O.B. Nechaeva, O.K. Biragova
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow
Summary. The regulatory and procedural framework for TB
care delivery has recently undergone significant changes. Target
indicators that are quality indicators of TB care delivery have been
approved.
The aim of the study was to implement objective monitoring of epidemiological indicators of tuberculosis in the Russian Federation.
Methods. TB care indicators were calculated according to forms of the state statistical monitoring.
Results. The monitoring results showed that in Russia the
level of tuberculosis morbidity is objective and reflects the true
decrease in TB morbidity. At the same time, organization of preventive
examinations for tuberculosis improved and the share of advanced forms
of TB among new cases decreased. The TB death rate declines faster than
TB morbidity rate.
Increased number of patients with HIV-TB co-infection and patients with
multi-drug resistance can potentially reduce rates of decline in key
indicators of tuberculosis.
In terms of importance and volume of care, inpatient TB services
significantly prevail over the outpatient services, which contradicts to
the modern approaches towards care organization. Lack of relevant
experience of TB care facilities in care delivery according to standards
and lack of experience of insurance companies in external quality audit
of care delivery to patients with tuberculosis further increases the
gap.
There was not registered any significant positive dynamics of TB cure
rates in 2010-2012. Indicators of the State Program for Healthcare
Development for 2020 cannot be attained without a major restructuring of
TB care facilities.
This work is intended for health care authorities of the Russian Federation, health managers, physicians, and TB specialists.
Keywords: tuberculosis, HIV-infection; multi-drug resistance; TB care facilities.
References
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