The 130th Annual Meeting of APHA

Abstract #43823

Hany Abdallah, MA, MHS and Rashad Massoud, MD, MPH. Quality Assurance Project, University Research Co., LLC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814-4811, 301 941-8435, Hany_Abdallah@jsi.com

The main cause of adult mortality in Tula, Russia, is cardiovascular disease, primarily from complications of hypertension, yet many known hypertension patients are not receiving adequate health care. Many patients are unaware that they have hypertension, others are simply doing nothing about it. Funded by the United States Agency for International Development, the Tula Health Ministry introduced a quality assurance program to improve the quality of care. The system of care was re–designed. As part of the improvement, evidence-based medicine was stressed in developing updated clinical guidelines.

This presentation describes the improvement in the system of hypertension care and results of an analysis to measure the economic impact of the new system. As a result of greater emphasis placed on screening and health education under the new system, more patients with AH were treated in primary care settings. Improved blood pressure control and reduced complications in these settings have contributed to fewer patients seeking emergency care or being hospitalized for AH. The analysis measured the shift in the cost of expensive hospital care for more cost-effective primary care, with potential savings in the total costs over time. Recommendations for re-aligning resources as well as the use of analysis results are presented, including the need for aligning incentive and health financing systems to support quality health care.

Learning Objectives:

• „h Define the quality improvement-based approach to strengthen the system of care for patients with arterial hypertension (AH) in Tula, Russia
• „h Describe findings on the economic impact of the new system
• „h Discuss implications for restructuring the health financing system to support quality care services

Keywords: Cost Issues, Quality of Care

Related Web page: www.qaproject.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: United States Agency for International Development (USADI), Quality Assurance Project II (funded by USAID)
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.