Regional features of hospitalizations and outpatient medical care among adults with established hypertension

Abstract

Aim. To analyze the indicators of hospitalization and outpatient visits of patients aged 18 years and older with hypertension (HЕТ) in federal districts (FD) and subjects of the Russian Federation from the perspective of the World Health Organization concept of ambulatory care sensitive conditions. Material and methods. The analysis included data from the annual forms of federal statistics (forms № 12 and № 14), on the number of hospitalizations and the outpatient visits of patients aged 18 years and older diagnosed of HTN (ICD10: I10-I12) in 2022. Results. We analyzed the data of the federal statistics (forms № 12 and № 14) of the FDs and subjects of the Russian Federation in 2022. It was found that the Siberian FD has one of the highest rates of adult outpatient visits with HЕТ aged 18 years and older, where, at the same time, one of the lowest rates of hospitalizations is recorded. In FDs with adult outpatient visits higher than the Russian average, there were higher adult hospitalization than the Russian average (Ural, Central and Volga FDs). In FDs with adult outpatient visits lower than the Russian average, there were higher adult hospitalization than the Russian average (South, North Caucasus and Far East FDs). In the Northwestern FD, adult outpatient visits and adult hospitalization were lower than the Russian average. When analyzing the HTN ratio among the adult population aged 18 years and older, the highest indicator was recorded in the North Caucasus FD, while the heterogeneity of the indicator within the FD was one of the highest among the other FDs. The lowest HTN ratio indicator among the adult population aged 18 years and older was recorded in the Ural FD, while the heterogeneity of the indicator within the FD was the lowest among the other FDs. There was a high variability of the ratio both for all subjects of the Russian Federation and FDs. The ratio values ranged from 1,2 in the Nizhny Novgorod region to 12,26 in the Republic of Dagestan. Conclusion. Accounting for diseases that can be treated on an outpatient basis can help to assess the quality of care to the adult population in primary health care facilities. However, before including this indicator as a quality criterion, a deeper understanding of the reasons influencing its change is required.