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The economic effect of providing medical care using simultaneous dental implantation by one specialist. 由一名专家同时提供植牙医疗服务的经济效益。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-73-78
G. I. Bezdetko, E. Y. Shkatova, V. S. Stupak, V. V. Liutsko
The economic effect of the introduction of a new organizational model “dentist-implantologist-orthopedist” is considered. Optimization of work, cost savings of the Ministry of Defense and an increase in the responsibility of a dentist who owns related specialties “Orthopedic Dentistry” and “Surgical Dentistry” were obtained. Purpose: assessment of the economic effect in the provision of medical care using simultaneous dental implantation. Materials and methods. The study was conducted in the dental polyclinic of the AUZ UR “RSP MZ UR” of Izhevsk, Udmurt Republic. The economic effect was assessed by comparing two models of providing medical care in orthopedic dentistry using dental implantation: the first – medical service was provided by two separate teams (1 – surgical care; 2 – orthopedic care); the second – medical service was provided by one team entitled to provide this type of care. Results. The economic effect of providing medical care using simultaneous dental implantation by one specialist allowed to reduce the use of the area of the medical organization, the number of full-time positions of nurses and reduced the costs of the medical organization for consultation. Conclusion. With the introduction of a new organizational model “dentist-implantologist-orthopedist”, an economic effect was obtained by reducing staff positions, reducing wage costs and rational use of MO areas. All this contributes to the optimization of the work of a medical organization, saving the Ministry of Health without reducing the quality of services provided and increasing the responsibility of one specialist for the final result of the treatment at the moment and in the future, which is one of the main factors of a value-based approach in healthcare.
引入一种新的组织模式“牙医-种植科医生-骨科医生”的经济效应被考虑。获得了工作的优化,国防部的成本节约和拥有相关专业“骨科牙科”和“外科牙科”的牙医的责任增加。目的:评估同时种植牙提供医疗服务的经济效果。材料和方法。该研究是在乌德穆尔特共和国伊热夫斯克的AUZ UR“RSP MZ UR”牙科综合诊所进行的。通过比较两种使用种植牙提供医疗服务的模式来评估经济效果:第一种医疗服务由两个独立的团队提供(1 -外科护理;2 -骨科护理);第二次医疗服务是由一个有权提供这种护理的小组提供的。结果。由一名专家同时进行植牙提供医疗服务的经济效果可以减少医疗机构的占地面积,减少全职护士的数量,并降低医疗机构的会诊费用。结论。引入“牙科-种植-骨科”的新型组织模式,通过减少人员岗位,降低工资成本,合理利用MO区域,取得了经济效益。所有这些都有助于优化医疗组织的工作,在不降低所提供服务质量的情况下节省了卫生部,并增加了一名专家对目前和将来的最终治疗结果的责任,这是基于价值的医疗保健方法的主要因素之一。
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引用次数: 0
The use of artificial intelligence technologies as a way to ensure the quality of chest radiography. 利用人工智能技术作为保证胸片质量的一种方式。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-91-101
A. A. Borisov, Yu.A. Vasiliev, A.V. Vladzymyrskyy, O. V. Omelyanskaya, K. M. Arzamasov, Yu.S. Kirpichev
When performing radiographic studies, errors may occur that reduce the diagnostic value of the radiographs and complicate their interpretation by radiologists and diagnostic software based on artificial intelligence technology. The creation of automated quality assessment systems will optimize this process, especially in conditions of increased workload of medical personnel. Purpose: development of an automated quality control tool for chest radiographs, which allows for quality control of the patient’s positioning and the correctness of filling in meta-information about the study. Material and methods.To train and test automated quality control models, were used 61505 chest radiographs, obtained from open datasets and the Unified Radiological Information Service of the Unified Medical Information Analysis System of the City of Moscow. To create models we used transfer training of deep neural network architectures VGG19 and ResNet152V2. Results. 7 models were created: a model for determining the anatomical area of study, a model for determining projection, a model for determining photometric interpretation, models for determining incomplete visualization of the anatomical area on the frontal and lateral projections of the chest radiographs, a model for determining rotation on the lateral projection of the chest radiographs. All created models have diagnostic accuracy metrics above 95%, which allows them to be used in clinical practice. Based on the developed models, a web-based quality control tool of the chest radiographs was created, which allows analyzing the quality of X-ray datasets. Conclusion. The active use of this quality control tool will optimize the process of assessing the quality of diagnostic studies and facilitate the processes of classification of studies and the formation of datasets. Also, this tool can be used to support the decision-making of an X-ray technician and assess the quality of the study before sending the study for processing to artificial intelligence-based services.
在进行放射学研究时,可能会出现错误,从而降低x光片的诊断价值,并使放射科医生和基于人工智能技术的诊断软件对其进行解释复杂化。自动质量评估系统的创建将优化这一过程,特别是在医务人员工作量增加的情况下。目的:开发一种用于胸部x线片的自动质量控制工具,该工具可以对患者的体位进行质量控制,并正确填写有关研究的元信息。材料和方法。为了训练和测试自动化质量控制模型,使用了61505张胸片,这些胸片来自莫斯科市统一医疗信息分析系统的开放数据集和统一放射信息服务。为了创建模型,我们使用了深度神经网络架构VGG19和ResNet152V2的迁移训练。结果:创建了7个模型:一个用于确定研究的解剖区域的模型,一个用于确定投影的模型,一个用于确定光度解释的模型,一个用于确定胸片正面和侧面投影上解剖区域不完全可视化的模型,一个用于确定胸片侧面投影上旋转的模型。所有创建的模型的诊断准确率指标都在95%以上,这使得它们可以用于临床实践。基于开发的模型,创建了基于网络的胸片质量控制工具,可以分析x射线数据集的质量。结论。积极使用该质量控制工具将优化评估诊断研究质量的过程,并促进研究分类和数据集形成的过程。此外,该工具可用于支持x射线技术人员的决策,并在将研究发送给基于人工智能的服务进行处理之前评估研究的质量。
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引用次数: 0
Rehabilitation and preventive measures for infectious and inflammatory diseases of the urinary system in children, considering the risk factors. 考虑危险因素的儿童泌尿系统感染性和炎症性疾病的康复和预防措施。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-79-84
M. M. Gasajnieva, E. N. Mingazova
The article presents an analysis of the materials of domestic and foreign scientific articles on the issues of modern features of the prevalence of infectious and inflammatory diseases of the genitourinary system among children and rehabilitation and preventive measures, taking into account risk factors. Information on the so-called internal risk factors, such as congenital malformations of the genitourinary system and disorders of the immunological state of the body, leading to infectious and inflammatory diseases (pyelonephritis, urinary tract infections, cystitis, urethritis, asymptomatic bacteriuria, etc.) is considered in detail. The emergence, in particular, of pyelonephritis can be facilitated by late breastfeeding, early transfer to mixed and artificial feeding. The risk group also includes children born to mothers with pyelonephritis, which is associated with heredity and perinatal risk factors (complicated pregnancy in the mother, chronic intrauterine fetal hypoxia, intrauterine growth retardation). Taking into account the whole variety of risk factors will make it possible to build programs for medical and social prevention and rehabilitation for infectious and inflammatory diseases of the genitourinary system in children.
本文对考虑危险因素的儿童泌尿生殖系统感染性和炎症性疾病流行的现代特征、康复和预防措施等问题的国内外科学文献资料进行了分析。详细考虑了所谓的内部危险因素的信息,如泌尿生殖系统的先天性畸形和身体免疫状态的紊乱,导致感染性和炎症性疾病(肾盂肾炎、尿路感染、膀胱炎、尿道炎、无症状细菌性尿症等)。尤其是肾盂肾炎的出现,可以通过母乳喂养后期,早期转移到混合喂养和人工喂养来促进。风险群体还包括患有肾盂肾炎的母亲所生的孩子,肾盂肾炎与遗传和围产期危险因素(母亲并发症妊娠、慢性宫内胎儿缺氧、宫内发育迟缓)有关。考虑到各种各样的风险因素,将有可能建立医疗和社会预防和康复方案的感染性和炎症性疾病的泌尿生殖系统的儿童。
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引用次数: 0
On the issue of the effectiveness of the maintenance of insurance medical organizations in the healthcare system of the Russian Federation. 关于保险医疗机构在俄罗斯联邦医疗保健系统中维持有效性的问题。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-11-19
A. R. Saraev, S. N. Cherkasov, A. G. Lukin
The problems of domestic healthcare are associated with a number of factors that are influenced by the indicators of the economic state of the country, while the main problem is insufficient funding, largely related to the participation of insurance medical organizations in healthcare. A comparison of the cost of maintaining the CFR and the Pension Fund of Russia over a long period of time clearly shows that the effectiveness of the healthcare system with the participation of the CFR is significantly less than the effectiveness of the Pension Fund.
国内保健问题与受国家经济状况指标影响的若干因素有关,而主要问题是资金不足,这在很大程度上与保险医疗组织参与保健有关。对俄罗斯长期维持CFR和养老基金的成本进行比较,可以清楚地看出,有CFR参与的医疗体系的有效性明显低于养老基金的有效性。
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引用次数: 0
New rules of paid medical services: is a medical organization required to have an official website. 付费医疗服务新规:医疗机构需要有官方网站。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-4-10
D. V. Piven, I. S. Kitsul, I. V. Ivanov
The Rules for the provision of paid medical services by medical organizations, approved by Government Decree No. 736 dated May 11, 2023, significantly expand the requirements that provide for an increase in the amount of information about the contractor and the paid medical services provided by him, which the medical provider must provide to the consumer. organization. Taking into account these requirements, the article considers in detail the question of whether medical organizations providing paid medical services are required to have their own official website. The authors substantiate that all medical organizations providing paid medical services, but not participating in the implementation of the State Guarantees Program, are required to post the information provided by law about themselves and about the paid medical services they provide on the Internet. At the same time, the specified information may be posted on the official website on the Internet and (or) in other information systems on the Internet. At the same time, all medical organizations providing paid medical services must take into account the risks associated with the use of information systems owned by foreign legal entities and citizens, the use of which is subject to the prohibitions established by Part 8 of Art. 10 of the Federal Law “On Information, Information Technologies and Information Protection”. One way to account for these risks is to create or develop your own official sites on the Internet.
2023年5月11日第736号政府令批准的《医疗组织提供有偿医疗服务规则》大大扩大了要求,规定增加关于承包商及其提供的有偿医疗服务的信息量,医疗提供者必须向消费者提供这些信息。组织。考虑到这些要求,文章详细考虑了提供付费医疗服务的医疗机构是否需要有自己的官方网站的问题。提交人证实,所有提供有偿医疗服务但未参与执行国家保障方案的医疗组织都必须依法在互联网上公布有关其自身及其提供的有偿医疗服务的信息。同时,指定的信息可能会在互联网上的官方网站和(或)互联网上的其他信息系统上发布。同时,所有提供付费医疗服务的医疗机构必须考虑到与使用外国法人实体和公民拥有的信息系统相关的风险,这些信息系统的使用受到《关于信息、信息技术和信息保护》联邦法第10条第8部分规定的禁止。考虑这些风险的一种方法是在互联网上创建或开发自己的官方网站。
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引用次数: 0
Organization of the educational process in improving the primary prevention of non-medical consumption of psychoactive substances by minors. 组织教育工作,加强对未成年人非医疗消费精神活性物质的初级预防。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-49-57
G.I. Tikhomirova, A.Yu. Lukin
The article presents the results of an experiment conducted in teaching teenagers from among healthy individuals and at-risk groups to prevent the use of psychoactive and other non-drug drugs using a differentiated approach taking into account their metacognitive styles and information coding styles. The main goal of teaching teenagers children was to instill motivation for health-saving behavior as the main meaning of life. After the classes conducted by specially trained personnel from among teachers, narcologists, medical psychologists, nurses with specialized teenagers, positive results were noted in increasing the assessments of hygienic competence of teenagers, their medical activity and motivation to preserve.
本文介绍了一项实验的结果,该实验是在健康个体和危险群体的青少年中进行的,使用差异化的方法来防止使用精神活性药物和其他非药物药物,同时考虑到他们的元认知风格和信息编码风格。教育青少年儿童的主要目标是灌输将健康行为作为生命主要意义的动机。在经过专门培训的教师、麻醉科医生、医学心理学家、专门照顾青少年的护士等人员授课之后,在提高对青少年卫生能力、医疗活动和保护动机的评估方面取得了积极成果。
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引用次数: 0
Urban infrastructure design as a significant means of shaping public health. 城市基础设施设计是塑造公共卫生的重要手段。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-102-108
V. M. Rotov
The article discusses the importance of urban infrastructure design in ensuring public health. Relevance. The growing level of urbanization of territories, the growth of cities and the formation of the urban environment currently provide relevance in the search for means to strengthen and maintain the health of the population at the proper level. One of the ways to achieve this goal is to form an eco-friendly, health-saving space that will have all the necessary resources to achieve comfort in the lives of urban residents. The purpose of the study is to analysis of the directions and methods of creating urban infrastructure design that have an impact on environmental and health-oriented characteristics of the external environment. The subject of the study is a health-oriented urban space. Research methods. The analysis of scientific information on this topic, the synthesis of opinions, statistical analysis, the method of graphical data transmission is carried out. Results. Thus, the conducted research has shown the importance of ensuring a safe urban space, eco-friendly and practical infrastructure design in ensuring public health. Conclusions. The health-oriented characteristics of urban space are the key to the successful development of sustainable urban indicators and the full socio-economic development of our country. The scope of the results. The results of the conducted research will be reflected in the development of such topics in the scientific healthcare system.
本文论述了城市基础设施设计在保障公共卫生中的重要性。的相关性。各领土城市化程度的不断提高、城市的发展和城市环境的形成,目前对寻求在适当水平上加强和保持人口健康的方法具有现实意义。实现这一目标的方法之一是形成一个生态友好、节约健康的空间,它将拥有所有必要的资源,以实现城市居民的舒适生活。本研究的目的是分析城市基础设施设计创造的方向和方法,影响环境和健康的外部环境特征。研究的主题是一个以健康为导向的城市空间。研究方法。对本课题的科学资料进行分析,综合意见,统计分析,图形化数据传输的方法。结果。因此,所进行的研究表明,确保安全的城市空间,生态友好和实用的基础设施设计在确保公共卫生方面的重要性。结论。城市空间以健康为导向的特点,是成功制定可持续城市指标和实现我国社会经济全面发展的关键。结果的范围。所进行的研究结果将反映在科学医疗保健系统中此类主题的发展中。
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引用次数: 0
On the issue of peculiarities of organization of preventive measures for patients with cardiovascular diseases. 论心血管疾病患者预防措施组织的特殊性问题。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-33-41
V. S. Nechaev, A. A. Zagoruychenko, O. B. Karpova
The problem of prevention of chronic non-communicable diseases in Russia is particularly acute, among which diseases of the circulatory system occupy the first place, becoming widespread. O b j e c t i v e : to analyze and study the features of the organization of preventive measures for patients with cardiovascular diseases, especially the elderly population. M a t e r i a l s a n d m e t h o d s . For the analysis were literary sources, statistical reporting data, regulatory documents, and electronic resources. In the context of this study, such methods as: studying and generalizing experience, content analysis, a systematic approach, and statistical analysis were used. R e s u l t s . In the framework of the study revealed a high overall and primary morbidity of BSK in older age groups, so you need to increase the interest of the population in activities of preventive medicine, in which medical services are provided free of charge; analyzed the main preventive measures in the world and the example of some of the subjects of the Russian Federation; the main role of physical activity of the population in the fight against CVD is determined; the main problems in the framework of prevention at the regional level are identified: low interest of the population in health care and low the problem of distribution of preventive measures in the framework of VHI programs is studied. C o n c l u s i o n . Higher common and primary morbidity of CVD in elderly age groups of population requires as priority-driven active enhancement of commitment of population in effective medical prevention on the basis of free-of-charge medical care and services. The key role of physical activity of population in prevention of CVD is approved. Among regional problems of CVD prevention of priority importance are critically low commitment of population in one’s own health care and inadequate exploration of prevalence of preventive activities within the framework of implementation of VMI programs.
俄罗斯预防慢性非传染性疾病的问题特别严重,其中循环系统疾病占首位,并且越来越普遍。目的:分析研究心血管疾病患者特别是老年人群预防措施的组织特点。我想把我的头发剪下来,然后把我的头发剪下来。用于分析的文献来源、统计报告数据、法规文件和电子资源。本研究主要采用经验研究与归纳、内容分析、系统分析、统计分析等方法。这是我最喜欢的。在研究的框架内,揭示了老年群体中BSK的总体发病率和原发性发病率很高,因此需要提高人们对免费提供医疗服务的预防医学活动的兴趣;分析了世界上主要的预防措施和俄罗斯联邦的一些主体的例子;确定了人口身体活动在防治心血管疾病中的主要作用;确定了区域一级预防框架中的主要问题:研究了人口对保健的兴趣不高以及在VHI方案框架内预防措施的分配问题不高。我想,我想,我想,这是我的梦想。老年人群心血管疾病的常见和原发性发病率较高,需要在免费医疗和服务的基础上,优先推动人群对有效医疗预防的积极承诺。人群体育活动在预防心血管疾病中的关键作用已得到认可。在心血管疾病预防的优先重要性的区域问题中,人口对自身卫生保健的承诺非常低,并且在实施VMI计划的框架内对预防活动的流行程度的探索不足。
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引用次数: 0
Comparative analysis of the standards of medical care for adults in the oncology profile approved before and after 2019 for the possibility of planning a program of state guarantees. 2019年前后批准的肿瘤学成人医疗保健标准的比较分析,以规划国家保障方案的可能性。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-63-72
Yu. A. Ledovskikh
In the healthcare system in Russian Federation, in recent decades, standards of medical care have been formed, which are tabular forms indicating medical services, medicines, medical devices implanted in the human body, blood components and clinical nutrition (components), indicating average frequency indicators. P u r p o s e – a comparative analysis of the standards of medical care for adults in the oncology profile, approved by orders of the Ministry of Health of Russia in the period from 2012 to 2018, and the standards developed on the basis of clinical guidelines and approved in the period from 2019 to 2022, with a view to the possibility of planning a state guarantee program based on them. M a t e r i a l s a n d m e t h o d s . The comparison was performed by comparing the standards of medical care in the context of types of medical care, the conditions for providing medical care, localizations and nosological forms according to ICD‑10 blocks, types of medical interventions and assessing consistency with planning units of the state guarantees program. R e s u l t s . The standards of medical care in the oncology profile, approved in the period from 2012 to 2018, were developed in the context of the types of medical interventions and were not coordinated either with the planning units of the state guarantees program or with the methods of payment by diagnosis-related group. The introduction of a methodology for the formation of standards of medical care based on clinical guidelines using standardized modules of medical care made it possible to revise the principle of the formation of standards for the oncology profile and harmonize them with the planning units of the state guarantees program and methods of payment by diagnosis-related group. F i n d i n g s . Structuring the process of developing medical care standards based on clinical guidelines and developing a methodology for their formation makes it possible to realize the economic function of medical care standards.
在俄罗斯联邦的医疗保健系统中,近几十年来形成了医疗保健标准,这些标准是表格形式,表明医疗服务,药物,植入人体的医疗器械,血液成分和临床营养(成分),表明平均频率指标。对2012年至2018年俄罗斯卫生部命令批准的肿瘤成人医疗保健标准与根据临床指南制定并于2019年至2022年批准的标准进行比较分析,以期在此基础上规划国家保障方案的可能性。我想把我的头发剪下来,然后把我的头发剪下来。进行比较的方式是,比较医疗保健类型背景下的医疗保健标准、提供医疗保健的条件、根据ICD - 10分类的地点和病种形式、医疗干预措施类型以及评估与国家保障方案规划单位的一致性。这是我最喜欢的。2012年至2018年期间批准的肿瘤科医疗标准是在医疗干预类型的背景下制定的,既没有与国家保障计划的规划单位协调,也没有与诊断相关团体的支付方式协调。采用了一种基于使用标准化医疗保健模块的临床指导方针制定医疗保健标准的方法,从而有可能修订肿瘤学概况标准的制定原则,并使其与国家保障方案的规划单位和诊断相关小组的支付方法相协调。如果我发现了它。构建以临床指南为基础的医疗标准制定过程和制定医疗标准形成的方法,使医疗标准的经济功能得以实现。
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引用次数: 0
Organization of preventive examinations of the adult population in the Healthy Moscow pavilions. 组织对健康莫斯科馆成年人口进行预防性检查。
Pub Date : 2023-08-01 DOI: 10.21045/1811-0185-2023-7-58-62
A. S. Bezymyanny, V. M. Grinin, E. N. Mingazova
The value and originality of the new organizational approach implemented in the Healthy Moscow program lies in the fact that mobile pavilions have been set up as part of a large-scale preventive examination of the population in convenient location accessibility – park areas, squares and recreation areas, which makes it possible to identify not only diseases at an early stages, but also risk factors among population groups who consider themselves healthy, as well as organize targeted promotion of a healthy lifestyle. During the period of the Healthy Moscow program, more than a million citizens underwent preventive examinations in the pavilions, and to a greater extent the population that, for a number of reasons, rarely visits polyclinics and who do not have pronounced symptoms of diseases. However, according to the results of the surveys, it was revealed that approximately 12% of the so-called healthy people have diseases.
“健康莫斯科”方案实施的新组织方法的价值和独创性在于,在公园、广场和娱乐场所等方便的地点,设立了移动亭子,作为对人口进行大规模预防性检查的一部分,这不仅可以在早期阶段发现疾病,还可以在自认为健康的人群中发现危险因素。以及组织有针对性的健康生活方式推广活动。在“健康莫斯科”方案实施期间,100多万公民在各场馆接受了预防性检查,更大程度上,由于种种原因,很少去综合诊所就诊,没有明显疾病症状的人也接受了检查。然而,根据调查结果显示,大约12%的所谓健康人患有疾病。
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引用次数: 0
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