PILOT PROJECT "DEVELOPMENT OF THE MEDICAL REHABILITATION SYSTEM IN RUSSIAN FEDERATION (DOME)": PRELIMINARY RESULTS OF IMPLEMENTATION IN THE FIRST AND SECOND STAGES
Aim: to demonstrate the effect of the "new" model of medical rehabilitation in comparison with the previous (traditional) model in three categories of patients (with stroke, myocardial infarction and after hip arthroplasty). Materials and methods. The study involved 70 clinics in 1, 2 and 3 stages of rehabilitation in 13 regions of Russia. The design of the study was consistent and had two phases. In the 1st phase of the project implementation ("traditional model of rehabilitation") they worked according to the traditional "traditional" scheme. In the second phase ("The New Model"), medical organizations worked on a "new" model with the implementation of a problem-oriented multidisciplinary approach. The main endpoint was a modified Rankin score (mRS) at the end of hospitalization. Results. Rehabilitation for the "New Model" in comparison with the " traditional model" is more effective, which is characterized by better indicators of recovery on mRS in patients with myocardial infarction, stroke and after hip arthroplasty due to non-traumatic lesion. Rankin scale is effective as a universal indicator for assessing disability, limiting life activity and dependence on caregivers, as evidenced by the results of the Pilot Project. Conclusion. "New Model" of the rehabilitation in comparison with the "traditional model" is more effective, which is characterized by better indicators of recovery of functions and vital activity in the first stage of rehabilitation of patients, regardless of the profile of rehabilitation.