The Analysis of Effectiveness of the Optimized Intensive Care Consultative System of Urgent Medical Care to Children in the Territory of Rostov Region

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Abstract


Increase of effectiveness of intensive care consultative providing of children is an actual problem.

Purpose: the analysis of effectiveness of the optimized system of intensive care consultative providing of the emergency medical care to children in the Rostov region.

Methods: the retrospective cohort study, including patients of the of intensive care consultative center (ICCC) is conducted. Databases and log-books of patients of ICCC were analyzed. Research period: 2012-I half of 2016. The studied groups: the 1st – 2012-2014 (before optimization, n = 1124), the 2nd – 2015-2016 (after optimization, n = 1432). Effectiveness was estimated on dynamics of a lethality in intensive care unit (ICU), it is padding – dynamics of number of distant consultations, departures and evacuations.

Results: Ninety-seven percent of patients of ICCC are evacuated in the ICU. The lethality decreased from 5,1% – in 2012 to 3% in the I half-year 2016. Increased: the number of distant (telephone) consultations for 119,6% from 572 to 1363 in 2015 in comparison with 2014; consultations near the patients for 37,6% with 237 to 326; a share of departures with the subsequent evacuation from 54,8% (338 of 617) in group 1 to 60,8% (270 of 444; p = 0,050) in group 2; indexes “the number of departures evacuations to departures consultations” to 1,8 in the I half-year 2016 in comparison with 1,2 in 2012 and “number of primary consultations to repeated consultations” to 3,1 in comparison with 2,2. Significant strong negative correlation between an index of a lethality, the relation of number of departures evacuations to departures to consultations (р = 0,028) and the relation of primary distant consultations to repeated is revealed (р = 0,026).

Conclusion: optimization of reanimation providing advice allowed to lower a lethality in ICU at increase in a flow of the evacuated patients.


Svetlana G Piskunova

prometnoy.d.v@gmail.com
State Budgetary Institution of Rostov Region “Regional Pediatric Teaching Hospital”
Russian Federation

MD, PhD Director Administration

Fedor G Sharshov

prometnoy.d.v@gmail.com
State Budgetary Institution of Rostov Region “Regional Pediatric Teaching Hospital”
Russian Federation

MD, PhD, Director, The Center of Anesthesiology and Intensive Care

Dmitry V Prometnoy

prometnoy.d.v@gmail.com
State Budgetary Institution of Rostov Region “Regional Pediatric Teaching Hospital”
Russian Federation

MD, PhD, Anesthesiologist, The Intensive Care Unit

Galina A Prometnaya

prometnoy.d.v@gmail.com
State Budgetary Institution of Rostov Region “Regional Pediatric Teaching Hospital”
Russian Federation

Nephrologist, The Department of Nephrology

Vera P Eryomenko

prometnoy.d.v@gmail.com
State Budgetary Institution of Rostov Region “Regional Pediatric Teaching Hospital”
Russian Federation

Head, Medical Statistics Department

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