Completed cases of provision of medical care and lethal outcomes in insured individuals with respiratory diseases in the Ryazan region

AIM: This study aimed to investigate the dynamics of the volume of medical care (MC) provided to the population within the territorial program of compulsory medical insurance (CMI). This study also aimed to examine the lethal outcomes of insured individuals with respiratory diseases (RD) for 5 months in 2020 and 5 months in 2019 in the Ryazan Region during the COVID-19 pandemic.

MATERIALS AND METHODS: Analysis was carried out on the basis of the paid registers of the accounts submitted by medical organizations to medical insurance organizations. These accounts were grouped in accordance with the order of the Federal CMI Fund No 104 «On Establishment of the Form and Procedure for Reporting on Cases of Providing MC and the Results of Expertise of the Quality of MC» dated June 04, 2018. In this study, all the completed cases of the treatment of the insured individuals with RD (ICD-10 codes: J00-J99) in the medical organizations of the Ryazan Region in 2019–2020 within the compulsory medical insurance were selected. The obtained data were statistically analyzed using the Microsoft Excel application package (Microsoft, USA) and descriptive statistics.

RESULTS: The completed treatment cases of the insured individuals with RD in 2020 were categorized according to the age of patients, nosological form, and conditions for the provision of MC. They had different dynamics of growth/decline relative to the same period in 2019. In the structure of the cases of the MC provision, RD accounted for 13.2% (third place). This tendency was observed in the group of patients aged > 60 years (7.8%). In patients aged 18–60 years, the proportions of RD (18.0%) and diseases of the digestive system (18.1%) were higher than those of the diseases of the circulatory system (14.2%). The total number of cases of the MC provision to patients with this pathology for 5 months in 2020 decreased by 12.9% compared with that for 5 months in 2019 (11.3% in the age group of 18–60 years and 16.6% in individuals aged >60 years). Despite the 38.3% decrease in the number of hospitalizations, the number of the completed cases of specialized MC for pneumonia increased by 27.7% (43.9% in the age group of 18–60 years and 11.4% in the age group of > 60 years). The comparative analysis of 5 months in 2020 and 2019 showed a 57.1% increase in deaths among patients aged > 60 years in the provision of specialized MC and a 20.0% reduction among individuals aged 18–60 years.

CONCLUSION: The number of insured individuals seeking MC for RD increased during the COVID-19 pandemic, and the level of hospital lethality was low. Therefore, the organizational level of MC in the region was high, and medical organizations were adequately prepared for emergency situations with the preserved provision of high-quality MC.