Evaluation of quality and effectiveness of rendering medical care to patients with gonococcal infection in medical institutions

Objective. To assess the intensity of epidemic process in a long-term dynamics of gonorrhea sickness rate and evaluate the quality and effectiveness of rendering medical care to patients with this infection in medical institutions of Perm.

Materials and methods. In this work, the data of official statistics of the State Budgetary Institution of Public Healthcare “Perm Regional Clinical Dermatovenerological Dispensary” are presented: official statistical form 12 “Information on the number of diseases” as well as accounting forms accepted by the Ministry of Public Health of Perm Krai. Epidemiological, descriptive-evaluative and analytical studies of the type “case-control, sociological (questioning method) and statistical methods were used.

Results. A long-term dynamics of gonococcal infection morbidity among the population of Perm for 1990–2020 was characterized by a marked tendency to decrease, an average annual decrease rate was 7.5 %. Despite the tendency to decline, from 2018 to 2020, there was observed an activation of epidemic process of the gonococcal infection. The growth rate was 137.5 %. Based on special investigations, it was established that 55.4 % of patients addressed to private clinics, 44.6 % (p>0.05) – to state ones (SBIPH PK RCDVD). In general, 76.5 % of patients from state and private clinics remained uncontrolled from the side of medical services. Thus, in three thirds of the foci, an active search of the sources of the infectious agent was not carried out. While studying medical documentation of 666 foci, epidemic diagnostics was performed only in 166 (24.9 %), in 500 foci the infectious agent source was not detected and investigated. At the same time, out of 500 foci, in 340 (68.0 %) one sexual partner for each focus remained unexamined, in 125 (25.0 %) foci – two-three sexual partners, and in 35 (7.0 %) foci – more than three sexual partners.

Conclusions. Recent years have witnessed the activation of epidemiological process of gonococcal infection in Perm. The gonococcal infection morbidity 2.5 times exceeded the indicators in the country as a whole. Patients with gonococcal infection addressed to state and private clinics in 55.4 % and 44.6 % of cases, respectively. Three thirds of patients with gonorrhea receive medical care not in a full volume, and with bad quality. In the state institutions, such patients make 15 %, in private ones – 85 %.