Journal of Pharmaceutical Negative Results

Table 2 Quality indicators of medical examination of children in rural medical centers based on expert 
assessment (% of total) 
Disease 
Timeliness of the 
survey 
Survey volume 
Conducting medical and 
recreational activities 
tim
ely
u
n
tim
ely
fu
ll
in
co
m
p
lete
fu
ll
in
fer
io
r 
Migraine,tension headache 
74,3 
25,7 
74,3 
25,7 
77,7 
22,3 
Radiculitis 
65,3 
34,7 
65,3 
34,7 
69,2 
30,8 
Encephalopathy 
94,5 
5,5 
84,5 
15,5 
94,5 
5,5 
Neuritis and Neuralgia 
82,1 
17,9 
72,1 
27,3 
74,8 
24,2 
Epilepsy 
93,1 
6,9 
87,1 
12,9 
93,3 
6,7 
Cerebral palsy 
66,6 
33,0 
66,6 
33,4 
67,6 
32,4 
Polyneuropathy 
94,5 
5,5 
74,5 
25,5 
94,3 
5,7 

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Journal of Pharmaceutical Negative Results ¦ Volume 13 ¦ Special Issue 9 ¦ 2022
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Transient cerebrovascular 
accident 
72,7 
27,3 
72,7 
27,3 
74,8 
24,2 
ONMK 
96,0 
4,0 
91,0 
9,0 
95,5 
4,5 
Conditions after transferred 
stroke 
72,9 
27,1 
72,9 
27,1 
74,8 
25,2 
Convulsive syndromes 
75,8 
24,2 
75,8 
24,2 
77,6 
22,4 
Parkinson’s disease 
78,9 
21,1 
78,9 
21,1 
80,6 
19,4 
Average 
80,1 
19,9 
76,4 
23,6 
82,5 
17,5 
Equally important in improving the quality of medical examination is the timely consultation of patients with narrow 
specialty doctors and general practitioners. However, according to expert estimates, in 21.9% of cases, consultations 
were held out of time. The reason for the untimely or failed consultation in 61% of cases was the lack of a specialist, in 
6% of cases the attending physician did not appoint a consultation.An important criterion for clinical examination is the 
assessment of its quality and effectiveness. For each nosological form, criteria for the effectiveness of medical 
examination were developed. 
In diseases of the nervous system, the following criteria were taken into account: improvement of motor functions and 
motor skills, increase in the amplitude of movements; reduction in relapse rate; reduction or disappearance of 
pathological reflexes; reduction in relapse rate; reduction or disappearance of contractures and deformations of joints 
and bones, etc. 
We analyzed the dynamics of the health of the population under dispensary observation in rural medical centers . The 
following results were obtained: recovery - 2.1%, improvement - 70.2%, no change - 22.8%, transition to disability - 
4.5%, worsening - 2.5% of patients. In the “no change” group, the main share falls on patients with cerebral palsy, the 
state after suffering a stroke, which may indicate an insufficient volume of medical and health measures, including 
rehabilitation treatment. 
It is known that indicators of the cost-effectiveness of medical examination of the population is a decrease in the 
frequency of cases of temporary disability in connection with patient care. 
It is known that the card of an outpatient is a legal document, which can speak “for” and “against” a doctor in case of 
lawsuit. However, according to expert estimates, in 46.3% of cases defects in the maintenance of this document were 
noted. In particular, an insufficient description of the medical history was detected in 23.2% of cases, and the absence of 
a doctor’s records. 
There was also a lack of data on the outcome of the disease, in some cases, recommendations were not given to patients. 
The materials of the expert assessment showed that in every third case there is no continuity in the examination and 
treatment of patients between outpatient and inpatient facilities. 
Thus, an in-depth study of the quality and effectiveness of clinical examination in rural medical centers with expert 
assessment showed that there are significant reserves for improving the quality of medical examination, which depend 
primarily on the level of professional training of general practitioners, nurses, the monitoring system for their activities 
and the availability of methodological recommendations for providing medical examination and quality control [13-14]. 
Identified defects in the organization and quality of the clinical examination indicate the lack of effectiveness of 
existing systems of departmental and non-departmental control over this process. 

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Journal of Pharmaceutical Negative Results ¦ Volume 13 ¦ Special Issue 9 ¦ 2022
4816 
 
Based on the materials of the study, we developed guidelines for improving the organization and improving the quality 
of medical examination in the conditions of rural medical centers. They, in particular, include organizational and 
methodological issues of ensuring the quality of medical examination of the population, indicators of the quality and 
effectiveness of medical examination; methods of analysis and assessment of the quality of medical examination using 
expert assessments; information support for the quality management process of the clinical examination; continuing 
education programs for general practitioners and nurses; rational organization of the work of the local therapist; 
proposals for improving the relationship of general practitioners and narrow specialists. 
Clinical examination is a complex of measures, including a medical examination by doctors of several specialties and 
the application of the necessary examination methods, which are carried out with the aim of early detection of chronic 
non-infectious diseases (conditions), which are the main cause of disability and premature mortality of the Uzbekistan 
population and risk factors for their development as well as in order to form health groups and make recommendations 
for patients.
Regular medical examinations and preventive medical examinations are the most important mass and highly effective 
medical technologies for preserving health and reducing premature mortality. Regular medical examinations will 
significantly reduce the likelihood of developing the most dangerous diseases that are the main cause of disability and 
mortality in our country or identify them at an early stage of developmen. When their treatment is most effective.