Пути совершенствования системы организации динамического диспансерного наблюдения больных офтальмологическими заболеваниями

Abstract

The aim of the research. To identify the most signifi cant problems in organisation of dynamic follow-up care (DFC) for patients with pathology of the eye and its adnexa and to find the ways for its improvement by determining a concerted view of experts on these issues. Material and methods. An expert survey of ophthalmologists was conducted at six ophthalmology hospitals in the Russian Federation. Kendall’s coefficient of concordance was used to measure the degree of agreement among experts. Th e survey results are presented as mean ranks of expert assessments. The Friedman test was used to assess the statistical significance of differences for individual issues. The study was carried out at the Sechenov University within the framework of the complex research topic No. 01201168237. Results. Only 1 (2.1%) expert expressed a positive assessment of the modern system of DFC for patients with eye disorders. Th e delay in referral of ophthalmic patients to surgical treatment is the most significant problem in DFC organisation (Kendall coeff . = 0.896; р<0.001). According to the expert opinion, the main problems in assessment of the quality of medical checkups in ophthalmology are the low follow-up coverage of patients and the low frequency of adherence to the stages of medical checkups (Kendall coeff . = 0.851; р < 0.001). Conclusion. Among the priority measures aimed at increasing the effectiveness of follow-up care for patients with eye disorders, the experts mentioned solving the problem of staffing, development of special regulations for follow-up care for patients with diseases of the eye and the ocular adnexa. A set of indicators for monitoring the effectiveness of follow-up care for patients with eye disorders has been proposed.