It is difficult to open your own ambulance, since this type of activity requires licensing and large investments. But if you are not afraid of difficulties and you have a certain amount in your stash, then you can try. Let’s talk in more detail about the specifics of the business of providing medical services and organizing private ambulances.

Business specifics

State bodies have transferred into private hands those areas that were previously inaccessible to entrepreneurs. These include housing and communal services, ambulance, education, and medical services. Of course, there are many complaints about the high cost of services that people are used to receiving for free, but positive reviews prevail.

For example, by calling an ambulance by phone 03, you can wait for doctors no earlier than 20-30 minutes later. A private ambulance will rush to the scene at the earliest short time– 5-10 minutes. It’s the same distance to travel to a patient in a state ambulance, but the staff is not always motivated, and they have a lot more challenges. In a private company, specialists receive a salary and a percentage for each call and service provided, so a good purpose and prosaic nature are intertwined. The doctor will rush to the patient and provide all the services he needs.

In addition, the Ministry of Health is receiving less and less funding, and high-quality modern equipment can only be found in private clinics. And a third of the success of treatment depends on its quality. Patients prefer to pay and receive help high level than using the policy and wasting time in queues.

According to statistics, 70% of entrepreneurs who are engaged in medical business in Russia do not have a medical education at all. Therefore, everyone will be able to open their own medical care service to the population.

Private ambulance services are provided to the public the following types services (the list in each private company can be expanded or narrowed):

1. Examination and consultation of the patient, diagnosis of the disease – 500–800 rubles.
2. Transporting a patient to a hospital or for diagnostics – 600-1000 rubles.
3. Providing first aid on site for a diagnosed disease – 500-1500 rubles.
4. Patronage and observation of a patient who needs constant monitoring - 2500 rubles/day.
5. Detoxification of patients (measures necessary to withdraw from drugs or alcohol intoxication) – 2500-4000 rub.
6. Accompaniment by medical staff of mass events or trips of schoolchildren - 3500-6000 rubles.
7. Additional services at the central ambulance office (ultrasound, ECG), consultation with specialists, massage - from 1200 rubles.

Target audience - any person with average and high income. People who want to get help incognito (for example, drug addicts or alcohol addicts) also often turn to a private emergency room.

A private emergency room can receive additional income by concluding contracts with the same entrepreneurs who provide medical services. But the patient is given a choice of which hospital to be taken to – private or public.

The technical side of the business

To organize a medical business, you must have a license. But it is difficult to obtain a document from Roszdravnadzor. You will have to undergo a series of checks from various government agencies, as a result of which you will be given written reports. Only an LLC can obtain a license to provide emergency medical services. Therefore, a limited liability company is initially registered. When registering, select a type code OKVED activities– 85.14.4 “Activities of emergency medical care institutions.”

A package of documents is submitted to Roszdravnadzor:

1. Statutory documentation of the company.
2. Application for a license. The form can be viewed on the Roszdravnadzor website.
3. Certificate.
4. Copy of passports and TIN of all founders.
5. Certificate of ownership or lease agreement for the premises where the emergency center is located.
6. Certificates of conformity for tools and equipment.
7. A copy of the conclusion from Rospotrebnadzor.
8. Copies of documents that confirm the education and qualifications of each employee of the company.

Detailed list of documents and requirements for medical equipment can be found in the SanPiN documents “On approval of the Licensing Regulations medical activities" You can download the list.

Red tape with documents can drag on for six months. It will take more than one week until the field commissions check you and each makes its own conclusion. Then a council meets, where a decision on issuing a license will be made.

Ambulance equipment

The most minimal equipment of a private ambulance will cost you at least 5 million rubles. Of course, you can start working with one car and a mobile team of several people, but such an “ambulance” may not be able to respond to all calls. Plus, if the team is busy doing field work, there will simply be no one to send to your clients.

The best option is to start working with four machines:

• Reanimation vehicle.
• Pediatric team car.
• Two line lines, for traveling to regular calls.

Each vehicle contains the following standard equipment:

• Defibrillator – 78-100 thousand rubles.
• Cardiac monitor – 150-300 thousand rubles.
• Device for artificial ventilation lungs – 60-100 thousand rubles.
• Perfusor (electronic syringe pump), 2-3 pcs for each machine, – 100-150 rub./pc.
• Oxygen apparatus – 30-150 thousand rubles.
• Mini-refrigerator for medicines – 20-40 thousand rubles.

A stationary refrigerator for storing medicines is installed in the company's office - 60-100 thousand rubles, a safe for storing drugs containing drugs - 50-100 thousand rubles. Each car is equipped with a walkie-talkie, a station is placed in the office - 90 thousand rubles. The biggest cost when equipping the center will be spent on a resuscitation vehicle; its price on the Moscow market depends on the brand.

A car based on a foreign car like Mercedes-Benz Sprinter will cost 2 million 850 thousand. A car based on a GAZelle will cost a little less - from 1 million 500 thousand. We do not recommend buying used equipment, since the quality of equipment in your ambulance will The reputation of the company and the lives of patients will depend.

Selecting staff

For travel, staff are hired with medical education and work experience of at least 5 years. Newbies can screw things up, and one misdiagnosis can jeopardize the reputation of a startup company.

The doctors’ work schedule does not differ from the state one – every day or three. You can hire part-time specialists from large public clinics. But a license is issued subject to permanent employees, so you must have 3 doctors on a permanent basis: the head physician, the deputy and the paramedic.

Except medical personnel, drivers with knowledge of the city and suburbs are required. How quickly the on-call team will arrive depends on their experience. For a large project, an accountant is hired who will manage the financial part of the business, and dispatchers who take calls. Students of medical universities are suitable for the role of the latter. Young professionals are theoretically familiar with the symptoms of diseases and will be able to select the right field team.

Eventually

When opening your own emergency room, you should understand that you will have to invest a lot in the business. The company will pay for itself no sooner than in 2-3 years. It is difficult to recruit regular clients, since trust in doctors comes with time. When investing 5-10 million rubles into a business, do not forget that ambulances should first of all serve people. Therefore, any savings can cost you the collapsed reputation of the company, and for someone - their life.