Opportunities for medical aid optimization for pulmonary patients in megalopolis

Abstract

The experience of the Sankt-Petersburg scientific and clinical Center of intensive pulmonology and thoracic surgery in 1995-1998 is presented in the article. The Center’s structure merges the outpatient department, the pulmonology department, the thoracic surgery department and the cardiorespiratory intensive care unit in a single technological chain. Results of examination and treatment of 17 845 patients demonstrate advantages of such a form of specialized medical care.
The interaction between the outpatient and inpatient departments contributed to a reduction in the mean bed-day for therapeutic patients and a preoperative bed-day for thoracic surgery patients. The outpatient department allowed solving diagnostic and therapeutic problems in 92% of the patients without their hospitaization. While using this technique we managed to reduce a preoperative bed-day in the thoracic surgery department up to 2.3 days and to increase the operative activity up to 89%. The method offered is based on the idea of a closed cycle of the diagnostics and treatment starting from the primary consultation via the inpatient stage, if necessary, up to the outpatient rehabilitation period. The advantages and reserve of this method are discussed in the article.