Problems and solutions on issues of medical care quality in community-acquired pneumonia in hospitals of Saratov region

Qualitative assessment of diagnostics and treatment of patients with community-acquired pneumonia (CAP) was carried out in ten therapeutic departments of urban and district hospitals of Saratov region, using quality indicators (Qls). Each case of CAP was assessed in expert health care quality (HCQ) card according to the diagnostic and treatment quality federal standards and the basic Ql. The application of Ql in CAP patients allowed revealing the following: low CAP agent isolation rate; late hospitalization of CAP patients; low frequency of sputum bacteriological and bacterioscopic investigations prior to antibiotic therapy; insufficient frequency of step-by-step introduction of antibiotics. Recommendations on CAP patients dispenserization were not properly prescribed; recommendations on vaccination were absent. The basic measures of HCQ improvement are as follows: organizing for each CAP patient therapeutic and diagnostic quality control according to Ql; quick administrative decisions; using of HCQ expertise during the first 2-3 days of treatment to correct diagnosis and treatment; optimizing hospital diagnostic resources (laboratory and instrumental) and rational pharmacotherapy