Key indicators of therapeutic and diagnostic activities of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, in 2012–2017

Abstract

Relevance. Arrangement of the medical support for the EMERCOM of Russia specialists and employees needs constant monitoring and analysis of activities of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia (NRCERM) as the leading multidisciplinary medical institution of the EMERCOM of Russia.Intention – To analyze NRCERM activities (2012–2017) on specialized primary care, including high-tech care, at outpatient, day-time and inpatient hospitals.Methods. Results of health care and treatment in the NRCERM were assessed (2012–2017): 787,057 out-patient cases, 3,782 day-time cases, and 79,572 inpatient cases.Results and Discussion. In 2017, volumes of specialized primary care in outpatient hospitals was 156.6 % compared to that in 2012. The proportion of this type of health care paid for by the federal budget varied from 44.3 to 57.0 %. The most popular types of specialized primary care were internal medicine, neurology, gastroenterology, otolaryngology, ophthalmology, gynecology, surgery, urology and dentistry. The proportion of individuals who underwent preventive physical examinations in 2012–2017 amounted to 22–23 % among the whole number of outpatient visits, with 95.4 % of them were EMERCOM of Russia employees and 4.6 % – patients who paid themselves or were paid for. NRCERM mobile medical teams performed prevention physical examinations of employees of the EMERCOM of Russia in the Republic of Crimea and the city of Sevastopol: 1431 and 2070 individuals were examined in 2015 and 2016, respectively. The number of patients in the day-time NRCERM hospital increased to 1059 individuals in 2017. In 2017, volumes of specialized primary care increased to 191.9 % compared to 2012, with maximums in 2015 and 2016. Inpatient specialized primary care within the federal budget decreased from 63 % in 2012 to 28 % in 2017. Volume of inpatient care increased progressively due to programs of obligatory and voluntary medical insurance and self-paying. The proportion of surgery patients among all the in-patients increased from 35 % in 2012 to 58.4 % in 2017. In the NRCERM as a whole, the average duration of patient’s stay in a hospital decreased from 9.9 days in 2012 to 8.0 days in 2017, which is considerably less than in the Russian Federation (11.7 days) and Saint Petersburg (11.3 days). The bed turnover in the NRCERM increased owing to both therapy and surgery departments, with maximums in 2015 (29.0) and 2016 (28.8). This parameter increased in 2017 compared to 2012 (27.5 vs 13.9; 197.8 %). In 2017, number of operations increases compared to that in 2012 up to 258.6 %, with related increase in anesthesia procedures up to 274.1 %. High tech surgeries considerably increased (3.5-fold) in 2017 compared to 2012. The proportion of high tech surgeries was 14.2 % in 2012 and 18.7 % in 2017. The NRCERM mortality rates in 2012–2017 were 0.4–0.5 % which is considerably less than in the Russian Federation (1.77 %) and in Saint Petersburg (2.49 %). In cause-of-death structure, the following diseases dominated: circulatory diseases (40.3 %), neoplasms (29.8 %) and, third, traumas (10.4 %) – a total of 80.5 %.Conclusion. Within NRCERM activities, volumes of specialized primary care increased, including high tech care, in outpatient, day-time and inpatient settings. Besides, intensity of medical-diagnostic process increased, with low hospital mortality rate due to optimized organizational structure of medical institution, improved performance of outpatient and inpatient departments, introduction of innovative medical technologies.