The influence of changes in the organization of medical care on the indicators of mental disorders in children

Abstract

AIM: This study aimed to assess the relationship between regulatory innovation strategy for changing the organization of medical care in children and adolescents and the dynamics of the incidence of mental and behavioral disorders in children aged 014 years.
 MATERIAL AND METHODS: The rate of chronicity was calculated as the ratio of the primary morbidity to the overall morbidity of mental and behavioral disorders. The presence of outliers (anomalous observations) in the series was determined using Irwins method, with n=11, cr=1.3. Mathematical apparatus: for the three analyzed series (primary, general morbidity, and chronicity coefficient), three mathematical models were built: one one-dimensional model and two with the introduction of dummy variables for orders No. 1346, No. 72n, No. 216n and order No. 1687n). The statistics of fit was compared between the one- dimensional model and each of the four models with dummy variables for the corresponding series. Moreover, their logarithmic values were used to reduce the variance of the series. Significance was assessed at p 0.05.
 RESULTS: Evaluation of the analyzed series for the presence of anomalous observations revealed a similar trend in the Arkhangelsk region and NorthWest Federal District. In all regions, except for the Russian Federation, emissions were concentrated from 2015 to 2017. In 2010, national analysis revealed only one anomalous observation. Graphical analysis and analysis by Irwins method revealed similar trends with regard to abnormal observations of the dynamics of the coefficient of chronicity in the Arkhangelsk region and Northwestern Federal District, which confirmed the previously established dynamic trends in the general and primary morbidity in children aged 014 years. In addition, after 2015, the dynamic changes were most pronounced in the Arkhangelsk region.
 CONCLUSIONS: No correlation was found among normative innovations for changing the organization of medical care among children and adolescents, changes in medical birth criteria, the dynamics of the incidence of mental disorders and behavioral disorders, indicators of the chronicity of this pathology in children aged 014 years, and mental and behavioral disorders in the Arkhangelsk region, Northwestern Federal District, and the Russian Federation in 20092019.