Introduction of methodology for assessing the quality of medical examination of adult population in system of internal control of quality and safety of medical activities

INTRODUCTION: It is reasonable that the realization of the state project of medical examination of adult population (MEAP) be assessed simultaneously with the assessment of the quality of medical care, and be integrated into the internal control of quality and safety of medical activities. The process approach is effective in realization of quality control of medical care provided as part of MEAP.

AIM: To develop and introduce the methodology of assessing MEAP quality, to assess the results of expertise conducted at the initial stage of MEAP introduction, and on the basis of the results of introduction of measures that improved MEAP organization.

MATERIALS AND METHODS: To assess the quality of MEAP, the ‘Expert Assessment Card for a Medical Examination Case’ was developed and introduced using the integrated quality assessment method. The assessment was carried out according to the blocks of the Card developed by I. V. Uspenskaya and O. N. Selyavina in accordance with the adopted assessment scale (0–0.5–1). The expertise of MEAP cases was carried out twice: in 2013 at the initial stage of realization of MEAP according to the new procedure, and in 2018 on the basis of the results of the realization of measures to improve the organization of MEAP.

RESULTS: Comparative analysis of defects identified at the initial stage of the medical examination in 2013 and as a result of the work performed for the introduction of the quality control system of medical examination cases in 2018, revealed a marked decrease (by 27.0%) in the defects in determining risk factors for chronic non-communicable diseases and indications for prescribing II stage MEAP measures. For other defects, a marked decrease by 5.2%–17.3% was revealed. Nevertheless, the leading positions were retained by defects in prescribing stage II measures (34.5% of the analyzed expert cards) and in determining risk factors for chronic non-communicable diseases (26.5% of the analyzed expert cards), which requires continuation of the work on MEAP control quality as part of the internal control of quality and safety of the medical activities.

CONCLUSION: Expert integration of the assessment of organization and introduction of MEAP and of the internal system of control of the quality and safety of medical activities led to a reliable reduction of the number of defects according to the results of expert assessment of medical examination cases.