DOI: 10.21045/2071-5021-2017-56-4-1

Sabgayda T.P., Zubko A.V.
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow

Contacts: Tamara Sabgaida, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Sabgaida T.P., http://orcid.org/0000-0002-5670-6315
Zubko A.V., http://orcid.org/0000-0001-8958-1400
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Summary

Relevance. The increase in mortality from vascular surgical diseases continues in Russia after development of the network of regional vascular centers. Less than half of these diseases are included in the List for expensive treatment and provision of high-tech medical care.

Purpose: Comparison of the average costs for inpatient treatment of vascular surgical diseases which are included and not included in the List for provision of high-tech medical care.

Methods. We analyzed the "unfinished cases of inpatient treatment" in terminology of health insurance, i.e. the first stage of providing emergency or planned care on the late stages of vascular disease. Depersonalized data of Rosstat death register and database of compulsory medical insurance fund were used for Moscow region in 2014. We compared indicators for vascular surgical diseases which are included (group 1) and not included (group 2) in the List for provision of high-tech medical care for medical institutions of different levels.

Results. In Moscow Region in 2014, cardiovascular mortality was 733.3 per 100,000 population and 6.1% of this death was due to arterial and venous diseases, while in Russia these rates were 611.7 and 3.5%, respectively. Among the unfinished cases of inpatient treatment of vascular surgical diseases, the diseases of group 1 consist 4.9% and 64.3% of them were treated in the third level hospitals while 18.6% were treated in the first level hospitals. In medical institutions of the first and second levels, the cost of treatment of vascular surgical diseases of group 2 is substantially greater than the cost of treating diseases of group 1.

Conclusions. Later detection of vascular surgical diseases leads to increase the expenses of medical insurance funds: the average cost of a bed-day for deceased from diseases which included in the List of provision of high-tech medical care is close in organizations of different levels; for patients who are transferred to other departments or organizations, it is three times higher than the cost of a bed-day in hospitals of the first and second levels and only on one-third less than the cost of a bed-day in hospitals of the third level with provision of high-tech medical care.

Inclusion of vascular surgical diseases into the List of provision of high-tech medical care improves the quality of medical care for patients with these diseases.

If atherosclerosis of extremities arteries (I70.2,), embolism and thrombosis of arteries (I74) is included into the List of provision of high-tech medical care, then the mortality from these diseases will significantly decrease.

Keywords: Mortality from vascular surgical diseases; the List of provision of high-tech medical care; cost of hospital bed-day; unfinished cases of inpatient treatment; medical institutions of different levels; atherosclerosis of extremities arteries; embolism and thrombosis of the arteries

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