DOI: 10.21045/2071-5021-2017-58-6-6
Vitkovskaya I.P.
Research Institute for Health Organization and Medical Management of the Healthcare Department of Moscow, Moscow
Contacts: Vitkovskaya Irina, email:
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Information about author:
Vitkovskaya I.P., http://orcid.org/0000-0002-0740-1558
Acknowledgments. The study had no sponsorship.
Conflict of interests. The author declares no conflict of interest.
Abstract
Significance. The problem of care organization for
children with rare (orphan) diseases is a universal one. The World
Health Organization (WHO) notes that none of the 27 member States of the
European Union can offer treatment for the entire spectrum of rare
diseases [17], while orphan diseases account for 35% of deaths during
the first year of life, for 10% of deaths within 1-5 years of life and
12% of deaths within 5-15 years of life [15]. Development of the system,
an integral component of which is involvement of parents will
contribute to early detection, treatment and rehabilitation of children
with rare (orphan) diseases. In Russia this system is yet to be tuned as
evidenced by the Government Order No. 1839-R as of 31.08.2016, that
approved the "Concept for developing early care until 2020". In this
regard, evaluation of the system of care for children at the level of
Moscow as a subject of the Russian Federation and participation of
parents of the patients will allow to identify the existing problems
from the perspective of the medical service consumers and make timely
corrections.
The purpose of the study: to analyze opinion of parents
of children with rare (orphan) diseases about availability and quality
of medical care in Moscow.
Materials and methods. Analysis of opinion of parents
of children suffering from rare (orphan) diseases was conducted at the
Reference center for congenital genetic diseases, genetic abnormalities,
and other rare orphan diseases of the Morozov Children’s City Hospital
of the Moscow Healthcare Department. The opinion survey included 158
parents. Research tool: a specially designed questionnaire consisting of
69 questions. Object of the study: family with a child suffering from a
rare (orphan) disease. The awareness evaluation criteria included
quality indicators, defined by the number of correct answers from the
options and their quantity, in % (know /don’t know). Data were processed
in the Statistica 5.0 (Statsoft, USA) program and Microsoft Excel.
Results. In Moscow, the following things have a
negative impact on availability and quality of care to children with
rare (orphan) diseases: doctors insufficiently inform parents about
health prognosis of the child; low capacity of facilities (lack of
genetic testing within the system of Compulsory Health Insurance); lack
of services needed by the patient (services of psychologists, speech
therapists, speech pathologists, physiotherapists, physiatrists,
specialists in physical therapy) in the individual rehabilitation
program; the need to retain paid medical services.
Keywords: children; orphan diseases; information; rehabilitation; medical services.
References
-
Al'bikov I. R. Pravovye aspekty meditsinskogo obsledovaniya lits,
vstupayushchikh v brak [Legal aspects of medical examination of persons
intended to marry]. Semeynoe i zhilishchnoe pravo 2013; (5): 10-12. (In Russian).
-
Apraksina K. Dlya rossiyskikh orfannykh patsientov otkryvaetsya "doroga
zhizni" [“The road of life” is opening for Russian orphan patients]. Remedium 2010; (8): 49-51. (In Russian).
-
Belousov Yu.B. Bolezni –siroty i sirotskie lekarstva [Diseases – orphans and orphan medicine]. Remedium 2007; (9): 8-10.(In Russian).
-
Burdo E.P. Meditsinskoe obsledovanie lits, vstupayushchikh v brak [Medical examination of persons intended to marry]. Mariyskiy yuridicheskiy vestnik 2015; 13 (2): 46-49. (In Russian).
-
Kravchuk Zh.P., Rumyantseva O.A. Orfannye zabolevaniya: opredelenie,
problemy, perspektivy [Orphan diseases: definition, problems, and
prospects]. Problemy zdorov'ya i ekologii 2013; 38 (4): 7-11. (In Russian).
-
Lomakina O.L. Obshcherossiyskiy registr patsientov s sistemnym
yuvenil'nym idiopaticheskim artritom - effektivnyy instrument
monitoringa zabolevaniya i meditsinskoy pomoshchi [Russian registry of
patients with systematic juvenile idiopathic arthritis is an effective
tool to monitoring the disease and health care]. Cand. Med Sci.
[thesis]. Moscow. 2017. 24 p. (In Russian).
-
Maksimovich L.B. Pravovye aspekty meditsinskogo obsledovaniya lits,
vstupayushchikh v brak [Legal aspects of health examination of persons
intended to marry]. Pravovye voprosy v zdravookhranenii 2012; (7): 66-73. (In Russian).
-
O dal'neyshem sovershenstvovanii organizatsii okazaniya meditsinskoy
pomoshchi zhitelyam goroda Moskvy, stradayushchim zabolevaniyami,
vklyuchennymi v perechen' zhizneugrozhayushchikh i khronicheskikh
progressiruyushchikh redkikh (orfannykh) zabolevaniy [On further
improving the organization of medical care to the citizens of Moscow
suffering from the diseases included in the list of life-threatening and
chronic progressive rare (orphan) diseases]. Prikaz Departamenta
zdravookhraneniya Moskvy ot 21.02.2014 ¹ 139. [Online] [cited 2017 Aug
14]. Available from: http://base.garant.ru/70605958/ . (In Russian).
-
O shtatno-organizatsionnoy strukture tsentrov planirovaniya sem'i i
reproduktsii [The staff and organization structure of the family and
reproduction planning centers]. Ukazanie Minzdrava RF ot 23.03.1998 N
219-U. [Online] [cited 2017 Aug 14]. Available from: http://www.consultant.ru/cons/cgi/online.cgi?req=doc;base=EXP;n=278650#0 (äàòà îáðàùåíèÿ 14. 08 2017). (In Russian).
-
Ob osnovakh okhrany zdorov'ya grazhdan v Rossiyskoy Federatsii [On the
basis of population health protection in the Russian Federation].
Federal'nyy Zakon ot 21 noyabrya 2011 g. N 323-FZ (s izmeneniyami i
dopolneniyami). [Online] [cited 2017 Aug 14]. Available from: http://base.garant.ru/12191967/#ixzz4hQn3fgrK. (In Russian).
-
Ob utverzhdenii Poryadka okazaniya meditsinskoy pomoshchi bol'nym s
vrozhdennymi i (ili) nasledstvennymi zabolevaniyami [On approving the
Procedure for providing medical care to the patients with congenital and
(or) hereditary diseases]. Prikaz MZ RF ot 15 noyabrya 2012 g. ¹917n.
[Online] [cited 2017 Aug 14]. Available from: https://www.rosminzdrav.ru/documents/9135-prikaz-ministerstva-zdravoohraneniya-rossiyskoy-federatsii-ot-15-noyabrya-2012-g-917n-ob-utverzhdenii-poryadka-okazaniya-meditsinskoy-pomoschi-bolnym-s-vrozhdennymi-i-ili-nasledstvennymi-zabolevaniyami. (In Russian).
-
Ob organizatsii referens-tsentra vrozhdennykh nasledstvennykh
zabolevaniy, geneticheskikh otkloneniy, orfannykh i drugikh redkikh
zabolevaniy [On organization of the reference-center for congenital
hereditary diseases, genetic disorders, orphan and other rare diseases].
Prikaz Departamenta zdravookhraneniya Moskvy ot 02.06.2015 g. ¹ 461.
[Online] [cited 2017 Aug 14]. Available from: http://healthy.moscow/ru-RU/document/default/index/22/10.html. (In Russian).
-
Orlov A.V., Simonova O.I., Roslavtseva E.A., Shadrin D.I. Mukovistsidoz
(klinicheskaya kartina, diagnostika, lechenie, reabilitatsiya,
dispanserizatsiya) [Cystic fibrosis (clinical evidence, diagnosis,
treatment, rehabilitation, prophylactic medical examination].
St-Petersburg: Izdatel'stvo SZGMU im. I. I. Mechnikova. 2014. 223 p. (In
Russian).
-
Ratner F.L., Sigal N.G., Yusupova A.Yu. Rabota s roditelyami detey s
ogranichennymi vozmozhnostyami: otechestvennyy i zarubezhnyy opyt [The
work with parents of children with disabilities: domestic and foreign
experience]. Sovremennye issledovaniya sotsial'nykh problem [serial online] 2015 [cited 04 July 2017]; 49 (5): 624-633. Available from: http://www.rare-diseases.ru/(In Russian).
-
Redkie bolezni i orfannye preparaty [Rare diseases and orphan medicine]. [Online] [cited 2017 July 04]. Available from: http://www.rare-diseases.ru/ . (In Russian).
-
Tatareva S.V., Modestov A.A., Nevolin Yu.S. Optimizatsiya i otsenka
raboty tsentrov zdorov'ya dlya detey v Sverdlovskoy oblasti.
Metodicheskie rekomendatsii [Optimization and assessment of children’s
health centers in Sverdlovsk region. Guidelines]. Ekaterinburg -Moscow.-
RIO FGBU «TsNIIOZ» Minzdrava RF.- 2016. 27 p. (In Russian).
-
Khamfreyza G. Ob"edinim usiliya [Let us join our efforts]. WHO Bulletin 2012; 90 (6):401-476. (In Russian).
-
×óìàêîâà Î.Â. Minzdrav rabotaet nad kriteriyami rasshireniya perechnya
orfannykh zabolevaniy [The Ministry of Health is developing the criteria
for increasing the list of the orphan diseases]. Novosti GMP. 15.07.2016. [Online] [cited 2017 Aug 23]. Available from: https://gmpnews.ru/2016/07/minzdrav-rabotaet-nad-kriteriyami-rasshireniya-perechnya-orfannyx-zabolevanij/. (In Russian).
-
Bavisetty S., Grody W.W., Yazdani S. Emergence of pediatric rare
diseases. Review of present policies and opportunities for improvement. Rare Diseases 2013; 1 (1):1-5.
-
Gupta S. Rare diseases: Canada’s "research orphans". Open Med. 2012; 6(1): 23-27.
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