Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot166610.32687/0869-866X-2023-31-2-247-254Научная статьяTHE ADAPTATION OF METHODOLOGY OF EXPERT SELECTION OF INDICATORS FOR INTEGRAL EVALUATION OF EFFECTIVENESS AND EFFICIENCY OF ORGANIZATION OF MEDICAL CARE SUPPORT AT THE LEVEL OF SUBJECT OF THE RUSSIAN FEDERATION AT THE “PEDIATRICS” PROFILEOmelyanovskyV. V.MikhailovI. A.PetrenkoYu. V.SolovevA. A.FisenkoA. P.AprosimovaS. I.KulichenkoT. V.KurnosovaT. I.SamsonovaE. S.LebedenkoG. G.The Federal State Budget Institution “The Center of Expertise and Control of Quality of Medical Care”, 109028, Moscow, RussiaThe Federal State Budget Educational Institution of Additional Professional Education “The Russian Medical Academy of Continuous Professional Education” of Minzdrav of Russia, 125445, Moscow, RussiaThe Federal State Budget Institution “The Research Financial Institute of Minfin of Russia”, 127006, Moscow, RussiaN. A. Semashko National Research Institute of Public Health, 105064, Moscow, RussiaThe Federal State Budget Educational Institution of Higher Education “The St. Petersburg State Pediatric Medical University” of the Minzdrav of Russia, 194100, St. Petersburg, RussiaThe Federal State Self-Contained Institution “The National Research Center of Children Health” of the Minzdrav of Russia, 119296, Moscow, RussiaThe Federal State Budget Educational Institution of Higher Education “N. I. Pirogov Russian National Research Medical University” Minzdrav of Russia, 117997, Moscow, Russia1512202331224725424062025Copyright © 2023,2023The adaptation of methodology of expert selection of indicators for integral evaluation of efficiency of organization of medical care on profile “pediatrics” at the level of the Subject of the Russian Federation. The study was organized as expert survey using structured interview technique. At the first stage, primary selection of indicators carried out. At the second stage, selection of experts in accordance with inclusion criteria and assessment of level of expert competence was organized. Then, criteria of expert evaluation of significance of selected indicators in accordance with international principles applied in of bench-marking systems construction were formulated. The Kendall's concordance coefficient (W) was calculated for quantitative assessment of degree of agreement between the experts answers. The non-parametric Friedman test was applied to evaluate significance of differences. The indicators with high degree of agreement between opinions of experts and availability of statistical significance according concordance coefficient are recommended as indicators for assessment of efficiency of organization of medical care of children at the level of the Subject of the Russian Federation. The following indicators satisfy these requirements: mortality of children aged 0–17 years (per 100 000 of population of corresponding age), mortality of children aged 0–1 year (per 1000 live births), mortality of children aged 0–4 years (per 1000 live births), support of population with beds for children, percentage of children aged 0–17 years under dispensary observation with diagnosis established for the first time. The study permitted to select indices (indicators) that can be applied both for integral rating of the Subjects of the Russian Federation and in formation of Federal projects or departmental target programs in pediatrics. The study results can also be applied in development of system of monitoring efficiency of implementation of these projects and programs.integral ratingefficiency indicatorsorganization of medical carepediatricseffectivenessFederal projectинтегральный рейтингпоказатели результативности и эффективностиорганизация оказания медицинской помощипедиатриярезультативностьэффективностьфедеральный проектBoerma T., Requejo J., Victora C. G., Amouzou A., George A., Agyepong I., Barroso C., Barros A. J. D., Bhutta Z. A., Black R. E. Countdown to 2030: tracking progress towards universal coverage for reproductive, maternal, newborn, and child health. Lancet. 2018;391(10129):1538—48.Kruk M. E., Gage A. D., Arsenault C., Jordan K., Leslie H. H., Roder-DeWan S., Adeyi O., Barker P., Daelmans B., Doubova S. V. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob. Health. 2018;6(11):e1196—252.Kruk M. E., Gage A. D., Joseph N. T., Danaei G., García-Saisó S., Salomon J. A. Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. Lancet. 2018;392(10160):2203—12.Tunçalp Ö., Were W. M., MacLennan C., Oladapo O. T., Gülmezoglu A. M., Bahl R., Daelmans B., Mathai M., Say L., Kristensen F. Quality of care for pregnant women and newborns — the WHO vision. BJOG. 2015;122(8):1045.World Health Organization. Standards for improving quality of maternal and newborn care in health facilities. 2013. Режим доступа: https://www.who.int/publications/i/item/9789241511216 (дата обращения 17.09.2022).World Health Organization. Standards for improving the quality of care for children and young adolescents in health facilities. 2018. Режим доступа: https://www.who.int/publications/i/item/9789241565554 (дата обращения 18.09.2022).World Health Organization. Standards for improving the quality of care for small and sick newborns in health facilities. 2020. Режим доступа: https://www.who.int/publications/i/item/9789240010765 (дата обращения 19.09.2022).Muzigaba M., Chitashvili T., Choudhury A., Were W. M., Diaz T., Strong K. L., Jackson D., Requejo J., Detjen A., Sacks E. Global core indicators for measuring WHO’s paediatric quality-of-care standards in health facilities: development and expert consensus. BMC Health Serv. Res. 2022 Jul;22(1):887.World Health Organization. Ending preventable child deaths from pneumonia and diarrhoea by 2025: the integrated global action plan for pneumonia and diarrhoea (GAPPD). 2013. Режим доступа: https://www.who.int/publications/i/item/9789241505239 (дата обращения 20.09.2022).Strong K., Requejo J., Agweyu A., McKerrow N., Schellenberg J., Agbere D. A., Billah S. M., Boschi-Pinto C., Horiuchi S., Lazzerini M. Child Health Accountability Tracking — extending child health measurement. Lancet Child Adolesc. Health. 2020;4(4):259—61.Campbell S. M., Kontopantelis E., Hannon K., Burke M., Barber A., Lester H. E. Framework and indicator testing protocol for developing and piloting quality indicators for the UK quality and outcomes framework. BMC Fam. Pract. 2011;12(1):1—11.Winslade N., Taylor L., Shi S., Schuwirth L., Van der Vleuten C., Tamblyn R. Monitoring community pharmacist’s quality of care: a feasibility study of using pharmacy claims data to assess performance. BMC Health Serv. Res. 2011;11(1):1—8.Peña A., Virk S. S., Shewchuk R. M., Allison J. J., Dale Williams O., Kiefe C. I. Validity versus feasibility for quality of care indicators: expert panel results from the MI-Plus study. Int. J. Qual. Health Care. 2010;22(3):201—9.Rubin H. R., Pronovost P., Diette G. B. Methodology Matters. From a process of care to a measure: the development and testing of a quality indicator. Int. J. Qual. Health Care. 2001;13(6):489—96.Madaj B., Smith H., Mathai M., Roos N., Van Den Broek N. Developing global indicators for quality of maternal and newborn care: a feasibility assessment. Bull. World Health Organ. 2017;95(6):445.Ntoburi S., Hutchings A., Sanderson C., Carpenter J., Weber M., English M. Development of paediatric quality of inpatient care indicators for low-income countries-A Delphi study. BMC Pediatr. 2010;10(1):1—11.Баранов А. А., Альбицкий В. Ю. Состояние здоровья детей России, приоритеты его сохранения и укрепления. Казанский медицинский журнал. 2018;99(4):698—705. doi: 10.17816/KMJ2018-698Tandon A., Murray C. J., Lauer J., Evans D. B. Measuring health system performance for 191 countries. Eur. J. Health Econ. 2002;3(3):145—8.Hibbard J. H., Stockard J., Tusler M. Hospital performance reports: Impact on quality, market share, and reputation. Health Aff. 2005;24(4):1150—60.Hibbard J. H., Stockard J., Tusler M. Does publicizing hospital performance stimulate quality improvement efforts? Health Aff. 2003;22(2):84—94.The Quality Indicator Study Group. An approach to the evaluation of quality indicators of the outcome of care in hospitalized patients, with a focus on nosocomial infection indicators. Am. J. Infect. Control. 1995;23(3):215—22.Roberts D. A., Ng M., Ikilezi G., Gasasira A., Dwyer-Lindgren L., Fullman N., Nalugwa T., Kamya M., Gakidou E. Benchmarking health system performance across regions in Uganda: A systematic analysis of levels and trends in key maternal and child health interventions, 1990—2011. BMC Med. 2015;13(1):1—16. doi: 10.1186/s12916-015-0518-xGiovanelli L., Marinò L., Rotondo F., Fadda N., Ezza A., Amadori M. Developing a performance evaluation system for the Italian public healthcare sector. Public Money Manag. 2015;35(4):297—302. doi: 10.1080/09540962.2015.1047274Willerman N. B. The adaptation and use of Kendall’s coefficient of concordance (W) to sociometric-type rankings. Psychol. Bull. 1955 Mar;52(2):132—3.Carinci F., Van Gool K., Mainz J., Veillard J., Pichora E. C., Januel J. M., Arispe I., Kim S. M., Klazinga N. S. Towards actionable international comparisons of health system performance: expert revision of the OECD framework and quality indicators. Int. J. Qual. Health Care. 2015 Apr;27(2):137—46.