Bogachevskaia S.A.1, Bondar V.Y.1,2, Bogachevskiy A.N.1, Letskin A.Y3.
1Federal Centre of Cardiovascular Surgery, Khabarovsk
2Far Eastern State Medical University, Khabarovsk
3 Regional clinical hospital ¹2, Khabarovsk
Abstract. The Russian healthcare system is characterized by
high rates of doctor and hospital bed availability; however the resource
potential is underused.
Reasons of ineffective health services include prolonged
hospitalization with the cost of treatment varying several times across
hospitals of different levels.
The purpose of the study. Widespread implementation of
high-tech medical care in regions necessitates elaboration of a new
approach to form development schemes, deployment of medical facilities
network and revision of current nomenclature of facilities with due
regard to regional peculiarities.
Methods and data. The authors analyzed performance
results of seven healthcare facilities of the Far Eastern Federal
district that provided treatment for acute coronary syndrome, and nine
facilities providing high-tech cardiovascular surgery in 2011-2013.
Results. It is operation in full capacity of the
regional vascular center (based at the Regional hospital ¹2, Khabarovsk)
that gave an impulse to effective management of acute coronary syndrome
and accounted for significant improvement of such care in the region in
2013.
Analysis of the facilities’ performance in the Far Eastern Federal
district that provide high-tech cardiovascular surgery shows that the
main volumes of routine care in 2011-2013 were provided by the Federal
Centre of cardiovascular surgery, Khabarovsk.
It is worth noting that limited hospitalization of non-surgery
patients to the high cost surgery hospital beds for diagnostics and
development of treatment plan (with the possibility of further surgery,
or its rejection) makes a significant contribution to improving
efficiency of hospital bed utilization and hospital performance on the
whole.
Conclusions and recommendations. Thus, concentration of
cardiovascular surgery resources within the highly specialized
institutions significantly improves performance of a very
resource-consuming cardiovascular surgery.
Organization of specialized regional institutions with differentiated
objectives will improve quality of high-tech medical care and its
accessibility. It is also advisable to divide the cardiovascular surgery
care into specialties: emergency medical treatment of acute coronary
syndrome should be provided in the majority of facilities, while routine
cardiovascular surgery should be concentrated in a limited number of
specialized hospitals depending on the regional needs and hospital
capacity.
Keywords: regional specialized centers; high-tech medical care; reorganization of health care delivery; compulsory health insurance.
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