D.B. Solomchak

Analysis of organization the surgical care to patients with urolithiasis in healthcare facilities of different levels and ownership

To evaluate the organization of surgical care to patients with urolithiasis in healthcare facilities of different levels and forms of ownership there was conducted peer review of inpatients medical records of private healthcare facility (108 units.), six central district hospitals (625 units.) and the regional hospital (157 units.). It was established that the indexes of surgical care to patients with urolithiasis correspond to the modern requirements only in private medical institution, where all patients were hospitalized for surgery with the innovative methods with the minimum waiting period for surgery (0,3 days) and average length stay in hospital (1,4 days). It was found that in regional hospital not all patients with urolithiasis have the surgery done (surgical activity - 78,3%), and significant part of surgeries are obsolete or palliative (22,4%) or could have done in outpatient conditions (12,9%). In addition to these facts, the long waiting time for surgery (1,9 days) and average length stay in hospital (8,1 days) point out the significant reserves of diagnostic and treatment process improvement. It is shown that in regional urological in-patient units only 9,3% of patients with urolithiasis have surgery done (60% of which according to all signs have endured the interference not in these healthcare settings) with the longest waiting period for surgery (5,3 days) and the average length stay in hospital (11,4 days). Eventually the further maintenance of specialized urological care in most hospitals of secondary level is unreasonable.