On the effectiveness of inpatient treatment of children with comorbid pathology
- Autores: Konovalov O.E.1, Modestov A.A.2, Ulishchenko I.A.3, Gudkov R.A.4
-
Afiliações:
- D. Sci. (Med.), Prof., Department of public health, healthcare and hygiene, Peoples’ Friendship University of Russia, Moscow, 118190, Russian Federation. E-mail: konovalov_oe@mail.ru
- N.I. Pirogov Russian National Research Medical University
- Russian Peoples Friendship University
- I.P. Pavlov Ryazan State Medical University
- Edição: Volume 64, Nº 2 (2020)
- Páginas: 76-82
- Seção: CHILDREN AND ADOLESCENTS’ HEALTH
- ##submission.dateSubmitted##: 25.10.2024
- URL: https://hum-ecol.ru/0044-197X/article/view/637520
- DOI: https://doi.org/10.46563/0044-197X-2020-64-2-76-82
- ID: 637520
Citar
Texto integral
Resumo
Introduction. A comprehensive approach in providing of medical aid to a child with comorbid pathology is intended to mean that child receives high-quality diagnostics, treatment, rehabilitation and informational support in the full extent in regard to all the diseases child has. The main problems of this category of patients are need of expanding treatment and diagnostic activities, attracting of consultants and also increasing of resource costs and breakdown of response to treatment.
The goal of research is to study the efficiency of hospital treatment of children with comorbidities in complex examination and treatment.
Material and methods. It was examined 616 children aged 7-14 years, hospitalized for asthma. At the same time, 368 children had comorbidities. One half of patients with comorbid pathology received a comprehensive examination and taking into account comorbidities, the other half - a standard set of examination and treatment of the main disease. The survey of parents and catamnestic observation of patients for 1 year was carried out.
Results. The presence of comorbidities in children with bronchial asthma, in particular the obesity and gastroenterological diseases, has a significant negative impact on the course of asthma, the efficiency of its therapy and the need for medical aid. The results of the study showed that children with high levels of comorbidity have more frequent and prolonged hospitalizations. Comprehensive screening and early treatment of comorbidities reduces the incidence of exacerbations, the risk of emergency hospitalizations and improves asthma control.
Discussion. An increase in the duration of hospitalization of patients with comorbid pathology may be associated with a severity of the main illness and a lower rate of response to therapy, possibly with reduced compliance. Although the presence of comorbidities contributes to the lengthening of hospitalization, a comprehensive examination and treatment does not increase the duration of the child’s stay in the hospital.
Conclision. The expansion of diagnostic and therapeutic actions in relation to concomitant diseases in a patient with bronchial asthma within the framework of hospitalization increases the clinical and economic efficiency of treatment measures, reduces the subsequent burden on the hospital and out-patient hospital, increases the assessment of medical care by parents and their adherence to the prescribed treatment.
Palavras-chave
Sobre autores
O. Konovalov
D. Sci. (Med.), Prof., Department of public health, healthcare and hygiene, Peoples’ Friendship University of Russia, Moscow, 118190, Russian Federation. E-mail: konovalov_oe@mail.ru
Autor responsável pela correspondência
Email: konovalov_oe@mail.ru
ORCID ID: 0000-0003-1974-9882
Rússia
A. Modestov
N.I. Pirogov Russian National Research Medical University
Email: noemail@neicon.ru
ORCID ID: 0000-0002-4196-8857
Rússia
I. Ulishchenko
Russian Peoples Friendship University
Email: noemail@neicon.ru
ORCID ID: 0000-0001-5654-307X
Rússia
R. Gudkov
I.P. Pavlov Ryazan State Medical University
Email: noemail@neicon.ru
ORCID ID: 0000-0002-4060-9692
Rússia
Bibliografia
- Артамонов Р.Г. К вопросу о коморбидности в педиатрической практике. Педиатрия. Журнал им. Г.Н. Сперанского. 2012; 91(4): 146-9.
- Fortin M., Lapointe L., Hudon C., Vanasse A., Ntetu A.L., Maltais D. Multimorbidity and quality of life in primary care: a systematic review. Health Qual. Life Outcomes. 2004; 2: 51. DOI: http://doi.org/10.1186/1477-7525-2-51
- Roger L.V. The changing landscape of heart failure hospitalizations. J. Am. Coll. Cardiol. 2013; 61(12): 1268-70. DOI: http://doi.org/10.1016/j.jacc.2013.01.011
- Fortin M., Lapointe L., Hudon C., Vanasse A. Multimorbidity is common to family practice: is it commonly researched? Can. Fam. Physician. 2005; 51: 244-5.
- Barnett K., Mercer S.W., Norbury M., Watt G., Wyke S., Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012; 380(9836): 37-43. DOI: http://doi.org/10.1016/S0140-6736(12)60240-2
- Ханов А.Г. Транснозологическая коморбидность ревматологических больных. Available at: http://visualrheumatology.ru/polimorbidnost.html
- Белялов Ф.И. Лечение внутренних болезней в условиях коморбидности. Иркутск; 2013.
- Баранов А.А., Намазова-Баранова Л.С., Вишнёва Е.А. Комплексный подход к оценке качества медицинской помощи в педиатрии. Педиатрическая фармакология. 2015; 12(5): 517-23. DOI: http://doi.org/10.15690/pf.v12i5.1451
- Mosquera R.A., Avritscher E.B., Samuels C.L., Harris T.S., Pedroza C., Evans P., et al. Effect of an enhanced medical home on serious illness and cost of care among high-risk children with chronic illness: a randomized clinical trial. JAMA. 2014; 312(24): 2640-8. DOI: http://doi.org/10.1001/jama.2014.16419
- Новикова В.П., Эглит А.Э. Бронхиальная астма и ожирение. Вопросы детской диетологии. 2014; 12(3): 46-51.
- Минеев В.Н., Трофимов В.И., Лалаева Т.М. Бронхиальная астма и ожирение: общие механизмы. Клиническая медицина. 2012; 90(4): 4-10.
- Новикова В.П., Белоусова Л.Н. Состояние пищевода при ожирении у детей и взрослых. Вопросы детской диетологии. 2015; 13(4): 29-34.
- Гудков Р.А., Коновалов О.Е. Особенности оказания медицинской помощи детям с сочетанной патологией. Российский педиатрический журнал. 2014; 17(4): 38-42.
Arquivos suplementares
