Quality of medical care for stroke patients in the Moscow region

Aim. To study the quality of care for stroke patients in the Moscow region in 2005, 2015 and 2019. Materials and methods. Annual reports, medical documents of 5 vascular centers, the Moscow regional medical information and analytical center were studied. Results. In 2005-2019, the incidence of acute cerebrovascular accident was at the level of 3.7-4.4 per 1 thousand population per year, the number of patients increased from 28.5 to 33.7 thousand, and the mortality rate decreased from 27.1 to 21.1%. In 2019, 38 vascular centers were functioning, and the profile hospitalization rate was 82.1%. The required volume of studies in 2005 was conducted in 5-51%, in 2015 - in 45-95%, in 2019 - in all patients, the number of systemic thrombolysis increased from 3 in 2015 to 10% in 2019. The subtype Determination by TOAST in 2015 was performed in 35, in 2019 - 47%. The number of patients prescribed secondary prevention increased from 40 to 87% (p<0.05). A decrease in the rating on the Rankin scale of at least 1 point was observed in 65, 80 and 97% of patients, respectively. Conclusion. There was an increase in the proportion of profile hospitalization of patients from 5.1% to 82.1%, but in the first 4.5 hours - less than a third, which limits the possibility of thrombolysis. There is an insufficient number of patients who have a subtype defined by TOAST, which leads to omissions in treatment tactics and a decrease in the effectiveness of secondary prevention. We believe it is important that the secondary prevention program be included in the discharge papers.

stroke, morbidity, lethality, quality, volume of studies, pathogenetic subtype