Экспертные подходы к оценке организации оказания медицинской помощи по профилю «челюстно-лицевая хирургия» на региональном уровне.

Abstract

Evaluating the effectiveness of healthcare services is an urgent task because it allows us to identify and analyze the existence of health potential risks and organizational difficulties, and it also assesses in developing preventive measures to eliminate them. Currently, there is no regional unified system to evaluate the existing organizational issues of the regional oral and maxillofacial surgery service. Purpose: accordingly, this study aims to determine an evaluation criterion for the organization of regional oral and maxillofacial surgery service and use an expert assessments method. Materials and methods. We conducted a study in 2019–2022 on the base medical organizations of the Volga Federal District using an expert evaluation method. In the first phase, we selected 60 participants in the organization of oral and maxillofacial surgery service, both at the level of the medical organization and at the regional and federal levels. The experts proposed 64 criteria for evaluating the organization of regional oral and maxillofacial services, which were included in the map of expert evaluation. In the second phase, we selected 21 experts by the inclusion criteria and scored the proposed criteria. To evaluate the questionnaire results, 95 percent of the confidence interval (MDI) was calculated using Fisher’s method. Kendall’s coefficient of concordance (W) was used to determine the consistency of experts’ views on the importance of the criteria chosen. The estimation of the concordance coefficient was considered relevant if the probability of the first type of error was less than 0.05. Results and discussion. Analysis of the results and their ranking by experts made it possible to identify the 20 most significant indicators and observe more than 8 points and a concordance correlation coefficient of 0.7 or more. According to experts, for organizing the provision of oral and maxillofacial surgery service, the most important issue is the availability of regulatory documents, regulations for routing patients, rules for the provision and infrastructure of oral and maxillofacial surgery service, the recommended standard of medical equipment and recommended staffing standards, staffing, the availability of emergency round-the-clock dental service, equipping a panel of devices, sets of surgical instruments for surgical interventions in the maxillofacial region, organizing the provision of care in oral and maxillofacial surgery for children and the disabled in the departments, regular monitoring of patient satisfaction by surveys. Conclusions. Significant criteria for assessing the organization of regional maxillofacial surgical service were identified, which made it possible to identify existing shortcomings in the organization of activities and outline ways to eliminate them.