The in-patient substituting technologies in maxillofacial surgery: characteristics of organization and ways of further development

The social economic crisis and international sanctions significantly affected health care system that requires implementation of new organizational approaches with medical, social and economic benefits. Currently, up to 80% of budgetary funds for health care are spent on in-patient care, although 20-50% of patients could be effectively treated in less expensive short-stay hospitals. The purpose of the study is to assess efficiency of specialized care in maxillofacial surgery in conditions of short-stay hospitals. In maxillofacial surgery, implementation of in-patient substitution technologies is justified that ensure availability of minimally invasive surgeries and reduction of treatment time. The analysis of data of 2,022 patients hospitalized in the Maxillofacial Hospital for War Veterans of the Moscow Health Department from January 1 to December 31 2023 demonstrated that 1,518 patients (65.37%) were treated in the 24-hour in-patient department and 504 patients (34.63%) in the short-stay in-patient department. Among them, 738 males (36.3%) and 1,284 females (63.7%), average age of patients was 42.5 ± 17.82 years. In the 24-hour in-patient department, females accounted for 62.85% and males 37.15%. In short-stay in-patient department, females accounted for 65.48%, males for 34.52%. The average stay in 24-hour hospital was 5.6 bed days and in short-stay hospital - 6-8 hours. The economic efficiency of short-stay hospitals was demonstrated in significant savings of medications and services. The level of patient satisfaction is higher in short-stay hospital (8.4 points versus 8.1 points in 24-hour hospital). The development of short-stay hospitals in maxillofacial surgery contributes into improving of quality and accessibility of medical care, modernizing medical infrastructure and optimizing budget expenditures.