Manager Zdravookhranenia最新文献

{"title":"Center for retinal pathology within the new model of organizational structure in the “Ophthalmology”profile for diabetic retinopathy.","authors":"I.A. Martusevich, O. S. Kobyakova, V. V. Liutsko","doi":"10.21045/1811-0185-2024-4-49-57","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-4-49-57","url":null,"abstract":"Relevance. The most serious consequences of the global epidemic of diabetes are its systemic vascular complications, one of which is diabetic retinopathy as the most common cause of visual function loss among diabetic patients and the leading cause of blindness and visual impairment among the working population. However, with a well-organized screening system and early detection of this complication, more than 80% of cases of blindness and visual impairment can be prevented or treated. One of such approaches is the establishment of a specialized ophthalmological Center, which will elevate medical care for patients with diabetes complications to a qualitatively new level. Purpose of the study is to evaluate the functional role of the created retinal pathology centre within the framework of the new information and technological model of medical care in the profile «ophthalmology» for diabetic retinopathy in the Tomsk region. Materials and methods. The data of the federal statistical observation form No. 12 were used as materials. Statistical analysis methods: analytical; descriptive statistical method. The critical level of significance was set at p <0.05 (95%). Data processing was carried out using electronic spreadsheets «MSOffice Excel 2010» and the application package «Statistica» for Windows 10.0. Results. In the Tomsk region, a project is being implemented to introduce a unified organizational model of telemedicine service for monitoring diabetic retinopathy based on artificial intelligence technology, including a regional expert Center for retinal pathology as the main organizational and methodological unit, operating in close collaboration with healthcare institutions in the Tomsk region. Тhe Center’s task is early detection of diabetic retinopathy with further organizational and methodological support for identified cases. The activities of the Center are regulated by regional legal documentation aimed at regulating its work and adapting a new patient routing scheme for patients with diabetic retinopathy. The expected results of the project will reduce the predicted visual disability due to diabetic retinopathy in the Tomsk region to 80%, which will have a positive impact on the main performance indicators of the ophthalmological service in the region. Findings. The model allows for the integration of the Center for Retinal Pathology, prevention rooms of medical organizations, including remote municipal entities of the Tomsk region, equipped with ophthalmological fundus cameras for digital retinal photography, the ability to exchange data between networked medical organizations and the Center for Retinal Pathology. All these organizational changes will have a positive impact on reducing the overall prevalence of diabetic retinopathy in the region.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"5 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143150","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}

{"title":"Organizational aspects of home-based telerehabilitation of post-stroke patients.","authors":"V. A. Nikolaev","doi":"10.21045/1811-0185-2024-4-74-81","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-4-74-81","url":null,"abstract":"Restoring neurological functions after a stroke is one of the main medical and social problems of the 21st century. Telemedicine technologies increase the accessibility and coverage of medical care for patients living remotely from medical organizations, with limited mobility, and also during periods of pandemics. However, to date there are no methodological recommendations for making management decisions on organizing home telerehabilitation for patients who have suffered a stroke. This is due to the comparative novelty of technologies and insufficient knowledge of clinical studies, absence or lack of managerial experience. Therefore, the purpose of this article – develop a methodological framework for drawing up methodological recommendations when making management decisions on organizing home telerehabilitation after a stroke, which is a relevant area in the context of the digital transformation of healthcare. Materials and methods. The study was conducted using analytical methods and information retrieval. Results. Matrices have been developed to assess the readiness of the patient and the medical organization to conduct personalized telerehabilitation. A management decision-making scheme is proposed to assess the possibility of organizing telemedicine rehabilitation of a post-stroke patient at home. Findings. The results of the study may be useful to healthcare organizers and become the basis for the development of methodological recommendations when making management decisions on organizing home telerehabilitation for patients of the relevant profile.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"11 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141054768","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}

{"title":"Implementation of a cluster initiative in the development of human resource potential of medical organizations in rural areas.","authors":"I. E. Esaulenko","doi":"10.21045/1811-0185-2024-4-65-73","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-4-65-73","url":null,"abstract":"The relevance of this study is due to the need to solve the problems of providing medical personnel for rural healthcare in order to increase the availability and quality of medical care for the population. Purpose of the study: to identify resources and identify risks for the formation of human resources in medical organizations in rural areas. Materials and methods. The work studied and analyzed the literature sources of domestic authors on the personnel problem in healthcare, as well as regulatory documents on the topic of research. To assess the state of health care staffing in the Voronezh region, data from statistical accounting forms No. 17, No. 30 were used. Using the method of comparative analysis, a study was carried out of indicators of the supply of medical personnel and staffing of medical positions in medical organizations of the Voronezh region, the main indicators of the activities of medical organizations in rural areas of the region. In order to study the factors contributing to the attraction of young specialists to medical organizations in rural areas, an anonymous online survey was conducted. To process the data obtained, sociological, analytical and statistical methods were used. Results. The Voronezh region has a satisfactory level of provision with medical workers, but they are unevenly distributed throughout the region. The shortage of personnel is more pronounced in rural areas – staffing of regular positions is decreasing, the proportion of people of retirement age is growing, and the influx of young specialists is decreasing. Discussions. The study made it possible to provide objective information about the state of provision of health care institutions with medical personnel and the reasons for understaffing in rural areas. A subjective assessment of graduates of medical universities of their employment opportunities in medical organizations in rural areas made it possible to identify “weak points” and take them into account when forming the personnel policy of the region. Conclusion. Recommendations for solving the problem of continuous professional development of medical personnel are proposed. The findings of the study can be used in the formation of effective personnel policies aimed at proactively predicting the process of their reproduction in the healthcare system.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032830","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}

{"title":"Law on mandatory requirements and mandatory requirements for the quality and safety of medical activities: what the head of a medical organization needs to know.","authors":"D. Piven, I. S. Kitsul, I. V. Ivanov","doi":"10.21045/1811-0185-2024-4-15-22","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-4-15-22","url":null,"abstract":"The article presents an analysis of the Federal Law of July 29, 2021 № 247-FZ “On Mandatory Requirements in the Russian Federation” in relation to the basic mandatory requirements for the quality and safety of medical activities. As a result of the analysis, the authors draw the following conclusions. Mandatory requirements for the quality and safety of medical activities are measures to protect the life and health of people established by the Law on Mandatory Requirements, which in turn emphasizes their special importance in terms of ensuring and monitoring the quality and safety of medical activities. Heads of medical organizations should consider compliance with established mandatory requirements for the quality and safety of medical activities as priority areas of work. Heads of medical organizations should be as active as possible by participating in public discussions of regulatory legal acts containing mandatory requirements for the quality and safety of medical activities. The increase in the number of mandatory requirements for the quality and safety of medical activities observed in recent years does not allow for any weakening/reduction of federal state control (supervision) of the quality and safety of medical activities.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"118 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141033582","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}

{"title":"Epidemiological characteristics of breast cancer in the Republic of North Ossetia-Alania in 2017-2021 and during the period of coronavirus infection COVID-19.","authors":"I.A. Dzhioeva, Z. R. Alikova, A. E. Mamieva, T. T. Alikova","doi":"10.21045/1811-0185-2024-4-113-120","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-4-113-120","url":null,"abstract":"The purpose of the study: to identify the features of the incidence and main diagnostic indicators of breast cancer in the Republic of North Ossetia-Alania and assess their change during the spread of coronavirus infection COVID‑19. Materials and methods. The data of the annual reports of the Republican Oncological Dispensary of the Republic of North Ossetia-Alania and the data of the state medical statistics (form No. 7 «Information on malignant neoplasms») for 2012–2021 were studied. The most important diagnostic indicators for breast cancer have been analyzed. A comparative assessment of the indicators in the republic, the Russian Federation and the North Caucasus Federal District is given. Results. The urgency of the problem of oncological morbidity in the Republic of North Ossetia-Alania is due to the increasing prevalence of malignant neoplasms, according to which it occupies the first place in the North Caucasus Federal District. The leading oncological pathology in the female population is breast cancer 26,6% (RF – 21,7%). The epidemiological situation associated with the spread of COVID‑19 coronavirus infection has had a significant impact on cancer incidence in recent years. The rate of newly diagnosed breast cancer incidence in 2021 (44,0 per 100,000 population) was lower than in 2019. The characteristic trends of deterioration of the main diagnostic indicators are revealed. Similar to the indicator for the Russian Federation (25,6%), the rate of active detection of breast cancer decreased (42,6%). Despite the positive dynamics of the detection of the tumor process at stage I, early detection of breast cancer suffers due to a decrease in the detection rate at stage II to 50,2%. A stable growth trend over a five-year period, more than 2 times, of the indicator of the neglect of the tumor process (stage IV), amounting to 16,3% by 2022, was revealed. The detection rate at stages III and IV by 2022 was 32,9% in North Ossetia, 34,5% in the North Caucasus Federal District, and 27.1% in the Russian Federation. In 2021, the mortality rate from breast cancer in the first year after diagnosis in North Ossetia (3,6%) is lower than in the Russian Federation (4,8%) and the North Caucasus Federal District (5,2%). There is a maximum decrease in the five-year survival rate in 2020 to 54,2%, correlating with similar trends in the Russian Federation (56,6%). The morphological verification index, indicating the quality of specialized oncological care, is consistently higher than the national average (99,7%). Conclusion. The improvement of oncological situation in the republic will be facilitated by the implementation of priority areas of the regional program for the fight against oncological diseases, the main task of which is the active detection of malignant neoplasms at early stages and their effective treatment. In order to eliminate the current situation, it is necessary to concentrate efforts to improve the effectiveness of providing oncological ca","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"41 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141033069","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}

{"title":"Semantic analysis of the development of the topic of management and management of hospitals from 1945 to 2021.","authors":"R.N. Khairullin, A.F. Shakirova, E.G. Nikiforova","doi":"10.21045/1811-0185-2023-10-24-33","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-10-24-33","url":null,"abstract":"The results of the study showed that the subject area on the topic of «Management» and «Hospital Management» has been developing since 1945, but it becomes wider from 1982 to 2021 and acquires clear boundaries of the object of research. The analysis of verbs allowed us to come to the conclusion that their number remains approximately at the same level. However, there are differences in the verbs used, so on the topic of «Management», first of all, actions related to the evaluation of the object of study are used, then actions related to the basis of management and then the impact on the object in order to change its state. While researchers on the topic of «Hospital management» are primarily interested in the impact on the object in order to change its condition, then an assessment of the condition of the object, at what stage this object of research is located and then its processing. Today, there is a growing interest not only in the general processes of hospital management and management, the stages of its implementation, but also in knowledge in narrow subject areas: cardiology, emergency medical care, medical technologies. It also highlights the continuous evolution of management practices in healthcare, exploring new ideas, strategies and practices to improve the efficiency and quality of «hospital management». P u r p o s e o f t h e s t u d y is to study the subject area on the topic of management and management of hospitals using semantic analysis. M a t e r i a l s a n d m e t h o d s . The works in which the application of semantic analysis, classification of verbs and nouns is directly reflected are studied. Articles were selected based on the presence of terms related to the subject of the study, keywords in the most cited articles were selected. The lexico-semantic analysis of L. M. Vasiliev was used for the analysis of keywords. 10 groups of verbs are defined. R e s u l t s . It was found that initially such areas as «Demography», «Gender Sociology», «Obstetrics», «Journalism» were leading in the topic of «Hospital Management». However, by the third period, the leading positions are occupied by «Cardiology», «Emergency medical care», «Medical Technologies». This dynamic indicates a growing interest in both general management processes and specialized knowledge in this area. Also, when analyzing verbs, it was revealed that in the topic «Management» and «Hospital Management» attention is differently focused on their categories. The field of research on the topics of «Management» and «Hospital Management» was divided into health sciences, sociology and business. F i n d i n g s . Thus, the results of the study led to the conclusion that today there is a growing interest not only in general management processes, but also in knowledge about management, narrow specialties and features of gender management.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136247577","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}

{"title":"The issue of biocompatibility of ceramic implants in the provision of orthopedic care.","authors":"Yu.A. Ulyanov, E. M. Zaripova, E. N. Mingazova","doi":"10.21045/1811-0185-2023-9-18-22","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-9-18-22","url":null,"abstract":"When organizing orthopedic care, specialists should be aware of scientific data regarding the ability of the zirconia implant system used to osseointegrate. The biocompatibility of implants depends on various parameters such as the nature of the material, chemical composition, surface topography, chemical composition and loading, surface treatment, physical and mechanical properties. Zirconium has a high biocompatibility with soft tissues, resistance to bacterial biofilms. Zirconia implants are a promising alternative to titanium, especially for titanium allergic patients.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134977644","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}

{"title":"Medical and social significance of diseases of the peripheral nervous system on the example of carpal tunnel syndrome.","authors":"A.G. Fedyakov, A.V. Shcherbin, M.A. Razin, А.V. Gorozhanin, О.N. Dreval, М.L. Maximov, О.О. Kizlik, Z.H. Plieva","doi":"10.21045/1811-0185-2023-10-85-92","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-10-85-92","url":null,"abstract":"Peripheral nerve diseases are one of the socially significant problems in the healthcare system of the Russian Federation. Effective care for patients suffering from these diseases is an important task for healthcare, as so as they are accompanied by prolonged disability. However, at present we do not have data that could fully demonstrate the medico-social and medico-economic aspects of carpal tunnel syndrome (CTS) and other peripheral nerve diseases in the Russian Federation. The aim of the study is to improve the quality of medical care for patients with carpal tunnel syndrome based on the analysis of statistical data of patients operated on for this pathology in the S. P. Botkin City Clinical Hospital. Material and methods. The patients in the study were all adult men and women who underwent surgical treatment of CTS at S. P. Botkin City Clinical Hospital in the period from 2016 to 2022. The sources of information about the treated patients were the information of medical information systems used in the hospital in different years. Statistical and visualization tools of the Microsoft® Excel® spreadsheet were used to obtain descriptive statistics and present data graphically. Results. In the S. P. Botkin City Clinical Hospital, which is the clinical base of the Department of neurosurgery of the Russian Medical Academy of Continuous Professional Education, in the period from 2016 to 2022, 692 surgical interventions were performed for patients with CTS. The analysis of statistical data has shown results comparable with the available literature data, however, a distinctive feature is an extremely long history of the disease before surgical treatment. Conclusions. Currently, in our country, there is an underestimation of the importance of peripheral nerve diseases, therefore, their separate statistical accounting in the structure of neurological morbidity is extremely important. Another important task is a multidisciplinary approach that provides high-quality medical care to patients with this pathology.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136248071","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}

{"title":"Assessment of the impact of the implementation of telemedicine in the sphere of health care.","authors":"D. M. Nazarov, F. I. Badaev","doi":"10.21045/1811-0185-2023-10-49-57","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-10-49-57","url":null,"abstract":"It has been revealed that telemedicine significantly improves the availability of medical care, especially in remote and sparsely populated regions. It has been determined that the integration of telemedicine can improve the quality of medical care due to prompt consultation of specialists and reduction of time for diagnosis. A direct relationship has been found between the use of telemedicine and patient satisfaction. The key factors influencing the effectiveness of telemedicine are identified: the quality of the Internet connection, the training of medical personnel, and the level of patient awareness. It has been established that the use of the DEMATEL method allows one to deeply penetrate the structure of relationships in the telemedicine system and identify potential growth points. Purpose of the study is to determine the complex relationships and interactions within the telemedicine system in the context of healthcare. Materials and methods. The study is based on the application of the DEMATEL method for analyzing cause-and-effect relationships in a telemedicine system. This method allows you to penetrate deeply into the structure of relationships, identify key factors, and highlight causes and consequences. Results. The study results confirm that the integration of telemedicine improves the availability and quality of medical care. The main cause-and-effect relationships influencing the effectiveness of telemedicine in the healthcare context were identified. It has been revealed that telemedicine significantly improves the availability of medical care, especially in remote and sparsely populated regions. It has been determined that the integration of telemedicine can improve the quality of medical care due to prompt consultation of specialists and reduction of time for diagnosis. A direct relationship has been found between the use of telemedicine and patient satisfaction. The key factors influencing the effectiveness of telemedicine are identified: the quality of the Internet connection, the training of medical personnel, and the level of patient awareness. It has been established that the use of the DEMATEL method allows one to deeply penetrate the structure of relationships in the telemedicine system and identify potential growth points. Findings. The importance of using analytical methods such as DEMATEL in the healthcare system has been confirmed. The use of such methods may be the key to optimization and further development of telemedicine in the digital economy.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136248072","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}

{"title":"Psoriasis: disease burden in current environment.","authors":"L.Yu. Bezmelnitsyna, Y.K. Besstrashnova, P.N. Zolotarev, F.N. Kadyrov, A.V. Lobanov, D.O. Meshkov, A.V. Feduaeva, S.N. Cherkasov, A.V. Shoshmin","doi":"10.21045/1811-0185-2023-9-52-63","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-9-52-63","url":null,"abstract":"Psoriasis currently is considered to be beyond the list of socially significant diseases; however, a pilot study shows that the medical, social and economic burden of the disease can be significant. The pilot study made it possible to identify the most actual research areas for assessing of disease burden indicators what is necessary for development of comprehensive multidisciplinary interdepartmental programs aimed at improving population health and reducing the medical, social and economic consequences of psoriasis.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134977208","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}