The Analysis of Effectiveness of the Optimized Intensive Care Consultative System of Urgent Medical Care to Children in the Territory of Rostov Region
Increase of effectiveness of intensive care consultative providing of children is an actual problem. Purpose: the analysis of effectiveness of the optimized system of intensive care consultative providing of the emergency medical care to children in the Rostov region. Methods: the retrospective cohort study, including patients of the of intensive care consultative center (ICCC) is conducted. Databases and log-books of patients of ICCC were analyzed. Research period: 2012-I half of 2016. The studied groups: the 1st - 2012-2014 (before optimization, n = 1124), the 2nd - 2015-2016 (after optimization, n = 1432). Effectiveness was estimated on dynamics of a lethality in intensive care unit (ICU), it is padding - dynamics of number of distant consultations, departures and evacuations. Results: Ninety-seven percent of patients of ICCC are evacuated in the ICU. The lethality decreased from 5,1% - in 2012 to 3% in the I half-year 2016. Increased: the number of distant (telephone) consultations for 119,6% from 572 to 1363 in 2015 in comparison with 2014; consultations near the patients for 37,6% with 237 to 326; a share of departures with the subsequent evacuation from 54,8% (338 of 617) in group 1 to 60,8% (270 of 444; p = 0,050) in group 2; indexes “the number of departures evacuations to departures consultations” to 1,8 in the I half-year 2016 in comparison with 1,2 in 2012 and “number of primary consultations to repeated consultations” to 3,1 in comparison with 2,2. Significant strong negative correlation between an index of a lethality, the relation of number of departures evacuations to departures to consultations (р = 0,028) and the relation of primary distant consultations to repeated is revealed (р = 0,026). Conclusion: optimization of reanimation providing advice allowed to lower a lethality in ICU at increase in a flow of the evacuated patients.