ORGANIZATION OF NEUROSURGICAL CARE IN A LARGE CITY (ON THE EXAMPLE OF SAINT РETERSBURG)

Abstract

The author presents the analysis of the structure of neurosurgical patients in in-patient departments of Saint-Petersburg in 2021. Parameters of in-patient and out-patient units and the status of neurosurgical care staffing were studied. The urgency of the investigation is determined by high level of nervous system morbidity and necessity of increasing quality and effectiveness of the neurosurgical service activity. The total and primary morbidity rates in the end of 2021 in St. Petersburg were 51.9 and 5.5‰, respectively. Transportation accidents became the leading external causes of morbidity and mortality. Twenty-three percent of discharged patients were diagnosed with episodic and paroxysmal disorders. The average duration of a patient’s stay in a neurosurgical department was 8.8 days. The provision of the population with profile beds was 9,90/0000, but the inpatient units showed overload activities (the average duration of a bed exceeded 340 days and the capacity of the inpatient unit was more than 100%). The average duration of bed work was 359 days per year, the average duration of treatment per patient was 8.8 days, bed turnover was 35.9, and mortality rate was 1.7%. There were 23% of patients under outpatient observation. Specialized out patient care is underdeveloped. The staffing level was 83.5% (83.7% in the inpatient unit, 75% in the outpatient unit). The coefficient of compatibility was 1.2. The highest qualification category was presented by 30,2% of doctors, the first category — by 13,2%, the second — by 5%; 51,7% of doctors-neurosurgeons were not certified.