Научные статьи \ Прикладные науки. Медицина. Технология \ Mедицинские науки \ Патология. Клиническая медицина \ Заболевания опорно-двигательной системы. Скелет и мышечная система

Организация оказания медицинской помощи пациентам с заболеваниями позвоночника: опыт зарубежных стран (систематический «scoping»-обзор)

Организация оказания медицинской помощи пациентам с заболеваниями позвоночника: опыт зарубежных стран (систематический «scoping»-обзор)

Автор: Дулаев Александр Кайсинович, Кутянов Денис Игоревич, Желнов Павел Викторович, Брижань Сергей Леонидович

Журнал: Гений ортопедии @geniy-ortopedii

Рубрика: Обзор литературы

Статья в выпуске: 4, 2020 года.

Бесплатный доступ

Цель. Изучение современного состояния и направлений совершенствования организации оказания медицинской помощи пациентам с заболеваниями позвоночника в экономически развитых странах Западной Европы и Северной Америки. Материалы и методы. Поиск материалов проводился в период с 2016 по 2020 г. в библиографических (Scopus, PubMed и др.) и диссертационных базах, на сайтах организаций и в других «серых» источниках, а также в библиографиях работ; глубина отбора информации - 27 лет (начиная с 1994 г). При оформлении обзора руководствовались рекомендациями PRISMA-ScR и PRISMA-S (препринт). Расширенное хронологическое описание методологии исследования доступно в репозитории данного обзора (https://doi.org/10.17605/OSF.IO/5JGN4). Результаты. Наибольшее внимание исследователей сосредоточено на организации первичной медико-санитарной помощи, особенно - в плане улучшения эффективности медицинской сортировки таких больных и обоснованности назначения им высокотехнологичных методик лучевой диагностики. Для реализации этих задач перспективным оказалось привлечение не только врачей общей практики, но и среднего медицинского персонала при обязательном условии получения ими соответствующей профессиональной подготовки. В то же время степень разработанности вопросов организации оказания стационарной медицинской помощи, в том числе определения роли специализированных отделений и центров спинальной хирургии в системе лечения больных рассматриваемой категории остается незначительной, что становится особенно заметным на фоне аналогичного аспекта проблемы позвоночно-спинномозговой травмы. Особенно жестко проблема организации диагностического поиска и последующего консервативного и хирургического лечения ощущается в сфере оказания специализированной медицинской помощи пациентам с острыми заболеваниями позвоночника, где нехватка научно обоснованной информации делает принятие эффективных управленческих решений крайне затруднительным. Заключение. На сегодняшний день существует необходимость дальнейшего научного поиска с целью создания практических клинико-организационных рекомендаций, учитывающих как уже накопленный научный опыт, так и особенности применяемых в конкретных условиях организационных и клинических подходов.

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Заболевания позвоночника, организация медицинской помощи, медицинская сортировка, врач общей практики, средний медицинский персонал, лучевая диагностика, хирургическое лечение, центр хирургии позвоночника

Короткий адрес: https://sciup.org/142226219

IDR: 142226219   |   УДК: 616.711.9:614.812:303.425(048.8)   |   DOI: 10.18019/1028-4427-2020-26-4-607-615

Healthcare resources to care for spinal conditions: international experience (a systematic scoping review)

Objective Review emerging trends within healthcare sectors internationally to care for spinal conditions in developed Western European and North American countries. Material and methods An explorative review of electronic bibliographic (Scopus, Pubmed, etc.), thesis and dissertation database, organization websites, grey literature resources and reference lists of relevant papers was undertaken to identify the key publication outlets for relevant content between 2016 to 2020. In the present review, the depth of the search was 27 years (post 1994). This review utilized a methodology structured using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR and PRISMA-S preprint) checklist with the description available on https://doi.org/10.17605/OSF.IO/5JGN4. Results The researchers explored the conditions for strong primary spine care providing effective measures and strategies in streamlining patients and examined the appropriateness of referrals for high-technology imaging assessment. Primary care with its integrative function is provided by professionals with specialized training including general practitioners and nurses. Guidance on the management and standards of inpatient care for a diverse and complex range of conditions are of concern with a focus on specialized spinal services providing invasive management strategies for traumatic spinal cord injuries, in particular. Direct access to diagnostic procedures is essential at specialised spinal services providing conservative and surgical management for a acute spinal diseases with the decision making process and care for this group of patients being very complex with little support of evidence based medicine sources. Conclusion Significant input from clinical and support services is required to provide clinical practice guidelines based upon the best available research evidence and practice experience with a greater range of approaches and techniques.

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