scholarly journals The development of criteria, indices and indicators and of medical care quality for patients with syndrome of diabetic foot in out-patient practice

2019 ◽  
Vol 60 (3) ◽  
pp. 138-142
Author(s):  
Oleg V. Udovichenko ◽  
E. A. Berseneva ◽  
D. O. Meshkov
Keyword(s):  
Data Collection ◽  
Medical Care ◽  
Diabetic Foot ◽  
Care Quality ◽  
Practice Analysis ◽  
Results Of Treatment ◽  
Quality Of Structure ◽  
Chronic Course

The special techniques of evaluation of every single disease are required for assessing quality and effectiveness of treatment in out-patient practice. The purpose of study was development of criteria, indices and indicators of evaluation of quality of out-patient medical care of patients with syndrome of diabetic foot. The technique of literary searching and practice analysis were applied to develop criteria, indices and indicators for evaluating structure, processes and results of treatment. The evaluation of quality of result requires more complicated techniques of data collection as opposed to indices of quality of structure and processes. The developed indices can be also applied in evaluating effectiveness of treatment of other diseases with chronic course though curable in the main.

scholarly journals THE MEDICAL AND LEGAL ASPECTS OF EFFECTIVENESS EVALUATIONOF THE EXAMINATION AND TREATMENT OF COMPLICATED FORMS OF DIABETICFOOT IN PATIENTS DISSATISFIED WITH THE QUALITY OF MEDICAL CARE PROVIDED

2017 ◽  
Vol 9 (3) ◽  
pp. 121-126
Author(s):  
K N Movchan ◽  
R B Iskhakov ◽  
A V Kovalenko ◽  
K I Rusakevich
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Quality Assessment ◽  
Diabetic Foot ◽  
Healthcare Providers ◽  
Legal Aspects ◽  
Care Quality ◽  
Patient Cooperation ◽  
Quality Of Medical Care

Medical care quality assessment in patients suffering from ulcerous-necrotic forms of diabetic foot is a rather problematic question, especially in cases of negative disease outcome. Patients fighting against diabetes mellitus and its complications for saving their lives occasionally not only criticize the healthcare organization without a good cause but use civil law procedures, bringing in an indictment accusing healthcare practitioners of unsuitable medical care. The article discusses deonto- logical aspects of providing medical care to patients with diabetic foot dissatisfied with the quality of examination and treatment in healthcare providing institutions. It also demonstrates the medical and legal conflict which arose due to medical care quality assessment in a patient with complicated form of diabetic foot who regularly was consulted and was under the care of different health care practitioners as an in-patient so as an out-patient. The article illustrates that important factors in successful treat- ment of patient with diabetes mellitus are professional engagement and interaction between healthcare providers of specialized centres and healthcare practitioners at the out-patient stage as well as case follow-up with suitable and well-timed correction of glucemia. Special attention should be given to doctor-patient cooperation. Only a multidisciplinatory approach offers the possibility to improve the quality of medical care provided to patients with complicated forms of diabetic foot and to reduce the frequency of complaints to different medical, social and politico-administrative authoritative bodies.

scholarly journals MEDICAL-SOCIAL AND ECONOMIC ISSUES IN TREATMENT OF PATIENTS WITH DIABETIC FOOT SYNDROME

2020 ◽  
pp. 42-48
Author(s):  
P. O. Gerasymchuk ◽  
D. B. Fira ◽  
A. V. Pavlyshyn
Keyword(s):  
Medical Care ◽  
Diabetic Foot ◽  
Chronic Wound ◽  
Social Issues ◽  
Diabetic Foot Syndrome ◽  
Economic Issues ◽  
Economic Problems ◽  
Results Of Treatment ◽  
Patients With Diabetes

Introduction. Аt the present stage of treatment of patients with diabetic foot syndrome can not yet be considered satisfactory, which requires further study of this problem in order to improve the provision of medical and social care to the above patients. Aim. Тo study medical, social and economic issues of providing medical care to patients with diabetic foot syndrome based on the analysis of their treatment in the Ternopil region. Matherials and Methods. The study is based on a retrospective analysis of the treatment of 1963 patients with diabetes mellitus complicated by diabetic foot syndrome during 2000–2017. Neuropathic-infected form of foot lesion was diagnosed in 692 (35.2 %) patients, ischemic-gangrenous - in 604 (30.8 %), mixed – in 667 (34 %) patients. According to the degree of lesion (according to Megitt - Wagner), the distribution of patients was as follows: II – 247 (12.6 %) patients, III – 995 (50.7 %), IV – 584 (29.7 %), V – 137 7 %) of patients. Patients with acute purulent-necrotic lesions and chronic wound defects of the lower extremities underwent surgery of various volumes: surgical debridement, small or high amputation. Results. The analysis of the obtained results allowed to note a number of social, medical and economic problems, the solution of which will significantly improve the results of treatment and in particular reduce the number of amputations in patients with diabetic foot syndrome. As the analysis shows, typical mistakes in the treatment of patients can be divided into three main groups: organizational, diagnostic and tactical. Organizational mistake lies in the fact that today in Ukraine there is no single system providing skilled care to patients with diabetic foot syndrome. The most common diagnostic mistakes include incorrect and insufficiently qualified diagnostics of clinical forms of diabetic foot syndrome and the depths of the spread of purulent-necrotic lesions of the tissues of the foot. The above mistakes significantly affected the timing and results of treatment, worsening the results of the latter. Conclusions. Based on the analysis of treatment of 1963 patients with various pathogenetic forms of the diabetic foot syndrome, a number of medical, economic and social issues have been identified that require their solution. The most typical mistakes and shortcomings in the treatment of these patients were analyzed. A program was proposed to improve the quality of specialized medical care for patients with diabetic foot syndrome.

scholarly journals The criteria and indices of evaluation of quality of out-patient medical care in case of chronic diseases exemplified by microvascular complications of diabetes mellitus

2019 ◽  
Vol 60 (5) ◽  
pp. 233-239
Author(s):  
Oleg V. Udovichenko ◽  
D. O. Meshkov ◽  
E. A. Berseneva
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Complications Of Diabetes ◽  
Rate Of Development ◽  
Practice Analysis ◽  
Results Of Treatment ◽  
Evaluation Techniques

The special evaluation techniques establishing quality and effectiveness of treatment in out-patient practice for every disease are required. The study was carried out to develop criteria and indices for evaluating quality of out-patient medical care of patients with micro-vascular complications of diabetes mellitus (diabetic retinopathy and nephropathy). The method of publications; search and practice analysis was applied to formulate criteria and indices of evaluating structure, processes and results of treatment. The evaluation of quality of result requires the most complicated techniques of data collection. In this respect the most perspective atre indices based on rate of development of terminal stages of mentioned complications. The obtained data can be applied to determine effectiveness of treatment of other diseases with chronic pro-gradient course.

scholarly journals Improved survival of children and adolescents with sickle cell disease

Blood ◽  
2010 ◽  
Vol 115 (17) ◽  
pp. 3447-3452 ◽  
Author(s):  
Charles T. Quinn ◽  
Zora R. Rogers ◽  
Timothy L. McCavit ◽  
George R. Buchanan
Keyword(s):  
Sickle Cell Disease ◽  
Young Children ◽  
Medical Care ◽  
Children And Adolescents ◽  
Sickle Cell ◽  
Care Quality ◽  
Transition To Adult Care ◽  
Cell Disease ◽  
Over Time

Abstract The survival of young children with sickle cell disease (SCD) has improved, but less is known about older children and adolescents. We studied the Dallas Newborn Cohort (DNC) to estimate contemporary 18-year survival for newborns with SCD and document changes in the causes and ages of death over time. We also explored whether improvements in the quality of medical care were temporally associated with survival. The DNC now includes 940 subjects with 8857 patient-years of follow-up. Most children with sickle cell anemia (93.9%) and nearly all children with milder forms of SCD (98.4%) now live to become adults. The incidence of death and the pattern of mortality changed over the duration of the cohort. Sepsis is no longer the leading cause of death. All the recent deaths in the cohort occurred in patients 18 years or older, most shortly after the transition to adult care. Quality of care in the DNC has improved over time, with significantly more timely initial visits and preventive interventions for young children. In summary, most children with SCD now survive the childhood years, but young adults who transition to adult medical care are at high risk for early death.

scholarly journals The role of thematic expertise of medical care quality in improvement of results of its performance in cases of acute pancreatitis

2020 ◽  
Vol 22 (1) ◽  
pp. 105-112
Author(s):  
O N Scryabin ◽  
K N Movchan ◽  
V V Tatarkin ◽  
O A Klitsenko ◽  
Yu M Morozov ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Medical Care ◽  
Care Quality ◽  
Diagnostic Process ◽  
Abdominal Organs ◽  
Treatment Measures ◽  
Medical Diagnostic ◽  
Surgical Teams ◽  
Operational Activity

The parameters of assessing the quality of medical care provided in 2014 to 416 patients with acute pancreatitis in 9 hospitals in St. Petersburg were expertly studied. All medical institutions were licensed in the format of providing services for the examination and treatment of patients suffering from acute surgical diseases of the abdominal organs. According to the results of the data analysis, a correlation was observed between the consequences of defects in the medical diagnostic process in medical organizations with insufficient regulation and activity in clinical expert work on the profile of “abdominal surgery”. The facts of overdiagnosis of cases of acute pancreatitis in mild variants of the severity of the disease have been established. Preservation of low operational activity indicators in the treatment of patients with acute pancreatitis without a tendency to use (when indicated) modern (primarily, endovideo surgical) technologies has been observed. It was noted that with a positive (in general) trend in the development of emergency pancreatology, in cases of assessing the particular results of the activities of specialists of specific surgical teams involved in providing medical care to patients with acute pancreatitis, compliance with systemic clinical and expert approaches with timely management decisions should be a priority in quality management of diagnostic and treatment measures. It is substantiated that the calculation of the volume of medical care for residents of a metropolis with acute pancreatitis should be based on the quality of the examination and treatment of patients with this disease on the basis of a thematic examination of assessing the conformity of the diagnostic process to the level of modern ideas about the theory of development and course of this disease.

scholarly journals ALGORITHM FOR MEDICAL EXAMINATION OF ENDODONTIC TREATMENT

2020 ◽  
Vol 5 (4) ◽  
pp. 20-25
Author(s):  
A. К. Iordanishvili ◽  
E. K. Barinov ◽  
I. B. Salmanov
Keyword(s):  
Quality Control ◽  
Medical Care ◽  
Dental Treatment ◽  
Care Quality ◽  
Endodontic Treatment ◽  
Internal Quality ◽  
Dental Clinics ◽  
Quality Of Medical Care ◽  
Te Material

Evaluation (including within the framework of medico-legal examination) of the quality and efectiveness of endodontic dental treatment is a matter of current interest in the clinical dentistry.Obiectives. Te aim of the work was to develop an algorithm of medico-legal examination in case of endodontic treatment, to test this algorithm in the work of the commissions of medical care quality control in the departments of therapeutic dentistry of outpatient dental clinics.Material and methods.Te material of the study was the reports of daily activities of dental clinics of various forms of ownership (municipal, departmental, private) in 3 regions of Russia (Moscow, St. Petersburg, Rostov-on-Don), including periodic reports and reference reports, ofcial statistical reports of the activities of the examined clinics, including registration books of the work of the commissions of the quality of medical care. Tese materials were used as a source of primary statistical information. Afer grouping of the information contained in them, the main data characterizing organization, condition and quality of endodontic care were recovered taking into account nosological entities: pulpitis and periodontitis. Taking into account the medical, statistical and analytical nature of the study, the main conclusions and recommendations were formulated on the basis of a retrospective study of these materials.Results. Based on the studies carried out and recommendations of the European Endodontic Association on provision of the standard of endodontic treatment, an algorithm for medico-legal examination of endodontic treatment was proposed. Tis algorithm allows to assess the quality and efectiveness of endodontic treatment of pulpitis and periodontitis in diferent terms (immediately afer treatment, remote period)Conclusion. Te use of the developed algorithm in clinical practice in internal quality control of endodontic care has shown its efectiveness. A large number of clinical cases of insufcient quality of endodontic treatment and its low efectiveness in the remote period indicate persistence of the potential for claims from patients. 

scholarly journals Is there a relationship between hospital care quality assessemnt and the patient’s place of residence?

2015 ◽  
Vol 125 (2) ◽  
pp. 77-82
Author(s):  
Marek Kos ◽  
Agnieszka Dziewa ◽  
Bartłomiej Drop ◽  
Marzena Furtak-Niczyporuk ◽  
Ewa Warchoł-Sławińska
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Medical Care ◽  
Hospital Care ◽  
Care Facility ◽  
Care Quality ◽  
Satisfaction Survey ◽  
Place Of Residence ◽  
Patient Satisfaction Survey

Abstract Introduction. Measuring the patient satisfaction with the hospital stay, as well as the knowledge of their requirements are very important in the management of health institutions. A good example of the recognition of patients’ expectations is studying the level of satisfaction with specially prepared questionnaires. Aim. The aim of the study was to investigate the relationship between the patients’ place of residence and their satisfaction with the medical care they received when treated in local hospitals Material and methods. Patient satisfaction survey was carried out in the Independent Public Health Care Centre in Kraśnik in two subsequent years: at the turn of 2011/2012 and in February 2013. The survey consisted of patients hospitalized in the surgical wards of the hospital. A testing tool for this survey was a self-designed questionnaire entitles “Patient satisfaction survey” specifically developed by nursing managers and approved by the management of the hospital. Results. Patients of the District Hospital in Kraśnik gave their complex assessment of satisfaction with the benefits provided by the health care facility, taking into account not only the quality of strictly medical services, but the entire infrastructure of the hospital, including ancillary services. The obtained results gave a positive assessment of the analyzed branches. No statistically significant differences between the assessments of rural and urban inhabitants were found. The results allow knowledge of the strengths and weaknesses of medical care in the wards. Conclusions. Residents of rural areas, who are slightly better than those who live in cities, assess the work of local hospital surgical wards. You can clearly see it by assessing the quality of nurses’ and doctors’ work and the assessment of nutrition and the appearance of patient rooms. Systematic research, measurement and evaluation of patient satisfaction with hospital care can be the basis for the improvement and ensure an appropriate level of quality

scholarly journals THE LEGISLATIVE FOUNDATION OF EXPERTISE OF MEDICAL CARE QUALITY ACCORDING CASES OF LETHAL OUTCOMES

2019 ◽  
Vol 62 (2) ◽  
pp. 95-102
Author(s):  
Konstantin V. Polyakov ◽  
N. M. Gayfullin ◽  
Zh. A. Akopyan ◽  
P. G. Mal'kov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Quality Evaluation ◽  
Evaluation Criteria ◽  
Care Quality ◽  
Icd 10 ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
Care Support

The article presents analysis of national and foreign legislative documents concerning issues of expertise of quality of medical care according cases of lethal outcomes (Universal Declaration of Human Rights, the Constitution of the Russian Federation, ICD-10, Federal laws and sectoral orders). It is established that key elements of system of medical care quality control (levels of control, authorized authority, forms of control, sources of development of criteria of quality evaluation, criteria of quality evaluation) are determined legislatively and reflect main requirements of international documents. The criteria of medical care quality evaluation are developed by groups of diseases of conditions on the basis of corresponding of medical care support Procedures, medical care Standards, Rules of implementation of laboratory, instrumental, pathologico-anatomic and other forms diagnostic analysis and Clinical Recommendations (records of treatment) related to issues of medical care support. The shortcoming of the Russian Federation legislation is an inadequate reflection of sources of development of criteria of medical care quality evaluation and relevant incompleteness of the very criteria of medical care quality evaluation. Therefore, their application by experts to issues of evaluation of medical care quality is complicated that effects formation of expert conclusion and negatively affects detection and prevention of possible violations during medical care support. The outdated normative regulation of clinical pathologic anatomic conference is noted as an important form of control of medical care support according cases of lethal outcomes. The necessity of alterations and additions in particular currently in force documents concerning issues of expertise of medical care quality, including according cases of lethal outcomes.

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