ЭКСПЕРТНАЯ ОЦЕНКА КАЧЕСТВА МЕДИЦИНСКОЙ ПОМОЩИ ДЛЯ СНИЖЕНИИ РЕПРОДУКТИВНЫХ ПОТЕРЬ

Abstract

The paper considers and highlights the modern principles and methods for assessing the quality of the process of providing medical care, as the most complex and least regulated component of the entire multicomponent system for assessing the quality of medical care. To date, two directions have been formed - theoretical and practical - to solve the problem of quality control of the medical care process. One, standardization, is based on previous medical experience - "method of choice", protocols of management. The second is the quality of the medical care process technology. Quality control of the result is carried out "post factum". Purpose: introduction of effective methods for assessing the quality of medical care by trimesters of pregnancy to reduce reproductive losses. Material and methods: statistical, analytical, prognostic, epidemiological analysis. Results and discussion. The results of the analysis of the assessment of the quality of medical care received by a woman during pregnancy, based on a study of medical records, as well as a study of the opinions of pregnant women, are presented. Comparison of the data obtained makes it possible to reveal the correlation dependence of the results of an expert assessment of the quality of medical care on the timing of a woman's registration for pregnancy. Integral registration defects were determined in the collection of anamnesis data from the examined women in the process of dynamic observation of pregnancy at the outpatient stage. The study of the state of the quality of medical care provided to pregnant women, women in childbirth and puerperas, took place in a complex manner, including laboratory diagnostic studies, registration of medical documentation and possible errors in making a clinical diagnosis. It has been proven that errors in diagnosis and treatment, as a rule, negatively affect the patient's condition. The sub-optimal use of resources is reflected in the lack of respect and use of existing standards. In the study groups with the highest risk of providing medical care of inadequate quality, there were violations that are associated with the risk of worsening the condition of a pregnant woman and the development of gestational complications in the future.