CERTAIN APPROACHES TO EFFICIENCY EVALUATION OF THE REGIONAL TB SERVICES
https://doi.org/10.21292/2075-1230-2017-95-12-28-34
Abstract
The goal of the study is to perform the comprehensive assessment of the efficiency of regional TB services based on the analysis of certain indicators reflecting accessibility and quality of tuberculosis care.
Subjects and Methods. This study used data of medical statistics on tuberculosis and demography. Processing and analysis were performed using Big Data, methods of descriptive statistics, correlation and cluster analysis.
In Primorsky Kray, where TB situation is much worse compared to the overall situation in the Russian Federation, the quality of tuberculosis care differs significantly depending on the municipality. Based on the rates reflecting the burden of tuberculosis and treatment efficiency using hierarchical clustering and k-means, 4 clusters of municipalities were identified having different levels of the above rates. The availability of human resources for tuberculosis care was assessed for each of 4 clusters. It was found out that clusters with a high burden of tuberculosis were characterized by poor human resources availability for all the rates and vice versa. The results of the study allowed concluding that human resources availability for tuberculosis care was a crucial factor providing an impact on the efficiency of TB services performance.
Keywords
About the Authors
I. B. GeltserRussian Federation
Boris I. Geltser – Far Eastern Federal University. Doctor of Medical Sciences, Professor, Correspondent Member of RAS, Director of Fundamental and Clinical Medicine Department, Biomedical School.
2, Sukhanova St., Vladivostok, 690091
K. I. Shаkhgeldyan
Russian Federation
Karina I. Shakhgeldyan – Doctor of Technical Sciences, Director of Information Technology Institute;
E. V. Krivelevich
Russian Federation
Evsey B. Krivelevich – Candidate of Medical Sciences, Professor of Public Health Department .
2, Ostryakova Ave., Vladivostok, 690002.
V. I. Medvedev
Russian Federation
Vladimir I. Medvedev –Candidate of Medical Sciences, Doctor of Statistics Unit Honored Doctor of Russia.
2, Pyatnadtsataya St., Vladivostok, 690041
M. Z. Ermolitskаya
Russian Federation
Marina Z. Ermolitskaya – Candidate of Biological Sciences, Associate Professor of Information Technology and Systems Department
41, Gogolya St., Vladivostok, 690014
References
1. Volkova M.V., Shakhgeldyan K.I., Geltser B.I., Krivelevich E.B., Trankovskaya L.V., Ermolitskaya M.Z., Kucherova S.V. Analysis of human resources of health care system of Primorsky Kray. Tikhookeansky Med. Journal, 2016, no. 3, pp. 84-88. (In Russ.)
2. Gosudarstvennaya programma «Razvitie zdravookhraneniya» v 2013-2020 gg. [State program of health care development in 2013-2020]. https://www.rosminzdrav.ru/ministry/programms/health/info. (Accesses as of March 1, 2017).
3. Lindenbraten A.L. Theoretical and practical aspects of health care quality management. Menedjment Kachestva v Sfere Zdravookhraneniya i Sotsialnogo Razvitiya. 2012, no. 3, pp. 23-26. (In Russ.)
4. Korablev V.N. Osnovy sovremennogo menedzhmenta vo ftiziatrii. [Basics of modern management in tuberculosis control]. Khabarovsk, Izdatelstvo Kraevoy Klinicheskoy Bolnitsy Khabarovskogo Kraevogo Tsentra Psikhicheskogo Zdorovya Publ., 2000, 202 p.
5. Kornachev А.S., Golubev D.N., Rebeschenko А.P. Assessment of tuberculosis epidemics activity and performance of tuberculosis control service in its prevention in the regions supervised by Ural Research Institute of Phthisiopulmonology in 1995-2009. Upgrade of the epidemic surveillance system. Ftisiatriya i Pulmonologiya, 2011, no. 1, pp. 74-89. (In Russ.)
6. Krivelevich E.B., Shakhgeldyan K.I., Geltser B.I., Trankovskaya L.V. Assessment of human resources efficiency of the regional tuberculosis control service. Tikhookeansky Med. Journal, 2016, no. 4, pp. 77-80. (In Russ.)
7. Orlov E.M., Sokolova O.N. The category of efficiency in the health care system. Fundamentalnye Issledovaniya, 2010, no. 4, pp. 70-75. (In Russ.)
8. Tuberkulez v Rossiyskoy Federatsii 2012, 2013, 2014 g. Аnaliticheskiy obzor statisticheskikh pokazateley, ispolzuemykh v Rossiyskoy Federatsii i v mire. [Tuberculosis in the Russian Federation in 2011, 2013. 2014. Analytic review of statistic rates used in the Russian Federation and in the world]. Moscow, 2015.
9. Federal Law no. 323 as o 21.11.2011 On Basics of Health Care for the Population in the Russian Federation, Art. 10. (In Russ.)
10. Flakh P. Mashinnoe obuchenie. Nauka i iskusstvo postroeniya algoritmov, kotorye izvlekayut znaniya iz dannykh. [Computer-aided training. The art of building algorithms, extracting knowledge from data]. Moscow, DMK PRESS Publ., 2015, 400 p.
11. Central Research Institute for Public Health Organization and Informatization. http://mednet.ru/index.php (Accessed as of February 26, 2017).
12. Davies D.L., Bouldin D.W. A cluster separation measure. IEEE Transactions on Pattern Analysis and Machine Intelligence. 1979, vol. 1, no. 2, pp. 224-227.
13. Elastic. We're About Data. Available at: https://www.elastic.co/ (Accessed as of February 26, 2016).
14. Gulliford M., Figueroa-Munoz J., Morgan M., Hughes D., Gibson B., Beech R., Hudson M. What does 'access to health care' mean? J. Health Service Research Policy, 2002, no. 7, pp. 186-188. DOI: 10.1258/135581902760082517.
15. RStudio. Available at: https://www.rstudio.com/ (доступ 26 июля 2016 г.).
16. Leferbvre N., Falzon D. Risk factors for death among tuberculosis cases: analysis of European surveillance data. Eur. Respir. J., 2008, vol. 31, no. 6, pp. 1256-1260.
Review
For citations:
Geltser I.B., Shаkhgeldyan K.I., Krivelevich E.V., Medvedev V.I., Ermolitskаya M.Z. CERTAIN APPROACHES TO EFFICIENCY EVALUATION OF THE REGIONAL TB SERVICES. Tuberculosis and Lung Diseases. 2017;95(12):28-34. (In Russ.) https://doi.org/10.21292/2075-1230-2017-95-12-28-34