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HighlightsWe have identified regional peculiarities of traditional and non-traditional cardiovascular risk factors.We have defined and characterized clinical and organizational characteristics of the specialized care, prevention, and treatment of diseases of the circulatory system in the Kemerovo region - Kuzbass.Moreover, we have described the principles of innovative organizational models for improving care for patients with diseases of the circulatory system, focused on the needs of outpatient organizations. AbstractThe review presents the main research findings obtained at the Department of Optimization of Medical Care for Cardiovascular Diseases of the Research Institute for Complex Issues of Cardiovascular Diseases over the past 13 years of work. The uniqueness of the obtained data lies in the fact that we have identified regional peculiarities of cardiovascular risk factors in residents of an industrial region (using the Kemerovo region data). Data on monitoring of health and risk factors served as the basis for the development of innovative organizational models for improving care for patients with diseases of the circulatory system from the stage of primary care to tertiary care using a systematic and integrated approach, and situational analysis. Management decisions within models are based on international quality standards that reaffirm that risk-based management, the role of personnel and the work environment are the integral to the improvement of performance and the achievement of the main goals of medical organization. Using the project approach, we have implemented management tools for internal quality control and safety of patients and personnel.
HighlightsWe have identified regional peculiarities of traditional and non-traditional cardiovascular risk factors.We have defined and characterized clinical and organizational characteristics of the specialized care, prevention, and treatment of diseases of the circulatory system in the Kemerovo region - Kuzbass.Moreover, we have described the principles of innovative organizational models for improving care for patients with diseases of the circulatory system, focused on the needs of outpatient organizations. AbstractThe review presents the main research findings obtained at the Department of Optimization of Medical Care for Cardiovascular Diseases of the Research Institute for Complex Issues of Cardiovascular Diseases over the past 13 years of work. The uniqueness of the obtained data lies in the fact that we have identified regional peculiarities of cardiovascular risk factors in residents of an industrial region (using the Kemerovo region data). Data on monitoring of health and risk factors served as the basis for the development of innovative organizational models for improving care for patients with diseases of the circulatory system from the stage of primary care to tertiary care using a systematic and integrated approach, and situational analysis. Management decisions within models are based on international quality standards that reaffirm that risk-based management, the role of personnel and the work environment are the integral to the improvement of performance and the achievement of the main goals of medical organization. Using the project approach, we have implemented management tools for internal quality control and safety of patients and personnel.
Background. The Constitution of the Russian Federation and federal laws define the main postulates of the methodology for preventive measures as a priority in the field of public health. Sectoral regulatory legal acts, namely, orders of the Ministry of Health of Russia present the methodology as a system of principles and methods for organizing preventive activities, including health check-ups of the adult population. The effectiveness of the largest preventive measure of the Russian health care system — health check-ups of certain groups of the adult population — depends on the quality and validity of the methodological provisions of the regulatory legal act.Objective. To assess the completeness and objectivity of methodological approaches to conducting and evaluating medical check-ups of certain groups of the adult population, reflected in regulatory legal acts.Methods. The research methodology involved a systematic review of the regulatory documentation of the Russian Federation in the field of health care from January 2012 to December 2022 to verify the basics of the methodology for conducting and evaluating preventive measures for certain groups of the adult population. The information was searched in the database of the ConsultantPlus legal reference system and on the official website of the Ministry of Health (Russian Federation), as well as in the electronic databases of the CyberLeninka and eLIBRARY.RU scientific electronic libraries. The study involved the methods of content analysis, analytical generalization, analogies, and formalization. Data analysis was focused on the organization of the health check-up of the adult population, the evaluation of its performance and effectiveness in accordance with regulatory legal acts, as well as the assessment of the quality of data obtained during the check-up.Results. A dynamic retrospective study of the regulatory framework, including the orders of the Ministry of Health of Russia, both those that have expired and those that are currently in force, identified methodological shortcomings in conducting and evaluating medical check-ups. The methodology for health check-ups of the adult population is reflected in regulatory acts. However, their number exceeds one or several documents, thereby creating a certain complexity in their interpretation and use in practice. The methodology for assessing and monitoring the implementation of health check-ups appears to be poorly defined, since it is based on a single indicator — coverage of the population with preventive check-ups and clinical examinations, thereby failing to reflect the real effect of the largest preventive measure of the state health care system. The issue requires new methodological approaches to conducting and evaluating health check-ups as a whole. The study and evaluation of check-up results is based on the statistical data analysis with imperfect methodology for collecting the data. This negatively affects the quality of statistical data, thereby leading to inadequate interpretation of the data and, as a result, to erroneous management decisions made at all levels of the executive branch.Conclusion. It is advisable to develop general methodology for conducting medical check-ups, and to consider the feasibility of creating an integral indicator for evaluating them. Specialists in the field of health care, as well as in related fields, should be involved for this purpose. A medical health officer should be assigned to coordinate the development of a methodology for organizing, conducting and evaluating health check-ups.
Background: The need to study behavioral patterns associated with lifestyle modification is evidenced not only by the high global mortality rate from cardiovascular diseases, but also by the growing burden of cardiovascular risk factors. Our objective was to assess the dynamics of risk factors in people with different health status and the role of healthy lifestyle recommendations in lifestyle changes. Materials and methods: The first stage of the study was conducted in 2016 and included 1,600 respondents while the second was in 2019 involving 991 respondents, which were then divided into three groups by their health status: apparently healthy, those who developed an atherosclerotic cardiovascular disease (CVD) during the observation period, and those already sick (initial CVD cases). The participants were examined and surveyed for the main cardiovascular risk factors, such as blood pressure, cholesterol, including its atherogenic lipoprotein, smoking, body mass index, and past illnesses. Lifestyle modification following the receipt of healthy lifestyle recommendations was assessed by survey. Results: The most pronounced dynamics of risk factors was revealed among those who developed a CVD in the course of observation: cholesterol decreased from 5.7 to 5.2 mmol/L, p = 0.005, its atherogenic lipoprotein – from 4.3 to 3.4 mmol/L, p < 0.001, systolic blood pressure – from 144 to 128 mmHg, p < 0.001, and the body mass index – from 30.8 to 30.7 kg/m2, p = 0.255. Most patients from this group (59.3 %) received healthy lifestyle recommendations and the proportions of those who followed them and modified their lifestyle were higher than in other groups (39.0 % and 54.7 %, respectively; p < 0.001). In the group of apparently healthy individuals, lifestyle recommendations were given to 27.4 % members; yet, this group was noted for a high prevalence of lifestyle self-modification (23.8 %). Among those who already suffered from a CVD at the beginning, the proportion of patients who received healthy lifestyle recommendations was 1.5 times lower (38.3 %) compared to the group of patients who developed the disease, p < 0.001. Conclusion: Those who developed a disease during observation received recommendations for a healthy lifestyle more often and modified it, but the number of such recommendations decreased with disease duration. The decision to modify the lifestyle was more often made by those who were given lifestyle recommendations, while self-modification was less frequent.
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