Pub Date : 2023-09-01DOI: 10.21045/1811-0185-2023-8-4-16
S. A. Orlov, O.Yu. Aleksandrova, R. V. Gorenkov, T. P. Vasilieva, A. B. Zudin
The relevance is explained by the need to determine the list of indicators of public health and the functioning of the health system, which are influenced by biological, geopolitical and man-made challenges, considered as the transition of one of the determinants that determine the state of public health to an extreme state, and the rationale for their changes for timely organizational and managerial decisions. O b j e c t i v e : conduction an expert assessment and substantiate the impact of global biological, geopolitical and technogenic challenges on population health indicators and healthcare system. M a t e r i a l s a n d m e t h o d s . Based on the content analysis of domestic (n=14) and foreign publications (n=30), using expert assessment, a list of parameters was compiled that determine the impact of biological, geopolitical and technogenic challenges on population health indicators and healthcare system. R e s u l t s . The directions of changes in such health indicators of the population as primary and general morbidity according to the data of the appeal, mortality of the population in different age groups, life expectancy, physical development, disability and health groups, and such indicators of the structure of consumption of resources of the health system as access to medical care, the burden on medical workers, changes in financial costs are determined, as well as the risks of its sustainable functioning. D i s c u s s i o n . The theoretical substantiation of the vector of the impact of a particular type of global challenge to society on the state of indicators of key determinants of public health, allows for timely development of a set of preventive measures taking into account the models of response of determinants, improving approaches to their planning and organization both for the industry as a whole and at the level of a medical organization and the region.
{"title":"Methodological and methodical approaches to assessing the impact of global challenges on population health indicators and healthcare system.","authors":"S. A. Orlov, O.Yu. Aleksandrova, R. V. Gorenkov, T. P. Vasilieva, A. B. Zudin","doi":"10.21045/1811-0185-2023-8-4-16","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-8-4-16","url":null,"abstract":"The relevance is explained by the need to determine the list of indicators of public health and the functioning of the health system, which are influenced by biological, geopolitical and man-made challenges, considered as the transition of one of the determinants that determine the state of public health to an extreme state, and the rationale for their changes for timely organizational and managerial decisions. O b j e c t i v e : conduction an expert assessment and substantiate the impact of global biological, geopolitical and technogenic challenges on population health indicators and healthcare system. M a t e r i a l s a n d m e t h o d s . Based on the content analysis of domestic (n=14) and foreign publications (n=30), using expert assessment, a list of parameters was compiled that determine the impact of biological, geopolitical and technogenic challenges on population health indicators and healthcare system. R e s u l t s . The directions of changes in such health indicators of the population as primary and general morbidity according to the data of the appeal, mortality of the population in different age groups, life expectancy, physical development, disability and health groups, and such indicators of the structure of consumption of resources of the health system as access to medical care, the burden on medical workers, changes in financial costs are determined, as well as the risks of its sustainable functioning. D i s c u s s i o n . The theoretical substantiation of the vector of the impact of a particular type of global challenge to society on the state of indicators of key determinants of public health, allows for timely development of a set of preventive measures taking into account the models of response of determinants, improving approaches to their planning and organization both for the industry as a whole and at the level of a medical organization and the region.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135387795","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}
Pub Date : 2023-09-01DOI: 10.21045/1811-0185-2023-8-54-67
Y. A. Vasiliev, A. V. Vladzimirsky, K. M. Arzamasov, I. M. Shulkin, L. E. Aksenova, L. D. Pestrenin, S. S. Semenov, D. V. Bondarchuk, I. V. Smirnov
Artificial intelligence technologies have great potential in improving the effectiveness of screening programs in the detection of malignant neoplasms of the breast. Given the high social, demographic and economic importance of mass preventive research, there is no doubt that the diagnostic accuracy of artificial intelligence must match or even exceed the accuracy of radiologists. In this regard, studies are needed to compare the accuracy of software based on artificial intelligence technology and radiologists during the mammography examinations in a clinical environment. P u r p o s e : to assess the quality of the medical service “Description and interpretation of mammography data using artificial intelligence” as part of screening. M a t e r i a l s a n d m e t h o d s . The sample for analysis consisted of 9684 digital mammograms. For each study, the BI-RADS category was determined by a radiologist and using software based on artificial intelligence technologies (AI based software) registered in the Russian Federation as a medical device. Forty-five studies from this sample with significant discrepancies in physician and software assessments were subject to peer review, which resulted in a BI-RADS category according to the physician expert. R e s u l t s . When evaluating weighted averages, there were no statistically significant differences between physician results and AI based software for 9684 digital mammography exams. Evaluation of physician and software consistency showed that matches are observed in 43,89% of cases for the BI-RADS scale and in 80,69% – 84,10% for binary scales. The presence of a case in which the pathology identified with the help of software and confirmed during the review of the results by the expert was missed by the doctor indicates the promise of using AI based software for evaluating mammography studies and requires further research. F i n d i n g s . When evaluating mammography studies, the agreement between the AI based decision and the radiologist reaches 84,10%, with the software assigning a higher BI-RADS category more often. Expert review of part of these discrepancies showed a potential reduction in the number of missed breast malignancies with the help of software.
{"title":"The first 10,000 mammography exams performed as part of the “Description and interpretation of mammography data using artificial intelligence” service.","authors":"Y. A. Vasiliev, A. V. Vladzimirsky, K. M. Arzamasov, I. M. Shulkin, L. E. Aksenova, L. D. Pestrenin, S. S. Semenov, D. V. Bondarchuk, I. V. Smirnov","doi":"10.21045/1811-0185-2023-8-54-67","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-8-54-67","url":null,"abstract":"Artificial intelligence technologies have great potential in improving the effectiveness of screening programs in the detection of malignant neoplasms of the breast. Given the high social, demographic and economic importance of mass preventive research, there is no doubt that the diagnostic accuracy of artificial intelligence must match or even exceed the accuracy of radiologists. In this regard, studies are needed to compare the accuracy of software based on artificial intelligence technology and radiologists during the mammography examinations in a clinical environment. P u r p o s e : to assess the quality of the medical service “Description and interpretation of mammography data using artificial intelligence” as part of screening. M a t e r i a l s a n d m e t h o d s . The sample for analysis consisted of 9684 digital mammograms. For each study, the BI-RADS category was determined by a radiologist and using software based on artificial intelligence technologies (AI based software) registered in the Russian Federation as a medical device. Forty-five studies from this sample with significant discrepancies in physician and software assessments were subject to peer review, which resulted in a BI-RADS category according to the physician expert. R e s u l t s . When evaluating weighted averages, there were no statistically significant differences between physician results and AI based software for 9684 digital mammography exams. Evaluation of physician and software consistency showed that matches are observed in 43,89% of cases for the BI-RADS scale and in 80,69% – 84,10% for binary scales. The presence of a case in which the pathology identified with the help of software and confirmed during the review of the results by the expert was missed by the doctor indicates the promise of using AI based software for evaluating mammography studies and requires further research. F i n d i n g s . When evaluating mammography studies, the agreement between the AI based decision and the radiologist reaches 84,10%, with the software assigning a higher BI-RADS category more often. Expert review of part of these discrepancies showed a potential reduction in the number of missed breast malignancies with the help of software.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135387799","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}
Pub Date : 2023-09-01DOI: 10.21045/1811-0185-2023-8-17-23
A. V. Starshinin, A. S. Bezymyanny, V. M. Grinin, E. N. Mingazova
Modern stroke screening and treatment requires a systematic organization of medical care at all levels of the health care system in order to obtain results. In many countries there is a multilevel system of prevention, screening and treatment of stroke. Given the limited availability of large centers capable of providing complex multidisciplinary care to patients with stroke, it is necessary to develop and implement routing protocols for patients at risk of stroke, including patients with BCA pathology. Due to early detection and optimal routing, a high percentage of identified patients with BCA occlusion survive. An analysis of the experience of implementing screening for BCA pathologies as part of stroke prevention in the “Healthy Moscow” project showed that timely detected deviations with proper prevention can not only avoid the serious consequences of a stroke, but often prevent the development of the disease. In view of the determined global disparity in the accessibility of obtaining the necessary endovascular care by the population, the population screening program for BCA pathology within the framework of the “Healthy Moscow program is a significant contribution to the introduction of clinical management of cardiovascular care. The routing of patients with BCA pathology, implemented in, the “Healthy Moscow” project, is of undoubted practical value for the healthcare of Moscow and our country.
{"title":"Scientific substantiation of the routing of patients with atherosclerosis of the brachiocephalic arteries in the framework of the “Healthy Moscow” project.","authors":"A. V. Starshinin, A. S. Bezymyanny, V. M. Grinin, E. N. Mingazova","doi":"10.21045/1811-0185-2023-8-17-23","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-8-17-23","url":null,"abstract":"Modern stroke screening and treatment requires a systematic organization of medical care at all levels of the health care system in order to obtain results. In many countries there is a multilevel system of prevention, screening and treatment of stroke. Given the limited availability of large centers capable of providing complex multidisciplinary care to patients with stroke, it is necessary to develop and implement routing protocols for patients at risk of stroke, including patients with BCA pathology. Due to early detection and optimal routing, a high percentage of identified patients with BCA occlusion survive. An analysis of the experience of implementing screening for BCA pathologies as part of stroke prevention in the “Healthy Moscow” project showed that timely detected deviations with proper prevention can not only avoid the serious consequences of a stroke, but often prevent the development of the disease. In view of the determined global disparity in the accessibility of obtaining the necessary endovascular care by the population, the population screening program for BCA pathology within the framework of the “Healthy Moscow program is a significant contribution to the introduction of clinical management of cardiovascular care. The routing of patients with BCA pathology, implemented in, the “Healthy Moscow” project, is of undoubted practical value for the healthcare of Moscow and our country.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135388020","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}
Pub Date : 2023-09-01DOI: 10.21045/1811-0185-2023-8-44-53
D. V. Voshev, N. A. Vosheva, R. N. Shepel, I. M. Son, O. M. Drapkina
The development of digital and information and communication technologies contributes to fundamental changes in all spheres of human life. Thanks to the Internet of Things technologies, medicine has moved to a new level of efficiency, convenience and quality of providing electronic medical services. The problems of the introduction of electronic services in the context of the development of e-governance require special consideration, potential threats in the collection, processing and storage of data in the field of healthcare are of particular concern. P u r p o s e o f t h e s t u d y is to conduct a comparative analysis of the use of modern trends in the introduction of electronic services in the healthcare sector of foreign countries and Russia with the use of Internet of Things technologies in the conditions of digitalization of the industry. M a t e r i a l s a n d m e t h o d s . The following methods were used in the work: analysis – when searching and familiarizing with various web resources, relevant programs and portals on electronic management and the Internet of Things; comparison – when comparing the stages and mechanisms of using Internet of Things technologies in the development of digitalization of healthcare in the world; analogy and extrapolation – to determine the possibilities, implementation of foreign experience. R e s u l t s . The best foreign practices of providing electronic services in the field of healthcare with the use of Internet of Things technologies were revealed. A trend has been established for the appearance and use of various devices using Internet of Things technology that are used to provide medical services, in particular those that have the functions of medical equipment and help to conduct an online examination. The US experience in the introduction of electronic medical records and the maintenance of relevant databases is disclosed. Separately, attention is focused on the experience of countries that are trying to prevent excessive personalization and identification of data. С o n c l u s i o n s . Thus, electronic services are services that are provided in electronic format online. In Russia, they are regulated by a significant list of regulatory legal acts. At the same time, for the effective use of Internet of Things technologies in the provision of electronic medical services, first of all, it is necessary to solve the problem of de-identification (depersonalization) of data that is collected to meet this service.
数字和信息通信技术的发展有助于人类生活各个领域的根本变化。借助物联网技术，医学在提供电子医疗服务的效率、便利性和质量方面达到了一个新的水平。在发展电子政务的背景下引入电子服务的问题需要特别考虑，保健领域数据收集、处理和存储方面的潜在威胁尤其令人关切。本研究的目的是对国外和俄罗斯医疗保健部门引入电子服务的现代趋势与在行业数字化条件下使用物联网技术进行比较分析。我想把我的头发剪下来，然后把我的头发剪下来。在工作中使用了以下方法:分析——搜索和熟悉电子管理和物联网的各种网络资源、相关程序和门户;对比——对比世界各国在医疗数字化发展中使用物联网技术的阶段和机制;类比与外推——确定可能性，实施国外经验。这是我最喜欢的。介绍了国外利用物联网技术在医疗卫生领域提供电子服务的最佳做法。使用物联网技术的各种设备的出现和使用已成为一种趋势，这些设备用于提供医疗服务，特别是那些具有医疗设备功能并有助于进行在线检查的设备。披露了美国在引进电子病历和维护相关数据库方面的经验。另外，关注的重点是那些试图防止数据过度个人化和识别的国家的经验。С o o o o o o o o o o o o o o o因此，电子服务是以电子形式在网上提供的服务。在俄罗斯，它们受到一系列重要的监管法律行为的监管。同时，为了在提供电子医疗服务中有效利用物联网技术，首先需要解决为满足这一服务而收集的数据的去身份化(去个性化)问题。
{"title":"Comparative analysis of the use of electronic Internet of Things technologies in the healthcare sector of foreign countries and Russia.","authors":"D. V. Voshev, N. A. Vosheva, R. N. Shepel, I. M. Son, O. M. Drapkina","doi":"10.21045/1811-0185-2023-8-44-53","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-8-44-53","url":null,"abstract":"The development of digital and information and communication technologies contributes to fundamental changes in all spheres of human life. Thanks to the Internet of Things technologies, medicine has moved to a new level of efficiency, convenience and quality of providing electronic medical services. The problems of the introduction of electronic services in the context of the development of e-governance require special consideration, potential threats in the collection, processing and storage of data in the field of healthcare are of particular concern. P u r p o s e o f t h e s t u d y is to conduct a comparative analysis of the use of modern trends in the introduction of electronic services in the healthcare sector of foreign countries and Russia with the use of Internet of Things technologies in the conditions of digitalization of the industry. M a t e r i a l s a n d m e t h o d s . The following methods were used in the work: analysis – when searching and familiarizing with various web resources, relevant programs and portals on electronic management and the Internet of Things; comparison – when comparing the stages and mechanisms of using Internet of Things technologies in the development of digitalization of healthcare in the world; analogy and extrapolation – to determine the possibilities, implementation of foreign experience. R e s u l t s . The best foreign practices of providing electronic services in the field of healthcare with the use of Internet of Things technologies were revealed. A trend has been established for the appearance and use of various devices using Internet of Things technology that are used to provide medical services, in particular those that have the functions of medical equipment and help to conduct an online examination. The US experience in the introduction of electronic medical records and the maintenance of relevant databases is disclosed. Separately, attention is focused on the experience of countries that are trying to prevent excessive personalization and identification of data. С o n c l u s i o n s . Thus, electronic services are services that are provided in electronic format online. In Russia, they are regulated by a significant list of regulatory legal acts. At the same time, for the effective use of Internet of Things technologies in the provision of electronic medical services, first of all, it is necessary to solve the problem of de-identification (depersonalization) of data that is collected to meet this service.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135388019","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}
Pub Date : 2023-09-01DOI: 10.21045/1811-0185-2023-8-68-80
D. S. Tyufilin, V. P. Chigrina, V. A. Medvedev, I. A. Deev, O. S. Kobyakova
One of the primary indicators of the efficiency of the healthcare system is the patient’s experience and his individual evaluation of the medical care given. With the development and launch of the Federal project “Modernization of primary health care”, a methodology for assessing the satisfaction of the population with medical care has been formed. The survey evaluates not only the general indicator of public satisfaction with medical care, but also a number of individual domains and parameters of respondents. The aim of the study: was to determine the relationship between the level of satisfaction with medical care and its domains with the gender and age characteristics of respondents, the timing of receiving medical care, the place of residence of the study participants and preferences in choosing medical organizations. Materials and methods. The data were obtained by conducting a survey by medical insurance organizations operating in 85 constituent entities of the Russian Federation. The satisfaction level was calculated as the ratio of the number of respondents who chose the answers “Mostly satisfied” and “Absolutely satisfied” to the total number of respondents who answered the corresponding question, translated into a percentage. To test the hypothesis about the impact of factors on the level of satisfaction, a generalized linear mixed model with a binomial error distribution function was used. Results. The total number of respondents is 254488. The maximum level of satisfaction is 45,8% (April 2023), the minimum is 40,0% (September 2022). Living in rural areas and the private type of medical organization were factors that increase the level of both overall satisfaction (OSH=1,12 and OSH=2,81) and all its domains. The age of the respondents was inversely proportional to the specified parameters. In men, compared with women, the chance of getting into the group satisfied with the general expectation and the solution of the problem increased by 1,04 and 1,09 times, respectively (p<0,001), and in the group satisfied with the comfort in a medical organization – decreased (OR=0,97, p<0,001). Conclusion. The data obtained during the study allowed us to determine the relationship between the level of satisfaction with medical care and its domains with the gender and age characteristics of respondents, the timing of receiving medical care, the place of residence of study participants and preferences in choosing medical organizations, which can become the basis for the development of measures aimed at achieving and maintaining a high level of the parameter under study.
{"title":"Satisfaction with medical care in the Russian Federation: factors influencing the assessment.","authors":"D. S. Tyufilin, V. P. Chigrina, V. A. Medvedev, I. A. Deev, O. S. Kobyakova","doi":"10.21045/1811-0185-2023-8-68-80","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-8-68-80","url":null,"abstract":"One of the primary indicators of the efficiency of the healthcare system is the patient’s experience and his individual evaluation of the medical care given. With the development and launch of the Federal project “Modernization of primary health care”, a methodology for assessing the satisfaction of the population with medical care has been formed. The survey evaluates not only the general indicator of public satisfaction with medical care, but also a number of individual domains and parameters of respondents. The aim of the study: was to determine the relationship between the level of satisfaction with medical care and its domains with the gender and age characteristics of respondents, the timing of receiving medical care, the place of residence of the study participants and preferences in choosing medical organizations. Materials and methods. The data were obtained by conducting a survey by medical insurance organizations operating in 85 constituent entities of the Russian Federation. The satisfaction level was calculated as the ratio of the number of respondents who chose the answers “Mostly satisfied” and “Absolutely satisfied” to the total number of respondents who answered the corresponding question, translated into a percentage. To test the hypothesis about the impact of factors on the level of satisfaction, a generalized linear mixed model with a binomial error distribution function was used. Results. The total number of respondents is 254488. The maximum level of satisfaction is 45,8% (April 2023), the minimum is 40,0% (September 2022). Living in rural areas and the private type of medical organization were factors that increase the level of both overall satisfaction (OSH=1,12 and OSH=2,81) and all its domains. The age of the respondents was inversely proportional to the specified parameters. In men, compared with women, the chance of getting into the group satisfied with the general expectation and the solution of the problem increased by 1,04 and 1,09 times, respectively (p<0,001), and in the group satisfied with the comfort in a medical organization – decreased (OR=0,97, p<0,001). Conclusion. The data obtained during the study allowed us to determine the relationship between the level of satisfaction with medical care and its domains with the gender and age characteristics of respondents, the timing of receiving medical care, the place of residence of study participants and preferences in choosing medical organizations, which can become the basis for the development of measures aimed at achieving and maintaining a high level of the parameter under study.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135387793","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}
Pub Date : 2023-09-01DOI: 10.21045/1811-0185-2023-8-38-43
S. A. Kuzmin, E. A. Kalinina, K. A. Izbagambetova, L. K. Grigorieva
Currently, the issues of human resources are raised by many Russian and foreign scientists. Personnel, being the main, most valuable and significant part of health resources, ultimately ensure the effectiveness, efficiency and quality of medical care to the population. Therefore, there is no accidental scientific interest in studying the state of human resources of draft commissions carrying out military medical expertise. The purpose of the study is to characterize the personnel composition of doctors of conscription commissions of municipalities of the Orenburg region. Materials and methods. The analysis of the personnel of doctors working in the draft commissions of the Orenburg region was carried out. Statistical, analytical and sociological research methods were used. The following indicators were analyzed: staffing of draft commissions with medical personnel; age composition of doctors; general medical experience of doctors and work experience in draft commissions; availability of certificates of specialists and medical categories. To compile a social “portrait” of doctors working in the draft commissions of the Orenburg region, a sociological survey was carried out, in which 393 specialist doctors took part. The sociological survey made it possible to study the opinion of doctors who carry out medical examination of conscripts on the organization of medical care for young men in the pre-conscription period. Results. The average doctor working in the conscription commission of the Orenburg region municipality is characterized by a high level of professional training, which proves that he has a great medical experience, medical category and a specialist certificate. Conclusion. The article presents the results of the analysis of staffing indicators and the level of professional training of doctors working in the draft commissions of the Orenburg region. Taking into account the completed questionnaire, a social “portrait” of doctors carrying out medical examination of persons of military age was compiled. The opinion of doctors on the organization of medical care for young men in children’s polyclinics and draft commissions was studied. The information received should be taken into account when planning priority measures at the regional level aimed at improving the quality of medical support for the preparation of citizens for military service.
{"title":"Analysis of human resources of medical specialists of draft commissions of municipalities of the Orenburg region.","authors":"S. A. Kuzmin, E. A. Kalinina, K. A. Izbagambetova, L. K. Grigorieva","doi":"10.21045/1811-0185-2023-8-38-43","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-8-38-43","url":null,"abstract":"Currently, the issues of human resources are raised by many Russian and foreign scientists. Personnel, being the main, most valuable and significant part of health resources, ultimately ensure the effectiveness, efficiency and quality of medical care to the population. Therefore, there is no accidental scientific interest in studying the state of human resources of draft commissions carrying out military medical expertise. The purpose of the study is to characterize the personnel composition of doctors of conscription commissions of municipalities of the Orenburg region. Materials and methods. The analysis of the personnel of doctors working in the draft commissions of the Orenburg region was carried out. Statistical, analytical and sociological research methods were used. The following indicators were analyzed: staffing of draft commissions with medical personnel; age composition of doctors; general medical experience of doctors and work experience in draft commissions; availability of certificates of specialists and medical categories. To compile a social “portrait” of doctors working in the draft commissions of the Orenburg region, a sociological survey was carried out, in which 393 specialist doctors took part. The sociological survey made it possible to study the opinion of doctors who carry out medical examination of conscripts on the organization of medical care for young men in the pre-conscription period. Results. The average doctor working in the conscription commission of the Orenburg region municipality is characterized by a high level of professional training, which proves that he has a great medical experience, medical category and a specialist certificate. Conclusion. The article presents the results of the analysis of staffing indicators and the level of professional training of doctors working in the draft commissions of the Orenburg region. Taking into account the completed questionnaire, a social “portrait” of doctors carrying out medical examination of persons of military age was compiled. The opinion of doctors on the organization of medical care for young men in children’s polyclinics and draft commissions was studied. The information received should be taken into account when planning priority measures at the regional level aimed at improving the quality of medical support for the preparation of citizens for military service.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135388027","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}
Pub Date : 2023-09-01DOI: 10.21045/1811-0185-2023-8-24-33
V. A. Zatulkin
There is an increase in the need of the population, regardless of age, for dental care. At the same time, today there is a personnel shortage, insufficient staffing of the material and technical base of medical organizations providing dental care in outpatient settings. In this regard, it is necessary to search for new organizational technologies in the activities of these organizations to improve the availability and quality of medical care and meet the growing needs of patients. The purpose of the study: to evaluate the effectiveness of the developed model for the use of lean manufacturing technologies in dental practice. Materials and methods. In basic dental polyclinics, data on the timing of time spent by patients at the registry, while waiting for an appointment with a dentist–therapist, the time spent by a dentist–therapist in the treatment of medium caries of permanent teeth, taking into account the filling out of medical documentation before and after the use of lean manufacturing technologies, were analyzed. The assessment of the existing navigation in polyclinics, routing schemes for patients, methods of making an appointment was carried out by visualization method. In addition, the data of the survey of patients and employees of the dental clinic in the previously conducted study were analyzed. Results. After the application of lean manufacturing technologies, the time spent by the patient in the registry was reduced by 12–16 minutes. The total number of actions of the registrar decreased by 31.0%, and the distance traveled by 38.0–40.0%. The time of adding value at the reception of patients by a doctor increased by 20.0% (SP No. 1) and 24.3% (SP No. 2). The time of appointment of a dentisttherapist decreased by 33.8% in joint venture No. 1 and by 32.3% in joint venture No. 2. 72.7% of medical workers noted a positive effect in the activities of their polyclinics. The proportion of patients satisfied with the organization of medical care in dental clinics increased by 33.0%. On average, 88.5% of them noted positive changes in the registry, 73.0% – in the appointment of a dentist-therapist, 74.5% – in the new navigation, 75.0% – in the appointment. Findings. The use of lean manufacturing methods helped to reduce the time spent by patients at the reception desk, at the dentisttherapist’s appointment, increased the availability of an appointment, increased the satisfaction of both medical workers and patients. Thus, the use of the lean manufacturing technology implementation model has shown its effectiveness.
{"title":"Application of the lean manufacturing model as an effective way to improve the activities of a dental clinic.","authors":"V. A. Zatulkin","doi":"10.21045/1811-0185-2023-8-24-33","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-8-24-33","url":null,"abstract":"There is an increase in the need of the population, regardless of age, for dental care. At the same time, today there is a personnel shortage, insufficient staffing of the material and technical base of medical organizations providing dental care in outpatient settings. In this regard, it is necessary to search for new organizational technologies in the activities of these organizations to improve the availability and quality of medical care and meet the growing needs of patients. The purpose of the study: to evaluate the effectiveness of the developed model for the use of lean manufacturing technologies in dental practice. Materials and methods. In basic dental polyclinics, data on the timing of time spent by patients at the registry, while waiting for an appointment with a dentist–therapist, the time spent by a dentist–therapist in the treatment of medium caries of permanent teeth, taking into account the filling out of medical documentation before and after the use of lean manufacturing technologies, were analyzed. The assessment of the existing navigation in polyclinics, routing schemes for patients, methods of making an appointment was carried out by visualization method. In addition, the data of the survey of patients and employees of the dental clinic in the previously conducted study were analyzed. Results. After the application of lean manufacturing technologies, the time spent by the patient in the registry was reduced by 12–16 minutes. The total number of actions of the registrar decreased by 31.0%, and the distance traveled by 38.0–40.0%. The time of adding value at the reception of patients by a doctor increased by 20.0% (SP No. 1) and 24.3% (SP No. 2). The time of appointment of a dentisttherapist decreased by 33.8% in joint venture No. 1 and by 32.3% in joint venture No. 2. 72.7% of medical workers noted a positive effect in the activities of their polyclinics. The proportion of patients satisfied with the organization of medical care in dental clinics increased by 33.0%. On average, 88.5% of them noted positive changes in the registry, 73.0% – in the appointment of a dentist-therapist, 74.5% – in the new navigation, 75.0% – in the appointment. Findings. The use of lean manufacturing methods helped to reduce the time spent by patients at the reception desk, at the dentisttherapist’s appointment, increased the availability of an appointment, increased the satisfaction of both medical workers and patients. Thus, the use of the lean manufacturing technology implementation model has shown its effectiveness.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135387796","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}
Pub Date : 2023-09-01DOI: 10.21045/1811-0185-2023-8-81-87
A. V. Novozhilov, I. S. Kitsul
The article presents a description of the algorithm developed by the authors for the formation of social activity of a person during organ transplantation using the example of a kidney. The peculiarity of the functioning of the patient in the medical and social environment is shown, taking into account all the factors that arise in the terminal stages of diseases, leading to the need for organ transplantation. The mechanisms of the emergence of personal motivation of patients for transplantation are described.
{"title":"Algorithm for the formation of social activity of a person during organ transplantation.","authors":"A. V. Novozhilov, I. S. Kitsul","doi":"10.21045/1811-0185-2023-8-81-87","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-8-81-87","url":null,"abstract":"The article presents a description of the algorithm developed by the authors for the formation of social activity of a person during organ transplantation using the example of a kidney. The peculiarity of the functioning of the patient in the medical and social environment is shown, taking into account all the factors that arise in the terminal stages of diseases, leading to the need for organ transplantation. The mechanisms of the emergence of personal motivation of patients for transplantation are described.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135387800","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}
Pub Date : 2023-08-01DOI: 10.21045/1811-0185-2023-7-85-90
A. D. Chuprov, A. О. Lositsky, N. A. Zhediale
Considering the increasing requirements for the quality of postoperative vision, the number of requests from patients for the implantation of a multifocal IOL is increasing, which makes it relevant to analyze the existing regulatory framework for the possibility and obligation to use this medical device in the provision of specialized medical care – surgical treatment of cataract within the framework of the state guarantees program. An analysis of the current regulatory framework showed that the existing regulatory framework allows the use of multifocal IOLs in the provision of medical services under the state guarantees program, however, it does not give the patient the right to choose, and makes considering the patient’s desire to implant this particular type of medical device is not mandatory when planning surgery. Considering the requirements of mandatory informed voluntary consent when receiving a medical service, the patient must be informed about the implantation or refusal to implant this type of medical device when providing him with specialized medical care. Most of the analyzed medical devices – IOLs with multifocal properties – are registered in the Russian Federation as “Intraocular lens for the posterior chamber of the eye, pseudophakic”, and not “Intraocular lens for the posterior chamber of the eye, pseudophakic, with increased depth of focus”. There is both a clinical need for changes (Clinical guidelines), and an organizational need to identify a group of operations, including with the application of additional coefficients to the tariff as part of the payment for medical services included in the program of state guarantees.
{"title":"Review of the regulatory framework regarding the use of multifocal IOLs for cataract surgery.","authors":"A. D. Chuprov, A. О. Lositsky, N. A. Zhediale","doi":"10.21045/1811-0185-2023-7-85-90","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-7-85-90","url":null,"abstract":"Considering the increasing requirements for the quality of postoperative vision, the number of requests from patients for the implantation of a multifocal IOL is increasing, which makes it relevant to analyze the existing regulatory framework for the possibility and obligation to use this medical device in the provision of specialized medical care – surgical treatment of cataract within the framework of the state guarantees program. An analysis of the current regulatory framework showed that the existing regulatory framework allows the use of multifocal IOLs in the provision of medical services under the state guarantees program, however, it does not give the patient the right to choose, and makes considering the patient’s desire to implant this particular type of medical device is not mandatory when planning surgery. Considering the requirements of mandatory informed voluntary consent when receiving a medical service, the patient must be informed about the implantation or refusal to implant this type of medical device when providing him with specialized medical care. Most of the analyzed medical devices – IOLs with multifocal properties – are registered in the Russian Federation as “Intraocular lens for the posterior chamber of the eye, pseudophakic”, and not “Intraocular lens for the posterior chamber of the eye, pseudophakic, with increased depth of focus”. There is both a clinical need for changes (Clinical guidelines), and an organizational need to identify a group of operations, including with the application of additional coefficients to the tariff as part of the payment for medical services included in the program of state guarantees.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135003306","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}
Pub Date : 2023-08-01DOI: 10.21045/1811-0185-2023-7-42-48
A.V. Gromov, Yu.V. Mikhailova, S.A. Sterlikov
Detection of cases of tuberculosis in temporary detention facilities (TDF) and police reception centers (PR) makes it possible to identify TB patients among socially vulnerable segments of the population with high efficiency; a similar result is expected for HIV infection. This is especially true for low-density entities where the population is exposed to specific risk factors. However, at present there are no calculations showing the potential effectiveness of implementing the method in them. T h e p u r p o s e o f t h e s t u d y : to develop theoretical prerequisites for the introduction of a survey of detainees, suspects and accused in order to detect tuberculosis and HIV infection in PR and TDF. M a t e r i a l s a n d m e t h o d s . We used information from official statistical observation to analyze the detection rate of tuberculosis and HIV in pre-trial detention centers. Information about the number of offenders according to the Ministry of Internal Affairs, and estimates of the detection of tuberculosis patients according to statistical materials. 95% confidence limits (95% CI) were used as limits for the 95% uncertainty interval. R e s u l t s . From 2018 to 2022 2,512 newly arrested people passed through the pre-trial detention center in Petropavlovsk-Kamchatsky, among whom 94 people living with HIV were identified for the first time (detection rate is 37,4 per 1,000 examined; for comparison, in public health care – 2,1 per 1,000 examined) and 54 patients tuberculosis (detection rate is 21,5 per 1000 examined; for comparison, in public health care – 0,29 per 1000 examined). During this time, the police detained 16,282 people who, one way or another, went through the PR and IVS. Their examination would make it possible to additionally identify from 80 to 108 PLHIV and from 34 to 71 TB patients annually. C o n c l u s i o n . Screening for the detection of tuberculosis and HIV infection in TDFs and PRs is a potentially extremely effective tool that can lead to a significant improvement in the detection of patients with socially significant infectious diseases with the potential to interrupt the infection chain among socially vulnerable part of the population.
{"title":"Theoretical substantiation of the organization of detection of cases of tb and hiv infection in temporary issuers of territories with low population density.","authors":"A.V. Gromov, Yu.V. Mikhailova, S.A. Sterlikov","doi":"10.21045/1811-0185-2023-7-42-48","DOIUrl":"https://doi.org/10.21045/1811-0185-2023-7-42-48","url":null,"abstract":"Detection of cases of tuberculosis in temporary detention facilities (TDF) and police reception centers (PR) makes it possible to identify TB patients among socially vulnerable segments of the population with high efficiency; a similar result is expected for HIV infection. This is especially true for low-density entities where the population is exposed to specific risk factors. However, at present there are no calculations showing the potential effectiveness of implementing the method in them. T h e p u r p o s e o f t h e s t u d y : to develop theoretical prerequisites for the introduction of a survey of detainees, suspects and accused in order to detect tuberculosis and HIV infection in PR and TDF. M a t e r i a l s a n d m e t h o d s . We used information from official statistical observation to analyze the detection rate of tuberculosis and HIV in pre-trial detention centers. Information about the number of offenders according to the Ministry of Internal Affairs, and estimates of the detection of tuberculosis patients according to statistical materials. 95% confidence limits (95% CI) were used as limits for the 95% uncertainty interval. R e s u l t s . From 2018 to 2022 2,512 newly arrested people passed through the pre-trial detention center in Petropavlovsk-Kamchatsky, among whom 94 people living with HIV were identified for the first time (detection rate is 37,4 per 1,000 examined; for comparison, in public health care – 2,1 per 1,000 examined) and 54 patients tuberculosis (detection rate is 21,5 per 1000 examined; for comparison, in public health care – 0,29 per 1000 examined). During this time, the police detained 16,282 people who, one way or another, went through the PR and IVS. Their examination would make it possible to additionally identify from 80 to 108 PLHIV and from 34 to 71 TB patients annually. C o n c l u s i o n . Screening for the detection of tuberculosis and HIV infection in TDFs and PRs is a potentially extremely effective tool that can lead to a significant improvement in the detection of patients with socially significant infectious diseases with the potential to interrupt the infection chain among socially vulnerable part of the population.","PeriodicalId":270155,"journal":{"name":"Manager Zdravookhranenia","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135003309","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}
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