PURPOSE OF THE STUDY This thesis presents the very current topic of general hospital preparedness to deal with crisis situations in mass casualty incidents. MATERIAL AND METHODS The key part of the work consists in a questionnaire survey of 26 foreign and domestic respondents, which provides a very good description of this issue in various countries of the world. The group is divided into health facilities in developed and developing countries of the world according to the UN Human Development Index. Another sub-group consists of hospitals in areas with a higher frequency of terrorist attacks and a separate group is formed by 5 hospitals in the Czech Republic. Based on the results of the questionnaire survey, the preparedness of hospitals for dealing with mass casualty incidents is compared in both the groups according to the advancement of the country and also in the subgroup of hospitals in the Czech Republic and in countries with frequent terrorist attacks. The maximum achievable score evaluating the hospital readiness is 20 points. The data obtained by the questionnaire survey is evaluated using statistical methods. RESULTS Higher preparedness of hospitals was found in developed countries, with a hospital preparedness score of 12.9 points compared with 5.9 points in developing countries' hospitals. Hospitals in the Czech Republic show a similar readiness for mass casualties as the other hospitals in developed countries, with the mean score of 12.2 points. Hospitals in countries with a higher number of terrorist attacks did not show a higher readiness to deal with crisis situations associated with mass casualties - the mean score of 9.4 points. DISCUSSION The following discussions and evaluations, together with personal experience and thorough knowledge of real-life solutions, became the basis for recommendations of triage procedures, organization of surgery and traumatology departments and material equipment of medical facilities in the Czech Republic. CONCLUSIONS By applying the results of the habilitation thesis it is possible to achieve an optimal solution and increase the reliability in the preparedness of hospitals in dealing with crisis situations, especially to eliminate the discrepancy between theory and practice. Key words: mass casualty incidents, triage, hospital preparedness, disaster management response.

1 chirurgická klinika klinika hrudní břišní a úrazové chirurgie Všeobecné fakultní nemocnice a 1 lékařské fakulty Univerzity Karlovy Praha

Klinika rehabilitačního lékařství 1 lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice Praha

Oddělení úrazové chirurgie Nemocnice České Budějovice

Ortopedicko traumatologická klinika Fakultní nemocnice Královské Vinohrady a 3 lékařské fakulty Univerzity Karlovy Praha

Ortopedicko traumatologické oddělení Nemocnice Znojmo

Traumatologické centrum Fakultní nemocnice Ostrava

Comparison of Hospital Preparedness to Deal with Crisis Situations in Mass Casualty Incidents According to the UN Human Development Index