EXPERT EVALUATION OF THE QUALITY OF MEDICAL CARE IN THE FIELD OF "UROLOGY" PROVIDED BY UROLOGISTS IN OUTPATIENT SETTINGS
A.A.Endovickij1
1. Federal Budgetary Healthcare Institution "Medical and Sanitary Unit of the Ministry of Internal Affairs of the Russian Federation for the Moscow Region"
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Summary:
Introduction. Currently, scientists worldwide are conducting research aimed at studying key issues related to assessing the accessibility and quality of medical care. The results of these studies lead to improvements in these parameters, finding ways for reasonable optimization of resource expenditures, and methods for coordinating production and technological processes in healthcare [3]. The increase in morbidity from diseases of the urinary system in the Russian Federation necessitates high-quality medical care in the field of "urology" provided in outpatient settings. Evaluating the quality of medical care in this field is relevant today, which prompted this research.
Objective. To conduct an expert evaluation of the quality of medical care in the field of "urology" provided in outpatient settings.
Materials and methods. Statistical and analytical research methods, as well as expert evaluation methods, were applied. The quality of medical care in the field of "urology" provided in outpatient settings was analyzed based on 394 electronic medical records of patients receiving outpatient medical care (Form No. 25/u). The research was conducted at the GBUZ "City Polyclinic No. 195 DZM," urology department. A basic research model was developed for the study, consisting of three parts. Based on the second and third parts of the informational model, expert physicians conducted an evaluation of the quality of medical care in the field of "urology" provided in outpatient settings.
Results. In most cases, the expert physicians noted the correctness of registering complaints in the outpatient medical record, however, in the overwhelming majority of outpatient examinations, the medical history of the disease was not fully clarified, and in most examinations, the objective status was not completely assessed. In more than half of the cases, the expert physicians noted the justification for all laboratory tests ordered. In about a third of the cases, the experts noted that laboratory tests were ordered in full. The expert physicians concluded that in two-thirds of the cases, patients were not fully examined. In one-fifth of the cases, the expert physicians disagreed with the established diagnosis, and a late diagnosis was noted in one-sixth of the cases. More than a week often passed from the initial consultation to the appointment of treatment. According to expert physicians, in more than half of the cases, the treatment complied with current clinical recommendations. More than half of the outpatient examinations did not contain recommendations for further treatment.
Discussion and conclusions. The study revealed defects in the quality of medical care in the field of "urology" provided in outpatient settings. The expert physicians identified discrepancies in collecting complaints, a lack of completeness in gathering the medical history of the disease in most cases, as well as insufficient attention to conducting physical examinations. In two-thirds of the cases, patients were generally not fully examined. In one-fifth of the cases, the expert physicians disagreed with the established diagnosis, and half of the cases did not conclude with recommendations for treatment and disease prevention; more than half of the patients were not placed under dispensary observation when indicated. However, the expert physicians frequently noted the justified ordering of laboratory tests and their completeness, and the overall prescribed treatment corresponded to current clinical recommendations.
Keywords quality of medical care, expert evaluation, urologists, healthcare organization
Bibliographic reference:
A.A.Endovickij, EXPERT EVALUATION OF THE QUALITY OF MEDICAL CARE IN THE FIELD OF "UROLOGY" PROVIDED BY UROLOGISTS IN OUTPATIENT SETTINGS // Scientific journal «Current problems of health care and medical statistics». - 2024. - №4;
URL: http://healthproblem.ru/magazines?textEn=1427 (date of access: 22.12.2024).
URL: http://healthproblem.ru/magazines?textEn=1427 (date of access: 22.12.2024).
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