The new approaches to the quality control of the phthisiologycal medical care in the city of Moscow

Abstract

The results of the new approaches to the quality and the safety control of the phthisiologycal medical care in Moscow Scientific and Clinical Center for TB Control are presented. The three-level system of the internal control was established, includes The Central Medical
TB Board (with subcommittees on TB in children and adolescents, on extra-pulmonary TB, on thoracic surgery, on MDR-TB) and medical boards in districts of the city of Moscow. In 2013 г. 4133 patients were considered, more than 50% – for TB verification, 30% – for treatment regimens confirmation and about 20% – in other reasons.
The centralized management control improvement enabled the good results of the new TB patients treatment (lung destruction repair in 82,5%, sputum conversion – in 93,8%, clinical recovery – in 48,6%). However the treatment success in MDR TB patients cohort-2011 was 35,0%, at that in new cases – 55,2% and in re-treatment cases appreciably low: 41,5% in relapses and 19,9% – in other cases. So, the strengthening of the management in these patients is essential.
In 2013 260 claims were obtained, include 133 about medical care quality, 17,3% of them were allowed. By patients’ anonymous questionnaires, the satisfaction with quality of care rate is 92,0%.
Implementation of the system of interior quality and care safety control, developed on the basis of internal regulations and reporting forms, allowed to improve quality indicators of the Center activity and to increase patients’ satisfaction with the quality of medical services.