Standardization of spedalized medical care to patients with shin fractures in multifield city hospital

• Main Authors: R. M. Tikhilov, T. N. Vorontsova, I. G. Belenkiy
• Format: Article
• Language: Russian
• Published: Vreden Russian Research Institute of Traumatology and Orthopedics 2013-06-01
• Series: Travmatologiâ i Ortopediâ Rossii
• Subjects: травматология; медико-экономический стандарт; организация здравоохранения; traumatology; standard of medical care; public health; organization
• Online Access: https://journal.rniito.org/jour/article/view/326

The aim of the investigation was development of science-based recommendations for increasing efficiency of operative treatment of adult patients with shin fractures in multiprofile city hospital. Investigation was made in Saint-Petersburg Alexandrovskiy City Hospital. Clinical material was presented by official hospital reports, individual medical documentation and results of direct survey of patients treated in this hospital in period 1999-2010 years. All patients had follow up treatment in outpatient department of this hospital. Information was completed following federal and local laws. Recommendations for standardization of modern specialized medical care of patients with shin fractures, based on methods of internal fixation, were performed. We took into consideration possibilities of conventional and minimally invasive fixation of closed and open fractures including politrauma injuries. Models of patients with shin fractures depending on method of internal fixation and list of basic diagnostic procedures and treatment were formed. Operations classifier of internal shin fractures fixation was developed. This classifier includes calculation of hospital costs in process of specialized medical care considering actual correction coefficients. Calculation of each surgical procedure component was performed. List and composition of instrument sets and expense materials for such operations were formed. Analisis of organizational, medico-technological, economica aspect and expert evaluation of clinical results of different methods of long bones fractures fixation have provided conceptual approach to treatment standardization. On this base we have developed medico-economical standards of long bones fractures treatment in city multiprofile hospital.