Analysis of the effectiveness of telemedicine consultations in obstetrics on the profile «Anesthesiology and Reanimation» in case of two-year experience of a national research center
The introduction of telemedicine technologies must level the geographical and time frames and considerably reduce the gap in the level of technicality and competencies of regional healthcare facilities in providing planned and emergency consultations in obstetrics.Pyregov A.V., Kholin A.M., Yurova M.V., Khamo A.A.
Objective. To analyze the effectiveness of telemedicine consultations and to compare the obtained data with international experience.
Materials and methods. In January 1, 2017 to January 1, 2018, the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, held 92 telemedicine consultations on the issues of anesthesiology and resuscitation. The treatment outcomes in inpatients were analyzed.
Results. The distribution by groups (obstetric diseases, extragenital diseases during pregnancy, and postoperative complications) was as follows: 32.4% (11), 23.5% (8), and 44.1% (15) in 2017; 70.2% (47), 10.5% (7), and 19.4% (13) in 2018, respectively. A total of 82 (32 and 50) conferences were held to determine treatment tactics and 9 (2 and 7) were done to agree the terms and conditions of hospitalization. The territorial coverage over 2 years amounted to 7 federal districts (the largest number of presentations came from the North Caucasus and Volga Regions) of the Russian Federation and to 36 regions (in 2018, the maximum patient visit rates were recorded in the Oryol Region, the Chechen Republic, and the Republics of Bashkortostan and Udmurtia). At the end of 2018, the most pronounced dynamic increase in visit rates was observed by nosological entities: multiple organ dysfunction and sepsis (from 23.53 to 29.85%), cardiovascular diseases (including congenital malformations; from 20.59 up to 22.38%), and severe central nervous system lesions (from 2.94 to 16.42%).
Conclusion. Telemedicine care is a promising area of healthcare organization designed to optimize the provision of medical care in the regions of Russia and to make a balanced decision to refer patients to an appropriate-level specialized institution to reduce maternal mortality.
Keywords
obstetrics and gynecology
emergency conditions in obstetrics
audit
telemedicine healthcare organization
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Received 24.06.2019
Accepted 04.10.2019
About the Authors
Aleksey V. Pyregov, MD, Head of the Department of Anesthesiology-Resuscitation, Head of the Department of Anesthesiology and Intensive Care Federal State Budgetary Institution «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakova» Ministry of Health of Russia.Tel .: +7 (916)140-65-49. E-mail: pyregov@mail.ru
Address: 117997, Russia, Moscow, ul. Academician Oparin, d. 4.
Alexey M. Kholin, Head of Department Telemedicine, Department of Regional Cooperation and Integration, «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakova» Ministry of Health of Russia. E-mail: a_kholin@oparina4.ru
Address: 117997, Russia, Moscow, ul. Academician Oparin, d. 4.
Maria V. Yurova, Specialist of the Federal State Budgetary Institution «National Medical Center for Obstetrics, Gynecology and Perinatology named after
Academician V.I. Kulakova» Ministry of Health of Russia; resident doctor of the Department of Obstetrics, Gynecology, Perinatology and Reproductive Health
IPO FSAEI HE First MGMU named after THEM. Sechenov of the Ministry of Health of Russia (Sechenov University).
Phone: + 7 (499)248-05-53. https://orcid.org/0000-0002-0179-7635.
E-mail: m_yurova@oparina4.ru Address: 119991, Russia, Moscow, ul. Trubetskaya, d. 8, p. 2.
Alexander A. Khamo, resuscitation anesthetist, department of anesthesiology and resuscitation of the Federal State Budgetary Institution «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakova» Ministry of Health of Russia.
Phone: + 7 (916)140-65-49. Email: tutaankhamon@gmail.com. Address: 117997, Russia, Moscow, ul. Academician Oparin, d. 4.
For citation: Pyregov A.V., Kholin A.M., Yurova M.V., Khamo A.A. Analysis of the effectiveness of telemedicine consultations in obstetrics on the profile «Anesthesiology and Resuscitation» in case of two-year experience of a national research center.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020; 1: 155-62. (In Russian).
https://dx.doi.org/10.18565/aig.2020.1. 155-162
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