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Role of the S. Fyodorov Eye Microsurgery Federal State Institution in the work of the regional children’s ophthalmological service. 费奥多罗夫眼科显微手术联邦国立机构在地区儿童眼科服务工作中的作用。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-32-39
A. V. Tereshchenko, I. G. Trifanenkova, S. N. Popov, S. V. Silayeva, A. Vydrina, G. V. Murav’yeva
One of the main tasks of the children’s ophthalmological service in any region is to ensure the availability of high-tech medical care, however, personnel and technological shortages can negatively affect this indicator. Using the resources of a federal specialized clinic at the regional level can help resolve this issue. The goal is to reflect the participation of the federal specialized clinic in the work of the regional children’s ophthalmological service. Material and methods. The data used to assess the state of provision of ophthalmological care to children was taken from the electronic database of medical records of patients who received ophthalmological care at the Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution in the period from 2017 to 2023. Results. In 2005, a pediatric surgical department was organized at the Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution. The work of the department’s ophthalmologists is primarily aimed at providing modern surgical treatment for children with various ophthalmological diseases. The leading scientific and practical direction is retinopathy of prematurity. To ensure optimal accessibility of specialized medical care, implementation of a system for early diagnosis and monitoring of the vision status of children, in the fall of 2020, a Children’s Ophthalmological Diagnostic Center (DOC) was opened within the structure of the Kaluga branch of the MNTK. The priority direction of the DOC is the introduction into clinical practice of innovative medical technologies aimed at early detection and formation of stages in the treatment of eye diseases in children and adolescents, and the determination of recommendations for preventive measures. From 2017 to 2023, the volume of ophthalmological care provided by the Kaluga branch of MNTK was within the range of 1,400–3,000 operations per year. Every year, ophthalmological care is provided directly to more than 1000 children at the Children’s Center. In total, over the entire period of operation of the center, conservative treatment was carried out in 3552 cases of amblyopia, myopia and other forms of ametropia, including severe forms. Using the new treatment method, 809 courses of treatment have been carried out at the Amblyokor complex since September 2020. During the work of the Center, 1908 orthokeratology lens sets were selected and issued. In addition to accepting patients living in the Kaluga region, we are actively accepting children from other regions. Conclusion. Thanks to the work of the branch of the MNTK «Eye Microsurgery» in the Kaluga region, the shortage of highly qualified medical personnel is compensated, the effective use of complex and unique diagnostic and treatment equipment is concentrated and implemented, the widespread introduction of progressive treatment methods into practice is ensured, the optimal route for patients is developed, taking into account the structure of medical organizati
在任何地区,儿童眼科服务的主要任务之一都是确保提供高科技医疗服务,但人员和技术短缺会对这一指标产生负面影响。在地区一级利用联邦专科诊所的资源有助于解决这一问题。我们的目标是反映联邦专科诊所参与地区儿童眼科服务工作的情况。材料和方法。用于评估儿童眼科医疗服务状况的数据来自斯-费奥多罗夫眼科显微外科联邦国家机构卡卢加分院2017-2023年间接受眼科医疗服务的患者病历电子数据库。研究结果斯-费奥多罗夫眼显微手术联邦国立机构卡卢加分院于 2005 年成立了小儿外科。该部门眼科医生的工作主要是为患有各种眼科疾病的儿童提供现代外科治疗。科学和实践的主要方向是早产儿视网膜病变。为了确保最佳的专业医疗服务、早期诊断系统的实施和儿童视力状况的监测,2020 年秋季在国家技术和科学部卡卢加分部的结构内开设了儿童眼科诊断中心(DOC)。儿童眼科诊断中心的优先方向是将创新医疗技术引入临床实践,旨在早期发现和形成治疗儿童和青少年眼疾的阶段,并确定预防措施建议。从 2017 年到 2023 年,MNTK 卡卢加分部每年提供的眼科治疗量在 1 400-3 000 例手术范围内。儿童中心每年直接为 1000 多名儿童提供眼科治疗。在中心运营的整个期间,共对 3552 例弱视、近视和其他形式的斜视(包括重度斜视)进行了保守治疗。自 2020 年 9 月以来,在 Amblyokor 综合中心使用新的治疗方法进行了 809 个疗程的治疗。在中心工作期间,共挑选并发放了 1908 套角膜塑形镜。除了接收卡卢加地区的患者外,我们还积极接收其他地区的儿童。结论由于卡卢加州 "眼科显微手术 "MNTK 分部的工作,弥补了高素质医务人员的不足,集中并有效地使用了复杂而独特的诊断和治疗设备,确保在实践中广泛采用先进的治疗方法,为患者制定最佳治疗路线,同时考虑到医疗组织的结构,参与实施国家保障向居民提供免费援助的计划。需要指出的是,通过 "S. Fyodorov "眼科显微手术联邦国立机构卡卢加分院为儿童提供的眼科治疗在很大程度上是跨地区的,影响到邻近地区的领土。
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引用次数: 0
On the need to improve legal regulation regarding medical care for patients before and after organ transplantation. 需要完善器官移植前后患者医疗护理方面的法律规定。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-4-12
A. V. Novozhilov, I. S. Kitsul, D. Piven
The article substantiates a set of problems associated with imperfect legislation regarding mechanisms for regulating the provision of medical care to patients before and after organ transplantation. The authors show that the current legislation does not define who is the attending physician of a patient awaiting and undergoing an organ transplant, and the legal context for organizing such medical care is not substantiated. This may pose significant risks to patients, reduce the quality of medical care provided, and adversely affect the function of the transplanted organ. Based on the analysis carried out, the article makes specific proposals for making additions to the current specialized procedure for providing medical care and the law of the Russian Federation “On transplantation of human organs and (or) tissues.”
文章证实了与器官移植前后为患者提供医疗服务的监管机制相关的立法不完善所带来的一系列问题。作者指出,现行法律没有规定谁是等待器官移植和接受器官移植的病人的主治医生,组织此类医疗护理的法律背景也没有得到证实。这可能会给患者带来重大风险,降低医疗质量,并对移植器官的功能产生不利影响。根据分析结果,文章提出了对现行医疗服务专门程序和俄罗斯联邦 "人体器官和(或)组织移植法" 进行补充的具体建议。
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引用次数: 0
Mixed, hybrid training as a necessary component of modern training of medical professionals. 混合式混合培训是现代医学专业人员培训的必要组成部分。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-87-96
T. B. Sviridova, R.G. Makiev, A. S. Lutikov, E. A. Goldina
The article presents a review of the literature on the introduction of mixed, hybrid training in educational programs of additional professional education of medical workers. Definitions of mixed and hybrid learning are given. Publications, research and best practices related to mixed, hybrid training of medical professionals are considered. Attention is focused on the importance of this approach and information is provided that can be useful for teachers, educational institutions and medical professionals seeking to update their skills and knowledge.
文章综述了在医务工作者补充专业教育课程中引入混合式培训的文献。文章给出了混合学习和混合学习的定义。文章考虑了与医学专业人员混合式混合培训有关的出版物、研究和最佳实践。重点关注了这一方法的重要性,并提供了对教师、教育机构和寻求更新技能和知识的医务专业人员有用的信息。
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引用次数: 0
Evaluation of clinical observation of children in the first year of life. 对出生后第一年儿童临床观察的评估。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-23-31
K. E. Moiseeva, M. G. Karailanov, V. V. Danilova, K. G. Shevtsova, Sh D Kharbediya, M. Daineko
Children’s health is a powerful resource that can become the key to the future health of the nation. Considering the significant increase in morbidity among children in recent years, the assessment of dispensary observation of children in the first year of life is a relevant topic for research. Purpose: to assess the level and dynamics of dispensary observation indicators for children in the first year of life living in St. Petersburg. Materials and methods. Based on copying information from statistical reporting forms No. 12, a retrospective one-time study of indicators of the frequency of taking children of the first year of life into dispensary registration, the frequency of continuing dispensary observation after the first year of life, as well as the proportion of children of the first year of life remaining under dispensary observation from those registered during the year. The significance of differences in indicators was assessed using Student’s t-test. Differences were considered significant at p<0.05. Statistical data processing was carried out using the MS Office‑2016 and StatSoft-Statistica 10.0 software packages. Results. Most often, children in the first year of life needed examination and treatment on an outpatient basis for diseases of the nervous system, certain conditions that arise in the perinatal period, as well as diseases of the respiratory and digestive organs. Most often, in children’s clinics of the metropolis, after the first year of life, dispensary observation of children with diseases of the nervous system, eyes and its appendages, digestive organs and congenital malformations continued. With a high frequency of children with respiratory diseases and certain conditions arising in the perinatal period being taken under dispensary observation, in most cases, by the end of the first year of life, children with these diseases are removed from the dispensary register. At the same time, with a low frequency of children being admitted to convalescent care, on average 71.3% of such patients remain under further dispensary registration. A high proportion of children who remain under clinical observation are patients with diseases of the genitourinary system, the eye and its adnexa, skin and subcutaneous tissue, the musculoskeletal system and connective tissue and the nervous system. Conclusion. In St. Petersburg, the increase in morbidity among children in the first year of life was due to the growing need for dispensary monitoring of children for almost all classes of diseases, except for respiratory diseases and certain conditions that arise in the perinatal period.
儿童健康是一种强大的资源,可以成为国家未来健康的关键。考虑到近年来儿童发病率的大幅上升,对出生后第一年的儿童进行诊室观察评估是一个相关的研究课题。目的:评估圣彼得堡市出生后第一年儿童的诊室观察指标水平和动态。材料和方法。根据从第 12 号统计报告表中复制的信息,对将一岁儿童送入诊所登记的频率、一岁后继续接受诊所观察的频率以及一岁儿童在当年登记的儿童中继续接受诊所观察的比例等指标进行一次性回顾性研究。指标差异的显著性采用学生 t 检验。P<0.05 为差异显著。统计数据处理采用 MS Office-2016 和 StatSoft-Statistica 10.0 软件包。结果大多数情况下,出生后第一年的儿童需要在门诊接受神经系统疾病、围产期的某些疾病以及呼吸和消化器官疾病的检查和治疗。在大都市的儿童诊所中,大多数情况下,儿童在出生后的第一年都要继续接受神经系统、眼睛及其附属器官、消化器官和先天性畸形等疾病的门诊观察。由于患呼吸系统疾病和围产期某些疾病的儿童在诊所接受观察的频率很高,在大多数情况下,到出生后第一年结束时,患有这些疾病的儿童都会从诊所登记册中删除。与此同时,由于儿童入院疗养的频率较低,平均 71.3%的此类患者仍需进一步进行诊疗登记。在继续接受临床观察的儿童中,泌尿生殖系统、眼睛及其附件、皮肤和皮下组织、肌肉骨骼系统和结缔组织以及神经系统疾病患者所占比例较高。结论在圣彼得堡,除了呼吸系统疾病和围产期出现的某些疾病外,几乎所有类型的疾病都需要对儿童进行门诊监测,这也是儿童出生后第一年发病率增加的原因。
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引用次数: 0
Comparative assessment of the quality life of children with bronchial asthma in different age groups. 不同年龄段支气管哮喘患儿生活质量的比较评估。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-119-126
Z. R. Alikova, L. S. Baisangurova, S. S. Enaldieva, I. T. Kusova
The purpose of the study: assessment of quality of life indicators and their impact on life parameters in children aged 6–17 years with bronchial asthma. Materials and methods. The study was performed using the Russian version of the SF‑36 questionnaire, which was filled out by children with bronchial asthma of younger age (6–14 years old) with their parents, older age (15–17 years old), independently. The survey was conducted among 408 children (6–17 years old) on the basis of the pulmonology department of the Republican Children’s Clinical Hospital and children’s polyclinics of the Republic of North Ossetia-Alania. The average age in the sample is 13.0 years, of which 76.2% are boys, 23.8% are girls. A comparative analysis of quality of life indicators was carried out in four age groups: 6–8 years (12.3%), 9–11 years (16.7%), 12–14 years (28.2%), 15–17 years (42.8%). The average values and the standard deviation (M±SD) were determined. The processing of the obtained data was carried out using the SPSS application software package (vers. 21). Results. According to the design of the study, the assessment of the health status of children was carried out in different age groups from 6 to 17 years old. The most unsatisfactory assessments of their health were revealed in three older age groups, especially pronounced at the age of 12–14 years. At the same time, half of the surveyed children (50.2%) did not improve their health during the year and more than 8% of them began to feel worse. It was revealed that bronchial asthma affects the parameters of quality of life: the physical and psychological condition of children suffers, their social adaptation is disrupted. With equal indicators of these components in girls, boys have a slightly higher physical component than the mental one. When comparing the age groups, a more significant violation of the mental component of the quality of life with the age of children was revealed. The largest number of children with bronchial asthma (31.1%) experience significant limitations during heavy physical exertion. A direct correlation has been revealed between the increase in difficulty with physical exertion and their performance in a smaller volume with age. According to the evaluation scales, the total indicators of the quality of life of children with bronchial asthma are interpreted unambiguously, low, and amount to slightly more than 47 points. Older children who have pronounced negative symptoms and need correction of therapeutic and preventive measures require special attention. At the same time, the existing complex problems in the organization of effective dispensary monitoring of children with bronchial asthma are being updated. Conclusion. The obtained quantitative measures of the health of children suffering from bronchial asthma indicate a low level of quality of life for patients in all age groups. For the identified risk groups, a full-fledged individual monitoring of the condition of patients shou
研究目的:评估 6-17 岁支气管哮喘患儿的生活质量指标及其对生活参数的影响。材料和方法。研究使用俄文版 SF-36 问卷,由年龄较小(6-14 岁)的支气管哮喘儿童在父母的陪同下独立填写,年龄较大(15-17 岁)的儿童独立填写。调查在共和国儿童临床医院肺科和北奥塞梯-阿拉尼亚共和国儿童综合诊所的 408 名儿童(6-17 岁)中进行。样本的平均年龄为 13.0 岁,其中 76.2%为男孩,23.8%为女孩。对四个年龄组的生活质量指标进行了比较分析:6-8 岁(12.3%)、9-11 岁(16.7%)、12-14 岁(28.2%)、15-17 岁(42.8%)。测定了平均值和标准偏差(M±SD)。数据处理采用 SPSS 应用软件包(21 版)。结果根据研究设计,对 6 至 17 岁不同年龄组儿童的健康状况进行了评估。对健康状况最不满意的是三个较大的年龄组,尤其是 12-14 岁年龄组。同时,半数受访儿童(50.2%)的健康状况在这一年中没有得到改善,超过 8%的儿童的健康状况开始恶化。调查显示,支气管哮喘影响了生活质量的参数:儿童的身体和心理状况受到影响,他们的社会适应能力也受到破坏。在女孩的这些指标相同的情况下,男孩的生理指标略高于心理指标。在对年龄组进行比较时发现,随着儿童年龄的增长,生活质量的心理部分受到的影响更为明显。患有支气管哮喘的儿童中,有 31.1%的人在进行重体力劳动时会受到严重限制。随着年龄的增长,体力消耗难度的增加与体力消耗量的减少有直接的关系。根据评价量表,支气管哮喘患儿生活质量的总指标解释明确、偏低,略高于 47 分。年龄较大的儿童如果有明显的不良症状,需要纠正治疗和预防措施,则需要特别关注。同时,在组织对支气管哮喘儿童进行有效诊室监测方面存在的复杂问题也在不断更新。结论对支气管哮喘儿童健康状况的定量测量结果表明,各年龄组患者的生活质量都很低。对于已确定的高危人群,应在该地区儿童医疗保健的综合诊所中对患者的病情进行全面的个体监测,并制定有针对性的康复计划,以改善和保护支气管哮喘儿童的健康。这种方法将提供更多有关儿童病情的信息,并有助于改善治疗效果。考虑到已取得的成果,有必要继续对支气管哮喘儿童的生活质量进行进一步研究。
{"title":"Comparative assessment of the quality life of children with bronchial asthma in different age groups.","authors":"Z. R. Alikova, L. S. Baisangurova, S. S. Enaldieva, I. T. Kusova","doi":"10.21045/1811-0185-2024-6-119-126","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-6-119-126","url":null,"abstract":"The purpose of the study: assessment of quality of life indicators and their impact on life parameters in children aged 6–17 years with bronchial asthma. Materials and methods. The study was performed using the Russian version of the SF‑36 questionnaire, which was filled out by children with bronchial asthma of younger age (6–14 years old) with their parents, older age (15–17 years old), independently. The survey was conducted among 408 children (6–17 years old) on the basis of the pulmonology department of the Republican Children’s Clinical Hospital and children’s polyclinics of the Republic of North Ossetia-Alania. The average age in the sample is 13.0 years, of which 76.2% are boys, 23.8% are girls. A comparative analysis of quality of life indicators was carried out in four age groups: 6–8 years (12.3%), 9–11 years (16.7%), 12–14 years (28.2%), 15–17 years (42.8%). The average values and the standard deviation (M±SD) were determined. The processing of the obtained data was carried out using the SPSS application software package (vers. 21). Results. According to the design of the study, the assessment of the health status of children was carried out in different age groups from 6 to 17 years old. The most unsatisfactory assessments of their health were revealed in three older age groups, especially pronounced at the age of 12–14 years. At the same time, half of the surveyed children (50.2%) did not improve their health during the year and more than 8% of them began to feel worse. It was revealed that bronchial asthma affects the parameters of quality of life: the physical and psychological condition of children suffers, their social adaptation is disrupted. With equal indicators of these components in girls, boys have a slightly higher physical component than the mental one. When comparing the age groups, a more significant violation of the mental component of the quality of life with the age of children was revealed. The largest number of children with bronchial asthma (31.1%) experience significant limitations during heavy physical exertion. A direct correlation has been revealed between the increase in difficulty with physical exertion and their performance in a smaller volume with age. According to the evaluation scales, the total indicators of the quality of life of children with bronchial asthma are interpreted unambiguously, low, and amount to slightly more than 47 points. Older children who have pronounced negative symptoms and need correction of therapeutic and preventive measures require special attention. At the same time, the existing complex problems in the organization of effective dispensary monitoring of children with bronchial asthma are being updated. Conclusion. The obtained quantitative measures of the health of children suffering from bronchial asthma indicate a low level of quality of life for patients in all age groups. For the identified risk groups, a full-fledged individual monitoring of the condition of patients shou","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"68 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Building an internal communication mechanism for participants in the procurement process of a public health institution. 为公共卫生机构采购流程的参与者建立内部沟通机制。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-50-59
A.V. Boychuk
The relevance of the work is determined by the need to optimize the procurement process in state medical institutions to improve the quality and efficiency of medical services provided. The subject of the study is the socio-economic interactions between participants in the procurement process, including preparation, implementation, and monitoring of procurement agreements. The purpose of the study is to identify and systematize the main problems in the field of procurement activities of public medical institutions and develop proposals for solving them based on the principles of cost-effectiveness, transparency and fairness. Materials and methods. The study includes a comprehensive analysis of current regulations governing procurement activities, as well as a study of the experience of implementing procurement procedures in medical institutions. Methods of comparative analysis, systematization and synthesis of the obtained data are used to identify key problems and challenges. Results. The work identified the main problems associated with the procurement process in medical institutions, including shortcomings in the regulatory framework, lack of a clear distribution of responsibilities between participants in the process and ineffective management decisions. Proposals were developed to optimize the procurement process, including adapting procurement models to the size and specificity of the activities of institutions, improving the documentation of the distribution of responsibilities and using digital technologies to improve the monitoring and management of procurement. Conclusions. Optimization of the procurement process in state medical institutions requires a comprehensive approach, including improving the legislative framework, enhancing interaction between structural units, and applying modern technologies to increase transparency and efficiency of procurement activities. These measures will not only help eliminate existing problems but also ensure higher quality and availability of medical services. Application of results. The results of the work can be applied in the healthcare system at the level of state medical institutions for the development and implementation of effective procurement models. They can also be used in the development of regulatory documents regulating procurement in the healthcare sector, as well as in the educational process for training specialists in procurement and logistics management in medical institutions.
这项工作的现实意义在于需要优化国立医疗机构的采购流程,以提高所提供医疗服务的质量和效率。研究的主题是采购流程参与者之间的社会经济互动,包括采购协议的准备、执行和监督。研究的目的是确定公立医疗机构采购活动领域存在的主要问题并将其系统化,并根据成本效益、透明度和公平性原则提出解决这些问题的建议。材料和方法。本研究包括对现行采购活动管理条例的全面分析,以及对医疗机构实施采购程序经验的研究。采用比较分析、系统化和综合所得数据的方法来确定关键问题和挑战。结果。这项工作确定了与医疗机构采购程序有关的主要问题,包括监管框架的缺陷、程序参与者之间缺乏明确的责任分配以及管理决策无效。提出了优化采购流程的建议,包括根据机构活动的规模和特殊性调整采购模式,改进责任分配文件,以及利用数字技术改进采购的监测和管理。结论优化国立医疗机构的采购流程需要采取综合措施,包括完善立法框架、加强结构单元之间 的互动以及应用现代技术提高采购活动的透明度和效率。这些措施不仅有助于消除现有问题,还能确保提高医疗服务的质量和可用性。成果应用。工作成果可应用于国家医疗机构一级的医疗系统,以制定和实施有效的采购模式。这些成果还可用于制定规范医疗保健部门采购的监管文件,以及用于培训医疗机构采购和物流管理专家的教育过程。
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引用次数: 0
Expert assessment of indicators and indicators for the development of a model of digital maturity of primary health care 专家评估制定初级保健数字化成熟度模型的指标和指数
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-97-107
D. V. Voshev, I. M. Son, A. P. Stolbov
The research is devoted to the development of a model of digital maturity of primary health care in the Russian Federation. Through expert evaluation, key indicators and indicators of digital maturity were identified, which made it possible to create a comprehensive model for assessing the digital development of medical organizations. The main attention is paid to the functional capabilities of medical information systems and information and communication technologies that ensure high quality and accessibility of medical care. Aim: to conduct an expert assessment of indicators and indicators for the development of a model of digital maturity of primary health care. This includes an analysis of existing indicators, identification of key indicators, their classification and assessment of significance for the formation of an objective model for assessing the digital maturity of medical organizations. Materials and methods. For a systematic assessment of the digital maturity of primary health care, a questionnaire was developed containing 6 indicators and 52 indicators reflecting various aspects of the digital maturity of the subjects of the Russian Federation. Regulatory documents, methodological guidelines and recommendations from experts in the field of medicine and information technology were studied. Experts assessed the importance of each indicator on a scale from 0 to 10 points, and the results of the assessments were classified to form the final model. Results. The expert assessment showed that the functionality of the medical information system is evaluated higher than the equipment of information and communication technologies. Key indicators, such as access to research results and telemedicine consultations, received high marks, indicating their importance for the digital maturity of medical organizations. The recommendations include updating the digital infrastructure, developing the functionality of the medical information system and improving the level of training of medical personnel. Conclusions: the study showed that in order to achieve a high level of digital maturity of PHC, it is necessary to pay attention to both the technical equipment and the development of the IIA functionality. An integrated approach, including updating the infrastructure and improving the digital literacy of medical personnel, will significantly improve the quality and accessibility of medical care. The proposed recommendations can serve as a basis for further planning of measures to increase the digital maturity of primary health care in the Russian Federation.
该研究致力于开发俄罗斯联邦初级卫生保健数字化成熟度模型。通过专家评估,确定了数字化成熟度的关键指标和指数,从而有可能建立一个评估医疗机构数字化发展的综合模型。主要关注医疗信息系统和信息通信技术的功能能力,以确保医疗服务的高质量和可及性。目的:对指标和指标进行专家评估,以建立基层医疗机构数字化成熟度模型。这包括对现有指标进行分析,确定关键指标,对其进行分类,并评估其对形成评估医疗机构数字化成熟度的客观模型的意义。材料和方法。为系统评估基层医疗机构的数字化成熟度,编制了一份调查问卷,其中包含 6 个指标和 52 个反映俄罗斯联邦主体数字化成熟度各个方面的指标。研究了医学和信息技术领域的监管文件、方法指南和专家建议。专家们对每项指标的重要性进行了 0-10 分的评估,并将评估结果进行分类,形成了最终模型。结果。专家评估结果显示,对医疗信息系统功能的评价高于对信息和通信技术设备的评价。获取研究成果和远程医疗咨询等关键指标获得了高分,这表明它们对医疗机构的数字化成熟度非常重要。建议包括更新数字化基础设施、开发医疗信息系统的功能和提高医务人员的培训水平。结论:研究表明,为了使初级保健中心的数字化成熟度达到较高水平,有必要同时关注 技术设备和开发 IIA 功能。采取综合方法,包括更新基础设施和提高医务人员的数字素养,将大大提高医疗服务的质量和可及性。提出的建议可作为进一步规划措施的基础,以提高俄罗斯联邦初级卫生保健的数字化成熟度。
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引用次数: 0
Early diagnosis of malignant skin tumors using a software product based on artificial intelligence and its medical and economic effect. 利用基于人工智能的软件产品对恶性皮肤肿瘤进行早期诊断及其医疗和经济效果。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-108-118
N. A. Sivodedova, N. N. Karyakin, I. L. Shlivko
Malignant neoplasms of the skin (hereinafter referred to as MNC) occupy a leading place in the structure of oncological diseases in the Russian Federation (female population: MNC – 13.4%, skin melanoma (hereinafter MC) – 2.2%; male population: MNC – 9.8%, MK – 1.73%). Over the past 10 years, there has been an increasing incidence of MNC [1]. The emergence of new treatment methods leads to increased effectiveness, but at the same time, the cost of treatment invariably increases. In the Russian Federation, the main share of costs for MC are direct medical costs (52%). Indirect costs amount to 14%, which is associated with the onset of disability, since the disease is typical for people of working age. direct non-medical costs, despite the small size of social benefits, also constitute a significant part of the total economic burden (about 34%). [2]. The costs of caring for a patient with early-stage MС are significantly lower than for caring for a patient in unresectable stage III/IV. [3],[4],[5],[6]. At the same time, radical surgical treatment of stage I melanoma can increase the number of positive outcomes for skin melanoma. [8] In general, it can be stated that diagnosing MС at late stages leads to an increase in the cost of treatment. In addition to the above, it should be noted that primary health care specialists are the first to face the problem of differential diagnosis of cancer with benign skin tumors. [9], [10] When conducting a visual examination by these specialists, the sensitivity of MC recognition is 40.2%, which is two times lower than that of an experienced dermatologist (92%) [11], [12]. Considering the seriousness of the identified problems, the search and implementation of new approaches for the early detection of cancer are coming to the fore. Possible solutions include the various methods recently proposed for the early detection of cancer in the form of the use of mobile applications based on artificial intelligence and teledermatology, which can expand the capabilities of imaging systems and help primary care specialists identify cancer [13], [14], [15], [16], [17], [18]. An equally pressing issue remains the implementation of an effective system for the prevention and early diagnosis of cancer, which would include mass screening of the population at the pre-outpatient stage and the use of modern diagnostic methods in the form of mobile applications at the outpatient stage, for any reason the patient visits a primary care doctor. Since 2023, in two regions of the Russian Federation (Nizhny Novgorod region, Republic of Tatarstan), a pilot project «Region without melanoma» has been carried out, the implementation of which is supported by the «Priority 2030» program of the national project «Science and Universities». The project includes mass screening of the population for the presence of cancer using the «ProRodinki» mobile application. To expedite the routing of patients to an oncologist with suspected cancer, a direct cal
该研究还评估了俄罗斯联邦 148 名МСⅠ期(38 人)、Ⅱ期(46 人)、Ⅲ期(34 人)、Ⅳ期(30 人)患者在 2022 年期间的治疗费用,并与俄罗斯联邦临床建议的治疗费用进行了比较。结论研究结果表明,"无黑色素瘤地区 "社会项目取得了显著成效,因为在该计划范围内实施的现代方法取得了重大成果。提高癌症诊断检测的人口覆盖率是提高这类疾病治疗效果的重要组成部分。在患者出院前阶段,利用 "ProRodinki "移动应用程序,采用现代诊断方法对人群进行癌症筛查是大有希望的。此外,在早期发现膀胱癌方面也取得了令人鼓舞的成果,这可能会增加该疾病的积极治疗效果。此外,根据获得的数据,早期发现可降低治疗费用,有助于节省医疗预算。总之,寻找和实施新的现代方法具有广泛的潜力,有可能显著提高医疗系统的效率,特别是在癌症的检测和治疗方面。
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引用次数: 0
Technologies for preventing professional burnout and maintaining the resource state of personnel in primary care in Moscow healthcare. 预防职业倦怠和保持莫斯科医疗机构初级保健人员资源状态的技术。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-80-86
A. S. Bezymyannyy, E. N. Mingazova
Advanced technologies for maintaining the resource state of personnel form the basis of a multi-level Comprehensive Program for the Prevention and Combating of Professional Burnout among Medical Workers, developed by the Moscow Department of Health based on an analysis of the experience of global and Russian public and private healthcare organizations. This program covers all aspects of the existing problem and solves it at the system level. Its implementation helps to increase the satisfaction of medical workers with working conditions, leads to a decrease in the number of days of incapacity and dismissals, which in turn leads to an increase in the availability and quality of medical care provided to citizens, as well as an improvement in the image of primary care in Moscow healthcare, and an increase in satisfaction with social policy city from the population as a whole.
保持人员资源状态的先进技术是莫斯科卫生局在分析全球和俄罗斯公共及私营医疗机构经验的基础上制定的多层次《预防和消除医务工作者职业倦怠综合方案》的基础。该方案涵盖了现有问题的方方面面,并在系统层面上加以解决。该方案的实施有助于提高医务工作者对工作条件的满意度,减少丧失工作能力和被解雇的天数,进而提高为公民提供的医疗服务的可用性和质量,改善莫斯科医疗保健中初级保健的形象,提高全体居民对社会政策城市的满意度。
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引用次数: 0
Results of targeted employment of health workers in urban and rural areas. 在城市和农村地区有针对性地聘用卫生工作者的成果。
Pub Date : 2024-07-01 DOI: 10.21045/1811-0185-2024-6-60-67
A. A. Latyshova, T. G. Bogdanova
Targeted training of future medical workers and their guaranteed employment is one of the state measures to address the issue of the shortage of specialists. The key mission of targeted training is the balanced regulation by the organization of training and employment. Currently, there are not enough scientific studies on the results and effectiveness of this measure in the health care system, but many researchers emphasize the problems of targeted employment of medical workers. According to the studies of a number of authors, the imperfection of normative legal regulation of issues of targeted training allows graduates not to fulfill the obligations of employment in medical organizations upon graduation [3–9]. The purpose of the study. Conduct an analysis of indicators reflecting the specifics of targeted employment of health workers in organizations located in urban and rural areas in 2022 and 2023. Materials and methods. The study used statistical data for 85 constituent entities of the Russian Federation on the basis of an operative documented request to the health protection authorities of the constituent entities of the Russian Federation, containing information on the number of employed doctors and nursing staff within the framework of targeted training, as well as the planned values of targeted employment in accordance with the concluded contracts. The study period is 2022 and 2023. The total data on targeted employment of medical workers after completion of the specialty program and completion of residency in the context of the names of positions of doctors and nursing staff were analyzed. Analytical and descriptive statistics methods were used in the research process. Results. The share of doctors and nursing staff employed after completion of targeted training from the total number of medical workers in organizations located in rural areas is higher than the share of those recruited to work in urban medical organizations. On average, 1.3% of doctors and 0.21% of nursing staff are annually recruited to urban medical organizations as part of targeted employment out of the total number of the respective key medical personnel as of the end of the reporting year. In rural areas, these figures are 2.6% and 0.30%, respectively. Specialists are predominantly employed in urban medical organizations, while in rural areas – district doctors. The study revealed that in 2023 there were 128.1 target recruitments per 10,000 doctors in urban areas in a given year, and in 2022–124.8, i. e. the intensity of employment by target recruitment in urban areas increased by 2.6% in two years. In rural areas, there were 260.2 target recruitment admissions per 10,000 physicians in 2023 and 262.8 in 2022, that is, the intensity of target recruitment employment of physicians in rural areas decreased by 1% in two years. When analyzing the indicator comparatively, it is noted that in rural areas it is almost twice as high as in urban areas. Conclusions. Targeted emp
对未来医务工作者进行有针对性的培训并保证其就业,是国家解决专科医生短缺问题的措施之一。定向培养的主要任务是组织培训和就业的平衡调节。目前,关于这一措施在医疗系统中的效果和有效性的科学研究还不够多,但许多研究人员都强调了医务工作者定向就业的问题。根据多位学者的研究,由于定向培养问题的规范性法律规定不完善,导致毕业生在毕业时无法履行在医疗机构就业的义务[3-9]。研究目的对反映 2022 年和 2023 年城市和农村地区医疗卫生机构定向就业具体情况的指标进行分析。材料和方法。研究使用了俄罗斯联邦 85 个主体的统计数据,这些数据是根据向俄罗斯联邦各主体卫生保 护机构提出的操作性文件请求而获得的,其中包含在定向培养框架内聘用医生和护理人员的数量以 及根据签订的合同计划的定向就业值等信息。研究期限为 2022 年和 2023 年。在医生和护理人员岗位名称的背景下,对完成专业课程和完成住院医师培训后医务工作者定向就业的总数据进行了分析。研究过程中使用了分析和描述性统计方法。研究结果在农村地区的医疗机构中,完成定向培养后就业的医生和护理人员占医务人员总数的比例高于城市医疗机构招聘的比例。截至报告年末,平均每年有 1.3%的医生和 0.21%的护理人员作为定向就业的一部分被招聘到城市医疗机构工作,而这些人员是相应的骨干医务人员总数的一部分。在农村地区,这两个数字分别为 2.6%和 0.30%。城市医疗机构主要聘用专科医生,而农村地区主要聘用地区医生。研究显示,2023 年,城市地区每万名医生中的目标招聘人数为 128.1 人,2022 年为 124.8 人,即城市地区目标招聘的就业强度在两年内增加了 2.6%。在农村地区,2023年每万名医师中定向招聘录取人数为260.2人,2022年为262.8人,即农村地区医师定向招聘就业强度两年下降1%。对比分析该指标,可以发现农村地区的指标几乎是城市地区的两倍。结论定向招聘医务工作者是吸引医务人员到缺医少药机构工作的有效措施。分析表明,全国城市地区每万名医生的定向就业密集率低于农村地区,分别为 128.1 人和 260.2 人。根据过去两年的结果,计划定向就业的医生中有 60%履行了义务,其中农村地区占 50%。造成目前就业水平的主要原因是在校生和毕业生违反义务导致定向招生培养计划指标无法完成,这就需要结合各医疗机构的实际情况,制定专门的方法对教育机构定向招生计划的合理形成进行评估。在比较定向招生框架内的医生空缺岗位数量和毕业生就业人数时,发现俄罗斯联邦各主体的指标范围很大,在 1%至 29%(9.0±15.95)之间。因此,可以认为定向招聘的就业人数并不取决于对医生的额外需求,也不能弥补现有的不足。
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引用次数: 0
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Manager Zdravookhranenia
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