DOI: 10.21045/2071-5021-2017-55-3-2
Shuvalova M.P., Pismenskaya T.V., Grebennik T.K.
Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, Moscow, Russia
Contacts: Tatyana V. Pismenskaya, e-mail:
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Shuvalova M.P., http://orcid.org/0000-0002-6361-9383
Pismenskaya T.V., http://orcid.org/0000-0002-4269-7913
Grebennik T.K., http://orcid.org/0000-0001-9619-1574
Acknowledgments.The study had no sponsorship.
Conflct of interests. The authors declare no conflict of interest.
Abstract.
Background. Development of the three-level system of
care delivery to women during pregnancy, labor and post-partum period
and to newborns is a current state priority and is associated with
progress in reducing infant and maternal mortality in Russia.
The study purpose was to determine approaches to assess
performance of the third level of the system of perinatal care
regionalization in the Russian Federation.
Methods. The authors conducted a retrospective analysis
of data of the Federal continuous statistical observation, form #232
“Data on regionalization of obstetric and perinatal care in maternity
hospitals (departments) and perinatal centers” in 2013 and 2016. All
available data were analyzed both for national and regional levels.
Results. The study showed that reduction in perinatal
mortality, neonatal lethality and number of maternal deaths in the third
level facilities during 2013-2016 was accompanied by reduction in the
similar national-level indicators.
Almost in every second Russian region regionalization of the
perinatal care delivery resulted in positive outcomes, including reduced
perinatal mortality and neonatal lethality both in the third-level
obstetric hospitals and facilities of the overall three-level system.
Conclusions. Development of the three-level system of
care delivery to women during pregnancy, labor and post-partum period
and to newborns is still in progress.
The existing regulatory framework is not focused on determining
target performance indicators of the third level obstetric hospitals.
Parameters characterizing the core trend in distribution of regional
indicators can serve as standard values.
Keywords: perinatal care; third level facilities; obstetric service; perinatal center; regionalization of medical care.
References
- Baybarina EN, Filippov OS, Guseva EV. Itogi razvitiya sluzhby
rodovspomozheniya v Rossiyskoy Federatsii i meropriyatiya po ee
sovershenstvovaniyu [Results of the development of the obstetric service
in the Russian Federation and measures for its improvement.]. Rossiyskiy vestnik akushera-ginekologa 2014; (4):4–7. (In Russian).
- Komarov Y.M. Zdravookhranenie na rasput'e. [Healthcare at the
crossroads]. [Online] [cited 2017 Jun 01]. Available from:
http://viperson.ru/articles/zdravoohranenie-na-rasputie. (In Russian).
- Povyshenie kachestva uslug po okhrane reproduktivnogo,
materinskogo, neonatal'nogo, detskogo i podrostkovogo zdorov'ya v
evropeyskom regione. Regional'naya programma podderzhki vnedreniya
politiki “Zdorov'e-2020” [Improving the quality of service for
protection of reproductive, maternity , neonatal, child and adolescent
health in the European region. The Regional program for supporting the
implementation of Health-2020 policy] Sotsial'nye aspekty zdorov'ya naseleniya
[serial online] 2017 [cited 2017 Jun 06]; 53 (1). Available from:
http://vestnik.mednet.ru/content/view/814/30/lang,ru/. (In Russian).
- Ob utverzhdenii gosudarstvennoy programmy Rossiyskoy Federatsii
«Razvitie zdravookhraneniya» [On the approval of the state program of
the Russian Federation "Development of healthcare "]: Postanovlenie
Pravitel'stva RF ot 15.04.2014; N 294 (red. ot 31.03.2017). [Online]
2017 [cited 2017 Jun 1]. Available from: http://base.garant.ru/70643470/ (In Russian).
- Ob utverzhdenii Poryadka okazaniya meditsinskoy pomoshchi po
profilyu «akusherstvo i ginekologiya» (za isklyucheniem ispol'zovaniya
vspomogatel'nykh reproduktivnykh tekhnologiy) [On the approval of the
procedure for providing medical care in "obstetrics and gynecology"
(with the exception of assisted reproductive technologies)]. Prikaz
Minzdrava Rossii ot 01 noyabrya 2012 goda ¹572n (red. ot 12.01.2016).
Zaregistrirovano v Minyust. [Online] 2016 [cited 2017 Jun 1]. Available
from: http://base.garant.ru/70352632/ (In Russian).
- Regionalizatsiya perinatal'noy pomoshchi. Prakticheskoe rukovodstvo
[Regionalization of perinatal care. Guidelines]. Moscow: Institut
Zdorov'ya Sem'i; 2012. 98 p. (In Russian).
- Soveshchanie o khode stroitel'stva perinatal'nykh tsentrov [Meeting
on the construction of perinatal centers]. [Online] [cited 2017 Jun
06]. Available from: http://government.ru/news/27657/. (In Russian).
- Donabedian A. The seven pillars of quality. Arch Pathol Lab Med. 1990; (114): 1115–8.
- Jensen EA, Lorch SA. Effects of a Birth Hospital’s Neonatal
Intensive Care Unit Level and Annual Volume of Very Low-Birth-Weight
Infant Deliveries on Morbidity and Mortality. JAMA Pediatr. 2015 Aug;169(8):e151906.
- Lasswell SM, Barfield WD, Rochat RW, Blackmon L. Perinatal Regionalization for Very Low-Birth-Weight and Very Preterm Infants. JAMA. 2010 Sep;304(9):992.
- Levels of Neonatal Care. Pediatrics. 2012;130(3):587–97.
- Rashidian A, Omidvari AH, Vali Y, Mortaz S, Yousefi-Nooraie R,
Jafari M, et al. The effectiveness of regionalization of perinatal care
services - a systematic review. Public Health. 2014;128(10):872–85.
- Six Success Stories in Making Pregnancy Safer. [cited 2017 Jun 2];
Available from:
http://www.euro.who.int/__data/assets/pdf_file/0016/126115/MPS_success_stories_brochure.pdf
- World Health Organization. Regional office for Europe Promoting effective perinatal care (PEPC) in the European region. 2000.
Views: 16182
|