Cardiorehabilitation organization in Russia. The results of the pilot project "Development of the system of rehabilitation of patients with cardiovascular diseases in medical institutions of the Russian Federation"

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Abstract

Goal. The pilot project to organize or conduct performance improvement of existing structural units in specific hospitals (LU) Russia to provide rehabilitative care for patients with cardiovascular diseases in three stages under the current "Procedure for the provision of medical care for patients in medical rehabilitation", to introduce in practice these units tested scientifically sound approaches, forms and methods of cardio-rehabilitation, and try to create some patients routing algorithm. Material and methods. The pilot project includes 17 of the medical institutions of 13 regions of Russian Federation. Single special cards that allow to evaluate the appropriate order on the medical rehabilitation provided rehabilitation assistance to cardiac patients, a multidisciplinary team involved in the provision of rehabilitation assistance, staffing and equipping MI To analyze the effectiveness of organizational models in cardiorehabilitation MI have been developed. Special cards consisted of three sections, each of which allows you to evaluate the effectiveness of each of the three stages cardiorehabilitation: Stage I - unit intensive care unit (BRIT), and a specialized cardiology department; Stage II - stationary cardiorehabilitation department; Stage III - patient department cardiorehabilitation. The article presents the results of a three-year analysis from January 2013 to December 2015. Results. The pilot project was organized with the cardiorehabilitational help stage I in 10 DR, II stage - a 10-LU and Phase III - 7 DR. By 2015, almost all of Latvia to provide assistance in cardiorehabilitational area, multidisciplinary teams consisting of a cardiologist, cardiologist, rehabilitator, medical physical culture (physical therapy) specialist, physical therapy instructor-methodologist, psychotherapist, clinical psychologist, physiotherapist were formed. They were provided and equipped with facilities to practice physical therapy, room for educational schools. Home rehabilitation process BRIT has reduced the patient's stay in the bed of 0.7 days (2013 to 2015) and for 1 day in the cardiology department. On average, 67% of patients with acute myocardial infarction (AMI) were translated into Phase II cardiorehabilitaяtion in which they have become actively involved in the physical rehabilitation program, which is based on a classic exercise therapy, dosage walking in the room, physical training on simulators. Each MI educational schools were organized for patients actively pursued discussions with the relatives. Special complexity of the project has caused the organization phase III cardiorehabilitation. The project is currently ongoing. Conclusion. The analysis of the organization of a three-stage kardioreabilitatsionnoy care system with AMI patients considering the use of staffing, equipment and methodology, according to the current normative law, showed a significant increase in recreational activities created by multidisciplinary teams in all three stages of cardio-rehabilitation, increasing the number of used rehabilitation methods and improve the quality of their performance, as well as demonstrated safety of the proposed principles of physical rehabilitation, according to Russian clinical guidelines "Acute myocardial infarction with ST-segment elevation ECG: rehabilitation and secondary prevention", in the framework of the proposed organizational models cardiorehabilitation.

About the authors

M. G Bubnova

State Research Centre for Preventive Medicine of the Ministry of Health of the Russian Federation

Email: mbubnova@gnicpm.ru
д-р мед. наук, проф., рук. отд. реабилитации и вторичной профилактики сочетанной патологии с лаб. профилактики атеросклероза и тромбоза ФГБУ ГНИЦ ПМ 101990, Russian Federation, Moscow, Petroverigskii per., d. 10, str. 3

D. M Aronov

State Research Centre for Preventive Medicine of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., засл. деятель науки РФ, рук. лаб. кардиологической реабилитации ФГБУ ГНИЦ ПМ 101990, Russian Federation, Moscow, Petroverigskii per., d. 10, str. 3

S. A Boytsov

State Research Centre for Preventive Medicine of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., дир. ФГБУ ГНИЦ ПМ, гл. специалист по мед. профилактике Минздрава России 101990, Russian Federation, Moscow, Petroverigskii per., d. 10, str. 3

G. E Ivanova

N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., зав. каф. мед. реабилитации фак-та дополнительного профессионального образования ФГБОУ ВО РНИМУ им. Н.И.Пирогова, гл. специалист по мед. реабилитации Минздрава России 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1

A. G Andreev

City Clinical Hospital №3

канд. мед. наук, гл. врач ОБУЗ ГКБ №3 153008, Russian Federation, Ivanovo, ul. Postysheva, d. 57/3

O. L Barbarash

Research Institute for Complex Issues of Cardiovascular Diseases

д-р мед. наук, проф., дир. ФГБНУ НИИ КПССЗ 650002, Russian Federation, Kemerovo, Sosnovyi b-l., d. 6

V. V Belova

Ivanovo State Medical Academy of the Ministry of Health of the Russian Federation

канд. мед. наук, зам. гл. врача клиники ФГБОУ ВО ИвГМА 153462, Russian Federation, Ivanovo, pr. Sheremetevskii, d. 8

V. N Belov

Voronezh City Clinical Hospital №3

д-р мед. наук, зав. отд-нием мед. реабилитации БУЗ ВО ВГКБ №3 394030, Russian Federation, Voronezh, ul. Plekhanovskaia, d. 66

B. V Borisov

Republic hospital №2 - Center of emergency medical aid

канд. мед. наук, гл. врач РБ №2 - Центр экстренной медицинской помощи 677000, Russian Federation, Yakutsk, ul. Petra Alekseeva, d. 83a

E. V Ivanov

Gorky Sanatorium of the Ministry of Health of the Russian Federation

гл. врач ФГБУ Санаторий им. Горького 141142, Russian Federation, Moscow region, Shchelkovskii r-n, pos. "Iunost'"

I. M Karamova

The emergency hospital

д-р мед. наук, проф., гл. врач ГБУЗ РБ Больница скорой медицинской помощи 450106, Russian Federation, Ufa, ul. Batyrskaia, d. 39/2

A. V Karpukhin

Sanatorium «Chernaya rechka»

канд. мед. наук, исполнительный дир. ЗАО Санаторий «Черная Речка» 197729, Russian Federation, Saint Petersburg, pos. Molodezhnoe, Primorskoe sh., d. 648

V. B Krasnitskiy

State Research Centre for Preventive Medicine of the Ministry of Health of the Russian Federation

канд. мед. наук, вед. науч. сотр. лаб. кардиологической реабилитации отд. реабилитации и вторичной профилактики сочетанной патологии ФГБУ ГНИЦ ПМ 101990, Russian Federation, Moscow, Petroverigskii per., d. 10, str. 3

E. S Kylbanova

M.K.Ammosov North-Eastern Federal University

д-р мед. наук, зав. каф. внутренних болезней и общеврачебной практики (семейной медицины) фак-та последипломного обучения врачей ФГАОУ ВО СВФУ им. М.К.Аммосова 677000, Russian Federation, Yakutsk, ul. Belinskogo, d. 58

P. A Lebedev

Samara State Medical University of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., зав. каф. ФГБОУ ВО СамГМУ 443099, Russian Federation, Samara, ul. Chapaevskaia, d. 89

E. A Lisnyak

Berzon 20th Krasnoyarsk interregional clinical hospital

канд. мед. наук, зам. гл. врача по мед. части КГБУЗ КМКБ №20 им. И.С.Берзона 660123, Russian Federation, Krasnoyarsk, ul. Instrumental'naia, d. 12

N. P Lyamina

V.I.Razumovskiy Saratov State Medical University of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., зам. дир. по науке НИИ кардиологии ФГБОУ ВО СГМУ им. В.И.Разумовского 410012, Russian Federation, Saratov, ul. Bol'shaia Kazach'ia, d. 112

T. N Mizurova

Republican Cardiology Dispensary of the Ministry of Health of Chuvashia

гл. врач БУ Республиканский кардиологический диспансер 480020, Russian Federation, Cheboksary, ul. Fedora Gladkova, d. 29A

O. F Misyura

Sanatorium «Chernaya rechka»

канд. мед. наук, гл. врач ЗАО Санаторий «Черная речка» 197729, Russian Federation, Saint Petersburg, pos. Molodezhnoe, Primorskoe sh., d. 648

I. E Mishina

Ivanovo State Medical Academy of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., зав. каф. госпитальной терапии ФГБОУ ВО ИвГМА 153462, Russian Federation, Ivanovo, pr. Sheremetevskii, d. 8

O. V Mishchenko

V.D.Seredavin Samara Regional Clinical Hospital

канд. мед. наук, зам. гл. врача ГБУЗ СОКБ им. им. В.Д.Середавина 443095, Russian Federation, Samara, ul. Tashkentskaia, d. 159

S. Yu Nikulina

Prof. V.F.Voino-Yasenetski Krasnoyarsk State Medical University of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., проректор по учебной работе, зав. каф. внутренних болезней №1 ФГБОУ ВО КрасГМУ им. проф. В.Ф.Войно-Ясенецкого 660022, Russian Federation, Krasnoyarsk, ul. Partizana Zhelezniaka, d. 1

N. I Ostroushko

The Department of Health of the Voronezh Region

канд. мед. наук, нач. отд. специализированной и высокотехнологической мед. помощи Департамента здравоохранения Воронежской области 394036, Russian Federation, Voronezh, ul. Nikitskaia, d. 5

S. A Pomeshkina

Research Institute for Complex Issues of Cardiovascular Diseases

канд. мед. наук, зав. лаб. реабилитации ФГБНУ НИИ КПССЗ 650002, Russian Federation, Kemerovo, Sosnovyi b-l., d. 6

A. S Sidorov

Republican Hospital №3

канд. мед. наук, гл. врач ГБУЗ РС(Я) РБ №3 677027, Russian Federation, Yakutsk, ul. Gor'kogo, d. 94

A. A Sprikut

City Clinical Hospital №2

канд. мед. наук, зав. отд-нием кардиореабилитации МБУЗ ГКБ №2 454080, Russian Federation, Chelyabinsk, pr Lenina, d. 82

I. S Sukhinina

Gorky Sanatorium of the Ministry of Health of the Russian Federation

зам. гл. врача по лечебной работе ФГБУ Санаторий им. Горького 141142, Russian Federation, Moscow region, Shchelkovskii r-n, pos. "Iunost'"

A. G Tkacheva

City Clinical Hospital №2

канд. мед. наук, гл. врач МБУЗ ГКБ №2 454080, Russian Federation, Chelyabinsk, pr Lenina, d. 82

S. A Ustyugov

Regional Clinical Hospital

канд. мед. наук, зав. кардиологическим отд-нием КГБУЗ ККБ 660022, Russian Federation, Krasnoyarsk, ul. Partizana Zhelezniaka, d. 3a

G. A Chumakova

Altai State Medical University of the Ministry of Health of the Russian Fedeartion

д-р мед. наук, проф. каф. госпитальной и поликлинической терапии ФГБОУ ВО Алтайский ГМУ 656038, Russian Federation, Barnaul, pr-t. Lenina, d. 40

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