ORGANIZATIONAL SOLUTIONS TO INCREASE THE AVAILABILITY OF MEDICAL CARE TO PATIENTS WITH CARDIOVASCULAR DISEASES IN THE KEMEROVO REGION – KUZBASS

Abstract

HighlightsWe have conducted the analysis of work processes in medical organizations of the Kemerovo region – Kuzbass providing cardiovascular care in the period 2021–2022. The results revealed key issues regarding personnel and organizational and methodological support of their work, and management of patients with high cardiovascular risk. Moreover, we have analyzed the availability of medical care for patients with cardiovascular diseases in the Kemerovo region – Kuzbass. Aim. To evaluate organizational solutions aimed to increase the availability of medical care for patients with cardiovascular diseases in the Kemerovo region – Kuzbass.Methods. The study involved analytical, statistical and direct observation methods for the analysis. Statistical data from Federal statistical survey forms based on the Federal State Statistics Service Order No. 985 dated 12/27/2022 (dated 10/27/2023) “On approval of Federal statistical survey forms with instructions on how to fill them out for organizations by the Ministry of Health of the Russian Federation of federal statistical observation in healthcare” (Form № 30 (annual), all-Russian classifier of management documentation code 0609362, Form N 14 (annual), all-Russian classifier of management documentation code 0609348), database on the provision of medical care, other relevant data from the Federal State Statistics Service, statistical data of the Central Research Institute of the Ministry of Health of the Russian Federation for the period from 2019–2022, and the results of an expert assessments of specialized Federal centers were studied.Results. In comparison with 2021, taking into account insufficient staffing of 59.5%, the number of cardiologists in the Kemerovo region decreased slightly. At the same time, there is a slight downward trend in the number of cardiologists with higher qualification, the percentage of doctors with higher qualification has decreased to 46.7% (of the total number of cardiologists). Regarding this profession, the availability of a doctor per 10,000 adults decreased by 10%, in 2022 the regional indicator was 19.8% lower than the national average, and 12% lower than the average for the Siberian Federal District. In the study period, some indicators displayed negative trends, indicating the presence of issues in medical organizations in the Kemerovo region, namely: the number of surgeries for acquired heart diseases decreased by 13.8%. The number of coronary artery bypass grafting surgeries decreased by 9.3%, per 1 million people in the region, this indicator remains 14% lower than the national value. The number of surgical procedures for rhythm disorders per 1 million population also 1.3% lower than the national value. The problem areas identified in the course of this study related to staffing, management of patients with high cardiovascular risk, organizational and methodological support for the work processes in medical organizations, served as the basis for the justification of the made organizational decisions.Conclusion. Organizational decisions taken in 2022 positively affected the availability of medical care for residents of the Kemerovo region – Kuzbass due to implementation of a systematic approach to cardiovascular risk management, with an emphasis on identifying patients at high-risk through additional diagnostic methods, the widespread introduction of remote medical care for the population and, as a result, an increase in the number of provided medical care procedures.