Development of a system of integrated assessment of efficiency of cardiac care in the Russian Federation regions

Abstract

Highlights. Methodology for the development of a system of indicators for the integral assessment of effectiveness and efficiency of cardiac care (cardiovascular surgery) in the subjects of the Russian Federation is proposed and tested.Indicators, such as the length of stay, the number of operations on the heart and blood vessels, the number of ambulatory patients have high overall rating and consistency of expert opinions.Aim. To develop a system of indicators for assessment of the effectiveness of cardiac care, cardiovascular surgery in particular, in the Russian Federation regions.Methods. The study using expert surveys was conducted in the form of a structured interview. At the first stage, the primary selection of indicators was carried out using the annual public and field reports of the national medical research center. At the second stage, experts were selected and the level of expert competence was assessed. In total, out of 14 interviewed specialists, 10 were defined as experts. The average expert authority coefficient was 0.89. To quantify the degree of agreement between the experts` answers, Kendall's coefficient of concordance (W) was calculated. The significance of differences was assessed using the nonparametric Friedman test.Results. The following indicators are recommended as indicators for rating efficiency of cardiac care in the regions of the Russian Federation: mortality after heart surgery, vascular surgery and percutaneous coronary interventions; mortality from diseases of the circulatory system; the number of ambulatory patients; the ratio of the number of endovascular interventions to the total number of discharged patients who suffered from acute coronary syndrome.Conclusion. The selected indicators can be used both for the rating of the constituent entities of the Russian Federation, and in the development of federal projects or ministerial target programs. The results of the study can also be used to organize a system for monitoring the effectiveness of the implementation of these projects and programs.