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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12710/15887
Title: Evaluarea asistenţei medicale prestate persoanelor decedate în condiţii extraspitaliceşti
Other Titles: Evaluation of the healthcare services provided to deceased people in extrahospital conditions
Оценка медицинской помощи умершим во внебольничных условиях
Authors: Colovin, Boris
Keywords: healthcare quality;investigations quality;medication therapy quality;surgical treatment quality;patients’ surveillance
Issue Date: 2010
Publisher: Asociația Obștească ”Economie, Management și Psihologie în Medicină” din Republica Moldova
Citation: COLOVIN, Boris. Evaluarea asistenţei medicale prestate persoanelor decedate în condiţii extraspitaliceşti. In: Sănătate Publică, Economie şi Management în Medicină. 2010, nr. 1(32), pp. 4-13. ISSN 1729-8687.
Abstract: Summary. The survey was aimed at emphasizing the weaknesses in the processes of providing healthcare services to deceased people in extrahospital conditions, in order to reveal the reason for organizational measures for healthcare quality improvement. The survey sample included 2782 death cases in extrahospital conditions for common diagnostics groups. The research revealed that the lack of the mandatory healthcare insurance at the population in rural areas and within the age groups of 18-57 and 62 is one of the main causes of the late medical aid appeal ability (one of the most important factors that determine high extrahospital mortality). Patient monitoring with major diseases is deficient and an important cause of death. Over 65% of extrahospital deaths, within the workingage population, were caused by heavy alcohol consumption. The non-conformity of diagnostics investigations with the requirements of national clinical protocols, accounts for: 62,1% of pneumonia deaths; 46,7% of myocardial infarction deaths and 30,1% of stroke deaths. The research revealed that in over 70% cases of patients with pneumonia, 39% cases of patients with myocardial infarction and 28% cases of patients with stroke medication, therapy during hospitalization did not correspond to the demands. The surgical treatment applied in rayonal hospitals corresponded to the requirements of national clinical protocols only in 33,7% cases. It was also identified that patient rehabilitation services for the afore mentioned serious diseases are underdeveloped and that only 50,9% of the at home deaths surveillance carried out by family doctors, were in accordance with the national clinical protocols. From the survey results it was concluded that in 6,6% of the cases, death could have been avoided altogether, and that in 13,1% of the cases, it could have been prevented if the quality of provided services corresponded to the established requirements. In this sense, there is a stringent need for developing and implementing patient-centered quality programs, so that the healthcare services would satisfy the consumers’ needs and expectations.
Резюме. Целью исследования было установление слабых звеньев медицинской помощи умершим на дому для обоснования организационных мероприятий по улучшению качества медицинских услуг. Исследованием охвачено 2782 случая умерших на дому по типичным группам диагнозов. Установлено, что неудовлетворительный охват трудоспособного сельского населения обязательным медицинским страхованием является основной причиной позднего обращения за медицинской помощью, а впоследствии и высокого уровня смертности на дому. Более 65% умерших в трудоспособном возрасте злоупотребляли алкоголем. Несоответствие диагностических исследований требованиям национальных протоколов качества выявлено в 62,1% случаях умерших от пневмоний, 46,7% – от инфаркта сердца и 30,1% – от цереброваскулярных инсультов. Лекарственная терапия не соответствовала установленным требованиям при лечении более 70% больных с пневмониями, 39% пациентов с инфарктом сердца и 28% с цереброваскулярными инсультами. Хирургическое лечение, проведенное в районных больницах, соответствовало протоколам лечения только в 33,7% случаев. Установлено слабое развитие реабилитационных служб. Надлежащее наблюдение умерших на дому проведено только в 50,9% случаях. Доказано, что в 6,6% случаях смерть можно было избегать, а 13,1% смертей – предотвратить. В результате исследования предложено разработать и внедрить интегрированные программы качества, призванные отвечать потребностям потребителей медицинских услуг.
metadata.dc.relation.ispartof: Sănătate Publică, Economie și Management în Medicină
URI: http://revistaspemm.md/wp-content/uploads/2019/04/cm1_32_2010.pdf
http://repository.usmf.md/handle/20.500.12710/15887
ISSN: 1729-8687
Appears in Collections:Sănătate Publică, Economie şi Management în Medicină Nr. 1 (32) / 2010

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