DAY HOSPITAL BEDS AND ORGANIZATION OF WORK OF DAY HOSPITALS
Significance. Since the mid-90s, day hospitals in the Russian healthcare system have received priority development, ensuring optimization of hospital beds. Many scientific studies have been carried out to substantiate effectiveness and efficiency of day hospitals in performing a number of diagnostic tests and treating certain conditions. However, researchers hardly focus on problems related to work organization of day hospitals. Purpose. To analyze problems related to work organization of day hospitals based on materials of the Republic of Tatarstan. Material and methods. Data of 107 medical organizations with 163 day hospitals were analyzed, which accounted for 80% of all medical organizations of the Republic of Tatarstan with day hospitals. The study used the following methods of mathematical statistics: methods of calculating dynamic series indicators, as well as analysis of contingency tables. Results. 73 day hospitals (44.8%) out of all 163 day hospitals under study were based at 24-hour hospitals, 73 (44.8%) - at polyclinics and 17 (10.5%) - at home. From 2015 to 2017, the average number of day hospital beds at 24-hour hospitals increased by 27.4%, at polyclinics - by 15.3%, while the number of day hospital beds at home remained changed. Only 23 out of 163 day hospitals were admitting and discharging patients 7 days a week accounting for 14% of all day hospitals under study. 108 of day hospitals (74%) work one shift. Decision on admission was made by heads of department in 25.2 % of cases, by district therapists - in 16.7% of cases and by narrow specialists - in 14.6% of cases. 32.5% of day hospitals based at 24-hour hospitals and 34.6% of day hospitals based at policlinics did not provide for patient discharge records for further outpatient follow-up and treatment. Conclusion. In general, the Republic is about to finalize the process of developing a network of day hospitals in medical organizations. The number of day hospital beds continues to grow, especially at 24-hour hospitals. The vast majority of day hospitals (86%) did not discharge patients on weekends and holidays, delaying the treatment and diagnostic process. Moreover, patients did not receive the prescribed treatment on weekends and holidays. 90% of day hospitals in polyclinics and hospitals failed to organize double shifts. Over half of all admissions to day hospitals were associated with treatment of the prime disease, while further treatment after discharge from hospital is the second most important reason for admission to day hospitals.