2 research outputs found
ΠΡΠΎΡΠΈΠ»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π² ΡΠΈΡΡΠ΅ΠΌΠ΅ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ
Relevance. Improvement of quality of medical care, level of training of personnel of health care, development of market conditions of providing medical services, growth of responsibility of the population for health, requirements of the population to the primary specialized medical care (PSMC) raise. In the conditions of development of the medical organizations of different forms of ownership there is a possibility of the choice and preferences of consumers on a service component, the range of services, territorial location of the medical organizations, transport availability, to the relations of medical personnel and patients. In this situation the importance acquires knowledge of individual characteristics of consumers - patients - and quality of the continuous medical education (CME) of personnel [1, 2, 3]. Purpose by results of a medico-social research to develop and prove Β«the patientβs profileΒ» - the consumer of medical services of the private and state medical organizations (MO). On the basis of knowledge of Β«the patientβs profileΒ» PSMC of large city agglomeration will become possible to make the adjusting management decisions for satisfaction of need of inhabitants for PSMC taking into account health care infrastructure. Results. During the research Β«the patientβs profileΒ» as the list of group characterologic and behavioural characteristics of the patients belonging to the sphere of knowledge, the relations, preferences and understanding of the PSMC system and the role in maintenance of health, medical activity, implementation of recommendations of medical personnel is developed and evidence-based. Knowledge of Β«the patientβs profileΒ» is necessary for adoption of correct management decisions taking into account health care infrastructure opportunities on satisfaction of needs for medical care and improvement of continuous medical education of personnel. Methods and materials. Results of questioning of patients (a sociological method) are used, at the request for medical care, personnel of the medical organizations of different forms of ownership, the content analysis of scientific publications, the statistical and logical analysis of data. A direct object of a research were the patients who asked for medical care in network of the private and state medical organizations for adult population (a method of "copy-pair"). The reliability and substantiality of the obtained data is accepted under a condition (Ρ < 0.05).ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. Π‘ΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ, ΡΡΠΎΠ²Π½Ρ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠΈ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»Π° Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ, ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΠ½ΠΎΡΠ½ΡΡ
ΡΡΠ»ΠΎΠ²ΠΈΠΉ ΠΏΡΠ΅Π΄ΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΡΠ»ΡΠ³, ΡΠΎΡΡΠ° ΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎΡΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ Π·Π° Π·Π΄ΠΎΡΠΎΠ²ΡΠ΅, ΠΏΠΎΠ²ΡΡΠ°ΡΡΡΡ ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΡ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΊ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ (ΠΠ‘ΠΠ). Π ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ ΡΠ°Π·Π½ΡΡ
ΡΠΎΡΠΌ ΡΠΎΠ±ΡΡΠ²Π΅Π½Π½ΠΎΡΡΠΈ ΠΏΠΎΡΠ²Π»ΡΠ΅ΡΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ Π²ΡΠ±ΠΎΡΠ° ΠΈ ΠΏΡΠ΅Π΄ΠΏΠΎΡΡΠ΅Π½ΠΈΠΉ ΠΏΠΎΡΡΠ΅Π±ΠΈΡΠ΅Π»Π΅ΠΉ ΠΏΠΎ ΡΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΡΠΎΡΡΠ°Π²Π»ΡΡΡΠ΅ΠΉ, Π°ΡΡΠΎΡΡΠΈΠΌΠ΅Π½ΡΡ ΡΡΠ»ΡΠ³, ΡΠ΅ΡΡΠΈΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠΌΡ ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ, ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ½ΠΎΠΉ Π΄ΠΎΡΡΡΠΏΠ½ΠΎΡΡΠΈ, ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡΠΌ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»Π° ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². Π ΡΡΠΎΠΉ ΡΠΈΡΡΠ°ΡΠΈΠΈ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ°Π΅Ρ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ Π·Π½Π°Π½ΠΈΠ΅ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΠΏΠΎΡΡΠ΅Π±ΠΈΡΠ΅Π»Π΅ΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² - ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ (ΠΠΠ) ΠΏΠ΅ΡΡΠΎΠ½Π°Π»Π° [1, 2, 3]. Π¦Π΅Π»Ρ. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°ΡΡ ΠΈ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°ΡΡ Β«ΠΏΡΠΎΡΠΈΠ»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°Β» - ΠΏΠΎΡΡΠ΅Π±ΠΈΡΠ΅Π»Ρ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΡΠ»ΡΠ³ ΡΠ°ΡΡΠ½ΡΡ
ΠΈ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ (ΠΠ). ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ Π·Π½Π°Π½ΠΈΡ Β«ΠΏΡΠΎΡΠΈΠ»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°Β» ΠΠ‘ΠΠ ΠΊΡΡΠΏΠ½ΠΎΠΉ Π³ΠΎΡΠΎΠ΄ΡΠΊΠΎΠΉ Π°Π³Π»ΠΎΠΌΠ΅ΡΠ°ΡΠΈΠΈ ΡΡΠ°Π½Π΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΠΌ ΠΏΡΠΈΠ½ΠΈΠΌΠ°ΡΡ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΡΡΡΡΠΈΠ΅ ΡΠΏΡΠ°Π²Π»Π΅Π½ΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π΄Π»Ρ ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΠΈ ΠΆΠΈΡΠ΅Π»Π΅ΠΉ Π² ΠΠ‘ΠΠ Ρ ΡΡΠ΅ΡΠΎΠΌ ΠΈΠ½ΡΡΠ°ΡΡΡΡΠΊΡΡΡΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Ρ
ΠΎΠ΄Π΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½ ΠΈ Π½Π°ΡΡΠ½ΠΎ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ Β«ΠΏΡΠΎΡΠΈΠ»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°Β» ΠΊΠ°ΠΊ ΠΏΠ΅ΡΠ΅ΡΠ΅Π½Ρ Π³ΡΡΠΏΠΏΠΎΠ²ΡΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΡΠ΅ΡΠΊΠΈΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΡΠΈΠ½Π°Π΄Π»Π΅ΠΆΠ°ΡΠΈΡ
ΠΊ ΡΡΠ΅ΡΠ΅ Π·Π½Π°Π½ΠΈΠΉ, ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΉ, ΠΏΡΠ΅Π΄ΠΏΠΎΡΡΠ΅Π½ΠΈΠΉ ΠΈ ΠΏΠΎΠ½ΠΈΠΌΠ°Π½ΠΈΠΉ ΡΠΈΡΡΠ΅ΠΌΡ ΠΠ‘ΠΠ ΠΈ ΡΠ²ΠΎΠ΅ΠΉ ΡΠΎΠ»ΠΈ Π² ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠ°Π½ΠΈΠΈ Π·Π΄ΠΎΡΠΎΠ²ΡΡ, ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ, Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΠΈ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»Π°. ΠΠ½Π°Π½ΠΈΠ΅ Β«ΠΏΡΠΎΡΠΈΠ»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°Β» Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ Π΄Π»Ρ ΠΏΡΠΈΠ½ΡΡΠΈΡ ΠΊΠΎΡΡΠ΅ΠΊΡΠ½ΡΡ
ΡΠΏΡΠ°Π²Π»Π΅Π½ΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΡΠ΅Π½ΠΈΠΉ Ρ ΡΡΠ΅ΡΠΎΠΌ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠ΅ΠΉ ΠΈΠ½ΡΡΠ°ΡΡΡΡΠΊΡΡΡΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΏΠΎ ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΠ΅ΠΉ Π² ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈ Π΄Π»Ρ ΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»Π°. ΠΠ΅ΡΠΎΠ΄Ρ ΠΈ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (ΡΠΎΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΌΠ΅ΡΠΎΠ΄), ΠΏΡΠΈ ΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΠΈ Π·Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΡΡ, ΠΏΠ΅ΡΡΠΎΠ½Π°Π»Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ ΡΠ°Π·Π½ΡΡ
ΡΠΎΡΠΌ ΡΠΎΠ±ΡΡΠ²Π΅Π½Π½ΠΎΡΡΠΈ, ΠΊΠΎΠ½ΡΠ΅Π½Ρ-Π°Π½Π°Π»ΠΈΠ· Π½Π°ΡΡΠ½ΡΡ
ΠΏΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΠΉ, ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΈ Π»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· Π΄Π°Π½Π½ΡΡ
. ΠΠ΅ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²Π΅Π½Π½ΡΠΌ ΠΎΠ±ΡΠ΅ΠΊΡΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ²Π»ΡΠ»ΠΈΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ, ΠΎΠ±ΡΠ°ΡΠΈΠ²ΡΠΈΠ΅ΡΡ Π·Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΡΡ Π² ΡΠ΅ΡΡ ΡΠ°ΡΡΠ½ΡΡ
ΠΈ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ Π΄Π»Ρ Π²Π·ΡΠΎΡΠ»ΠΎΠ³ΠΎ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ (ΠΌΠ΅ΡΠΎΠ΄ Β«ΠΊΠΎΠΏΠΈ-ΠΏΠ°ΡΠ°Β»). ΠΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎΡΡΡ ΠΈ Π΄ΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΏΡΠΈΠ½ΡΡΠ° ΠΏΡΠΈ ΡΡΠ»ΠΎΠ²ΠΈΠΈ (Ρ < 0,05)
REMOTE CLINICAL QUALITY MANAGEMENT OF ENDOVASCULAR CARE
To assess the effectiveness of remote clinical quality management of endovascular Aim care. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008β2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019β2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The Methods system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019β2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at pβ€0.005. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In April-December 2020 it increased up to 71.6% (p<0.001). The frequency of performing Results PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005). Remote clinical management based on telemedicine and mentoring process Conclusion technologies contributes to improving the quality of endovascular care in MI. Β© 2021 Angles. All rights reserved