Types of Medical Care in Modern Clinical Practice at a Moscow Hospital

The paper presents an analysis of the types of medical care in inpatient medical institutions of Moscow using the example of the Department of Surgery of the Scientific and Clinical Center No. 3 of the Russian Scientific Center of Surgery named after Academician B.V. Petrovsky. Identification of the ways to improve and develop organizational approaches to clinical practice in Moscow hospitals has been elaborated on its basis. The types of medical care in the departments of surgery have been identified, and the distinctive features of the surgical care organization in Moscow have been described. The performance results of the Department of Surgery of the Scientific and Clinical Center No 3 of the Russian Scientific Center of Surgery named after Academician B.V. Petrovsky for 2021-2023 have been analyzed. Regarding the types of medical care, fundamental trends have been presented, including the transition from predominantly emergency surgery to balanced elective and emergency interventions; further technological modernization with an advanced trend of transition to minimally invasive technologies; and a focus on high-tech oncology in the department of surgery. The directions for improving the provision of various types of medical care in the clinical practice of the Department of Surgery have been identified, including the introduction of an expanded system of quality indicators, the development of technologies for patient flow split, the introduction of enhanced recovery protocols, and the development of same-day surgery. The experience of Scientific and Clinical Center No. 3 can serve as an example for similar departments, as it confirms the possibility of simultaneously achieving high quantitative indicators and maintaining the quality of medical care by implementing a systematic approach to surgical care.

1. Cartwright A. Human Relations and Hospital Care. London. Routledge. 1964. https://doi.org/10.4324/9781003425151

2. Ippoliti R., Falavigna G., Zanelli C. et al. Neural Networks and Hospital Length of Stay: An Application to Support Healthcare Management with National Benchmarks and Thresholds. Cost Effectiveness and Resource Allocation. 2021;19:67. https://doi.org/10.1186/s12962-021-00322-3

3. Qian M., Zhang X., Chen Y. et al. The Pilot of a New Patient Classification-Based Payment System in China: the Impact on Costs, Length of Stay and quality. Social Science & Medicine. 2021;289:114415. https://doi.org/10.1016/j.socscimed.2021.114415

4. Xu Y., Zheng X., Li Y. et al. Exploring Patient Medication Adherence and Data Mining Methods in Clinical Big Data: A Contemporary Review. Journal of Evidence-Based Medicine. 2023;16(3):342-375. https://doi.org/10.1111/jebm.12548

5. Gadzhieva S.M. The Creation of Competence Centers (Using the Example of the Organization of Outpatient Cancer Care Centers) in the Public Health System: the Experience of Moscow. National Health Care (Russia). 2024;5(3):30-40. https://doi.org/10.47093/2713-069X.2024.5.3.30-40 (In Russ.)

6. Gromov P.V. Transformation of the Business Model of a Medical Institution to Increase Customer-Centered Orientation in the field of Industrial Medicine. Bulletin of the Law Institute of MIIT. 2024;1(45):57- 72. (In Russ.)

7. Al Harbi S., Aljohani B., Elmasry L. et al. Streamlining Patient Flow and Enhancing Operational Efficiency through Case Management Implementation. BMJ Open Quality. 2024;13:e002484. https://doi.org/10.1136/bmjoq-2023-002484

8. Mihalj M., Corona A., Andereggen L. et al. Managing Bottlenecks in the Perioperative Setting: Optimizing Patient Care and Reducing Costs. Best Practice & Research Clinical Anaesthesiology. 2022;36(2):299-310. https://doi.org/10.1016/j.bpa.2022.05.005

9. Naderi B., Roshanaei V., Begen M.A. et al. Increased Surgical Capacity without Additional Resources: Generalized Operating Room Planning and Scheduling. Production and Operations Management. 2021;30(8):2608-2635. https://doi.org/10.1111/poms.13397

10. Voshev D.V., Vosheva N.A., Son I.M., Drapkina O.M. Factors Influencing the Digital Transformation in Primary Health Care (Review Article). Current Problems of Health Care and Medical Statistics. 2023;4:751- 774. https://doi.org/10.24412/2312-2935-2023-4-751-774 (In Russ.)

11. Esina E.A., Kalitskaya V.V., Borzunov I.V. et al. Digital Technologies as a Driver for Transformation of Economic Development of Healthcare. Natural Sciences and Humanities Research. 2024;4(54):122-125. (In Russ.)

12. Korobeynikova A.N. Medical Decision Support System: from General to Specific. Innovative doctor’s development. 2023;3:51-58. https://doi.org/10.24412/cl-37091-2023-3-51-58

13. Gracia Martínez J.L., Pfang B., Morales Coca M.Á. et al. Implementing a Closed Loop Clinical Decision Support System for Sustainable Preoperative Care. npj Digital Medicine. 2025;8(1):6. https://doi.org/10.1038/s41746-024-01371-7

14. Fedotkina S.A., Akhmineyeva A.Kh., Karaylanov M.G. Best Practices for the Application of Telemedical Technologies in the Russian Federation and Abroad. Siberian Journal of Life Sciences and Agriculture. 2023;15(3):295-312. https://doi.org/10.12731/2658-6649-2023-15-3-295-312 (In Russ.)

15. Von Schudnat C., Schoeneberg K.P., Albors-Garrigos J. et al. The Economic Impact of Standardization and Digitalization in the Operating Room: A Systematic Literature Review. Journal of Medical Systems. 2023;47(1):55. https://doi.org/10.1007/s10916-023-01945-0

16. Munshi C., Garai R., Mondal S. et al. Fundamentals of the Global Healthcare System and Its Reforms During the COVID-19 Pandemic. Global Health Economics and Sustainability. 2025;3(3):74-91. https://doi.org/10.36922/ghes.8492

17. Saulnier D.D., Duchenko A., Ottilie-Kovelman S. et al. Re-Evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons from the First Two Years of the Pandemic. International Journal of Health Policy and Management. 2023;12(1):1-18. https://doi.org/10.34172/ijhpm.2022.6659

18. Troisi R., De Simone S., Vargas M., Franco M. The Other Side of the Crisis: Organizational Flexibility in Balancing Covid-19 and non-Covid-19 Health-Care Services. BMC Health Services Research. 2022;22(1):1096. https://doi.org/10.1186/s12913-022-08486-1

19. Polushin Yu.S. Sepsis and Management: How to Improve Treatment Outcomes for Patients with Sepsis. Grekov’s Bulletin of Surgery. 2022;181(5):38-46. https://doi.org/10.24884/0042-4625-2022-181-5-38-46 (In Russ.)

20. Bhati D., Deogade M.S., Kanyal D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus. 2023;15(10):e47731. https://doi.org/10.7759/cureus.47731

21. Connor L., Dean J., McNett M. et al. Evidence-Based Practice Improves Patient Outcomes and Healthcare System Return on Investment: Findings from a Scoping Review. Worldviews on Evidence-Based Nursing. 2023;20(1):6-15. https://doi.org/10.1111/wvn.12621