Использование высокотехнологичных методов лечения – путь повышения эффективности и качества оказания специализированной медицинской помощи пациентам с урологической патологией.

Abstract

Diseases of the genitourinary system due to their high prevalence in the population and the frequent development of complications are an urgent medical and social problem and require timely, effective and high-quality medical care. In the Russian Federation, urolithiasis, prostate adenoma, obstructive (reflux) uropathies occupy the leading positions in the structure of hospitalized morbidity in urological departments of hospitals, which account for more than 3/4 of all hospitalizations. Improving the efficiency and quality of medical activities in providing specialized medical care to patients with diseases of the genitourinary system in hospital settings requires the use of high-tech diagnostic and treatment methods. The purpose of the study is to study the dynamics of morbidity of the adult population of the Orenburg region with diseases of the genitourinary system, and to assess the effectiveness and quality of specialized medical care for patients in the urological department of the Orenburg Regional Clinical Hospital. Materials and methods. The study analyzes information copied from information statistical collections of the Ministry of Health of the Orenburg Region and the Federal State Statistics Service. The indicators of general and primary morbidity of diseases of the genitourinary system among the adult population of the Orenburg region are analyzed. The dynamics of changes in morbidity rates was studied for the period from 2017 to 2021 by constructing dynamic series and calculating special indicators: absolute increase/decrease, growth/decrease rate, growth/decrease indicator, visibility indicator. To assess the effectiveness and quality of specialized medical care for patients with diseases of the genitourinary system, the urological department of the Orenburg Regional Clinical Hospital named after V. I. Voynov was selected as the base of the study. During the study, the bed performance indicators and special indicators of the effectiveness and quality of medical activities were analyzed. Study period: 2019–6 months of 2023. In addition, a comparative analysis of the department’s performance in 2007 and 2022 was carried out. The following research methods were used: statistical and analytical. Statistical processing of the materials included the calculation of absolute, relative and average values. Results. In the Orenburg region, from 2017 to 2021, the level of general morbidity of the adult population with diseases of the genitourinary system decreased by 14,4%. At the same time, in the studied region over the past period, the indicator of primary morbidity of the adult population with diseases of the genitourinary system had a more pronounced decrease, which amounted to 37,4% over five years. It has been established that over the past 5 years, when high-tech operations using endoscopic and laser technologies were widely performed in the urological department of the hospital, the overall performance of the department has improved. The exception was in 2020, when a tense epidemiological situation was recorded for the new coronavirus infection Covid‑19. In the last 3 years, there has been a decrease in the average length of patient stay in bed, which allowed an increase by 19,3% in the number of treated patients, as well as to perform more operations – in 2022, 1 019 surgical interventions were performed compared to 905 in 2019. The urology department of the hospital has a low mortality rate, which was minimal (0,3%) in 2019 and 2023. As a result of a comparative analysis of the performance of the urological department in 2022 and in 2007, it was found that in recent years, the average length of stay in a bed has decreased in 2,5 times. If in 2007 the number of operations amounted to 385, then in 2022 their number increased to 1019. At the same time, the turnover of the bed increased 2,6 times. There was also a 27,5% increase in surgical activity. Conclusions. Thus, in the Orenburg region over the past five years, there has been a decrease in the level of general morbidity of the adult population with diseases of the genitourinary system by 14,4%, and the level of primary morbidity of the adult population with diseases of the genitourinary system by 37,4%. The introduction of high-tech methods of surgical treatment, including endoscopic and laser technologies, in the urological department of the V. I. Voynov State Medical University has significantly improved the efficiency and quality of specialized medical care for patients with diseases of the genitourinary system.