[Research of medical social effectiveness of family care to elderly patients with chronic limb ischemia.]

Abstract

Forms of family assistance to elderly patients with chronic limb ischemia (CLI) are based on the communication motivation of the subjects of the system «patient-family-doctor» and activation of the medical function of the family. Objective - to research the medical social effectiveness of family care for elderly patients with CLI. Objects of the research (2017-2024): patients with stage 2A-3 CLI (n=615), average age 76±5,8 years; family members of patients participating in integrated (joint) consultations with the sick relative. Patients were divided into 2 groups: group A - 513 patients with stage 2B-3 CLI with indications for surgical treatment of CLI; group B - 102 patients with stage 2A-2B CLI without indications for surgical treatment of CLI. The research of the medical function of the family was carried out on the basis of the experience of the specialized department using a special questionnaire. The observation period was 24 months. The share of primary integrated consultations in group A was 42%, in group B - 17,6% (p=0,001). After 24 months follow up, increase of integrated consultations in group A was 16,7%, in group B - 161,4%. Medical social effectiveness of family care for elderly patients was achieved in the processes of accessibility of medical care, controlled dispensaryzation, compliance to physician's recommendations and survival. 2-year survival of patients was 98,05% (in group A - 97,9%, in group B - 100%). Medical social efficiency of pre-medical family care for elderly patients with CLI is based on the autonomous and controlled behavior of the system subjects «patient-family-doctor», professional competence of cardiovascular surgeons, information management of dispensarysation and activation of the medical function of the family.