ABSTRACT
Purpose. To present the practical experience of using databases of circulatory diseases patients in the Brest region by example of atrial fibrillation and to demonstrate the impact of structuring and analysis of information acquired on the quality of care in patients with atrial fibrillation, including the dynamics of medical and demographic indicators as a criterion for implementing the State Action Plan program "Health of the Nation and Demographic Security" for 2021–2025. Materials and methods. A sample of 200 subjects was generated as a pilot project based on materials of the experimental computerized database of patients with atrial fibrillation under dynamic outpatient follow-up in Baranovichi interdistrict cardiological center of the central polyclinic of the city of Baranovichi using the method of random non-repetitive selection. This amounted to 9.2% of all patients with atrial fibrillation under observation during the study period in this health care institution (a total of 2,164 patients). Based on the materials of the database, the results of the monitoring of prophylactic treatment measures related to anticoagulants intake and achievement of target international normalized ratio (INR);complications and mortality in atrial fibrillation;atrial fibrillation form ratios;presence of concomitant pathologies and their impact on the course of underlying pathology, including in those in the regions with significant deviations in social and economic (disability, hospitalization time, re-hospitalization) and medical and demographic variables (mortality, lethality, morbidity due to acute cerebral circulation disorders) indicators were evaluated. The dynamics of morbidity and in-hospital mortality due to acute cerebral circulation disorders during the period from 2010 to 2019 was studied and demonstrated, and the cost-effectiveness of implemented medical and organizational measures was calculated. Results. As shown by the analysis of the database on the example of Baranovichi region, the absence of control over dynamics of INR, HR, BP values while using anticoagulants affected the final results: although this group drugs were administered in 85% of cases, only 40% of target values were achieved in the study group patients;whereas in male patients this indicator was two times lower than in female patients, indicating low commitment both to treatment and to monitoring of the target values achievement. A particular attention should be paid to the prevention of thromboembolic complications at the present stage in patients who underwent COVID-19 infection, since the proportion of complications in this category of patients is rather high. As a result of the organizational experiment carried out in health care institutions following the example of Baranovichi Interdistrict Cardiological Center (hereinafter referred to as IRCC), the overall incidence of cerebral infarction in the general adult population of Brest region for the period from 2016 to 2020 decreased from 40.8 cases per 10 thousand population to 32.9 cases, respectively. The calculated cost-effect of organizational measures for the analyzed period is approximately 2,462,600 Belarusian rubles. Conclusion. The algorithm we developed could be used as a basis in the practice to create a registry of patients with atrial fibrillation. The use of such a register is necessary for monitoring the quality of their medical care, and it provides an opportunity to affect medical and demographic indicators in the region, determined by circulatory system diseases as a major socially significant pathology. © 2022, Professionalnye Izdaniya. All rights reserved.