Analysis of the cause of death among the adult population in the provision of poor-quality medical services in public health institutions of the Republic of Tajikistan

Introduction. The trend of increasing cases of harm to health/life of patients in the provision of poor-quality medical services is of particular importance in the field of public health.

The purpose of the study. Analysis of the cause of death among the adult population in the provision of poor-quality medical services in public health institutions of the Republic of Tajikistan.

Materials and methods. The study was conducted on the basis of data on deaths among the adult population (over 18 years) of the Republic in the structure of hospital institutions of the Republic of Tajikistan 0ver period of 2019–2021 and 6 months of 2022.

Results. Over period of 2019–2022 there were registered 1881, 4119, and 2567 deceased patients older 18 years, respectively, the hospital mortality rate was 0.2; 0.6, and 0.3%. The frequency of respiratory diseases during 2020 compared to the previous year (n = 70; 0.2%) due to complications of COVID-19 increased by more than 15 times (n = 1577; 3.1%), and in 2021 decreased to 2.2 times (n = 541; 1.4%). In the structure of causes of death there were dominated complications of diseases of the circulatory system (39.5%), the consequences of surgical interventions (12.7%), followed by injuries (10.7%), tumors (3.8%) and the endocrine system (3.3%). The duration of the period before hospitalization of patients who died from surgical diseases was 8.5% — up to 1 day, 68.5% — up to 5 days and 22.8% — from 5 to 15 days.

Research limitation. Pathological anatomical examination of the corpses of deceased patients, which is of key importance in establishing the causes of deaths in healthcare institutions, is carried out in the republic at an extremely low number for religious reasons.

Conclusion. In state healthcare institutions of the Republic, the registration of deaths due to the provision of poor-quality medical services in the period before and after hospitalization does not correspond to reality, which requires the improvement of the reporting system in accordance with international standards.

Compliance with ethical standards. This study was approved by the local committee on biomedical ethics of the State Institution “Tajik Research Institute of Preventive Medicine” (protocol No. 4 dated 12.09.2022).

Contribution of the authors:
Olimov D.A. — concept and design of the study, collection and processing of material, writing the text, statistical data processing;
Tursunov R.A. — the concept and design of the study, writing the text, compilation of a list of references, statistical data processing;
Khojamuradov G.M. — concept and design of the study, editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interests. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article.

Received: November 1, 2022 / Accepted: January 12, 2023 / Published: April 29, 2024