Monitoring of indications for hospitalization of patients in round-the-clock hospitals of anti-tuberculosis facilities of the Department of Health of the city of Moscow

Abstract

The article presents the results of five-year (2014–2019) monitoring data analysis of indications for hospitalization of adult patients to in-patients’ tuberculosis hospitals in Moscow. The structure of the collected information, created on the basis of the developed guidelines, is presented. From 1 to 15 indications were notified for each hospitalization. It has been shown that the majority of patients were hospitalized on the basis of groups of indications associated with the tuberculosis process and / or the need for a diagnostic examination (91.2%). These groups of indications were registered in 73.7% and 28,0% respectively. Also, 48.2% of hospitalizations were associated with the presence of concomitant diseases and conditions requiring hospital treatment and / or seriously aggravating the course of tuberculosis, and 32.8% – with epidemiological and social factors. These four groups were analyzed for their various indications, such as the presence of bacterial excretion and lung cavern, a widespread tuberculosis process, the need to use special treatment methods or individual selection of chemotherapy regimens, the presence of different concomitant diseases and various social factors, such as living with children under 14 years of age, old age, etc. Separately, a comparative analysis of indications was carried out depending on the presence of HIV coinfection, which showed that these patients more often have indications associated with a widespread tuberculosis process, the need for individual selection of therapy, drug addiction, bad treatment adherence, and belonging to homeless people. Periodic monitoring of indications for hospitalization is a necessary measure that allows you to obtain information necessary to optimize the quantitative and qualitative structure of the bed fund of antituberculosis medical organizations.