Analysis of the Implementation of Standardized Clinical Protocol «Diabetes Mellitus Type 2» by Quality Indicators in Institutions of Kyiv Region
Journal Title: Міжнародний ендокринологічний журнал - Year 2014, Vol 7, Issue 63
Abstract
In Ukraine, a standardized clinical protocol (SCP) to provide medical care in diabetes mellitus type 2 (order of the Ministry of Healthcare of Ukraine dated 21.12.2012 № 1118), which identifies 4 quality indicators, is being implemented. The objective of research — to analyze the implementation of SCP based on monitoring of quality indicators in the institutions of the Kyiv region. Materials and Methods. Technique for assessing the quality of diabetes care, one element of which is the monitoring of quality indicators specified in SCP, has been developed and applied. Collection and analysis of information was carried out by forms of primary records № 025/030 and 030/o, forms of statistical reporting № 12 and 20. Statistical analysis was performed using Excel 2007, SPSS. Results. Today, primary health care institutions in Kyiv region developed local protocols that confirms the implementation of the first quality indicator, in accordance with the desired level of the indicator value by SCP. The second indicator — the percentage of patients who were defined the level of glycated hemoglobin in the reporting period amounted to 12.2 %, which is higher than in 2012 (8.84 %), but remains low. The third quality indicator — the percentage of patients who were admitted to hospital for diabetes mellitus and its complications during the reporting period amounted to 15.01 %, while in 2012 it stood at 8.66 %. For comparison, this figure in 2007 was 9.37 %. Conclusions. The quality of care at an early stage of implementation is not enough, partly due to the lack of awareness by physicians of major provisions of the protocol, lack of equipment, the need of payment by a patient for medical services specified in the protocol, lack of doctors’ understanding of the characteristics of different types of medical and technological documents and difficulties in the development and implementation of local protocols, particularly. The obtained results are consistent with the European experience of introducing new guidelines for the management of diabetes mellitus. The situation in Ukraine requires further analysis and search for ways to optimize.
Authors and Affiliations
V. I. Tkachenko
Keywords
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