E.L. BORSHCHUK¹, A.D. CHUPROV², D.N. BEGUN¹, A.O. LOSITSKIY²

¹Orenburg State Medical University, 6 Sovetskaya St., Orenburg, Russian Federation, 460000

²Orenburg branch of S. Fyodorov Eye Microsurgery Federal State Institution, 17 Salmyshskaya St., Orenburg, Russian Federation, 460000

  Borshchuk E.L. ― D. Med. Sc., Professor, Head of the Department of Public Health and Healthcare №1, tel. (3532) 77-30-53, e-mail: [email protected]

Chuprov A.D. ― D. Med. Sc., Professor, Director, tel. (3532) 36-44-59, e-mail: [email protected]

Begun D.N. ― Cand. Med. Sc., Assistant Professor of the Department of Public Health and Healthcare №1, tel. (3532) 77-30-53, e-mail: [email protected]

Lositskiy A.O. ― Head of Organizational and Methodological Department, tel. (3532) 65-02-46, e-mail: [email protected]

 According to the data of the World Health Organization, all countries of the world try to settle the problem of improving the quality of medical care. The task of the study was to reveal clinically significant characteristics of patients and medical staff, which have priority in predicting complications during cataract surgery, and prioritize them. The database of the medical information system of the clinic was studied: all cases of surgical treatment with lensectomy in 2011-2015 were selected. During the study period, the total number of surgical complications was 169 cases out of 23855 (0.71%). The best results (without complications) occurred when the surgeon performed more than 900 cataract surgeries.

The average age of patients with complications was 75 (from 65 to 80) years and patients who didn’t have complications ― 71 (62-77) years. Thus, patients over 65 years are in risk zone of complications.

The diagnosis of the patient also played a significant role. The highest incidence of complications occurred with senile Morgagni cataract (2.6%), complicated cataract (0.93%) and other senile cataracts (0.71%).

The best results were observed at phacoemulsification. The incidence of complications with this method was the most minimal and amounted to 0.70%.

Key words: quality of medical care, cataract, surgery, complications, organization of medical care.

REFERENCES

1. Agalakov V.I., Kukovyakin S.A., Kukovyakina N.D. Quality of medical care (literature review). Vyatskiy meditsinskiy vestnik (in Russ.), 2003, 2, available at: https://cyberleninka.ru/article/v/kachestvo-meditsinskoy-pomoschi-obzor-literatury (accessed on: 30.11.2017).
2. Ledyaeva N.P., Gaydarov G.M., Safonova N.G., Alekseeva N.YU. The main approaches to improving the management and organization of quality control of medical care in a multidisciplinary medical institution. Vestnik Roszdravnadzora, 2013, no. 1, pp. 43-54 (in Russ.).
3. Shchepin O.P., Medik V.A. Obshchestvennoe zdorovʹe i zdravookhranenie: uchebnik [Public health and health: a textbook]. Moscow: GEHOTAR-MEDIA, 2011. 592 p.
4. Donabedian A. Evaluating the quality of medical care. 1966. The Milbank Memorial Fund quarterly, 2005, vol. 83, no. 4, pp. 691-729.
5. Savelʹev V.N., Vinogradova T.V., Dunaev S.M. Indicators of the quality of medical care. Meditsinskiy alʹmanakh, 2011, vol. 14, no. 1, pp. 11-14 (in Russ.).
6. Sorokin E.L., Postupaeva N.V., Postupaev A.V. A study of the initial conditions for the adequate performance of phacoemulsification of age-related cataracts in the presence of primary open-angle glaucoma. Dalʹnevostochnyy meditsinskiy zhurnal, 2013, no. 2, pp. 70-72 (in Russ.).
7. Vvedenskiy A.S., Yusef YU.N., Reznikova E.V. et al. Cataract Surgery in Patients with High Myopia. Vestnik oftalʹmologii, 2005, no. 6, pp. 47-49 (in Russ.).
8. Sokolov K.V. Features of surgical treatment of cataract in patients with degenerative myopia. Tambovskiy meditsinskiy zhurnal, 2016, vol. 65, no. 3, pp. 54-57 (in Russ.).
9. Kolesnikov A.V., Kolesnikova M.A., Mironenko L.V. et al. Results of phacoemulsification of cataract in patients older than 85 years. Prakticheskaya meditsina, 2017, vol. 104, no. 3, pp. 51-53 (in Russ.).
10. Chuprov A.D., Borshchuk E.L., Lositskiy A.O. Analysis of some clinically significant characteristics of patients who received treatment for lens pathology in the Orenburg branch of FGMA «MNTK» Eye Microsurgery «named after. acad. S.N. Fedorov for the years 2011-2015. Vyatskiy meditsinskiy vestnik, 2016, vol. 54, no. 2, pp. 7-12 (in Russ.).