Indicators of potentially preventable hospitalizations as a tool for improving the quality of care in cardiovascular diseases

摘要

Aim. To assess the possibility of using indicators of potentially preventable hospitalizations of cardiovascular diseases to assess the quality of medical care. Methods. Indicators of quality of cardiovascular disease treatment were formed based on the analysis of literature, current clinical recommendations and the structure of potentially preventable hospitalizations in the districts and cities of the Republic of Tatarstan. The proposed indicators were studied in the districts of the Republic of Tatarstan in 20112015. Results. It is revealed that the distribution of indicator values in the regions of the Republic of Tatarstan differs from normal and is characterized by high variation. Median, minimum and maximum of hospitalization levels for hypertension in 2015 were 8.4, 1.3 and 26.8 respectively; unstable angina, myocardial infarction 2.2, 0.02 and 8.6. Indicators for hospitalization due to stable angina, chronic ischemic heart disease also had a high level of variation (6.3, 0.2 and 17.4). As criteria for quality and optimal use of resources, it is proposed to use nonparametric estimates, one of which is the upper quartile. According to this study, in 2015, upper quartile for hypertension was 11.2; for unstable stenocardia, myocardial infarction 3.4; for stable angina, chronic ischemic heart disease 8.6. Conclusion. The results of this study prove that indicators of potentially preventable hospitalizations may be part of a comprehensive assessment of the quality of care.