[The status of and outlook for improving the diagnosis of acute intestinal infections at the prehospital stage]. / Sostoianie i perspektivy sovershenstvovaniia diagnostiki ostrykh kishechnykh infektsii na dogospital'nom étape.

Comprehensive analysis of the incidence of acute enteric infections (AEI) in Moscow over the period of 1985-1990 was made. The analysis demonstrated serious drawbacks in the diagnosis of a number of AEI, including alimentary toxicoinfections, salmonellosis, dysentery, typhoid-paratyphoid diseases, Yersinia and Escherichia infections, and in rendering timely medical care of the patients at the prehospitalization stage. The analysis also revealed that in all AEI the outpatient and inpatient diagnosis still did not coincide in too many cases, and the diagnostic errors in recognition of surgical diseases in infectious patients were too frequent. This analysis also showed an increase in the number of cases of untimely hospitalization of AEI patients, which was the cause of severe and prolonged course of diseases and lethal outcomes. To improve the work at the prehospitalization stage, the following recommendations were made: to improve professional skills of medical personnel at all levels; to introduce differentiated hospitalization of AEI patients, with due consideration of the severity of the case and concomitant diseases and the patient's age; to organize hospital-type treatment at home, as well as to promote insurance medicine.