scholarly journals Japanese Medical Facilities Maintained the Quality of Medical Care for Acute Coronary Syndrome during the First Wave of the Coronavirus Disease 2019 Pandemic in Japan

2021 ◽  
Author(s):  
Koshi Nakamura
Keyword(s):  
Acute Coronary Syndrome ◽  
Medical Care ◽  
Coronary Syndrome ◽  
Medical Facilities ◽  
Quality Of Medical Care

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.

scholarly journals Simulation Trainings in the Optimization of Medical Care for Patients with Acute Coronary Syndrome

2021 ◽  
pp. 60-63
Author(s):  
I. I. Dolgina ◽  
I. G. Dolzhenkova ◽  
V. V. Savich ◽  
M. F. Grigorian
Keyword(s):  
Quality Of Life ◽  
Acute Coronary Syndrome ◽  
Thrombolytic Therapy ◽  
Medical Care ◽  
Clinical Outcomes ◽  
Simulation Training ◽  
Patient Survival ◽  
Coronary Syndrome ◽  
Quality Of Medical Care

The study analyzes the effectiveness of simulation training aimed at introducing protocols for resuscitation and thrombolytic therapy for emergency medical workers and vascular centers in teamwork by analyzing the clinical outcomes of resuscitation measures, the number and effectiveness of thrombolytic therapy at the prehospital stage and in vascular centers. It has been shown that team simulation trainings contribute to improving the quality of medical care for patients with acute coronary syndrome, improving patient survival and their quality of life.

scholarly journals �A Phenomenal Person and Doctor�: Thank You Letters to Medical Care Providers (Preprint)

2016 ◽  
Author(s):  
Talya Miron-Shatz ◽  
Stefan Becker ◽  
Franklin Zaromb ◽  
Alexander Mertens ◽  
Avi Tsafrir
Keyword(s):  
Medical Care ◽  
The United States ◽  
Care Providers ◽  
Good Care ◽  
Patient Centered ◽  
Medical Facilities ◽  
Centered Care ◽  
Quality Of Medical Care ◽  
The Web

BACKGROUND Thank you letters to physicians and medical facilities are an untapped resource, providing an invaluable glimpse into what patients notice and appreciate in their care. OBJECTIVE The aim of this study was to analyze such thank you letters as posted on the Web by medical institutions to find what patients and families consider to be good care. In an age of patient-centered care, it is pivotal to see what metrics patients and families apply when assessing their care and whether they grasp specific versus general qualities in their care. METHODS Our exploratory inquiry covered 100 thank you letters posted on the Web by 26 medical facilities in the United States and the United Kingdom. We systematically coded and descriptively presented the aspects of care that patients and their families thanked doctors and medical facilities for. We relied on previous work outlining patient priorities and satisfaction (Anderson et al, 2007), to which we added a distinction between global and specific evaluations for each of the already existing categories with two additional categories: general praise and other, and several subcategories, such as treatment outcome, to the category of medical care. RESULTS In 73% of the letters (73/100), physicians were primarily thanked for their medical treatment. In 71% (71/100) of the letters, they were thanked for their personality and demeanor. In 52% cases (52/100), these two aspects were mentioned together, suggesting that from the perspective of patient as well as the family member, both are deemed necessary in positive evaluation of medical care. Only 8% (8/100) of the letters lacked reference to medical care, personality or demeanor, or communication. No statistically significant differences were observed in the number of letters that expressed gratitude for the personality or demeanor of medical care providers versus the quality of medical care (χ21, N=200=0.1, not statistically significant). Letters tended to express more specific praise for personality or demeanor, such as being supportive, understanding, humane and caring (48/71, 68%) but more general praise for medical care (χ21, N=424=63.9, P<.01). The most often mentioned specific quality of medical care were treatment outcomes (30/73, 41%), followed by technical competence (15/73, 21%) and treatment approach (14/73, 19%). A limitation of this inquiry is that we analyzed the letters that medical centers chose to post on the Web. These are not necessarily a representative sample of all thank you letters as are sent to health care institutions but are still indicative of what centers choose to showcase on the Web. CONCLUSIONS Physician demeanor and quality of interaction with patients are pivotal in how laymen perceive good care, no less so than medical care per se. This inquiry can inform care providers and medical curricula, leading to an improvement in the perceived quality of care.

scholarly journals Cardiogenic shock in patients with acute coronary syndrome (data from Russian Federal Acute Coronary Syndrome Registry)

2019 ◽  
Vol 91 (9) ◽  
pp. 47-52
Author(s):  
O V Sagaydak ◽  
E V Oschepkova ◽  
I E Chazova
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiogenic Shock ◽  
Medical Care ◽  
Clinical Guidelines ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Registry System ◽  
St Segment

Mortality in acute coronary syndrome (ACS) and its complications remains high, despite significant advances in the treatment of coronary heart disease and its complications. One of the most life - threatening complications of ACS is cardiogenic shock (CS). CS is an extreme degree of acute heart failure and develops on average in 5-8% of patients hospitalized with ACS. In the present work, we analyzed data from Russian Federal ACS Registry - frequency of CS occurrence, treatment methods, and outcomes of ACS complicated by CS. Aim. Assess the quality of medical care in patients with ACS, which complicated by CS, and its compliance with current clinical guidelines. Materials and methods. Data from patients with ACS were exported from the Russian Federal ACS Registry. The study analyzed the data of 29.736 patients with ACS entered into the registry system in the period from 01.01.2018 to 31.12.2018. Of the 29.736 patients with ACS, 824 patients were diagnosed with CS. To assess the quality of care provided to patients with ACS and CS, the main clinical gguidelines were used. Results. The group of 824 patients with ACS and CS was analyzed. Among them patients with ACS with ST segment elevation prevailed - 77.8% (n=641). According to Russian Federal ACS Registry 44.3% (n=365) of patients with ACS and CS received conservative treatment, of which 58.6% (n=108) were with ACS with ST segment elevation. Percutaneous coronary intervention was performed in 39% (n=321) of patients, of whom 89.4% (n=271) of patients with ACS with ST segment elevation. According to the data of this study, thrombolytic therapy was performed in 26.5% (n=218) of patients. Conclusion. The data obtained demonstrated that patients with ACS and CS did not receive optimal medical care and their treatment does not fully comply with modern clinical guidelines.

scholarly journals Evaluation of the quality of medical care in a multiprofile Federal center

2009 ◽  
Vol 15 (2) ◽  
pp. 170-180
Author(s):  
Y. Kasherininov
Keyword(s):  
Medical Care ◽  
High Technology ◽  
Regional Health ◽  
Simple Method ◽  
Coronary Syndrome ◽  
Regional Health Care ◽  
Quality Of Medical Care ◽  
Treatment Procedures ◽  
Federal Center

A simple method of evaluating the quality of medical care is presented. Using offered form and expert findings it is possible to make a quantitative conclusion assessing different stages of the diagnostic and treatment procedures, comparing different departments and workers, and analyzing co-elaboration between multitype Federal centre and regional health care system of Russian federation in performing high-technology treatment and diagnostics. There are several examples showing comparative sample check examination between different cardiology departments, and an example of an expert evaluation of an acute coronary syndrome case is given.

scholarly journals Management of acute coronary syndrome in older adults (data from russian federal acute coronary syndrome registry)

2018 ◽  
Vol 90 (3) ◽  
pp. 67-71
Author(s):  
E V Ocshepkova ◽  
O V Sagaydak ◽  
I E Chazova
Keyword(s):  
Acute Coronary Syndrome ◽  
Age Groups ◽  
Younger Patients ◽  
Economic Problems ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Quality Of Medical Care ◽  
Current Guidelines ◽  
Global Aging

The frequency of cardiovascular diseases is increasing progressively with age, and the global aging of the population poses the problem of treatment of patients of older age groups in a row with other relevant medical and socio-economic problems. Aim. In the present study was to investigate the quality of medical care for patients with acute coronary syndrome (ACS) old age and compliance of the treatment current guidelines. The data is exported from the system of the Federal register OKS. Materials and methods. Analyzed medical history 33 893 patients with ACS entered in the system registry of ACS for the period from 01.01.2016 to 31.12.2016. a comparison was made of the quality of care in patients with ACS elderly (75 years and older, n=8773) and in younger patients. Results. The results of the study showed that in patients of senile age, when compared with younger patients, comorbid conditions are significantly more often observed, as well as a significantly higher risk of hospital and 6-month death, calculated on the GRACE scale. Conclusion. Patients of senile age with ACS are almost twice less likely to undergo percutaneous coronary interventions than younger ones, which worsens the prognosis in these patients and increases mortality.

scholarly journals Peculiarities of the Course and Provision of Medical Care to Patients with Acute Coronary Syndrome in the Precarpathian Region

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Roksolana Nesterak
Keyword(s):  
Quality Of Life ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Diseases ◽  
Medical Care ◽  
Clinical Characteristics ◽  
Work Capacity ◽  
Care Provision ◽  
Coronary Syndrome ◽  
Applied Method

Abstract. Cardiovascular diseases are the first ones in mortality among other diseases. Particular attention should be paid to patients after acute coronary syndrome, since their quality of life, the possibility of restoration of work capacity. Objective of the research. To evaluate indicators of medical care provision for patients with acute coronary syndrome in the Precarpathian region. Materials and methods. The medical-geographical indicators, data of the local registry (2014-2018) included clinical and objective parameters, peculiarities of the course, rehabilitation and treatment of patients with acute coronary syndrome. Results. The peculiarities of the course of acute coronary syndrome, clinical characteristics of patients depend on the form of IHD and the applied method of ACS treatment. There is an increase of the number of PCI performance and the reduction of TLT, the percentage of admission of patients up to 2 hours remains low. The increase of PCI performed in the districts of the region in the dynamics from 2014 to 2018 has been determined, as well as the geographical peculiarities of the Ivano-Frankivsk region. The percentage of patients’ undergoing rehabilitation after acute coronary syndrome remains low. Conclusions. The Precarpathian region has a number peculiarities that are related to the location of the region. Taking into account the characteristics will contribute to the improvement of the organizational model of medical care provision in the region.

Responsibility for a quality of medical care provided via telemedicine

2018 ◽  
Vol 2018 (1-2) ◽  
pp. 9-15
Author(s):  
Morozov S.P. ◽  
◽  
Vladzymyrskyy A.V. ◽  
Varyushin M.S. ◽  
Aronov A.V. ◽  
...  
Keyword(s):  
Medical Care ◽  
Quality Of Medical Care
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