Организация здравоохранения
IMPROVING THE ORGANIZATION OF MEDICAL CARE FOR WOMEN WITH INFERTILITY
A.Yu. Prokopov1, E.M. Osmanov2
1. Tambov Regional State Budgetary Institution of Health «Children's Regional Clinical Hospital», Tambov
2. The Federal State Autonomous Educational Institution of Higher Education «The I. M. Sechenov First Moscow State Medical University» of the Ministry of Healthcare of the Russian Federation (Sechenovskiy University), Moscow
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Summary:
Introduction. The process of providing medical care to women with infertility is currently out of focus, although the restoration of reproductive health is a significant reserve for increasing fertility.
Purpose: to improve the organization of medical care for women suffering from infertility in the Tambov region.
Material and methods. Using binary logistic regression analysis, a model was developed to calculate the individual level of risk of termination of examination and treatment of infertility among women. To do this, we used data on the medical, demographic and social characteristics of women who stopped examining and treating infertility before being referred for treatment with assisted reproductive technologies (n=235) and aimed at treating infertility using assisted reproductive technologies (n=205). The ranking of risk factors was carried out using the odds ratio (OR), calculated when creating the model, the higher the OR, the higher the level of influence on the final value.
Results. A program has been developed that allows one to calculate the individual level of risk of termination of the restoration of reproductive health, which included the following risk factors: low level of financial security (OR=4.2; 95% CI 2.5-6.9), a history of infections transmitted sexually (OR=4.1; 95% CI 2.1-7.7), living in rural areas (OR=3.4; 95% CI 2.1-5.6), secondary education (OR=2,6; 95% CI 1.5-4.5), secondary genesis of infertility (OR=2.3; 95% CI 1.4-3.8), age (OR =1.2; 95% CI 1,16-1.28). Data on the level of risk contributes to the distribution of women into groups of low (1-34%), medium (35-67%) or high (68-99%) levels of risk of termination of examination and treatment of infertility, which results in the possibility of a differentiated approach to treatment. -diagnostic measures taking into account the developed routing algorithm of the model of the three-stage organization of medical care for women with infertility. To reduce the likelihood of stopping the restoration of reproductive health for women from a low-risk group, most of the treatment and diagnostic measures to restore reproductive health are carried out in medical organizations that provide medical care at the first stage. For women from a group of medium-risk levels - in medical organizations that provide medical care at the second stage, women from a high-risk group - in medical organizations providing medical care at the third stage.
Conclusions. The developed directions for improving the organization of medical care for women with infertility make it possible to optimize treatment and diagnostic measures at the regional level, which increases the availability and quality of medical care for the studied category of persons and contributes to the restoration of reproductive health.
Keywords female infertility, reproductive health, organization of medical care, availability of medical care
Bibliographic reference:
A.Yu. Prokopov, E.M. Osmanov, IMPROVING THE ORGANIZATION OF MEDICAL CARE FOR WOMEN WITH INFERTILITY // Scientific journal «Current problems of health care and medical statistics». - 2021. - №3;
URL: http://healthproblem.ru/magazines?textEn=694 (date of access: 23.11.2024).
URL: http://healthproblem.ru/magazines?textEn=694 (date of access: 23.11.2024).
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