Современная онкология (Dec 2023)
Patient resource to improve the effectiveness of oncological care for the population
Abstract
Background. Improving oncological care for the population is defined as one of the main priorities for the development of domestic health care, which is determined by the high medical and social significance of malignant neoplasms. The problem of improving cancer care is multidimensional. However, there are not enough scientific papers that consider the patient's resource as a factor in achieving a greater level of effectiveness of cancer care. Aim. To assess the state and possibilities for improving the patient's resource of cancer care. Materials and methods. The study was conducted at the Ivanovo Regional Oncology Center, Ivanovo in the period 2020-2022 on the basis of a comprehensive program using traditional methods: sociological, expert assessment, analytical, documentary. The assessment of the patient's resource of oncological care was carried out according to the original methodology, which included 10 parameters. A survey of 1000 oncological patients at different stages of diagnosis and treatment of malignant neoplasms was carried out and its results were analyzed, taking into account the factors of the staging of the oncological process, medical and demographic characteristics of patients. The assessment of the quality of life of patients was carried out using the SF12 (12Item ShortForm Health Survey) questionnaire. Based on the examination data of 410 cases of the provision of oncological medical services by experts of medical insurance companies, according to regulatory medical, economic and clinical criteria, as well as an assessment of patient satisfaction with the care provided, all cases are divided into 2 groups with an optimal and non-optimal level of care effectiveness. Statistical data processing was carried out on the basis of electronic databases using applied computer programs and provided for the calculation of relative values, the reliability of the difference in indicators, and the Spearman correlation coefficient. Results. Data were obtained on the decrease in the patient resource of oncological care for all its selected components and its established relationship with the effectiveness of care, which requires the improvement of medical and organizational technology for working with oncological patients. A medical and organizational technology for providing assistance to oncological patients in the conditions of passing through the stages of the treatment and diagnostic process is proposed. Conclusion. An integral assessment of the 10 components of the patient resource at the stages of clinical observation of patients in an oncological dispensary makes it possible to monitor the main factors on the part of the patient that determine the effectiveness of care, as well as to carry out planned measures to correct adverse and strengthen favorable factors. The proposed approach is the basis for making management decisions.
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