ORGANIZATION OF MEDICAL CARE DELIVERY TO CHILDREN WITH CONSEQUENCES OF PERINATAL CONDITIONS: PROBLEMS AND REGIONAL FEATURES

Abstract

Significance. Consequences of perinatal conditions do not have a clear definition, with the exception of lesions of the nervous system, for which there are certain classifications (2003, 2009). At the same time, perinatal conditions in the future may become a predictor of cerebral asthenia (36.0-72.0%); speech disorders (30.0-50.5%), mental retardation (30.0%); disorders of the emotional-volitional sphere (29.2%), early childhood autism (12.3%), problems of behavior and attention (7.7%); disorders of visual perception (20.0-30.0%) or hearing (6.0-7.0%), and according to some data, cognitive problems in adulthood. However, despite the developed criteria for implementation and needs, target indicators, available best regional practices, there are still problems in organizing medical care delivery to children suffering from consequences of perinatal conditions. Purpose of the study: to analyze the existing problems related to the organization of medical care deliver to children with consequences of perinatal conditions at the regional level. Material and methods. Continuous single-stage study in medical organizations of the Arkhangelsk region. Respondents included parents of children with consequences of perinatal conditions with disabilities, aged 8-12 years (ntotal = 162, ntest = 62). Data processing was carried out in the STATISTICA 13 program using descriptive statistics (calculation of M, Me, SD, 95% CI), correlation analysis to identify the relationship between the considered characteristics at p ≥ 0.05, and Student's t-test to determine statistical significance of differences. Results. In the structure of perinatal conditions associated with disability in children, diseases of the nervous system dominated - 62.90% (n = 39), followed by mental disorders - 16.13% (n = 10), with congenital malformations ranking third (6.45%; n = 4). The greater the time lag between the time of the disease diagnosis associated with disability and the disability itself, the worse the physical and mental functioning of the child (11.80±6.60 and 11.52±6.72; p = 0.0001), and the less pronounced the psycho-emotional and social disorders (8.29±6.09 and 6.80±5.36; p = 0.0000001). Being under medical follow-up directly affected the child rehabilitation (t= 3.61; p = 0.0006; r = 0.40 at p ≤0.05). At the same time, only 55.84% of the children (n= 34) had an individual follow-up program or the program was developed prior to going to kindergarten and/or school. Conclusion. The analysis shows a number of problems related to medical care delivery to children with consequences of perinatal conditions: untimely registration for medical follow-up; disruption of the schedule of appointments with narrow specialists, envisaged by the current Procedure