ASSESSMENT OF THE HEALTH CARE QUALITY AT THE PRIMARY LEVEL FOR PATIENTS WITH PSORIASIS: EVALUATION OF VOLUME AND ADEQUACY OF THE THERAPEUTIC AND PREVENTIVE MEASURES

Cherkashyna L. V.

SOCIAL MEDICINE AND ORGANIZATION OF HEALTHCARE PROTECTION

Scentific article

The level of therapeutic and preventive measures implementation at the primary healthcare stage was evaluated for 110 patients with psoriasis of various severity course. Considering the process for providing the effective therapeutic and preventive measures as multicomponent system, the methodology of the system approach, assessment and analysis have been determined. To obtain the integrated assessment of the therapeutic and preventive measures quality, the indicators of the system arrangement were used, for which the entropy index (h, bit) of each indicator was calculated in each clinical group of patients. At the same time, the entropy value of the quality indicator (h, bit) was determined by the formula h = -k × log2k, where k is the frequency of use a particular type of therapeutic and preventive measures, and the value of the generalized quality indicator (H, bit) for each of two groups of therapeutic and preventive measures was determined by the formula H = n- (h1 + h2 + h3 + ... + hn), where n is the quantity of rating indicators in the corresponding component. It was revealed that the completeness of the drug-free agents application by the general practice family medicine doctors in the period between psoriasis exacerbations according to the generalized quality indicator was at the level of (50.3 ÷ 58.8)%; it was characterized by insufficient use of adaptogens before the period of exacerbation – in (73.0 ± 5.6) %, natural sedatives − in (81.0 ± 4.9)%, methods of autotraining with psychocorrection elements − in (79.4 ± 5.1)%, and also nonspecific stimulating prophylaxis methods − in (71.4 ± 5 7)% of patients. The completeness of the use of pharmacotherapeutic agents in the period between psoriasis exacerbations by the general practice family medicine physicians was at the level of (58.3 ÷ 60.5)% and was characterized by the low level of magnesiumcontaining drugs administration − in (70.9 ± 4.3)%, detoxification drugs − in (68.2 ± 4.4)%, and also sorbents − in (44.5 ± 4.7)% of patients. The analysis of generalized indices-indicators of the therapeutic and preventive measures quality in the period between the psoriatic disease exacerbations determined that the general practice family medicine doctors administered pharmacotherapeutic agents more often than drug-free measures and underestimated the importance of non-pharmacological agents, especially those which correct the psycho-physiological state of patients with formation of long-term and constant self-control of CD.

general practice – family medicine, healthcare quality, therapeutic and preventive process, chronic dermatosis, psoriasis

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«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 324-327 pages, index UDK 616.517-092: 616.1/8 - 036.12 - 06: 616.85:612.26.015.11

10.29254/2077-4214-2018-4-2-147-324-327