УЖМБС 2021, 6(5): 270–275https://doi.org/10.26693/jmbs06.05.270
Social medicine and organization of health care
Medical and Social Component of Medical Management: Improving the Model of Providing Medical Aid for Children with Infectious-Inflammatory Diseases of the Urinary SystemBezruk V. V., Velia M. I., Makarova O. V., Yurkiv O. Y., Yurniuk S. V.
- Bukovinian State Medical University. 2, Theatralna Sq., Chernivtsi 58002, Ukraine
The purpose of the study was to substantiate and develop the improved model of the specialized nephrology care for the children with infectious inflammatory diseases of the urinary system at the regional level.
Materials and methods. The official statistical data have been studied (reports on the state of medical care for children in the Chernivtsi region and data from the Center of medical statistics of the Ministry of Healthcare from 2006 to 2017), information-analytical and statistical methods have been used. The modern etiological structure of uropathogens – urinary tract infection pathogens among the children of the Chernivtsi region (2009-2016) was studied. Clinical and laboratory examination of 3,089 children (0-17 years old) was conducted in the region; the regional spectrum of sensitivity to antibacterial drugs was determined among the main groups of urinary tract infection pathogens; their age, gender and administrative-territorial differences among the children's population of the region are analyzed.
Results and discussion. During 2012-2017 there was a significant increase (by 23.0%) in the incidence of infectious and inflammatory groups of the urinary system diseases among children of 0-14 years old, while among adolescents there was simultaneously an intensive decrease in indicators (by 40.0%) compared to 8.7% in 2006-2011. The ratio of indicators and their dynamics suggests that the growth of sick adolescents is largely due to the insufficient effectiveness of medical care, while children of 0-14 years old is due to their low and insufficient prevention.
The data formed the foundation for substantiation and development of an improved functional-organizational model of the system. In addition to the existing and functionally changed elements the model contains new elements: regional/inter-regional center of specialized medical aid for children with infectious-inflammatory diseases of the urinary system.
Conclusion. Implementation of the elements of the suggested improved model in a part of a rational approach in distribution of functions concerning medical observation of patients at the stages of providing medical aid enabled to make the period of hospitalization of nephrological patients by 11.40% shorter and an average period of treatment of patients with infectious-inflammatory diseases of the urinary system by 2.93% shorter. Efficiency of implementation of certain elements of the suggested model with its positive evaluation by independent experts and its compliance with the strategy of branch reforms enables to recommend the improved functional-organization model of providing medical aid for children with infectious-inflammatory diseases of the urinary system at the regional level to be introduced into the health care system of Ukraine
Keywords: quality of the medical care, urinary tract infections, antibiotic resistance, children
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