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Main arrow Archive of previous Issues arrow ¹4 2014 (38) arrow Geographical availability of cardiology care to patients after surgical treatment of congenital heart disorders
Geographical availability of cardiology care to patients after surgical treatment of congenital heart disorders Print
Monday, 01 September 2014

L.A. Bockeriya, E.B. Milievskaya, S.M. Krupyanko. O.A. Manerova
Bakoulev Center for Cardiovascular Surgery, Moscow

Abstract. Russia currently faces the following crucial problems and circumstances that affect organization and availability of cardiology care after surgical treatment of congenital heart disorders: geographical remoteness, regional climate patterns, transport connections, staffing problems, irregularity of geographical distribution of cardiology hospitals.

The aim is to analyze influence of geographical remoteness of patients with congenital heart disorders from the cardiology surgical hospitals where the surgery was performed on the availability of high-quality cardiology care to such patients.

Methods and data. The unit of observation was represented by a patient with congenital heart disorder under 18 years old treated at the Bakoulev Center for Cardiovascular Surgery from January 2005 to March 2012 (n=18346). The survey covered families of 1346 patients with congenital heart disorders residing in the Central Federal District.

Results. Availability of cardiology care to patients after surgical treatment of congenital heart disorders depends upon certain number of factors and circumstances, including: territorial peculiarities of the Russian regions, remoteness of the health facility that provides specialized cardiology care from the patient’s residency; transport connections; non-profitability of cardiology care delivery in small settlements.

In the country’s regions there is a significant shortage of pediatric cardiologists and specialists of functional diagnostics qualified to interpret results and provide counseling to this category of patients. This problem is characteristic not only to rural areas but to big cities as well.

Lack of qualified specialists leads to the situation when out-patient stage often becomes a transitional one for the patient; counseling services are provided by the hospital where surgery was performed.

In general, the number of cardiology surgery clinics in the Russian Federation that provide the whole range of surgeries for patients with congenital heart disorders is insufficient, with existing ones being unevenly distributed along the Russian regions.

Keywords: congenital heart disorder; cardiology surgery clinic; transport connections; cardiology care; survey of families.

References:

  1. Bokeriya L.A., Gudkova R.G. Cardiovascular surgery-2012. Diseases and congenital anomaly of circulatory system. Ìoscow: A.N. Bakulev Research center for cardiovascular surgery. RAMS; 2013. 210 p. (In Russian).
  2. Bokeriya L.A., Stupakov I.N., Musatov L.I., Chichua D.T., Gerber V.I. Cardiovascular morbidity and accessibility of surgical care. Byulleten' NTsSSKh im. A.N. Bakuleva RAMN 2005; (3): 53-57. (In Russian).
  3. On approving the order of providing medical care in the profile of “pediatric surgery”: the Order of the Ministry of Health of the RF ¹ 440n of 2012 October 25. URL: http://www.rg.ru/2012/12/21/kardiologiya-dok.html (In Russian).
  4. Russian statistical yearbook. 2013. Statistical collection. Moscow: Rosstat; 2013, 717 p. (In Russian).
  5. Russia 2013: Statistical Handbook. Moscow: Rosstat; 2013. 62 p. (In Russian).
  6. Bernier PL, Stefanescu A, Samoukovic G, Tchervenkov CI. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin. Thorac. Cardiovasc. Surg.: Pediatr. Card. Surg. Annu 2010; 13(1):26-34.
  7. Daenen W., Lacour-Gayet F., Maruszewski B., Hamilton L., Daebritz S., Lindberg H., at al. Optimal Structure of a Congenital Heart Surgery Department in Europe. Available from: URL: http://www.ctsnet.org/committee/eacts/183/roster
  8. Gerber A.U., Torre A.H., Büscher G., Stock S.A.K., Graf C., Schickendantz S., at al. Direct non-medical and indirect costs for families with children with congenital cardiac defects in Germany: a survey from a university centre. Cardiology in the Young 2010 April; 20 (2): 178-185.

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Last Updated ( Wednesday, 03 September 2014 )
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