Management in healthcare
  • 2023 № 1 Problems of organization of outpatient care for patients with carpal tunnel syndrome

    Peripheral nerve diseases occupy an important place in the structure of morbidity, accompanied by temporary disability and invalidation of the population. In addition, these diseases lead to an increase in the citizens’ and state’s expenditure for maintaining health and active lifestyle.
    P u r p o s e of the study is to analyze and evaluate the routing of patients with carpal tunnel syndrome, formulate proposals for its improvement.
    M a t e r i a l s a n d m e t h o d s . The study used the following methods: analytical, expert assessments of medical organization employees who provide care to patients with diseases of the peripheral nervous system. The analysis of medical documentation of S. P. Botkin City Clinical Hospital have been carried out. The object of the study were patients treated in this hospital from 2007 to 2021.
    R e s u l t s . Analyzing the routing stages of a patient with carpal tunnel syndrome, attention is drawn to the violation of the priority of the patient’s interests not only within the rational use of his time, but also the duration of neuropathic pain syndrome. The timeframes of medical care are violated. In addition, in conditions of limited resources and lean production, budgetary funds are unreasonably spent on the examination of the patient.
    F i n d i n g s . Optimization of routing of patients with this pathology will contribute to the timely provision of high-quality medical care, which will reduce the time of temporary disability and avoid invalidation of population.

    Authors: Boyko Yu. P. [1] Fedyakov A. G. [2] Shcherbin A. V. [2] Razin M. A. [2]

    Tags: carpal tunnel syndrome2 outpatient care6 patient-oriented healthcare model1

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  • 2023 № 10 Medical and social significance of diseases of the peripheral nervous system on the example of carpal tunnel syndrome.

    Peripheral nerve diseases are one of the socially significant problems in the healthcare system of the Russian Federation. Effective care for patients suffering from these diseases is an important task for healthcare, as so as they are accompanied by prolonged disability.
    However, at present we do not have data that could fully demonstrate the medico-social and medico-economic aspects of carpal tunnel syndrome (CTS) and other peripheral nerve diseases in the Russian Federation.
    The aim of the study is to improve the quality of medical care for patients with carpal tunnel syndrome based on the analysis of statistical data of patients operated on for this pathology in the S. P. Botkin City Clinical Hospital.
    Material and methods. The patients in the study were all adult men and women who underwent surgical treatment of CTS at S. P. Botkin City Clinical Hospital in the period from 2016 to 2022. The sources of information about the treated patients were the information of medical information systems used in the hospital in different years. Statistical and visualization tools of the Microsoft® Excel® spreadsheet were used to obtain descriptive statistics and present data graphically.
    Results. In the S. P. Botkin City Clinical Hospital, which is the clinical base of the Department of neurosurgery of the Russian Medical Academy of Continuous Professional Education, in the period from 2016 to 2022, 692 surgical interventions were performed for patients with CTS. The analysis of statistical data has shown results comparable with the available literature data, however, a distinctive feature is an extremely long history of the disease before surgical treatment.
    Conclusions. Currently, in our country, there is an underestimation of the importance of peripheral nerve diseases, therefore, their separate statistical accounting in the structure of neurological morbidity is extremely important. Another important task is a multidisciplinary approach that provides high-quality medical care to patients with this pathology.

    Authors: Fedyakov A. G. [2] Shcherbin A. V. [2] Razin M. A. [2] Gorozhanin А. V. [1] Dreval О. N. [1] Maximov М. L. [1] Kizlik О. О. [1] Plieva Z. H. [1]

    Tags: carpal tunnel syndrome2 multidisciplinary approach1 peripheral nerve diseases1 statistical analysis1

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