Assessing management and quality of outpatient care for economically active population

Aim. To evaluate the management and quality of healthcare provided by outpatient clinics of two Moscow administrative districts to economically active population in the period of 2009-2013.

Methods.937 medical charts of outpatients [518 (55.3%) males, 419 (44.7%) females, mean age 39.4±4.2 years] were processed using a specially designed registration form, based on the use of the Delphi method and medical care quality integrated index calculation. Data were processed in accordance with existing procedures for managing and conducting complex studies on social and health care and public health. Parametric and non-parametric statistics was applied. The null hypothesis was rejected in all cases if the chance for alpha-error was lower than significance level of 5% (p

Results. It was found that, despite the rather high level of medical care quality integrated index (0.87±0.04 points), there are preventable problems, such as no clear documentation of medical administrations (34.5% of cases), overdiagnosis (62%), sub-optimal administration of diagnostic tests (29.1%). In some cases, preventive measures were not administered, or administration did not comply with standards; no active follow-up to evaluate the treatment effect was scheduled. As a result, the predicted treatment outcome was only achieved in 42.4% of cases.

Conclusion. The prevention of the malpractices revealed requires systematic administrative procedures targeted at complying the requirements of the approved healthcare standards. The introduction of institutional standard protocols for patient management is also of great importance.