Oshyvalova O. O.

SOCIAL MEDICINE AND ORGANIZATION OF HEALTHCARE PROTECTION

Scentific article

According to the data of National cancer-register of Ukraine for 2014-2015 in the structure of incidence of malignant skin neoplasms non-melanoma skin cancers occupied the second place among women and the third among men. In view of the absence as at 2015 of the current regulatory framework and medical-technological documents with the provision of medical care for actinic keratosis (AK), non-invasive (SCCis) and invasive (cSCC) forms of squamous cell carcinoma of the skin in Ukraine it was logical to create medical-technological documents of local significance. Objective of the research is to substantiate, develop and implement local protocol of medical assistance (LPMA) to the patients with AK, SCCis, cSCC in a multidisciplinary medical facility. Methods. International databases of clinical protocols on high standards of scientific quality in the development of local protocols providing medical care to patients with АК, SCCis, cSCC were used for the implementation of the objectives. The implementation of the protocols was made in State Scientific Institution “Scientific and Practical Centre of Preventive and Clinical Medicine” of the State Administration (SSI) in 2015-2018. Results. Comparing the incidence rates of the affiliated contingent SSI AK, SCCis, cSCC after the implementation of LPDA (2015-2018) with similar indicators before the implementation of LPDA (2011-2014) it should be noted that the incidence rate of AK significantly increased (p≤0.05) with the stabilization of the incidence of SCCis and cSCC (p = 0.05 and p = 0.04 respectively). Analysis of the performance criteria revealed that the implementation of the LPDA over 4 years has reliably influenced the increase in the effectiveness of the criterion «achieved remission» in patients with AK, as well as in patients with SCCis, cSCC (p≤0.001, p≤0.02 and p≤0.01 respectively), and the reduction of the criterion «progression of the disease» for skin pathology (р≤0,01, р≤0,01, p≤0,05). Conclusions. The use of LPDA is an opportunity to introduce modern medical diagnostic and treatment methods in its own medical practice, the effectiveness of which is proved by numerous controlled studies, thereby increasing the quality and effectiveness of providing medical care to patients.

medical-technological documents, local protocol of medical assistance, epidermal dysplasia of the skin, actinic keratosis, squamous cell carcinoma

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«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 307-313 pages, index UDK 616.5-006-005.552.3

10.29254/2077-4214-2019-1-1-148-307-313