Indicators of potentially preventable hospitalizations as a tool for improving the quality of care in cardiovascular diseases

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Abstract

Aim. To assess the possibility of using indicators of potentially preventable hospitalizations of cardiovascular diseases to assess the quality of medical care.

Methods. Indicators of quality of cardiovascular disease treatment were formed based on the analysis of literature, current clinical recommendations and the structure of potentially preventable hospitalizations in the districts and cities of the Republic of Tatarstan. The proposed indicators were studied in the districts of the Republic of Tatarstan in 2011–2015.

Results. It is revealed that the distribution of indicator values in the regions of the Republic of Tatarstan differs from normal and is characterized by high variation. Median, minimum and maximum of hospitalization levels for hypertension in 2015 were 8.4, 1.3 and 26.8‰ respectively; unstable angina, myocardial infarction — 2.2, 0.02 and 8.6‰. Indicators for hospitalization due to stable angina, chronic ischemic heart disease also had a high level of variation (6.3, 0.2 and 17.4‰). As criteria for quality and optimal use of resources, it is proposed to use nonparametric estimates, one of which is the upper quartile. According to this study, in 2015, upper quartile for hypertension was 11.2‰; for unstable stenocardia, myocardial infarction — 3.4‰; for stable angina, chronic ischemic heart disease — 8.6‰.

Conclusion. The results of this study prove that indicators of potentially preventable hospitalizations may be part of a comprehensive assessment of the quality of care.

About the authors

R Kh Khafisianova

Kazan State Medical University

Author for correspondence.
Email: rofija_kh@mail.ru
ORCID iD: 0000-0002-3906-3661
SPIN-code: 2842-7468
Scopus Author ID: 6506022378
ResearcherId: Y-7981-2018
Russian Federation, Kazan, Russia

I M Burykin

Kazan State Medical University

Email: rofija_kh@mail.ru
SPIN-code: 5274-4340
Russian Federation, Kazan, Russia

G N Aleeva

STADA FarmDevelopment

Email: rofija_kh@mail.ru
Russian Federation, Moscow, Russia

References

  1. Burykin I.M., Aleeva G.N., Hafizianova R.Kh. Indikativnaya otsenka kachestva farmakoterapii i meditsinskoy pomoshchi bol'nym s serdechno-sosudistymi zabolevaniyami. Metodicheskie rekomendatsii. (Indicative assessment of the quality of pharmacotherapy and medical care for patients with cardiovascular diseases. Guidelines.) Kazan: Medicina. 2016; 68 p. (In Russ.)
  2. Singh H., Graber M.L. Improving diagnosis in health care — the next imperative for patient safety. N. Engl. J. Med. 2015; 373: 2493–2495. doi: 10.1056/NEJMp1512241.
  3. Paikov V.L., Ishmetov R.P. Analysis of population appealability for emergent medical care for cardiac reasons. Kazanskiy medicinskiy zhurnal. 2012; 93 (4): 680–682. (In Russ.) doi: 10.17816/KMJ1572.
  4. Jackson G., Tobias M. Potentially avoidable hospitalisations in New Zealand, 1989–98. Aust. NZ J. Public Health. 2001; 25 (3): 212–221. doi: 10.1111/j.1467-842x.2001.tb00565.x.
  5. Schiøtz M., Price M., Frølich A. et al. Something is amiss in Denmark: A comparison of preventable hospita­lisations and readmissions for chronic medical conditions in the Danish Healthcare system and Kaiser Permanente. BMC Health Serv. Res. 2011; 11: 347. doi: 10.1186/1472-6963-11-347.
  6. Tran B., Falster M.O., Douglas K. et al. Health behaviours and potentially preventable hospitalisation: A pros­pective study of older Australian adults. PLoS One. 2014; 9 (4): e93111. doi: 10.1371/journal.pone.0093111.
  7. Scollan-Koliopoulos M. OECD. Health at a Glance 2011: OECD Indicators. Paris: OECD Publishing. 2011; 190 р.
  8. Plavinski S.L., Kuznetsova O.Yu., Andreeva M.R., Zholobov V.E. Outpatient care quality indicators based on hospitalization data. Rossijskij semejnyj vrach. 2009; 13 (4): 17–25. (In Russ.)
  9. Burykin I.M., Aleyeva G.N., Hafizyanova R.H. Prospective value of Big Data analysis method for assessment of pharmacotherapy quality and efficacy in patients with arte­rial hypertension. Sovremennye tehnologii v medicine. 2017; 9 (4): 194–200. (In Russ.) doi: 10.17691/stm2017.9.4.24.
  10. Jorm L.R., Leyland A.H., Blyth F.M. et al. Asses­sing Preventable Hospitalisation In Dicators (APHID): protocol for a data-linkage study using cohort study and administrative data. BMJ Open. 2012; 2 (6): e002344. doi: 10.1136/bmjopen-2012-002344.
  11. Vorob'ev P.A. Non-standard standards and disorderly orders. Problemy standartizacii v zdravoohranenii. 2017; (1–2): 3–10. (In Russ.)
  12. Orlov A.E. Modern problems of medical care qua­lity. Vestnik novyh medicinskih tehnologij. 2015; (1): 4-1. (In Russ.) doi: 10.12737/8114.
  13. Pozdnyakova O.Y., Shikina I.B. Evalu­ation of bronchial asthma treatment in a polyclinic. Vestnik Roszdravnadzora. 2013; (3): 74–77. (In Russ.)
  14. Martse­vich S.Yu., Zakharova N.A., Kutishenko N.P. et al. Practice of prescribing beta-blockers and its compliance with cli­nical guidelines according to two registers of cardiovascular di­seases. Ratcionalnaia farmakoterapiia v kardiologii. 2016; 12 (3): 260–264. (In Russ.) doi: 10.20996/1819-6446-2016-12-3-260-264.
  15. Kemps H.M., van Engen-Verheul M.M., Kraaijenhagen R.A. et al. Improving guideline adherence for cardiac rehabilitation in the Netherlands. Neth. Heart J. 2011; 19 (6): 285–289. doi: 10.1007/s12471-011-0104-6.
  16. Sidorenkov G., Voorham J., Zeeuw D. et al. Treatment quality indicators predict short-term outcomes in patients with diabetes: a prospective cohort study using the GIANTT database. BMJ Qual. Saf. 2013; 22: 339–347. doi: 10.1136/bmjqs-2012-001203.
  17. Grimshaw J.M., Russell I.T. Achieving health gain through clinical guidelines II: Ensuring guidelines change medical practice. Qual. Health Care. 1994; 3 (1): 45–52. doi: 10.1136/qshc.3.1.45.

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2. Рис. 1. Гистограмма распределения показателя госпитализации (болезни, характеризующиеся повышенным артериальным давлением) в районах и городах Республики Татарстан в 2015 г. (‰)

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3. Рис. 2. Гистограмма распределения показателя госпитализации (нестабильная стенокардия, инфаркт миокарда) в районах и городах Республики Татарстан в 2015 г. (‰)

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4. Рис. 3. Гистограмма распределения показателя госпитализации (стабильная стенокардия, хроническая ишемическая болезнь сердца) в районах и городах Республики Татарстан в 2015 г. (‰)

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© 2020 Khafisianova R.K., Burykin I.M., Aleeva G.N.

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