Big data analysis on medical services in coronary heart disease for outpatient care quality management and assessment of the risk of the adverse outcomes

Objective. To determine the significance of big data analysis on medical services in coronary heart disease (CHD) for outpatient care quality management and assessment of the risk of the adverse outcomes. Material and methods. In 2016, data were taken from the database of medical services of the regional compulsory medical insurance fund of the Orenburg region on 329,349 patients, among them 34,168 patients had stable angina and 295,181 had no CHD. In 2017, the proportion of patients with myocardial infarction (MI) in these groups was determined, and the probability of the MI depending on age and the presence of angina was calculated. In 2017 and 2019, in the group of patients with CHD we estab lished and compared the age differentiation of the probability of MI and hospitalizations, referrals to outpatient clinics, and ambulances. Based on the analysis results, the effectiveness of the developed technology for information management of outpatient care quality implemented in the Orenburg region in 2018 was assessed. Results. Patients of young and mature age with stable angina have lower adherence to outpatient visits than elderly patients and, consequently, a higher MI risk. They are more likely to go to the ER and to be admitted to the hospital for CHD. The patients without CHD have the highest MI risk in the elderly/older age and the lowest in the younger. Among patients of mature age and elderly ones with CHD over 2017—2019, the MI risk decreased significantly, and the proportion of patients seeking outpatient care increased from 53.5% to 76.7% and from 73.1% to 84.9%, respectively (p<0.01). Conclusion. Information management of outpatient care quality for CHD based on the analysis of big data on medical services increases the adherence of patients with CHD to outpatient visits and decreases the MI risk, thus demonstrating the effectiveness of this technology. © 2021, Media Sphera Publishing Group. All rights reserved.