Системный подход к процессу подготовки взрослого населения к плановой госпитализации

Профилактическая медицина. 2022. Т. 25. № 8. С. 7–13.

Унмут С. С., Русских С. В., Тимурзиева А. Б., Tarasenko E. A., Васильев М. Д., Орлов С. А.

The reason of the study: To improve the process and content of pre-hospital training, it is necessary to form a unified procedure for referring adult patients for planned hospitalization and formalize the relationship between all participants in the three-level healthcare system, including the unification of the content and validity of lists of diagnostic examinations. Objective - to compare content of the lists of diagnostic examinations and its validity in the process of adult patients preparation for planned hospitalization in in-patient hospitals to check problems that increase the risks of time, clinical and financial costs in the process of preparation of adult patients for planned hospitalization in in-patient hospitals. Material and methods. The authors analyzed the regulatory framework for the preparation of patients at the stage of providing primary specialized health care. The empirical basis for comparative quantitative analysis was the lists of diagnostic examinations and their duration for the preparation for surgical and conservative treatments in 24 in-patient hospitals (the Cardiology profile) in Moscow in 2020. Also, as part of the participant qualitative observation, the analysis of the patient's route for planned hospitalization in one of the in-patient hospitals (the profile "Cardiology") was carried out. Results. Conclusion. The authors identified that the list of medical examinations performed at the outpatient stage for the purpose of prehospital preparation of the adult population for planned treatment in in-patient hospitals and the validity of the results of studies on similar diseases and the type of hospitalizations in medical organizations in Moscow differ. To introduce a systematic approach to unify the processes of a patient preparation for planned hospitalization, to optimize medical care costs, it is necessary to create a unifies regulation approved at the level of regions, which should include the procedure for hospitalization, as well as a unified basic list of medical examinations (clinical, laboratory, functional) considering the main profiles - therapeutic and surgical.

Keywords: системный подход, systematic approach, prehospital workup, standards of medical care, management of planned hospitalization, problems of workup for planned treatment, optimization of medical care costs, догоспитальная подготовка, стандарты оказания медицинской помощи, управление плановой госпитализацией, проблемы подготовки к плановому лечению, оптимизация расходов на медицинскую помощь