On Realisation of Measures Directed at Enhancing Vascular Diseases Treatment Quality
Since 2008, measures to enhance vascular diseases treatment quality have been implemented in 12 constituent entities of the Russian Federation in accordance with the National Health Project and Government Decree No. 1012 "On Allocating Funds from the Federal Budget to Implement Measures to Enhance Vascular Diseases Treatment in 2008" signed on December 29, 2007.
In the first quarter of 2009, the quality of vascular diseases treatment was enhanced significantly. Every person, regardless of residence, can receive specialised high-technology medical care due to the creation of specialised care departments and the logistics processing system of patients.
In 2008, the following measures to enhance vascular treatment quality were implemented:
- increased staff training in emergency service; providing modern equipment and medicines that allowed increasing the number of patients with ischemic stroke who received thrombolytic therapy by 3.3 times, and myocardial infarction by 1.5 times.
- quality diagnostics of cerebral stroke and myocardial infarction during triage;
- prompt transportation of patients with acute stroke to the hospital within the "stroke window;"
- doubling the number of patients with stroke and increasing by 52% the number of patients with myocardial infarction that were taken to hospitals.
Due to creating and equipping regional vascular centres, the vascular diseases mortality rate has decreased. In Russia, in the first quarter of 2009, it decreased by 5.6% per 100,000 people as compared with the same period in 2008.
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In the Altai Territory, the measures directed at enhancing vascular diseases treatment quality have been implemented since 2008.
An allocation of 241.5 million roubles from the federal budget was used to buy medical equipment.
As part of this programme, one regional vascular centre and three primary care departments were built.
The regional vascular centre is based in the Territorial Clinical Hospital in Barnaul. The location of the regional vascular centre and primary care departments allow the transport of patients to hospital from any residential area within 30-40 minutes. The logistics at the regional vascular centre has enabled 24-hour consulting and diagnostic services at primary care departments and increased the number of high-technology life-saving surgeries by 2.2 times.
Primary care departments were opened at Barnaul City Hospital No. 5, Barnaul City Hospital No. 11, and Biisk Central City Hospital.
Providing hospitals with modern equipment, transporting patients to intensive care rooms, prompt diagnostics, 24-hour vital function monitoring and modern treatment methods, including thrombolytic therapy reduced the myocardial infarction mortality rate by 1.8%, and cerebral stroke mortality by 13.3%. The number of patients with myocardial infarction increased by 15.6% over the previous year.
For the first time, the programme includes not only life-saving treatment after the acute stage of the disease, but also improves the quality of life after the treatment. Changing hospital conditions and introducing teams specialising in primary rehabilitation that consist of trained neurologists, remedial gymnastics specialists, physiotherapists, speech therapists, neuropsychologists, and clinical psychologists with the use of modern high-technology equipment, provided an increase is the number of patients who can function independently in daily activities on the 21-28 day after the stroke by 5.3 times. This significantly reduces the expenses for social support of these patients.
During the realisation of these measures in the first quarter of 2009, vascular diseases mortality was reduced by 6.3% in the Altai Territory and in Russia in general.
