scholarly journals Evaluation of the quality of medical care in a multiprofile Federal center

2009 ◽  
Vol 15 (2) ◽  
pp. 170-180
Author(s):  
Y. Kasherininov
Keyword(s):  
Medical Care ◽  
High Technology ◽  
Regional Health ◽  
Simple Method ◽  
Coronary Syndrome ◽  
Regional Health Care ◽  
Quality Of Medical Care ◽  
Treatment Procedures ◽  
Federal Center

A simple method of evaluating the quality of medical care is presented. Using offered form and expert findings it is possible to make a quantitative conclusion assessing different stages of the diagnostic and treatment procedures, comparing different departments and workers, and analyzing co-elaboration between multitype Federal centre and regional health care system of Russian federation in performing high-technology treatment and diagnostics. There are several examples showing comparative sample check examination between different cardiology departments, and an example of an expert evaluation of an acute coronary syndrome case is given.

Social portrait of a professional group of doctors in the regional healthcare

2020 ◽  
pp. 70-74
Author(s):  
M. G. Eremina ◽  
E. P. Kovalev ◽  
V. L. Krom
Keyword(s):  
Health Care ◽  
Public Health System ◽  
Professional Group ◽  
Sociological Study ◽  
Regional Health ◽  
The Public ◽  
Primary Health ◽  
Regional Health Care ◽  
Quality Of Medical Care

The article presents the results of a sociological study «Social portrait of a professional group of doctors in regional health care», for which a survey of 976 doctors of state, municipal and private medical organizations of the Saratov region was conducted. In regional health care, there is a shortage of polyclinic doctors in the public health system (–986 doctors) with a small surplus of doctors in inpatient medical organizations (+91). The main deficit (–939 people out of the estimated 3727 people) was established among the doctors of the district service, which determines the low availability and quality of medical care in the provision of primary health care, which is the basis of the Russian health care system.

scholarly journals Treatment of patients with acute coronary syndrome in 2019 (data from federal registry of acute coronary syndrome)

2020 ◽  
pp. 37-45
Author(s):  
О.В. Сагайдак ◽  
Е.В. Ощепкова ◽  
Ю.В. Попова ◽  
О.М. Посненкова ◽  
А.Р. Киселев ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Medical Care ◽  
Median Time ◽  
Myocardial Revascularization ◽  
Care Quality ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Quality Of Medical Care

Введение. Проблема качества оказания медицинской помощи больным с острым коронарным синдромом (ОКС) является одной из наиболее актуальных для нашей страны, так как летальность, особенно при ОКС с подъемом сегмента ST (ОКСсST) остается на высоком уровне. Федеральный регистр больных с ОКС (далее – Регистр) дает возможность выявлять недостатки и разрабатывать подходы к улучшению оказания медицинской помощи больным в реальной клинической практике. Цель исследования: анализ качества оказания медицинской помощи больным с ОКС, прошедших лечение в 2019 году. Материалы и методы. За период с 01.01.2019 по 31.12.2019 в Регистр были внесены данные 27929 больных с ОКС из 138 медицинских организаций 32 субъектов Российской Федерации (средний возраст 65,3±11,7 лет, 62,7% мужчин). Результаты: Из 20757 у 65,9% (n= 13399) диагноз при выписке – острый и повторный инфаркт миокарда, у 32,6% – нестабильная стенокардия. 44,7% (n=9287) составили больные с ОКС с подъемом сегмента ST (ОКСсST), 55,3% (n=11470) – c ОКС без подъема сегмента ST(ОКСбST). Из 9287 больных с ОКСсST75,8% (n=7044) была выполнена реваскуляризация миокарда. Из них у 21,7% (n=1532) использовался фармакоинвазивный подход, у 61,1% (n=4304) больных выполнено только ЧКВ, у 17,0% больных проводили только тромболитичсекую терапию без ЧКВ. Остальным больным реваскуляризация не была проведена и выбрана консервативная тактика лечения. Из 11470 больных с ОКСбST реваскуляризация выполнена лишь у 31,5% (n=3621). У больных с ОКСсSTмедиана времени от момента госпитализации до начала ЧКВ составило 55 [34;106] мин. Медиана времени от начала симптомов заболевания до начала ЧКВ составила 320 [180;807] мин. Среди больных с ОКСбST медиана времени от момента госпитализации до начала ЧКВ составила 195 [75;1025] мин. От начала симптомов заболевания до начала ЧКВ составила 945 [370;2620] мин. Заключение При анализе соответствия клиническим рекомендациям, отмечается, что оказание медицинской помощи больным с ОКС оказывается не в полном объеме, что наиболее выраженно в подгруппе больных с ОКС без подъема сегмента ST. Introduction. The problem of the quality of medical care for patients with acute coronary syndrome (ACS) is one of the most relevant for our country, since mortality, especially for patients with ACS with ST segment elevation (ACSwST) remains high. The Federal Registry of Patients with ACS (hereinafter referred to as the Register) makes it possible to identify gaps in medical care quality and develop approaches for its improvement. Objective: to analyze the quality of medical care for patients with ACS who underwent treatment in 2019. Materials and methods. For the period from January 1, 2019 to December 31, 2019, data from 27029 patients with ACS from 138 medical organizations in 32 regions of the Russian Federation was included in the Registry (average age 65.3 ± 11.7 years, 62.7% of men). Results: Out of 20757, 65.9% (n = 13399) had an acute and repeated myocardial infarction diagnosis at discharge, and 32.6% had unstable angina pectoris. 44.7% (n = 9287) were patients with ACS with ST segment elevation (ACSwST), 55.3% (n = 11470) - with ACS without ST segment elevation (ACSnST). Of 9287 patients with ACSwST, 75.8% (n = 7044) underwent myocardial revascularization. Of these, in 21.7% (n = 1532) the pharmacoinvasive approach was used, in 61.1% (n = 4304) of patients only PCI was performed, in 17.0% of patients only thrombolytic therapy without PCI was performed. The remaining patients did not undergo revascularization and conservative treatment was chosen. Of 11470 patients with ACSnST, revascularization was performed only in 31.5% (n = 3621). In patients with ACSwST, the median time from hospitalization to the onset of PCI was 55 [34; 106] min. The median time from the onset of symptoms to the onset of PCI was 320 [180; 807] min. Among patients with ACSnST, the median time from the time of hospitalization to the onset of PCI was 195 [75; 1025] min. From the onset of symptoms to the onset of PCI, it was 945 [370; 2620] min. Conclusion Analyzing the quality of ACS patients medical care we concluded that ssufficient part of patients with ACS are provided with non-optimal treatment due to clinical guidelines, and the medical care is the it was noted that the provision of medical care to patients with ACS is not in full, which is most pronounced in the subgroup of patients with ACS without raising the ST segment.

scholarly journals Simulation Trainings in the Optimization of Medical Care for Patients with Acute Coronary Syndrome

2021 ◽  
pp. 60-63
Author(s):  
I. I. Dolgina ◽  
I. G. Dolzhenkova ◽  
V. V. Savich ◽  
M. F. Grigorian
Keyword(s):  
Quality Of Life ◽  
Acute Coronary Syndrome ◽  
Thrombolytic Therapy ◽  
Medical Care ◽  
Clinical Outcomes ◽  
Simulation Training ◽  
Patient Survival ◽  
Coronary Syndrome ◽  
Quality Of Medical Care

The study analyzes the effectiveness of simulation training aimed at introducing protocols for resuscitation and thrombolytic therapy for emergency medical workers and vascular centers in teamwork by analyzing the clinical outcomes of resuscitation measures, the number and effectiveness of thrombolytic therapy at the prehospital stage and in vascular centers. It has been shown that team simulation trainings contribute to improving the quality of medical care for patients with acute coronary syndrome, improving patient survival and their quality of life.

scholarly journals Avoidable mortality in the Russian regions

Stanovnistvo ◽  
2011 ◽  
Vol 49 (2) ◽  
pp. 1-23
Author(s):  
T.P. Sabgajda ◽  
A.E. Ivanova ◽  
V.G. Semenova ◽  
G.N. Evdokuskina
Keyword(s):  
Public Health ◽  
Medical Care ◽  
Malignant Tumors ◽  
Avoidable Mortality ◽  
Death Rates ◽  
Regional Health Care ◽  
Quality Of Medical Care ◽  
The Difference ◽  
Death Cases

The current trends of avoidable mortality, which is an integral indicator of health system performance, were analyzed. The paper discusses the regional heterogeneity of levels and trends in avoidable mortality in the Russian Federation. Also, it contains the analysis of impact of the financial costs of public health on avoidable mortality in regions with different levels of economic development. The last 20-years period was studied, which includes a stage of crisis as well as a social recovery phase. The official data of the State Statistics Committee were analyzed. In Russia, all death cases are registered in accordance to the international classification ICD-10. Special computer program summarizes death cases from preventable causes, and calculates the standardized rates for the population aged from 5 to 64 years. The old European standard of population age structure is used. Estimates of avoidable mortality were made in accordance with the European approach, under which avoidable mortality accumulates deaths of persons aged from 5 to 64 years due to 34 causes and 4 classes of causes. These 38 causes are divided into 3 groups according to three levels of diseases prevention. The level of avoidable mortality in the different regions varies up to 8 times. That is comparable to the difference between Russia and the countries of European Union in 1994. This gap is due to the coexistence of different stages of epidemiological development among the regions in Russia. When death rates increased, it is shown that mortality from causes which are preventable by measures of primary and tertiary prevention increased to a greater extent than mortality from the causes which depend from measures of secondary prevention. Therein, the largest growth of observed mortality was due to low quality of medical care in case of males (group 3), and due to causes which are preventable by measures of primary prevention in case of females (group 1). When mortality was reduced, the rates of change for causes in groups 1 and 3 were approximately the same for both sexes. Avoidable mortality due to late detection of malignant tumors (group 2) has been changed the least. Preventable component defines over 80% of the regional differences in death rates. In 2009, the level of avoidable mortality differed more than fourfold among different regions of the Russia. Similarly, the difference in the level of unavoidable mortality was 1.3-fold and 1.7-fold, for males and females respectively. Proportion of deaths from preventable causes in the total sum of death cases varies from 40% till 75%. Funding for comprehensive programs of public health to a greater extent stimulates the reduction in mortality from preventable causes of the first group. Mortality connected with quality of medical care is more determined by socio-political situation in the country than by regional health care expenses. Based on these results, it is concluded that the action plans to reduce mortality in Russia must have a strong regional specificity, different targets and indicators. Using the proportion of preventable causes, it is possible to separate the regions into groups with different ratios of death determinants, which, therefore, require different approaches to reduce mortality.

Monitoring the opinions of resident physicians on the state of healthcare system, quality of medical care, and readiness for professional activity in current conditions

2020 ◽  
Vol 26 (4) ◽  
pp. 205-210
Author(s):  
Nataliya A. Kasimovskaya
Keyword(s):  
Medical Care ◽  
Healthcare System ◽  
Medical Profession ◽  
Medical Personnel ◽  
Professional Activity ◽  
System Quality ◽  
Resident Physicians ◽  
Regional Health Care ◽  
Quality Of Medical Care

Despite the ongoing reforms, the staff shortage in the healthcare system and the loss of medical personnel in the field still negatively affect the quality of medical care. The article presents the results of monitoring the opinions of future resident physicians of the current organization and the quality of medical care and their readiness for professional activity, as well as their views to the healthcare system needs. It has been established that every third graduate was not ready for the profession before entering the residency, 36.7% considered their future profession to be nonprestigious, only half of the residents (50.3%) considered the medical profession to be highly paid, and personal aptitude (53%) and abilities (40%) were considered the leading factors in choosing the profession. The residents evaluated the quality of medical care at a high level only in a clinical setting (69.7%), and they do not plan to work in regional health care but prefer to stay in Moscow (60.3%). To preserve the healthcare system human resources, it is advisable to develop a program for managing risk factors for the professional environment, starting with training of personnel at the institute of higher education.

Responsibility for a quality of medical care provided via telemedicine

2018 ◽  
Vol 2018 (1-2) ◽  
pp. 9-15
Author(s):  
Morozov S.P. ◽  
◽  
Vladzymyrskyy A.V. ◽  
Varyushin M.S. ◽  
Aronov A.V. ◽  
...  
Keyword(s):  
Medical Care ◽  
Quality Of Medical Care

METHODOLOGICAL APPROACH TO EVALUATING THE EFFECTIVENESS OF RESOURCE USE BY MEDICAL ORGANIZATIONS

2020 ◽  
Vol 3 (7) ◽  
pp. 62-69
Author(s):  
S. S. BUDARIN ◽  
Keyword(s):  
Medical Care ◽  
Resource Use ◽  
Methodological Approach ◽  
Use Of Resources ◽  
Quality Of Medical Care ◽  
Methodological Approaches ◽  
Performance Audit ◽  
Available Resources

The article reveals methodological approaches to evaluating the effectiveness of the use of resources of medi-cal organizations in order to improve the availability and quality of medical care based on the application of the methodology of performance audit; a methodological approach to the use of individual elements of the efficiency audit methodology for evaluating the performance of medical organizations and the effectiveness of the use of available resources is proposed.

Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

2020 ◽  
Author(s):  
Agustin Lara-Esqueda ◽  
Sergio A Zaizar-Fregoso ◽  
Violeta M Madrigal-Perez ◽  
Mario Ramirez-Flores ◽  
Daniel A Montes-Galindo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Serum Lipids ◽  
Quality Care ◽  
Premature Death ◽  
Current Standard ◽  
Anonymized Data ◽  
Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

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