The quality of medical care in a round-the-clock hospital during the COVID-19 pandemic

Abstract

Violations in the provision of medical care are detected by controlling the volume, timing, quality and conditions of medical care. The objective of the work is assessment of the activities of the round-the-clock hospital from the standpoint of the quality of medical care during the COVID-19 pandemic. Material and methods. A database of indicators reflecting the activity of round-the-clock hospital for four years, from 2017 to 2020 (Omsk) was formed. Analytical, statistical methods and the method of expert assessments were used to analyze the required indicators. Results. Evaluation of inpatient hospital activities during the COVID-19 pandemic compared to the “pre-pandemic” years showed a 1.9-fold and 2.9-fold decrease in the total number of quality examinations performed and the number of defects detected, respectively. The number of defects that were grounds for denial or reduction of payment for medical care found in the “before-COVID-19” years was 2.1 times higher than in 2020. In 2020, the weight of the share of those defects that directly reflect the quality of medical care increased signifcantly. The quantitative composition of the inpatient hospital staff changed insignifcantly during the analyzed period – the number of physicians increased  by only 5 % over four years, with no dynamics in the qualitative characteristics of the staff. The number of medical equipment increased by 27.6 %. Due to re-profling in 2020, there was a decrease in the number of hospitalized patients, with an increase in the proportion of patients admitted by emergency care (up to 91 %) and an increase in mortality by 2.7 times. Conclusions. One of the conditions for maintaining high quality of medical care is a balance between the main components of quality: accessibility, timeliness, sufciency, efciency and safety and the speed of its achievement, which in turn depends on the amount of resources and reserves.