2013 № 5 Regarding methodology approaches in forming clinical-statistic groups when heart attack occurs (State Health Care Entity of Samara regional clinical cardiologic dispensary, Samara, Russia)
Annotation. This article presents a reasoning of clinical and technological criteria in forming clinic-statistic groups for treating acute coronary syndrome (heart attack). There is given a detailed explanation of a technical approach towards organizing treatment of this disease, as well as presented results of realized program on health care modernization in the department of implementing medical aid standards in treating heart attacks in Samara region.
2022 № 2 Estimation of the impact of trans-regional routing of patients with ST-segment elevation acute coronary syndrome on acute myocardial infarction mortality reduction based on the digital twin of Kurgan region
Reduction of the time required for medical evacuation to the regional vascular center in order to carry out percutaneous coronary intervention in case of ST-segment elevation acute coronary syndrome is an essential factor directly affecting the mortality rate of this condition. The concept of territorial attribution in rendering emergency medical services militates against the effective use of such emergency medical services aimed to promptly deliver patients to the hospital.
Research objective. The research objective is to study the efficiency of trans-regional communication in reducing the time required to deliver patients with ST-segment elevation acute coronary syndrome to hospitals in order to carry out percutaneous coronary intervention and its impact on acute myocardial infarction mortality rate basing on the digital twin of Kurgan region.
Materials and methods. the digital twin of the Kurgan region represents the time required to evacuate patients with ST-segment elevation acute coronary syndrome to regional vascular centers by ambulance crews in pursuance with an applicable order, compared with patient routing in case of trans-regional cooperation with vascular centers of neighboring regions.
Results: due to the implementation of trans-regional cooperation, mean patient evacuation time within the region had been reduced by 21,3 ± 9,84 minutes, and mean time on routes from the localities wherefrom it was faster to deliver patients to vascular centers in neighboring regions had been reduced by 55±25,73 minutes. The estimated myocardial infarction mortality rate on average for the Kurgan region caused by medical evacuation time reduction in case of implementing trans-regional cooperation had been reduced by 5,32%.
Conclusions: the use of resources of neighboring regions when working out regional orders on routing the patients with acute coronary syndrome in a number of instances contributes to the provision of two-hour availability of percutaneous coronary intervention and serves as a significant reserve for acute myocardial infarction mortality reduction.
2018 № 1 Experience of use of medico-economic standards for the endovascular treatment of diseases
Endovascular surgery and interventional radiology is the most modern technologies in interventional medicine. The standardization of endovascular methods is the main condition for application in practice.
Materials: Reports of the main specialists on X-ray and endovascular diagnostics and treatment of MZRF and MZ of the Moscow region. Regional medico-economic standards (MES) for endovascular treatment of diseases are developed and implemented by the Ministry of Health of the Moscow Region in 2012-2014. The results of the work showed a significant increase (6,4 times) of the performed endovascular procedures for various diseases in medical organizations involved in the implementation of the Moscow region Medical Insurance Program. This made it possible to increase the efficiency of the work of cardiology, surgery, oncology and gynecology departments, to reduce hospital mortality from acute myocardial infarction in vascular centers from 22 in 2012 to 7-8% in 2015, and mortality from cardiovascular dis¬eases in the Moscow Region from 878.5 in 2012 to 680.5 in 2015 per 100 thousand of the population. The opening of 10 catheterization centers in the Moscow region, the introduction of MES treatment of patients with acute coronary syndrome according to routing, ensured the effective hospitalization of patients in "invasive" centers from 2% in 2012 to 82.8% in 2015. The standardization of the endovascular methods of treatment leads to an increase in the use of hospital beds, improved routing of patients' flows, provision of endovascular care of patients.
2015 № 6 Improving system specialized medical care in acute coronary syndromes: experience at the level of the Russian Federation, outstanding issues
A review is presented of the Kemerovo regional experience improving specialized medical care in acute coronary syndrome. Marked the problematic issues in the health care in acute coronary syndrome in modern conditions (late hospitalization, poor interaction of medical organizations). To improve the social and economic efficiency of medical care is necessary to strengthen the preventive orientation in the activities of the primary health care, to create organizational, economic conditions compliance with the order of care in hospitals, to carry out external control of health care health insurance organizations, to provide a system of care in acute coronary syndrome information and statistical tools.