Chronic coronary artery disease: regional characteristics of outpatient visits and hospitalizations of the Russian adult population

Abstract

Aim. To analyze hospitalizations and outpatient visits to primary health care facilities of patients aged 18 years and older with chronic coronary artery disease (CAD) by federal districts and the constituent entities of the Russian Federation from the perspective of the World Health Organization concept for diseases treating mainly on an outpatient basis.Material and methods. We used data from Federal Statistical Monitoring for 2022 on the number of diseases, hospitalizations and the number of outpatient visits of patients aged 18 years and older with an established diagnosis of CAD (ICD 10:I25).Results. In the Central, Southern and Northwestern Federal Districts, the hospitalizations and outpatient visits of the adult population with chronic CAD were higher, and in the North Caucasus, Far Eastern and Ural Federal Districts — below the Russian average level. In the Volga Federal District, the outpatient visits with chronic CAD were higher than the Russian average, and the hospitalizations were below the Russian average. In the Siberian Federal District, the outpatient visits were lower, and the hospitalizations were higher than the Russian average level. When analyzing the ratio of hospitalization rate to the number of outpatient visits of the adult population with an established chronic CAD in the primary health care unit, characterizing the availability, quality and efficiency of outpatient care, the highest indicator was recorded in the Siberian Federal District, while its heterogeneity within the federal district was the highest in comparison with other federal districts. Its lowest was recorded in the Southern Federal District, while heterogeneity within the federal district was the lowest in comparison with other federal districts. The values of this parameter varied from 3,67 in the Kurgan Oblast to 38,33 in the Republic of Tuva.Conclusion. Accounting for diseases treating primarily on an outpatient basis can become one of the tools for assessing the quality of adult primary health care. However, before including this indicator in the criteria for assessing the quality of medical services, a deeper understanding of the reasons influencing its change is required.