The register as a tool for researching trends in phlebological care for the population of a large industrial center of Russia

Introduction. The Russian Phlebological Register began work in 2016 under the patronage of the Association of Phlebologists of Russia. The creation of a phlebological register in a separate municipal center of the country complements and enriches national plans.
Aim. Тo investigate the trends in the organization of medical care to the population with chronic venous diseases (CVD) of a large industrial center using the phlebological register over the past 20 years.
Materials and methods. The data of municipal and private medical institutions of Ekaterinburg from 2003 to 2022 are analyzed. Data on municipal hospitals (MHs) are provided by the TFOMS of the Sverdlovsk region. Data on private medical centers (PMCs) are obtained by exporting them from the electronic databases of each center. The statistics of phlebectomies (PhE), outpatient minimally invasive interventions and procedures are summarized.
Results. Over the entire period of time, the number of classical phlebectomies in MHs decreased by 4 times – from 2300 (2003) to 587 (2022). At the same time, the development of minimally invasive procedures on the main veins in the PMCs increased from 313 (2003) to 4364 (2022). This made it possible to double the coverage of patients suffering from CVD with specialized medical care. In the structure of patients operated in MHs, the proportion of persons with severe chronic venous insufficiency (CVD C4–6) significantly decreased. The number of patients with superficial thrombophlebitis had a steady downward trend: the first 5 years (2003–2007) – about 200 PhE/year, then 5 years (2008–2012) – about 120 PhE/year, and from 2013 to 2022 < 100 PhE/year.
Discussion. Private medical centers have consistently introduced the latest technologies, but endovasal laser coagulation remains the leader.
Conclusion. The analysis of the register revealed a number of systemic changes in the organization of phlebological care.

1. De Maeseneer MG, Kakkos SK, Aherne T, Baekgaard N, Black S, Blomgren L et al. European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63(2):184–267. https://doi.org/10.1016/j.ejvs.2021.12.024.

2. Stoyko YuM, Kirienko AI, Zatevakhin II, Pokrovskiy AV, Karpenko AA, Zolotukhin IA et al. Russian clinical guidelines for the diagnosis and treatment of chronic venous diseases. Flebologiya. 2018;12(3):146–240. (In Russ.) https://doi.org/10.17116/flebo20187031146.

3. Lal BK, Almeida JI, Kabnick L, Wakefield TW, Pappas PJ, Raffetto JD et al. American Venous Registry – The First National Registry for the Treatment of Varicose Veins. J Vasc Surg Venous Lymphat Disord. 2013;1(1):105. https://doi.org/10.1016/j.jvsv.2012.10.020.

4. Iliukhin EA, Demekhova MYu, Stoiko YuM. The Russian Registry of the Methods for the Treatment of Chronic Venous Diseases. Flebologiya. 2018;12(3):96–100. (In Russ.) https://doi.org/10.17116/flebo201812396.

5. Crawford JM, Gasparis A, Almeida J, Osborne N. A review of United States endovenous ablation practice trends from the Medicare Data Utilization and Payment Database. J Vasc Surg Venous Lymphat Disord. 2019;7(4):471–479. https://doi.org/10.1016/j.jvsv.2019.01.66.

6. Kobrinsky BA, Podolnaya MA, Bogorad AE, Rozinova NN, Sokolova LV, Gryazina OV, Mizernitsky YuL. Register rare chronic lung diseases in children. Medical Doctor and Information Technology. 2015;(3):64–69. (In Russ.) Available at: https://www.vit-j.ru/upload/uf/d96/ntg9fxi9yh66h1pt17xns4t44gkyfoy5/vit_2015_03.pdf.

7. Yagudina RI, Litvinenko MM, Sorokovikov IV. Patient registers: structure, functions, possibilities of use. Farmakoehkonomika. 2011;4(4):1–5. (In Russ.) Available at: https://cyberleninka.ru/article/n/registry-patsientov-struktura-funktsii-vozmozhnosti-ispolzovaniya.

8. Obi AT, Sutzko DC, Almeida JI, Kabnik L, Cronenwett JL, Osborne NH et al. First 10-month results of the Vascular Quality Initiative Varicose Vein Registry. J Vasc Surg Venous Lymph Disord. 2017;5(3):312–320. https://doi.org/10.1016/j.jvsv.2016.12.007.

9. Catarinella FS, Stavast I, Wittens CH. A European venous registry: pitfalls and opportunities. Phlebology. 2014;29(1):188–192. https://doi.org/10.1177/0268355514529695.

10. Ivanov AV. Registers as the basis for data collection and evidence building. Real-World Data & Evidence. 2021;1(1):10–15. (In Russ.) https://doi.org/10.37489/2782-3784-myrwd-3.

11. Shakirov AA. Some features of the organization of private medicine in the Russian Federation and the provision of the medical services by private organizations. Vestnik of Moscow University of the Ministry of Internal Affairs of Russia. 2019;(7):83–89. (In Russ.) https://doi.org/10.24411/2073-0454-2019-10382.

12. Peshkov AV, Burleva EP, Antonova AE, Kirilyuk MM. Medical and social characteristics of patients who applied for the treatment of chronic venous diseases in an outpatient phlebosurgical center. Nepreryvnoe Medicinskoe Obrazovanie i Nauka. 2023;18(1):64–73 (In Russ.) Available at: https://cmedas.elpub.ru/jour/article/view/12.