Aim. To assess the possibility of using indicators of potentially preventable hospitalizations of cardiovascular diseases to assess the quality of medical care. Methods. Indicators of quality of cardiovascular disease treatment were formed based on the analysis of literature, current clinical recommendations and the structure of potentially preventable hospitalizations in the districts and cities of the Republic of Tatarstan. The proposed indicators were studied in the districts of the Republic of Tatarstan in 20112015. Results. It is revealed that the distribution of indicator values in the regions of the Republic of Tatarstan differs from normal and is characterized by high variation. Median, minimum and maximum of hospitalization levels for hypertension in 2015 were 8.4, 1.3 and 26.8 respectively; unstable angina, myocardial infarction 2.2, 0.02 and 8.6. Indicators for hospitalization due to stable angina, chronic ischemic heart disease also had a high level of variation (6.3, 0.2 and 17.4). As criteria for quality and optimal use of resources, it is proposed to use nonparametric estimates, one of which is the upper quartile. According to this study, in 2015, upper quartile for hypertension was 11.2; for unstable stenocardia, myocardial infarction 3.4; for stable angina, chronic ischemic heart disease 8.6. Conclusion. The results of this study prove that indicators of potentially preventable hospitalizations may be part of a comprehensive assessment of the quality of care.

GOALAcute myocardial infarction is one of the causal factors of society and economic losses of companionship. Success in the treatment of acute myocardial infarction raises questions on the effective rehabilitation of the first places. New methods, clinical guidelines and standards have been introduced into clinical practice. However, the effectiveness of rehabilitation in the Russian Federation lower than developed countries. The present study was aimed to improve rehabilitation care to patients after acute myocardial infarction. Analysis of the effectiveness of rehabilitation and pharmacoepidemiological studies was conducted on the basis of a medical spa facility in 2006 and 2009.MATERIAL AND METHODSExperts form and database were developed to achieve the objectives. Quantitative assessments were carried out on the basis of the developed quality indicators. We used pharmacoepidemiological and statistical methods in the study.RESULTSMyocardial infarction was often combined with hypertension (73.8% and 61.9%) and chronic heart failure (87.6% and 85.8%). Patients had a high prevalence of risk factors: smoking (46.1% and 42.3%), overweight (53.8% and 67.2%), dyslipidemia (44.6% and 66.1%) in 2006 and 2009, respectively. Rehabilitation includes physical exercise, mineral baths, swimming pool. The average number of drugs of rehabilitation stage was 4,46±0,12 and 4,11±0,11. Beta-blockers are indicated for all patients after acute myocardial infarction, and they were prescribed in 86.1% and 90.1% of cases. Drugs affecting renin-angiotensin system were in second place frequency of prescribing. These drugs are prescribed in 67.6% and 41.7% patients. The frequency of prescribing of statins increased by 5.8 times from 2006 to 2009 and reached 81.32%.CONCLUSIONRehabilitation and pharmacotherapy in patients after acute myocardial infarction corresponds to the principle evidence-based medicine. However, the list of use drugs was narrow, and the doses were lower than recommended by current clinical guidelines. These facts may indicate a deficiency of awareness of doctors around the characteristics of drug usage. Standards of health - resort treatment and rehabilitation of patients after myocardial infarction is limited and their revision is required based on existing clinical guidelines and evidence-based medicine.

Одними из приоритетных задач современной клинической фармакологии являются повышение безопасности и рациональности фармакотерапии. Доступным инструментом оценки рациональности фармакотерапии на уровне медицинского учреждения является проведение ABC/VEN анализа. Однако до настоящего времени интерпретация его результатов и использование их в системе принятия управленческих решений до конца не разработана. В настоящей работе проведена оценка показателей ABC/VEN анализа учреждения здравоохранения за десятилетний период. Проведено сравнение долей «жизненно важных» и «необходимых» лекарственных препаратов при различных условиях финансирования учреждения здравоохранения. Предложены критерии рациональности фармакотерапии и использования ABC/VEN анализа для совершенствования формуляра лечебного учреждения. Дано обоснование возможности перевода формуляра лечебного учреждения из рекомендательного в инструмент регулирования.

Optimization of pharmacotherapy, as improving the quality of care is an important goal of modern medicine. The solution to this problem can be realized with the development and adoption of clear formal criteria. Using aprocess-based approach, we have developed a method for detecting defects in pharmacotherapy. We have analyzed the prospects of using this approach to research the quality of pharmacotherapy in health care and the formation of national programs to improve the quality of care.