Кардиоваскулярная терапия и профилактика (Dec 2016)

ORGANIZATIONAL ISSUES OF CARDIOREHABILITATION SERVICE IN RUSSIA. THE RESULTS OF PILOT PROJECT “DEVELOPMENT OF REHABILITATION SYSTEM OF CARDIOVASCULAR PATIENTS IN MEDICAL INSTITUTIONS OF RUSSIAN FEDERATION ENTITIES”

  • D. M. Aronov,
  • M. G. Bubnova,
  • S. A. Boytsov,
  • G. Е. Ivanova,
  • A. G. Andreev,
  • О. L. Barbarash,
  • V. V. Belova,
  • V. N. Belov,
  • B. V. Borisov,
  • Е. V. Ivanov,
  • I. М. Karamova,
  • A. V. Karpukhin,
  • V. B. Krasnitskiy,
  • Е. S. Kyblanova,
  • P. А. Lebedev,
  • Е. А. Lisnyak,
  • N. P. Lyamina,
  • Т. N. Mizurova,
  • О. F. Misyura,
  • I. E. Mishina,
  • О. V. Mischenko,
  • S. Yu. Nikulina,
  • N. I. Ostroushko,
  • S. А. Poteshkina,
  • А. S. Sidorov,
  • А. А. Sprikut,
  • I. S. Sukhinina,
  • А. G. Tkacheva,
  • S. А. Ustyugov,
  • G. А. Chumakova

DOI
https://doi.org/10.15829/1728-8800-2016-6-4-12
Journal volume & issue
Vol. 15, no. 6
pp. 4 – 12

Abstract

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Aim. To analyze, how is, under the framework of the Pilot Project, organized and being conducted the improvement of work of the known departments in exact medical institutions (MI) of RF for rehabilitation of cardiovascular diseases (CVD) patients at the three steps under the current “Order of medical care and medical rehabilitation”, and how do the scientifically proven and types and methods of cardiorehabilitation (CR) being implemented, and to try to elaborate on an exact algorithm for patients course.Material and methods. Into the Pilot Project, 17 MI included, from 13 entities of RF. For the analysis of effectiveness of organizational models of CR in MI the unified charts were developed making to assess the equality to the Order of the rehabilitation care provided to patients with CVD, of multidisciplinary team involved in care, the staff list and MI equipment. Specific charts included the units assessing the efficacy of work on three stages of CR: I stage — in resuscitation and intensive care unit or specialized cardiology department, II — in in-patient department, III — in polyclinics. The article presents data from CR analysis of Jan 2013 to Dec 2015. Results. The CR was organized at the stage I in 10 MI, stage II in 10 MI and stage III in 7 MI. By the year 2015, almost in all MI the multidisciplinary teams were shaped, including cardiologist, cardiorehabilitologist, exercise specialist, clinical psychologist, physiotherapist; the rooms for exercise were equipped, as the halls for education of patients. The start of rehabilitation process from ICU made it to decrease the remaining of patient on the bedside for 0,7 days in average (2013-2015) and for 1 day in cardiovascular department. About 67% myocardial infarction patients in average were transferred to the stage II of CR. In all MI there were educational Schools organized, and the explanatory talks with the relatives were done as well. By now, the project is on its way. Conclusion. The analysis of three-staged CR system for myocardial infarction patients according to current laws, showed significant improvement of rehabilitational activeness of the newly created multidisciplinary teams at all stages of CR, increase of the number of methods of CR and better fulfillment of those, as demonstrated the safety of proposed principals of physical rehabilitation according to the Russian clinical guidelines “Myocardial infarction with ST elevation: rehabilitation and secondary prevention” under the framework of the organizational model of CR.

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