Management and results of the clinical-anatomical sector in Saint-Petersburg
Petrova, N.G.; Rybakova, M.G.; Kobal'skiĭ, G.B.; Grantyn', V.A.; Kolmeĭtseva, N.V.
Problemy Sotsial'noi Gigieny Zdravookhraneniia i Istorii Meditsiny 6: 36-39
2003
ISSN/ISBN: 0869-866X PMID: 14708195 Document Number: 555733
A standard of diagnostics, namely, of divergence or coincidence (in %) between the clinical and the postmortem diagnoses as well as a category of such divergence (diagnostic error) is of primary importance within the system of final criteria-based evaluations of the medical care. City Morbid Anatomy Bureau (CMAB) was set up, 1989, in Saint Petersburg in order to coordinate the clinical and pathologoanatomic functions as well as to shape the unified approaches and to ensure equal opportunities of obtaining the unified information from all city patient-care facilities. A unified and formalized card, i.e. "card of the diseased", is filled in for all dead who were examined by the pathologist. The data, when processed by a special program, can be used to derive statistics on the mortality structure (in hospitals, at home, and in separate patient-care facilities), on complications (immediate death causes), as well as on a presence and nature of diagnostic errors (in different patient-care facilities, in cases of various nosological forms, and for certain age-and-sex categories etc.). This, in its turn, can be used to draw the annual reports for the city and, if necessary (e.g. upon a request from a medical institution), to compose the analytic reports. Finally, the paper contains the nosological structure of those who died in and outside the urban hospitals; there is also a dynamic analysis of the nature and reasons of diagnostic errors.