EXPERT EVALUATION OF QUALITY OF INPATIENT MEDICAL CARE FOR CHILDREN WITH RESPIRATORY PATHOLOGY IN ROSTOV REGION


E.A. Besedina (1, 2), S.G. Piskunova (1, 3), Т.В. Kulichenko (4), N.V. Moiseyenko (2)

1) Department of Children’s Diseases №1 FBEI HE RostSMU of RMH, Rostov-on-Don; 2) Territorial Federal Compulsory Medical Insurance Fund of the Rostov Region (TFCMIF RR), Rostov-on-Don; 3) SBI RR “Regional Children’s Clinical Hospital”, Rostov-on-Don; 4) FSAI “National Scientific and Practical Center for Children’s Health” of the Ministry of Health of Russia, Moscow
Low quality of medical care can not only impede the achievement of targeted health indicators, but also lead to unjustified direct and indirect costs of the health system as a whole. The article presents the results of the analysis of the quality of medical and diagnostic care for acute respiratory diseases in children hospitalized in pediatric hospitals (based on the example of the Rostov Region), and its conformity with the clinical guidelines approved in the Russian Federation. It was revealed that low quality of medical care for children with ARI was caused by unjustified hospitalization (66%), excessive chest x-ray in the absence of indications (49%), unreasonable prescription of antibacterial therapy (70%) and antihistamines (59%), irrational antiviral and immunomodulatory therapy (51%), inadequate administration of inhalation therapy (29%). Overdiagnosis of pneumonia occurred in 71% of cases, mainly due to incorrect interpretation of the results of X-ray examination. Irrational antibiotic therapy for community-acquired pneumonia was noted in 69% of cases, and polypharmacy – in 63% of cases. The results of the expert evaluation point out the directions for improving the quality of medical care for children: training and attestation of physicians in accordance with the Federal clinical recommendations for diagnosis and treatment of respiratory diseases; control over the use of antibiotics and other medicines in hospitals; internal and external audit of radiological services of hospitals; regular internal and external audit of quality of inpatient medical care.

About the Autors


Corresponding author: T.V. Kulichenko – MD, Prof. of RAS, Head of the Pediatric Emergency Department FSAI «NSPCCH» of RMH, Moscow; tel. 8 (499) 134-08-39; e-mail: Tkulichenko@yandex.ru


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