Principles of organization of medical care for patients with heart failure in the system of cardiovascular risk management: focus on continuity of care and patient routing. Practical materials

Виллевальде, C. В.; Soloveva, A.; Звартау, Надежда; Avdonina, N.; Яковлев, А. Н.; Ситникова, М. Ю.; Федотов, П. А.; Лопатин, Ю. М.; Галявич, А. С.; Дупляков, Д. В.; Фомин, И. В.; Шляхто, Е. В.

doi:10.15829/1560-4071-2021-4558

Cited by 10 publications

(5 citation statements)

References 22 publications

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“…На примере пациентов с хронической сердечной недостаточностью убедительно продемонстрировано, что в первые недели после выписки пациента, госпитализированного по поводу декомпенсации хронической сердечной недостаточности, значительно возрастает риск неблагоприятных исходов. Поэтому именно в этот наиболее "уязвимый" период необходимо наблюдение врача поликлиники, контроль за соблюдением всех назначений, как лекарственных, так и немедикаментозных, обучение пациентов и их родственников [7]. Данная проблема возникает не только у пациентов с обострением хронических заболеваний, но и при ряде "острых" патологий.…”

Section: Discussionunclassified

Research-to-practice conference as a component of improving knowledge and mastering professional competencies by medical students and young scientists

Larina,

Kudina,

Mikava

et al. 2023

Cardiovasc Ther Prev

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Aim. To evaluate the importance of certain aspects of research-to-practice conferences, organized by the Department of General Practice of Pirogov Russian National Research Medical University, as well as its contribution to preparing students for future professional activities within the outpatient healthcare and the impact of these events on the interest of participants and speakers for research work.Material and methods. An anonymous online survey included 37 participants in the discussed conferences regarding the respondents’ motivation to attend conferences, assessment of declared subject coverage, the practical applicability of the knowledge gained and other aspects.Results. The most important motivating factors for conference participation were interest in outpatient healthcare (52,4% for the conference "Internal diseases at the prehospital stage" and 87,5% for the conference "A multimorbid patient — continuity between hospital and clinic"), analysis of interesting cases (66,7% and 75%, respectively) and multidisciplinary focus of activities (47,6% and 68,8%). An important aspect was the coverage of current problems of practical healthcare. The most important results were considered by the majority of participants to be expanding their medical horizons (85,7% and 87,5%) and gaining new knowledge on the declared subject (90,5% and 75%). Almost half of the respondents (52,4% and 56,3%) improved their interest in scientific activities as a result of visiting the conferences.Conclusion. Conducting research-to-practice conferences for students, residents and postgraduates serves as a platform for increasing the knowledge and mastering professional competencies. The results of a survey of conference participants and speakers indicate the relevance of involving students in conferences and the numerous benefits they receive, which are discussed in detail in this article.

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Section: Discussionunclassified

Research-to-practice conference as a component of improving knowledge and mastering professional competencies by medical students and young scientists

Larina,

Kudina,

Mikava

et al. 2023

Cardiovasc Ther Prev

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“…Нами установлено, что в течение года хотя бы однократно были госпитализированы 57% пациентов. С позиции организации оказания медицинской помощи это подчеркивает необходимость совершенствования системы медицинской помощи [28,29]. Расширенный подход к кодированию СН (без кодов I50.x) может обозначать подгруппу пациентов с высокой потребностью в профилактических мероприятиях и контроле сердечно-сосудистых факторов риска на амбулаторном этапе -для предотвращения развития клинически явной СН и ее дальнейшего прогрессирования и роста неблагоприятных исходов; стандартный подход (коды I50.x) -подгруппу пациентов с СН очень высокого риска, для которых необходима разработка схемы маршрутизации, обеспечение преемствен-ности и оптимальной терапии СН, ведение в мультидисциплинарной команде и организация работы патронажной службы.…”

Section: Discussionunclassified

ICD-10 code-based definition of heart failure in Saint Petersburg electronic health records: prevalence, health care utilization and outcomes

et al. 2021

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Aim. To analyze prevalence of heart failure (HF), clinical and demographic characteristics, health care utilization, and outcomes according to the used International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) codes in regional integrated electronic health record database in Saint Petersburg.Material and methods. The retrospective analysis of the Saint Petersburg regional integrated electronic health record database for 2019 was performed. At least one of the following ICD-10 codes has been considered as HF case: I50.x (standard coding) and/or I11.0, I13.0, I13.2, I25.5, I42.0, I42.9, I09.9, I43.0, I43.1, I43.2, I43.8, I42.5, I42.6, I42.7, I42.8 (extended coding).Results. A total of 64070 adult patients with HF had medical encounters in 2019, 34,5% of whom were identified using standard coding, 65,5% — using extended coding. The combination of codes was observed in 9,9% of cases. HF prevalence/mortality was 1,4%/6,8% in general, as well as 0,49%/15,7% and 0,93%/2,1% with standard and extended coding, respectively. HF patients had high healthcare utilization with the mean number of 14 encounters per patient per year. Actually, 24% of patients had more than 20 both inpatient and outpatient encounters and 54% of patients — at least 1 all-cause hospitalization during the year. Encounters of patients with HF accounted for 4,3% of all visits, 6,5% of all hospitalizations, 4,1% of all outpatient visits and 9,7% of all emergency contacts during the year. Patients identified by the standard coding compared with the extended coding had older age and higher incidence of comorbidities, as well as greater hospitalization and death rates, but lower number of outpatient visits.Conclusion. The prevalence of HF among the adult population of Saint. Petersburg in 2019 was 1,4%. HF was characterized by a high health care utilization and mortality rate reaching 15,7 % per year. The use of different approaches to coding presumably could help to identify different groups of patients with HF, which requires the adaptation of healthcare models and an active monitoring system to reduce the risk of adverse events.

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“…Информация по запросу получена от 28 из 40 субъектов РФ, курируемых ФГБУ "НМИЦ им. В. А. Ал -чение пациентов с СН, способствующие улучшению прогноза пациентов [3][4][5][6]. Показано, что в идеальных условиях рандомизированных клинических исследований современные классы лекарственных препаратов существенно снижают риск развития и прогрессирования СН, а их комбинация у пациентов с СН с низкой фракцией выброса (ФВ) левого желудочка может обеспечить более чем двукратное снижение общей смертности [7].…”

Section: результатыunclassified

Analysis of the information about the incidence of heart failure, associated mortality and burden on the healthcare system, based on the encoding data in 15 subjects of the Russian Federation

Zvartau,

Solovyova,

Endubaeva

et al. 2023

Russ J Cardiol

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Aim. This study aims to assess the incidence of heart failure (HF) and associated mortality, and also the burden on the healthcare system in the subjects of Russian Federation, based on the HF encoding data.Material and methods. We made a structured request for the number of patients with HF and the number of cases of providing medical care in 2019. HF was understood to mean the presence of at least one of the codes I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.5, I42.6, I42.7, I42.8, I42.9, I43.0, I43.1, I43.2, I43.8, I50.X (expanded encoding) according to International Classification of Diseases 10th Revision. The code I50.X was considered separately (the standard HF enconding).Results. The information about the incidence of HF, associated mortality and burden on the healthcare system was obtained from 15 subjects (53,6% from those that gave the data according to the request; the adult population is 18,9% from total adult population of Russian Federation). We noted significant heterogeneity between the regions. The median of the incidence of HF and associated mortality was 2,6 and 3,2% in accordance with the data of the expanded encoding, and 0,21 and 11,3% — according to the standard HF encoding. The presence of the code I50.x was observed in average in 9,4% of all cases of HF and defined the patients who frequently used emergency medical services and were frequently hospitalized (60 (18, 96) and 48 (20, 137) cases per 100 patients versus 9 (5, 24) and 17 (10, 70) cases in the expanded encoding).Conclusion. According to the encoding, the indicators of the incidence of HF and associated mortality vary greatly between the regions, the median values are 2,6 and 3,2% in expanded and 0,21 and 11,3% in standard approaches. In the standard encoding, there were more frequent use of emergency medical services and less number of outpatient visits. The development and introduction of a unified approach to encoding and recording the cases of HF will provide obtaining objective statistical data and using them for management decisions.

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Principles of organization of medical care for patients with heart failure in the system of cardiovascular risk management: focus on continuity of care and patient routing. Practical materials

Cited by 10 publications

References 22 publications

Research-to-practice conference as a component of improving knowledge and mastering professional competencies by medical students and young scientists

Research-to-practice conference as a component of improving knowledge and mastering professional competencies by medical students and young scientists

ICD-10 code-based definition of heart failure in Saint Petersburg electronic health records: prevalence, health care utilization and outcomes

Analysis of the information about the incidence of heart failure, associated mortality and burden on the healthcare system, based on the encoding data in 15 subjects of the Russian Federation

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