Klymeniuk V. Medical and social substantiation of the system of survival improvement and disability reduction in adults due to cardio-vascular diseases.

The thesis substantiates the possibility of advancements of system of medical care to disabled due to cardiovascular diseases by functional of survival. It has been shown that it is timely hospitalization is the key factor to increase survival. Associated wit htimely diagnostics and delivery to the hospitalis severity of condition at the time of hospitalization (RR=1,98), the immediate administration of ?-blockers (1-RR=0,549), and reperfusion (1-RR=0,35). Intensification and completeness of the treatment process is another proved significant possibility to prevent lethality (RR=2,767). Nevertheless, the most important appeared to be the elimination of territorial disparities in access to continuum of health care by disabled persons. Among advantages of the proposed optimization model of continuum of care we made emphasis on extra territoriality, simplified and beeline patient rout, a combination of optimization criteria as timeliness and efficiency, responsiveness to the regional situation, population settlement and resource capacity of the health system. On average implementation gained additional 0,8788 months of life for patients during the first 5years since disability certification. The annual effect of implementation in Vinnitsa region estimated as gain of 1757,6 months of life for patients during the first 5years since disability certification. It was shown that only 15,8% of the total effect of implementation were related to improvement in the quality of treatment, while 84,2% were due to improvement in the accessibility and availability ofemergencyandspecialized care.