Introduction of the disease management Program (further - DMP) in a pilot regime North Kazakhstan and Pavlodar oblasts allowed to reduce the number of cases of hospitalization of patients with chronic heart failure 2 times.
Implementation of DMP in 7 polyclinics of above-mentioned regions began since 2013 in three nosologies: arterial hypertension, chronic heart failure and sugar diabetes.
With 1213 participants of DMP concluded agreements, issued diaries of self-control which the patients are keeping. In accordance with agreement the medical organizations are creating the multi-discipline team which being found in constant contact with patient – participant of DMP, is providing dynamic observation of a patient.
In polyclinics work the health schools where patients are educated on the principles for rendering self-help, right attitude towards the own health, provided with information material on self-education and healthy lifestyle.
The informed patient keeps a diary of self-control, controls factors influencing his health, at the same time his behavior changes, responsibility for the own health increases.
Thus the program provides a possibility for the patients together with medical officers to manage their disease and prevent complications.
As a result of implementation of pilot project indicators of 75% patients of the level of arterial pressure stabilized, skills of his control and regularities of an intake of hypertensive drugs are formed. The number of patient hospitalization cases with chronic heart failure are decreased 2 times. The number of patients examined for sugar diabetes increased (in SKO – to 64 %, in Pavlodar oblast – to 98 %). It should be noted 100% coverage of training by self-management to all participants of DMP.
Taking into consideration positive experience of introduction of DMP in pilot regions, its implementation will continue based on stage: In period 2016 -2017 - additionally in towns Astana, Almaty, WKO, Karaganda and Kostanay oblast since 2018 – in all oblasts of Kazakhstan.
We remind, introduction of the disease management Program as a component of modernization and priority development of primary health care for improvement of quality and increase of patient's life duration with chronic diseases are one of the main directions of the State program on development of healthcare of RK for 2016-2019 "Densaulyk".