scholarly journals Analysis of the Quality of Emergency Medical Care to Patients with Acute Coronary Syndrome at the Pre-Hospital Stage

2020 ◽  
Vol 5 (3) ◽  
pp. 243-248
Author(s):  
E. V. Sid ◽  
Keyword(s):  
Acute Coronary Syndrome ◽  
Medical Care ◽  
Emergency Medical Care ◽  
Coronary Syndrome ◽  
Emergency Medical

ANALYSIS OF ORGANIZATIONAL COMPONENTS OF EMERGENCY MEDICAL CARE FOR PATIENTS WITH ACUTE CORONARY SYNDROME IN POLTAVA REGION OF UKRAINE

2021 ◽  
Vol 8 (2) ◽  
pp. 90-99
Author(s):  
Vyacheslav M. Zhdan ◽  
Iryna A. Holovanova ◽  
Grygori A. Oksak ◽  
Maksym V. Khorosh
Keyword(s):  
Acute Coronary Syndrome ◽  
Medical Care ◽  
Rural Areas ◽  
Emergency Medical Care ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Emergency Medical ◽  
St Segment ◽  
Number Of Patients ◽  
The One

The aim of our research was to study the structure of patients with acute coronary syndrome and determine the organizational components of medical care for patients with suspected acute coronary syndrome in Poltava region. Material and methods: For our study was on the one hand statistical reports of health care institutions for 2016-2018, and on the other – a survey of doctors and paramedics of emergency medical care teams on tactics management of patients with AMI. The methodological apparatus used to achieve the set goals was based on the determination of relative values and analysis of time series. Results: The number of patients hospitalized with acute coronary syndrome is growing every year: from 82 people in 2012 to 489 in 2018. According to the monitoring conducted in Poltava region, emergency medical care for patients with acute coronary syndrome with ST segment elevation in 2018 in the cities was provided in the amount of 717, while in rural areas – 288. Conclusions: Data from the analysis of emergency medical care for patients with acute coronary syndrome showed that among patients with ST-segment elevation, urban residents predominate; in 90.6% of cases, the time to the patient’s hospitalization was less than 120 minutes.

scholarly journals The main aspects of improvement of emergency medical care for patients with acute coronary syndrome

2019 ◽  
Vol 4 (4) ◽  
pp. 33-37
Author(s):  
Aleksey V. Breusov ◽  
Vladimir V. Kharchenko ◽  
Dmitriy A. Breusov
Keyword(s):  
Acute Coronary Syndrome ◽  
Medical Care ◽  
System Analysis ◽  
Motor Vehicle ◽  
Emergency Medical Care ◽  
Coronary Syndrome ◽  
Emergency Medical ◽  
Medical Institutions ◽  
Care Improvement ◽  
Mandatory Use

Objectives - to develop the main strategies of emergency medical care improvement for patients with acute coronary syndrome, in order to to reduce the morbidity and mortality in the population of a large industrial region. Material and methods. The study was conducted on the basis of the Moscow regional ambulance station. We used the content analysis, logical, system analysis, the method of mathematical statistics. Results. In the period 2017-2018, in the region's population, there is a tendency for decrease in the number of calls for ambulance teams caused by acute coronary syndrome. During the analyzed period, we noticed the reduction of the number of cases of pre-hospital thrombolytic therapy (by 17.5%). The response time to the patient's call not more than 20 minutes was observed in 92.9% of cases, the number of lethal outcomes in presence of the ambulance team decreased by 4. 6%. The results can be explained by the dynamic development of the infrastructure of cities and districts of the Moscow Region, by the improvement of road networks, by the complete renewal of the service's motor vehicle fleet, and by the opening of a number of new specialized medical institutions. A set of medical and organizational measures has been developed and put into practice in the ambulance service of the region, aimed at further improvement of the system of ambulance care for patients with acute coronary syndrome at the prehospital stage. Conclusion. The mortality reduction, preservation and improvement of public health can be achieved only through the comprehensive sustainable development of the region’s infrastructure, improvement of the organizational structure of the emergency medical service, mandatory use of algorithms and standards for the provision of medical care to patients at all stages.

scholarly journals The New Japanese Postgraduate Medical Education and Quality of Emergency Medical Care

2012 ◽  
Vol 43 (3) ◽  
pp. 494-501 ◽  
Author(s):  
Yasuharu Tokuda ◽  
Eiji Goto ◽  
Junji Otaki ◽  
Fumio Omata ◽  
Mina Shapiro ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Care ◽  
Postgraduate Medical Education ◽  
Emergency Medical Care ◽  
Emergency Medical

scholarly journals Medical quest as a method of distance simulation training

2021 ◽  
pp. 64-67
Author(s):  
S. V. Khodus ◽  
Vladimir S Oleksik
Keyword(s):  
Medical Care ◽  
Simulation Training ◽  
Emergency Medical Care ◽  
Emergency Medical ◽  
Before And After ◽  
Simulation Scenario

A study was conducted among 76 students who passed the Olympiad competitions on practical medical skills in an innovative remote format. The data obtained indicate the effectiveness of distance simulation training, which was evaluated by students answering test questions before and after passing the competition task, as well as by evaluating the actions of students during the remote passage of the simulation scenario. The proposed method of remote simulation allowed to increase the quality of knowledge of certain issues of emergency medical care.

Client satisfaction on Emergency department services and quality of emergency medical care in Ethiopia: A systematic review

2019 ◽  
Vol 27 ◽  
pp. 23-31
Author(s):  
Addis Adera Gebru ◽  
Ali Mohammad Mosadeghrad ◽  
Ali Akbari Sari ◽  
Tadesse Bekele Tafesse ◽  
Woldegebriel Gebreegziabher Kahsay
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Medical Care ◽  
Client Satisfaction ◽  
Emergency Medical Care ◽  
Emergency Medical

scholarly journals Treatment of patients with acute coronary syndrome in 2019 (data from federal registry of acute coronary syndrome)

2020 ◽  
pp. 37-45
Author(s):  
О.В. Сагайдак ◽  
Е.В. Ощепкова ◽  
Ю.В. Попова ◽  
О.М. Посненкова ◽  
А.Р. Киселев ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Medical Care ◽  
Median Time ◽  
Myocardial Revascularization ◽  
Care Quality ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Quality Of Medical Care

Введение. Проблема качества оказания медицинской помощи больным с острым коронарным синдромом (ОКС) является одной из наиболее актуальных для нашей страны, так как летальность, особенно при ОКС с подъемом сегмента ST (ОКСсST) остается на высоком уровне. Федеральный регистр больных с ОКС (далее – Регистр) дает возможность выявлять недостатки и разрабатывать подходы к улучшению оказания медицинской помощи больным в реальной клинической практике. Цель исследования: анализ качества оказания медицинской помощи больным с ОКС, прошедших лечение в 2019 году. Материалы и методы. За период с 01.01.2019 по 31.12.2019 в Регистр были внесены данные 27929 больных с ОКС из 138 медицинских организаций 32 субъектов Российской Федерации (средний возраст 65,3±11,7 лет, 62,7% мужчин). Результаты: Из 20757 у 65,9% (n= 13399) диагноз при выписке – острый и повторный инфаркт миокарда, у 32,6% – нестабильная стенокардия. 44,7% (n=9287) составили больные с ОКС с подъемом сегмента ST (ОКСсST), 55,3% (n=11470) – c ОКС без подъема сегмента ST(ОКСбST). Из 9287 больных с ОКСсST75,8% (n=7044) была выполнена реваскуляризация миокарда. Из них у 21,7% (n=1532) использовался фармакоинвазивный подход, у 61,1% (n=4304) больных выполнено только ЧКВ, у 17,0% больных проводили только тромболитичсекую терапию без ЧКВ. Остальным больным реваскуляризация не была проведена и выбрана консервативная тактика лечения. Из 11470 больных с ОКСбST реваскуляризация выполнена лишь у 31,5% (n=3621). У больных с ОКСсSTмедиана времени от момента госпитализации до начала ЧКВ составило 55 [34;106] мин. Медиана времени от начала симптомов заболевания до начала ЧКВ составила 320 [180;807] мин. Среди больных с ОКСбST медиана времени от момента госпитализации до начала ЧКВ составила 195 [75;1025] мин. От начала симптомов заболевания до начала ЧКВ составила 945 [370;2620] мин. Заключение При анализе соответствия клиническим рекомендациям, отмечается, что оказание медицинской помощи больным с ОКС оказывается не в полном объеме, что наиболее выраженно в подгруппе больных с ОКС без подъема сегмента ST. Introduction. The problem of the quality of medical care for patients with acute coronary syndrome (ACS) is one of the most relevant for our country, since mortality, especially for patients with ACS with ST segment elevation (ACSwST) remains high. The Federal Registry of Patients with ACS (hereinafter referred to as the Register) makes it possible to identify gaps in medical care quality and develop approaches for its improvement. Objective: to analyze the quality of medical care for patients with ACS who underwent treatment in 2019. Materials and methods. For the period from January 1, 2019 to December 31, 2019, data from 27029 patients with ACS from 138 medical organizations in 32 regions of the Russian Federation was included in the Registry (average age 65.3 ± 11.7 years, 62.7% of men). Results: Out of 20757, 65.9% (n = 13399) had an acute and repeated myocardial infarction diagnosis at discharge, and 32.6% had unstable angina pectoris. 44.7% (n = 9287) were patients with ACS with ST segment elevation (ACSwST), 55.3% (n = 11470) - with ACS without ST segment elevation (ACSnST). Of 9287 patients with ACSwST, 75.8% (n = 7044) underwent myocardial revascularization. Of these, in 21.7% (n = 1532) the pharmacoinvasive approach was used, in 61.1% (n = 4304) of patients only PCI was performed, in 17.0% of patients only thrombolytic therapy without PCI was performed. The remaining patients did not undergo revascularization and conservative treatment was chosen. Of 11470 patients with ACSnST, revascularization was performed only in 31.5% (n = 3621). In patients with ACSwST, the median time from hospitalization to the onset of PCI was 55 [34; 106] min. The median time from the onset of symptoms to the onset of PCI was 320 [180; 807] min. Among patients with ACSnST, the median time from the time of hospitalization to the onset of PCI was 195 [75; 1025] min. From the onset of symptoms to the onset of PCI, it was 945 [370; 2620] min. Conclusion Analyzing the quality of ACS patients medical care we concluded that ssufficient part of patients with ACS are provided with non-optimal treatment due to clinical guidelines, and the medical care is the it was noted that the provision of medical care to patients with ACS is not in full, which is most pronounced in the subgroup of patients with ACS without raising the ST segment.

THE QUALITY OF MEDICAL CARE IN MEDICAL ORGANIZATIONS OF MOSCOW PUBLIC HEALTH CARE SYSTEM IN APPRAISALS OF PATIENTS AND PHYSICIANS

2017 ◽  
Vol 16 (2) ◽  
pp. 100-106 ◽  
Author(s):  
I. Ya Tadjiev ◽  
A. V Belostotsky ◽  
S. S Budarin
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Medical Personnel ◽  
Public Health Care ◽  
Fee For Service ◽  
Emergency Medical Care ◽  
Emergency Medical ◽  
Quality Of Medical Care ◽  
High Level

The article presents the analysis of results of complex medical sociological survey of effectiveness and efficiency of medical care as main criteria of its quality and accessibility. The survey comprised 1,737 patients of various social groups of population of Moscow and 203 physicians of polyclinics. At self-rating of health, 13.2% of respondents determined it as unsatisfactory, 45.1% as satisfactory and 31.3% as good. In all population groups, the most called-for proved to be polyclinic institutions. The high level of satisfaction of patients with quality of emergency medical care was established in all groups. The quality of medical care in polyclinics and hospitals was assessed significantly lower. The most negatively assessed criteria turned out transition to fee-for-service forms of medical support and time limits of waiting for all modes of medical care, except emergency medical care and district therapist. The evaluation by physicians of their own activity and present problems is characterized by their unanimity in need of increasing of salary (100%) and increasing of typical sectoral standards of time of reception of a patient (96.5%), decreasing of intensity of work of medical personal (92.3%) and reduction of some forms of record cards with the purpose of releasing of time and attention of physician for a patient (88.4%). The disrespectful attitude of patients to medical personnel was mentioned by 77.3% of physicians which is a new phenomenon testifying loss of confidence in patient-physician relationship. The quality of implemented work was assessed equally and rather high by both young and experienced physicians. The positive and negative aspects of reorganization of health care were analyzed. Two alternatives of problems were established to focus plans of development of system of Moscow health care to support accessible and qualitative medical care of population.

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