CLINICAL AND ANATOMICAL COMPARISONS IN ASSESSING THE QUALITY OF MEDICAL CARE

Purpose of research: To study methodological, organizational and normative problems of comparison of final clinical and pathological-anatomical diagnoses in the Russian Federation on the basis of a review of domestic and foreign publications.

Abstract: Clinical and anatomical comparisons remain the most important function of quality control of medical and diagnostic work. Cases of divergence of diagnoses should be the subject of professional discussion in the medical community with the adoption of appropriate administrative measures to address deficiencies in the provision of medical care. Currently, there is no adequate regulatory regulation of the issue of comparison of clinical and pathological-anatomical diagnoses. This gives rise to many problems, including the subjectivism of the pathologist in the interpretation of the actions of the clinician, the permanent threat of criminal liability of medical workers for misdiagnosis. Penalties for discrepancies in diagnoses imposed by the Сompulsory Health Insurance Fund lead to an artificial underestimation of the divergence of diagnoses in medical organizations and to incorrect statistical accounting. The underestimation of the role of comorbid diseases and the lack of clear norms of their use in the diagnosis create difficulties in the correct assessment of the disease tanatogenesis, limits the analysis of morbidity and mortality for multiple reasons and entails the loss of some of the available information.