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Section 2. Preventive medicine
Asatryan A., Mardiyan M., Kurghinyan R., Mnatsakanyan A.,
"Natali Pharm" LTD "Astghik" Medical Centre, Yerevan, RA YSMU, Public Health and Healthcare Organization Department
E-mail: [email protected]
ANALYSIS OF HOSPITAL MORBIDITY AND EVALUATION OF ACTIVITY OF A MULTI-PROFILE MEDICAL CENTER
Abstract: Under the influence of external economic factors, the medical institution should change its tactics, management system and structure. On the other hand, there is no technology to improve the quality of the management of medical care. Managing the quality of health care will make it become a monitoring function, ignoring issues of planning, organization and motivation.
The performance indicators of "Astghik" Hospital (2011-2016) have been analyzed. Indicators have been calculated according to official statistical reporting forms. The structure of patients has been analyzed according to the main disease classes. It was found that reasons of hospitalization of patients were pregnancy, childbirth and postpartum - 47,0%, blood diseases 17.2% - (I00-I99), and on third place-diseases of digestive organs - 13.1% (K00-K93). According to research data, the mean duration of treatment of acute myocardial infarction has been 7 days, and in case of brain vascular disease - 8 days. So the research confirms, that the latest technologies introduced at the Multi-profile Medical Center aimed at improving the quality of care, diagnostics, improved treatment, reduced the average duration of treatment of patients, and reduced the level of hospital mortality.
To improving the quality and effectiveness of further medical care, it is required to invest more effective models of hospital care, and make refinement of inter-hospital ambulant care, day care and advisory-diagnostic centers.
Keywords: Morbidity; average duration of treatment; Multi-Profile Medical Center; hospital care.
Introduction. Formation of the market of med- In conditions of socio-economic development and
ical services, the formation of a private sector in the market relations, the introduction of modern in-
health care system, introduction of a mandatory and novative processes into the health care system is
voluntary medical insurance system are the main an important driving force. Under the influence of
reasons that substantiate the quality of health care external economic factors, the medical institution
quality control and introduction of mechanisms. should change its tactics, management system and
structure. On the other hand, there is no technology to improve the quality of the management of medical care. Managing the quality of health care will make it become a monitoring function, ignoring issues of planning, organization and motivation. In practical health care, modern methods of
medical care quality management, which should be based on ISO 9000 international standards, are absence [1; 2].
Today, the most important problem is to use expensive hospital beds only for the most severe case, which require such diagnostic activities, that can not be carried out in an out-of-hospital environment [3; 4]. Numerous researchers have found that the investment of new hospital technologies have the potential to increase not only the ambula-tory-polyclinic ring but also the overall healthcare system's effectiveness. The results of the researches justify, that one of the realistic ways to organize hospital care is the investment of forms and methods that can replace hospital care. The alternative forms of patient care have powerful resources: home, day care center, and day care hospital. The
ambulatory model includes ambulatory and hospital care elements and can provide diagnostic, preventive, therapeutic and rehabilitation measures. Most researchers have found that the work of these modeling associations is 20-28% more effective. This model provides access to a cheaper hospital care. For having more effectiveness, the investment of ambulatory surgical service in the structure of the combined hospital is most applicable. The research material and methods The performance indicators of "Astghik" Hospital (2011-2016) have been analyzed. Indicators have been calculated according to official statistical reporting forms.
Research results and discussion. 44796 - is the number ofhospital patients, which, declined to 15.1% in 2011, while it became 29.2% in 2016 (diagr.1). The structure of patients has been analyzed according to the main disease classes. It was found that reasons of hospitalization of patients were pregnancy, childbirth and postpartum - 47.0%, blood diseases 17.2% - (I00-I99), and on third place - diseases of digestive organs -13.1% (K00-K93).
Diagram1. Patient Dynamics of Multiprofile Medical Center
Diagram 2. Distribution of hospitalized patients according to main classes of diseases (2011)
According to the research data, in 2011 (diagr. 2), with blood circulatory system diseases (6.4 days), skin the average duration oftreatment was 4.7 days. More- and subcutaneous diseases (7.2 days), injuries, intoxi-over, the duration oftreatment was longer for patients cations and external causes (8.2 days) (table 1).
Table 1.- The average duration of stationary treatment according to the basic disease classes
Name of the disease Code by ICD Patients that were discharged Bed days Average duration of treatment
1 2 3 4 5 6
1. Infectious and parasitic diseases A00-B99 11 100 9.1
2. Tumors C00-D48 139 1091 7.8
3. Diseases of blood and blood-forming organs D50-D89 1 12 12
4. Endocrine system diseases T00-T90 33 160 4.8
5. Mental disorders F00-F99 22 52 2.4
6. Nervous system diseases G00-G99 119 599 5
7. Diseases of the eye and its appendix H00-H59 1 1 1
8. Ear and mastoid diseases H60-H95 0 0 0
9. Diseases of blood circulatory system I00-I99 821 5235 6.4
10. Diseases of respiratory organs J00-J99 76 374 4.9
11. Diseases of digestive organs K00-K93 624 3868 6.2
12. Diseases of the skin and subcellular cells L00-L99 34 244 7.2
1 2 3 4 5 6
13. Diseases of musculoskeletal system and connective tissue V00-V9*9 165 1042 6.3
14. Diseases of the urogenital system N00-N99 186 552 3
15. Pregnancy, childbirth and postpartum period C00-C99 2248 6907 3.1
16. Congenital anomalies Q00-Q99 2 8 4
17. R00-R99 R00-R99 29 71 2.4
18. Traumas, poisons and external causes S00-T98 272 2233 8.2
19. Total A00-T98 4783 22549 4.7
In 2011, the rate of hospital mortality was 2.5%, tem - 10.0%, and the diseases of endocrine system -because of the diseases of the blood circulatory sys- 15.0% (table 2).
Table 2.- Hospital mortality indicator according to the main classes of diseases
Name of the disease Code by ICD Patients that were discharged Died Hospital mortality rate
1. Infectious and parasitic diseases A00-B99 11 1 9.1
2. Tumors C00-D48 139 8 5.8
3. Diseases of blood and blood-forming organs D50-D89 1 0 0
4. Endocrine system diseases T00-T90 33 5 15
5. Mental disorders F00-F99 22 1 4.5
6. Nervous system diseases G00-G99 119 1 0.8
7. Diseases of the eye and its appendix H00-H59 1 0 0
8. Ear and mastoid diseases H60-H95 0 0 0
9. Diseases of blood circulatory system I00-I99 821 82 10
10. Diseases of respiratory organs J00-J99 76 4 5.3
11. Diseases of digestive organs K00-K93 624 9 1.4
12. Diseases of the skin and subcellular cells L00-L99 34 0 0
13. Diseases of musculoskeletal system and connective tissue V00-V9*9 165 0 0
14. Diseases of the urogenital system N00-N99 186 2 1.1
15. Pregnancy, childbirth and postpartum period C00-C99 2248 0 0
16. Congenital anomalies Q00-Q99 2 0 0
17. R00-R99 R00-R99 29 1 3.4
18. Traumas, poisons and external causes S00-T98 272 7 2.6
19. Total A00-T98 4783 121 2.5
Since hospitalization and hospital mortality rates according to basic nasological forms. It was found out have been high especially because of blood circulatory that 30.2% had been hospitalized because cardiovas-system diseases, we have analyzed this class ofdiseases cular disease, 18.1% of stenocardia (diagr. 3).
■ Diseases characterized with increased blood pressure
■ Stenocardia
Acute myocardial infarction
■ Otherforms of acute ischemic heart disease
■ Chronicischemicheart disease Ce rebral vasculardiseases Otherdiseases of this class
Diagram 3. Distribution of hospitalized patients with blood circulation diseases according to basic neocolologic forms
According to research data, the mean duration of days, and in case of brain vascular disease - 8 days treatment of acute myocardial infarction has been 7 (table 3).
Table 3.- The average duration of treatment of major nosologic forms of diseases of the blood circulatory system (2011)
Diseases of blood circulatory system Patients that were discharged Bed days Average duration of treatment
1. Diseases caused by increased blood pressure 101 400 3.96
2. Stenocardia 149 651 4.369
3. Acute heart attack 164 1175 7.165
4. Acute ischemic heart attack 1 1 1
5. Chronic ischemic heart disease 24 111 4.625
6. Vascular diseases of the brain 248 2141 8.633
7. Other diseases of this class 134 756 5.642
8. Total 821 5235 6.376
In 2011, the hospital mortality rate was 10.0%, in the case of cardiac acute infarction - 14.6% the rate of cardiovascular disease was 19.2%, and (table 4).
Table 4.- Features of hospital mortality rate, caused by blood circulatory system diseases (2011)
Diseases of blood circulatory system Patients, that have been discharged Died Hospital mortality rate
1. Diseases caused by increased blood pressure 101 1 1,0
2. Stenocardia 149 0 0
3. Acute heart attack 164 24 14.6
4. Acute ischemic heart attack 1 0 0
5. Chronic ischemic heart disease 24 1 4.2
6. Vascular diseases of the brain 248 48 19.2
7. Other diseases of this class 134 8 6,0
8. Total 821 82 10.0
An important indicator of the evaluation of surgical activity is the evaluation of the multi-profile clinical activity. In 2011, 56.9% of surgeries fell on obstetric surgery, and 19.8% on surgeries of abdominal organs (diagr. 4).
41.7% of emergency surgeries have been performed because of the acute inflammation of the
gallbladder, 38.0% for acute appendicitis, 7.8% for congenital hernia disease (diagr. 5).
As a result of the 2012 annual report, it was found that the average duration of treatment was 5-6 days, including 7 days for diseases of the blood circulatory system and 9 days for the skin and subcutaneous diseases (table 5).
0,84 2,21^0^6040,32-0,
0,16 0,04
I on endocrine system I on respiratory organs I Vascular surgery I on kidneys and urine on female genital organs on the musculoskeletal system on skin and subcutaneous fibers
Ion the ear, throat, nose organs I The surgical insertion of an cardiostimulator on abdominal Organs on prostate I Obstetric surgeries on breast Other surgeries
Diagram 4. Surgical Activity Structure of Multi-profile Hospital according to Names of Surgical Operations (2011)
0,3
Acute intestinal obstruction Acute inflammation of the appendix Perforated gastric and duodenal ulcer Gastrointestinal bleeding Inguinal Hernia
Acute gallbladder inflammation Acne inflammation of pancreas Ectopic pregnancy
Diagram 5. Special Nosological Needs for Emergency Surgery (2011)
Table 5.- The average duration of treatment according to the specifications of major disease classes (2012)
Name of the disease Code by ICD Patients that have been discharged Bed days Average duration of treatment Hospital mortality rate
1 2 3 4 5 6
1. Infectious and parasitic diseases A00-B99 7 116 16.6 0
2. Tumors C00-D48 111 829 7.47 3.6
3. Diseases of blood and blood-forming organs D50-D89 0 0 26.7
4. Endocrine system diseases T00-T90 15 119 7.93 0
5. Mental disorders F00-F99 8 19 2.38 4.1
6. Nervous system diseases G00-G99 49 292 5.96 0
7. Diseases of the eye and its appendix H00-H59 0 0 0
8. Ear and mastoid diseases H60-H95 1 2 2 0
9. Diseases of blood circulatory system I00-I99 871 6050 6.95 12.5
10. Diseases of respiratory organs J00-J99 80 439 5.49 1.2
11. Diseases of digestive organs K00-K93 665 4743 7.13 2
12. Diseases of the skin and subcellular cells L00-L99 22 205 9.32 0
13. Diseases of musculoskeletal system and connective tissue V00-V9*9 29 338 11.7 0
1 2 3 4 5 6
14. Diseases of the urogenital system N00-N99 154 542 3.52 1.3
15. Pregnancy, childbirth and postpartum period C00-C99 0 6433 3.92 0
16. Congenital anomalies Q00-Q99 1 4 4 0
17. R00-R99 R00-R99 76 98 1.29 0
18. Traumas, poisons and external causes S00-T98 234 1958 8.37 2.6
19. Total A00-T98 0 22207 5.6 3.5
The hospital morbidity rate was 3.5%. It was higher, especially, in the cases of diseases of the blood circulatory system (13.0%) and diseases of the endocrine system (27.0%). According to the 2012 report, the average duration of treatment for the diseases of the blood circulatory system was 7.0
days, for acute myocardial infarction- 7 days and 9 days for cardiovascular diseases. According to the research data, in 2012, diseases, that caused patients death were diseases of the blood circulation system 12.2%, and acute myocardial infarction, which made 18.0% (table 6).
Blood circulatory system diseases Patients, that have been discharged Bed days Average duration of treatment Hospital mortality rate
1. Diseases caused by increased blood pressure 79 378 4.8 0
2. Stenocardia 168 720 4.3 0
3. Acute heart attack 205 1403 7 18
4. Other types of acute ischemic heart attack 8 16 2 0
5. Chronic ischemic heart disease 32 162 5.1 3.1
6. Vascular diseases of the brain 278 2586 9.3 2.2
7. Brain Infarction 237 2179 9.2 18
8. Other diseases of this class 95 730 7.7 7.4
9. Total 871 6050 7.0 12
For 2012, the number of surgeries, performed, especially, on heart with implantable cardiostimulator and surgeries on abdomen, have increased (diagr. 6).
Table 6.- The average duration of treatment of major nosological forms of diseases of the blood circulatory system (2012)
on endocrine system
on the ear, throat, nose organs
on respiratory organs
The surgical insertion of an cardiostimulator Vascular surgery
on abdominal Organs
on kidneys and urine
on prostate
on female genital organs Obstetric surgeries on the musculoskeletal system on breast
on skin and subcutaneous fibers
Diagram 6. Surgical Activity in 2012 by Type of Surgery
0
In 2013, the average duration of treatment was 4 days, and hospital mortality was 2.1% (table 7).
Table 7.- Average duration of hospital treatment and hospital mortality, according to main classes of diseases (2013)
Name of the disease Code by ICD Patients, that have been Bed days Average duration of Hospital mortality
discharged treatment rate
1 2 3 4 5 6 7
1. Infectious and parasitic diseases A00-B99 6 124 21 16.7
2. Tumors C00-D48 232 1338 5.8 2.6
3. Diseases of blood and blood-forming organs D50-D89 0 0 0
4. Endocrine system diseases T00-T90 38 201 5.3 18.4
5. Mental disorders F00-F99 13 74 5.7 0
6. Nervous system diseases G00-G99 132 962 7.3 3.0
7. Diseases of the eye and its appendix H00-H59 0 0 0 0
8. Ear and mastoid diseases H60-H95 0 0 0
9. Diseases of blood circulatory system I00-I99 2309 9274 4 4.0
10. Diseases of respiratory organs J00-J99 33 143 4.3 9.1
11. Diseases of digestive organs K00-K93 911 4031 4.4 1.8
12. Diseases of the skin and subcellular cells L00-L99 58 278 4.8 0
1 2 3 4 5 6 7
13. Diseases of musculoskeletal system and connective tissue V00-V9*9 48 301 6.3 0
14. Diseases of the urogenital system N00-N99 263 883 3.4 1.9
15. Pregnancy, childbirth and post-partum period C00-C99 2454 7439 3 0
16. Congenital anomalies Q00-Q99 3 7 2.3 33.3
17. R00-R99 R00-R99 23 64 2.8 0
18. Traumas, poisons and external causes S00-T98 306 2426 7.9 3.3
19. Total A00-T98 6829 27545 4 2.1
The average duration of treatment for patients receiving hospital treatment for diseases of the circulatory system has been 4 days. It should be noted, that in the case of acute myocardial infarction, the average duration of treatment was 5 days, for stenocardia - 2 days,
In 2013, the surgical activity was especially higher for surgeries performed on vessels (30.0%) and on heart, with implantable cardiostimulator (4.1%).
but the length of treatment for cerebrospinal cases is still high. Hospital morbidity rate of blood circulatory system diseases made 4.0. At the same time, the rate of acute myocardial infarction and cerebral hemorrhage has dropped dramatically (table 8).
The average duration of the medical treatment in 2014 was 4 days, but the hospital morbidity dropped dramatically (table 9).
Table 8.- Features of the rate of hospital mortality and average duration of treatment in cases of blood circulatory system diseases (2013)
Blood circulatory system diseases Patients, that have been discharged Bed days Average duration of treatment Hospital mortality
1. Diseases caused by increased blood pressure 323 722 2.24 0.6
2. Stenocardia 261 674 2.58 0
3. Acute heart attack 318 1598 5.03 8.2
4. Other types of acute ischemic heart attack 60 147 2.45 0
5. Chronic ischemic heart disease 260 891 3.43 4.6
6. Vascular diseases of the brain 263 2629 10 17.9
7. Brain Infarction 212 2069 9.76 11.3
8. Other diseases of this class 822 2608 3.17 0.6
9. Total 2309 9274 4.02 4.0
Table 9.- Average duration of hospital treatment and hospital mortality, according to main classes of diseases (2014)
Name of the disease Code by ICD Patients that have been discharged Bed days Average duration of treatment Hospital mortality
1. Infectious and parasitic diseases A00-B99 7 67 9.57 0
2. Tumors C00-D48 253 1391 5.5 2
3. Diseases of blood and blood-forming organs D50-D89 0 0 0
4. Endocrine system diseases T00-T90 42 205 4.88 11.9
5. Mental disorders F00-F99 14 63 4.5 0
6. Nervous system diseases G00-G99 167 1274 7.63 3
7. Diseases of the eye and its appendix H00-H59 0 0 0
8. Ear and mastoid diseases H60-H95 0 0 0
9. Diseases of blood circulatory system I00-I99 2734 10640 3.89 3.4
10. Diseases of respiratory organs J00-J99 48 1969 41 8.3
11. Diseases of digestive organs K00-K93 928 4381 4.72 1.7
12. Diseases of the skin and subcellular cells L00-L99 61 350 5.74 0
13. Diseases of musculoskeletal system and connective tissue V00-V9*9 80 605 7.56 0
14. Diseases of the urogenital system N00-N99 416 14140 34 1.2
15. Pregnancy, childbirth and postpartum period C00-C99 2548 8150 3.2 0
16. Congenital anomalies Q00-Q99 2 4 2 0
17. R00-R99 R00-R99 21 71 3.38 0
18.. Traumas, poisons and external causes S00-T98 362 2488 6.87 1.4
19 Total A00-T98 7683 31299 4.07 1.8
Table 10.- The average duration of hospital treatment for patients with diseases of the blood circulation system and features of rates of hospital mortality (2014)
Name of the disease Patients, that have been discharged Bed days Average duration of treatment Hospital mortality rate
1. Diseases caused by increased blood pressure 353 796 2.25 0
2. Stenocardia 377 956 2.54 0
3. Acute heart attack 309 1620 5.24 7.1
4. Other types of acute isch-emic heart attack 151 328 2.17 0
5. Chronic ischemic heart disease 338 1234 3.65 1.5
6. Vascular diseases of the brain 275 2742 9.97 19.2
7. Brain Infarction 231 2331 10.1 13
8. Other diseases of this class 930 2962 3.18 1.3
9. Total 2964 12969 4.38 4.1
As it is clear from (Table 10), the average duration ofhospital treatment for the patients with blood circulatory system disease was 4 days. The rate of morbidity, cause by heart and brain infarction has dramatically decreased. A huge surgical activity was recorded for the operations of the vessels and, urgent surgical treatments, in case of gallbladder acute inflammation.
As it is clear from table 11, the average duration of hospital treatment was 3.8 days, and hospital mortality was 1.4%. The average duration of treatment for the patients with diseases of the blood circulation system was 3.8 days, and the hospital mortality rate was 2.7% (table 12).
Name of the disease Code by ICD Patients that have been discharged Bed days Average duration of treatment Hospital mortality rate
1 2 3 4 5 6 7
1. Infectious and parasitic diseases A00-B99 14 115 8.21 7.1
2. Tumors C00-D48 271 1243 4.59 1.5
3. Diseases of blood and blood-forming organs D50-D89 0 0 0
4. Endocrine system diseases T00-T90 90 441 4.9 7.8
5. Mental disorders F00-F99 5 18 3.6 0
Table 11.- Average duration of hospital treatment and hospital mortality, according to main classes of diseases (2015)
1 2 3 4 5 6 7
6. Nervous system diseases G00-G99 192 1584 8.25 1
7. Diseases of the eye and its appendix H00-H59 2 3 1.5 0
8. Ear and mastoid diseases H60-H95 3 7 2.33 0
9. Diseases of blood circulatory system I00-I99 2846 11087 3.9 2.7
10. Diseases of respiratory organs J00-J99 353 980 2.78 0.6
11. Diseases of digestive organs K00-K93 1071 4165 3.89 1
12. Diseases of the skin and subcel-lular cells L00-L99 69 321 4.65 1.4
13. Diseases of musculoskeletal system and connective tissue V00-V9*9 65 362 5.57 0
14. Diseases of the urogenital system N00-N99 463 1278 2.76 1.7
15. Pregnancy, childbirth and post-partum period C00-C99 2593 8223 3.17 0
16. Congenital anomalies Q00-Q99 4 27 6.75 0
17. R00-R99 R00-R99 45 146 3.24 0
18. Traumas, poisons and external causes S00-T98 393 2268 5.77 0.3
19. Total A00-T98 8479 32268 3.81 1.4
Table 12.- The average duration of hospital treatment for patients with diseases of the blood circulation system and features of rates of hospital mortality (2015)
Blood circulatory system diseases Patients, that have been discharged Bed days Average duration of treatment Hospital mortality
1. Diseases caused by increased blood pressure 413 892 2.2 0
2. Stenocardia 355 842 2.3 0
3. Acute heart attack 361 1738 4.8 5.5
4. Other types of acute ischemic heart attack 122 252 2.0 0
5. Chronic ischemic heart disease 419 1422 3.3 3.1
6. Vascular diseases of the brain 301 3103 10.3 10.6
7. Brain Infarction 259 2566 9.9 7.7
8. Other diseases of this class 916 2900 3.1 1.3
9. Total 2846 11087 3.8 2.7
Analyzing results of the annual data of 2016, it nificant changes, but the level of hospital mortality has been found, that the average duration of treat- has dropped dramatically (table 13). ment compared to the previous year has not had sig-
Table 13.- Average duration of hospital treatment and hospital mortality, according to main classes of diseases (2016)
Names of the diseases Code by ICD Patients, that have been discharged Bed daus Average duration of treatment Hospital mortality rate
1. Infectious and parasitic diseases A00-B99 15 138 9.2 20
2. Tumors C00-D48 596 3953 6.6 2.7
3. Diseases of blood and blood-forming organs D50-D89 7 14 2 14.3
4. Endocrine system diseases T00-T90 245 835 3.4 0.4
5. Mental disorders F00-F99 20 105 5.3 0
6. Nervous system diseases G00-G99 308 2025 6.6 0
7. Diseases of the eye and its appendix H00-H59 20 36 1.8 0
8. Ear and mastoid diseases H60-H95 30 101 3.4 0
9. Diseases of blood circulatory system I00-I99 4200 20886 5 0
10. Diseases of respiratory organs J00-J99 530 1646 3.1 0
11. Diseases of digestive organs K00-K93 1404 6092 4.3 0
12. Diseases of the skin and sub-cellular cells L00-L99 105 488 4.6 0
13. Diseases of musculoskeletal system and connective tissue V00-V9*9 797 3946 5 0
14. Diseases of the urogenital system N00-N99 875 2220 2.5 0
15. Pregnancy, childbirth and postpartum period C00-C99 3214 10680 3.3 0
16.. Congenital anomalies Q00-Q99 29 79 2.7 0
17. R00-R99 R00-R99 65 220 3.4 0
18. Traumas, poisons and external causes S00-T98 600 3839 6.4 0
19. Total A00-T98 13060 57303 4.4 1.7
■ on nervous system
■ on endocrine system
1 1,8 1,5 on the ear, throat, nose organs
■ on respiratory organs
■ The surgical insertion of an
cardiostimulator
■ Vascular surgery
■ on abdominal Organs
■ Organs on kidneys and urine
■ on prostate
■ on female genital organs
■ Obstetric surgeries on the musculoskeletal system
■ on breast
■ breast on skin and subcutaneous fibers
■ Other surgeries
Diagram 7. The structure of surgical interventions by basic causes
In 2016, 24,0% of surgical interventions, per- in 2016, that total percent of all performed surgeries
formed in Medical Center, were performed on the make 31.0%, and percent of endoscopic surgeries is
blood vessels, and 3,4% of them on heart (diagr.7). 26.6% (table 14).
We have analyzed the surgical activity of the medical center from 2011 to 2016. It turned out that
Table 14.- Surgical activity of Multi-profile Medical center from 2011-2016
Period Surgeries Endoscopic surgeries Surgeries, performed on abdomen
n % n % n %
2011 2487 8.8 161 8.7 492 10.8
2012 1609 5.7 142 7.7 476 10.4
2013 4527 16.0 332 18.0 771 16.9
2014 4998 17.7 346 18.8 804 17.6
2015 5875 20.8 372 20.2 921 20.2
2016 8779 31.0 490 26.6 1105 24.2
So the research confirms, that the latest technolo- improved treatment, reduced the average duration of gies introduced at the Multi-profile Medical Center treatment of patients, and reduced the level of hos-aimed at improving the quality of care, diagnostics, pital mortality.
To improving the quality and effectiveness of further medical care, it is required to invest more effective models of hospital care, and make refine-
ment of inter-hospital ambulant care, day care and advisory-diagnostic centers.
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