emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2021.5.2.1239emcardio-142Research ArticleОбзоры и лекцииReviews and lecturesРеализация и оценка эффекта технологий организации медицинской помощи пациентам с высоким кардиоваскулярным риском на примере Брестской области (Часть 2)Implementation and evaluation of the effect of technologies for organizing medical care for patients with high cardiovascular risk on the example of the Brest region (part 2)ПобиванцеваН. Ф.PabivantsavaN. F.СурмачМ. Ю.SurmachM. Yu.УЗ «Брестский областной кардиологический диспансер»Brest Regional Cardiology DispensaryУО «Гродненский государственный медицинский университет»Grodno State Medical University2021221020255112391246Copyright © Побиванцева Н.Ф., Сурмач М.Ю., 20252025Побиванцева Н.Ф., Сурмач М.Ю.Pabivantsava N.F., Surmach M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/142

В статье показано, как на примере Брестской области были реализованы организационные мероприятия по усовершенствованию организации диспансеризации пациентов из групп кардиоваскулярного риска, имеющих прогностически неблагоприятные исходы. Посредством изучения показателей здоровья населения области до и после внедрения, в работе выполнен анализ эффективности новых организационных технологий. Установлено, что в силу принятых профилактических мероприятий на каждом территориальном участке и контроля за маршрутом пациента посредством баз данных от районного до областного уровня оказания помощи, наблюдается снижение первичной заболеваемости болезнями системы кровообращения, в том числе ишемической болезнью сердца, со значительным снижением частоты возникновения острых состояний (острый коронарный синдром). Рост общей заболеваемости свидетельствует об усилении контроля за всеми пациентами с болезнями системы кровообращения и ишемической болезнью сердца, которые были приглашены для проведения диспансерного динамического наблюдения в целях стратификации рисков их осложнений.

The article shows how organizational measures were implemented to improve the organization of medical examinations of patients from cardiovascular risk groups with prognostically unfavorable outcomes on the example of the Brest region. By studying the health indicators of the region’s population before and after implementation, the paper analyzes the effectiveness of new organizational technologies. It is established that due to the adopted preventive measures at each territorial site and monitoring the patient’s route through databases from the district to the regional level of care, there is a decrease in the cardiovascular primary incidence, including coronary heart disease, with a significant decrease in the rate of acute conditions (acute coronary syndrome). The increase in prevalence indicates increased monitoring of all patients with circulatory diseases and coronary heart disease who were invited for conducting dynamic follow-up (dispensarization) in order to stratify the risks of their complications.

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(in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatelstvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 06.12.2011 № 1194. Prilozhenie 9. Minsk, 2011. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatelstvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 06.12.2011 № 1194. Prilozhenie 9. Minsk, 2011. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 28.11.2012 № 1398. Prilozhenie 7. Minsk, 2012. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 28.11.2012 № 1398. Prilozhenie 7. Minsk, 2012. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatelstvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 12.12.2013 № 1260. Prilozhenie 7. Minsk. 2013. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatelstvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 12.12.2013 № 1260. Prilozhenie 7. Minsk. 2013. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 25.11.2014 № 1232. Prilozhenie 7. Minsk, 2014. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 25.11.2014 № 1232. Prilozhenie 7. Minsk, 2014. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 04.12.2015 № 1215. Prilozhenie 46. Minsk, 2015. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 04.12.2015 № 1215. Prilozhenie 46. Minsk, 2015. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatelstvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 30.11.2016 № 1192. Prilozhenie 31. Minsk, 2016. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatelstvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 30.11.2016 № 1192. Prilozhenie 31. Minsk, 2016. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 21.11.2017 № 1331. Prilozhenie 28. Minsk, 2017. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 21.11.2017 № 1331. Prilozhenie 28. Minsk, 2017. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 29.11.2018 № 1266. Prilozhenie 28. Minsk, 2018. (in Russian).Svedeniya o vysokotechnologichnych i slozhnych kardiochirurgicheskich medizinskich vmeshatel’stvach i issledovaniyach, o zabolevaemosti, effektivnosti diagnosticheskich i lechebno-reabilitazionnych meropriyatiy pri ostrych koronarnych sindromach v organizaziyach zdravoochraneniya Respubliki Belarus [Information about high-tech and complex cardiosurgical medical interventions and research, about the incidence, the effectiveness of diagnostic and treatment and rehabilitation measures for acute coronary syndromes in healthcare organizations of the Republic of Belarus] : prikaz M-va zdravoochraneniya Respubliki Belarus ot 29.11.2018 № 1266. Prilozhenie 28. Minsk, 2018. (in Russian).The decree of the President of the Republic of Belarus dated 22.03.2012 “preferential provision of medicines for certain categories of citizens”.The decree of the President of the Republic of Belarus dated 22.03.2012 “preferential provision of medicines for certain categories of citizens”.The order of the Ministry of health of the Republic of Belarus dated 23.03.2012 № 315 “On the order of preferential provision of medicines for certain categories of citizens”.The order of the Ministry of health of the Republic of Belarus dated 23.03.2012 № 315 “On the order of preferential provision of medicines for certain categories of citizens”.The order of the Department of health of the Brest regional Executive Committee from 29.03.2012 No. 28 “On the order of preferential provision of medicines for certain categories of citizens».The order of the Department of health of the Brest regional Executive Committee from 29.03.2012 No. 28 “On the order of preferential provision of medicines for certain categories of citizens».O nekotorych voprosach besplatnogo i l’gotnogo obespecheniya lekarstvennymi sredstvami i perevyazochnymi materialami otdel’nych kategoriy grazhdan [On some issues of free and preferential provision of medicines and dressings for certain categories of citizens] : Postanovlenie Soveta Ministrov Respubliki Belarus, 30 noyabrya 2007 g., № 1650 (v red. Postanovleniya Soveta Ministrov Respubliki Belarus ot 15 iyunya 2020 g. № 344). ETALON. Zakonodatelstvo Respubliki Belarus / Naz. zentr pravovoy inform. Resp. Belarus’. Minsk, 2020. (in Russian).O nekotorych voprosach besplatnogo i l’gotnogo obespecheniya lekarstvennymi sredstvami i perevyazochnymi materialami otdel’nych kategoriy grazhdan [On some issues of free and preferential provision of medicines and dressings for certain categories of citizens] : Postanovlenie Soveta Ministrov Respubliki Belarus, 30 noyabrya 2007 g., № 1650 (v red. Postanovleniya Soveta Ministrov Respubliki Belarus ot 15 iyunya 2020 g. № 344). ETALON. Zakonodatelstvo Respubliki Belarus / Naz. zentr pravovoy inform. Resp. Belarus’. Minsk, 2020. (in Russian).

The authors declare that there are no conflicts of interest present.