NATIONAL EXPERIENCE OF CREATING AND IMPLEMENTING MEDICAL STANDARDS IN CASE EVIDENCE APPEARS «LATER¼ (DURING THE COVID-19 CORONAVIRUS DISEASE PANDEMIC).

OBJECTIVE: The aim: Identification of methodological processes to accelerate the development of clinical guidelines in an emergency situation (in particular, coronavirus disease COVID-19), analysis of the practice of implementing clinical guidelines and clinical pathway. PATIENTS AND METHODS: Materials and methods: The processes of developing COVID-19 clinical guidelines are described on the websites of the developers. Implementing the patient's own clinical pathway. Survey of 117 health professionals involved in medical care at COVID-19 on management information. A retrospective pragmatic study of organizational and clinical aspects of medical care for 9,259 patients over 18 years with COVID-19 from March 18, 2020 to March 31, 2021. RESULTS: Results: Acceleration of the methodology of clinical guidelines, changes in legislation have contributed to the improvement of medical care for patients with COVID-19. Clinical pathway (CPw) professionals surveyed: 88.2% satisfied with the structure of CPw, 91.0% were in favor of local instructions and explanations, templates of registration forms, 72.7% needed on-the-job training, 78.1% needed training on medical features, 74.5% noted the positive impact of remote interaction, 61.6% required standard operating procedures. 9259 patients with suspected COVID-19 confirmed PCR in 55.2%. Among those checked, 31.2% of chest computed tomography confirmed pneumonia in 95.7% of CT; 9.3% were hospitalized; fatalities 5.5% of hospitalized or 0.5% of verified. CONCLUSION: Conclusions: Changes in the methodology of clinical guidelines, changes in legislation, education based on clinical guidelines have contributed to improving the results of management in COVID-19.

RESULTS OF MEDICAL-SOCIAL RESEARCH ON MEDICAL CARE QUALITY FOR PATIENTS WITH COVID-19 OF INPATIENT HOSPITAL DEPARTMENTS IN SUMY REGION.

OBJECTIVE: The aim: The aim of the study is to assess the quality of medical care and determine the relationship between treatment outcomes of patients and acute respiratory viral infectious disease caused by SARS-CoV-2,depending on patients` age, the time from onset of symptoms to hospitalization, and the presence of comorbidity. PATIENTS AND METHODS: Materials and methods: According to the specially designed form, a retrospective analysis of primary accounting documents was carried out (f. No. 103/o) in 158 patients with COVID-19. The research was carried out in specialized inpatient infectious diseases wards of health institutions of the Sumy region during the period from April to September 2020. The study used a systemic approach, bibliosemantic, comparative and statistical analyses, logical generalization methods. RESULTS: Results: Among the study group of patients, namely 158 people, a bigger number of women (56.33±3.95%) than men (43.67±3.95%) were recorded. Patients of working age (from 18 to 64 years old) took 70.89±3.61% of all patients, and people aged 65 years and older - 29.11±3.61%. The time from the beginning of symptoms to hospitalization in each second patient (49.37±3.98%) lasted 5-7 days. In most cases, the patient's stay in the hospital equaled 13-15 bed-days - 32.28±3.72%. The index of patients with severe and critical state was 20.89±3.23% (33 patients). In 8.23±2.19% (13 people) of treated cases of hospital stay ended in death. A large index of patients with a severe course of the disease, the treatment of which ended in discharge, were in hospital for more than 13 bed days - 12.03±2.59% (19 people). All of these patients were older, had CNCDs (chronic non-communicable diseases), half of them were hospitalized on day 7 and later from the onset of symptoms. CONCLUSION: Conclusions: In older people, the disease progresses faster and complications are developing more often. Also, the severity of the SARS-CoV-2 pattern and the length of staying in the hospital are affected by the time starting the onset of symptoms till hospitalization and the presence of CNCDs. The hereinafter data allows to increase knowledge about spreading of COVID-19, to improve the quality of organizational and preventive events in the provision of medical care, and reducing mortality.