Outpatient cardiac rehabilitation center at the Municipal level (Moscow region, Zhukovsky Moscow regional cardiology center on the basis of MBUZ "City Clinical Hospital")
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The problem of outpatient cardiac rehabilitation is currently very relevant, because only a small part of patients who have had myocardial infarction are sent for rehabilitation to cardiological sanatoriums (age groups: up to 55 years for women and up to 60 years for men), and at an older age - only those who work. A very difficult situation with patients who have undergone acute coronary syndrome and myocardial revascularization (angioplasty and CABG), because the number of paid tours is very limited.
At the same time, the level and quality of rehabilitation at the sanatorium stage does not meet the modern requirements of rehabilitation (there are no adequate educational programs, aerobic training, psychodiagnostics and psychocorrection are not carried out).
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Patients with stable angina pectoris, on the one hand, are not sent to the sanatorium stage of rehabilitation, on the other hand, there is no necessary cardiac rehabilitation in an outpatient setting.In the Moscow region, Zhukovsky, in 2010, within the framework of a pilot project at the municipal level, an outpatient cardiac rehabilitation center was organized at the expense of extra-budgetary funds.
Goal:
Provision of outpatient prophylactic and rehabilitative care to patients with angina pectoris 2-3 FC, who have undergone acute coronary syndrome, myocardial infarction, after myocardial revascularization.
Tasks:
1. Providing dispensary observation
2. Carrying out sanitary and educational work on the formation of a healthy lifestyle
3. As part of the secondary prevention of coronary artery disease, conducting a cycle of classes to correct risk factors for coronary artery disease (Coronary Club)
4. Conducting rehabilitation treatment: physical rehabilitation (exercise therapy, physical training)
5. Psychological rehabilitation
6. Providing medical supervision of rehabilitation
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The following categories of patients are subject to cardiac rehabilitation:
• acute myocardial infarction
• acute coronary syndrome
• after myocardial revascularization
• stable angina pectoris II-III FC
Patient streams are directed from:
• cardiological hospital
• city polyclinics
For 2 years of work of the Center 480 patients have been rehabilitated. For the patients of the Cardiac Rehabilitation Center, a series of 10 leaflets on IHD risk factors has been published.
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Since 2012, regional medical and economic standards for managing patients in outpatient rehabilitation have been developed, which are currently approved by the TFOMI of the Moscow Region. The cost of MES in 2012 was 14,522 rubles for a completed case (the average duration of 1 case is 23 days).
The creation of an outpatient cardiac rehabilitation center at the municipal level, on the one hand, can be an effective alternative to sanatorium treatment, and on the other hand, it can work as a modern experience for replicating advanced technologies both in the municipalities of the Moscow region and the Russian Federation.
