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Management of the rehabilitation of the patients diagnosed with the degenerative and posttraumatic diseases of large articulations


Author: Cimil Anișoara
Degree:doctor of medicine
Speciality: 14.00.33 - Social Medicine and Management
Year:2019
Scientific adviser: Mihail Ciocanu
doctor habilitat, associate professor (docent), Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Nicolae Caproş
doctor habilitat, associate professor (docent), Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 16 May, 2019 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document0.76 Mb / in romanian

Thesis

CZU 617.3-036.82+616-036.86

Adobe PDF document 10.68 Mb / in romanian
202 pages


Keywords

medical rehabilitation, degenerative and posttraumatic diseases, large joints, management, quality of life, prognosis, economic analysis

Summary

Structure of the thesis: the thesis comprises 95 pages, summary in Romanian, Russian and English, list of abreviations, introduction, 4 chapters, conclusions, practical recommendations, 25 tabels, 12 figures, bibliography of 177 sources, 20 annexes, declaration regarding the assumption of responsibility, CV of author.

Domain of study:social medicine, rehabilitation medical management.

Purpose of the research: Creation of the scientific framework of the development of medical rehabilitation assistance management, based on medical effectiveness and economic efficiency in the process of the recovery of the patients with degenerative and posttraumatic diseases of large joints.

Objectives of research: 1. analysis of the efficacy of the medical recovery in terms of the dynamics of the functional parameters of the reference patients; 2. the impact of the intervention of the medical recovery on the valorisation of the paradigm “quality of life” appreciated by the beneficiaries of the cure; 3. adjustment of the management of the recovery service in terms of the economic-medical analysis: costeffectiveness and cost-utility; 4. elaboration of the methodology of the forecasting of the potential of the recovery; 5. the establishment and practical utility of the algorithm of the monitoring of the medical recovery process.

Scientific novelty and originality. For the first time in RM, there was estimated the effectiveness of the recovery of the functionality of the locomotor system in terms of the dynamics of the quality of life of the beneficiaries of the treatment, and the results processed statistically in two selections allowed the deduction of a rule as a criterion of the discrimination and the assignment of a new element to one of those two multitudes with the role of prognostics in the recovery; there was applied the analysis costeffectiveness and cost-utility for the purpose of the prioritization of the economic performance of the treatment the cost-effectiveness of the treatment through the report cost/effectiveness.

The issue solved in the thesis: the evaluation of the effectiveness and efficiency of the recovery assistance from the economic point of view, as well as the elaboration of the recovery prognosis by the discriminatory statistical method of the potential of the recovery applicable on the range of locomotor nosology. Theoretical significance: the estimation of the efficacy and economic advantage of the recovery treatment appreciated by the economic and statistical analysis based on the discriminatory criterion appreciated by the beneficiaries of the treatment, reflects the necessity of the compliance of the rehabilitation assistance with the requirements of the population carried out by the public health management.

Applicative value: The results of the thesis offers the recovery doctors, orthopaedists-traumatologists and public health managers the suggestions for the purpose of the optimization of the service of the Rehabilitation and improvement of the quality of life of the patients with the deficiencies of the locomotor system.

Implementation of the results of study: There was submitted the proposal to the Ministry of Health, Labour and Social Protection of the Republic of Moldova for the practical implementation of the economic analysis and Monitoring Algorithm of the medical recovery process in patients with the locomotor diseases.