Pub Date : 2022-10-17DOI: 10.47470/0044-197x-2022-66-5-375-379
D. V. Goryaev, I. Tikhonova
The relation of tasks of managing the sanitary and epidemiological situation at the regional level to the storage, transmission and analysis of large data arrays determines the relevance of their digitization for data transformation and computational operations. Purpose: to use digital technologies for processing dynamic spatially distributed information to optimize management decisions regarding the provision of sanitary-epidemiological welfare of the population. Methods: system and mathematical analysis, geoinformation analysis, forecasting, online consulting, computing technologies. Results. Using the example of the Krasnoyarsk Territory, digital technologies were used to assess, analyze and optimize the sanitary-epidemiological situation at the regional and municipal levels (55 municipalities, 2.9 million people, 40 thousand production facilities, 19 classes of diseases and causes of death, about 10 years of observations, 50.0 thousand health studies, etc, a total of 1.5 billion units of information). The territorial distribution of the total risk of causing potential harm to the health of the population has been quantified with geoinformation binding, and a shift in priorities towards the location of the activities of economic entities has been revealed. The zones of aerotechnogenic impacts on the population were digitized, the maxima of the spread of diseases associated with the risk of harm to the health of the exposed population were estimated. There are obtained digital parameters of models of dependence of morbidity of the population on the total risk of harm to the health of the population formed by subjects of various types of aactivity. With the use of digital technologies, at the regional level there is substantiated an effective model of the system of socio-hygienic monitoring, based on the combination with risk-oriented control and supervisory activities. Their optimal interaction in relation to the sanitary-epidemiological situation is ensured by a cyclical interconnected planning process that eliminates zones of excessively high or unacceptably low intensity of observations. Limitations. The results of the conducted research on the use of digital technologies for processing dynamic spatially distributed information for the assessment, analysis and optimization of the sanitary-epidemiological situation are applicable only in the territories of federal districts, regional and municipal levels of the Russian Federation. Conclusion. The potential for optimizing the sanitary-epidemiological situation at the regional and municipal levels is quite high. Digitalization provides efficiency, high accuracy, and selection of scenario management decisions to minimize risks to public health.
{"title":"Digital technologies in the tasks of managing the sanitary-epidemiological situation at the level of the subject of the Federation","authors":"D. V. Goryaev, I. Tikhonova","doi":"10.47470/0044-197x-2022-66-5-375-379","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-5-375-379","url":null,"abstract":"The relation of tasks of managing the sanitary and epidemiological situation at the regional level to the storage, transmission and analysis of large data arrays determines the relevance of their digitization for data transformation and computational operations. Purpose: to use digital technologies for processing dynamic spatially distributed information to optimize management decisions regarding the provision of sanitary-epidemiological welfare of the population. Methods: system and mathematical analysis, geoinformation analysis, forecasting, online consulting, computing technologies. Results. Using the example of the Krasnoyarsk Territory, digital technologies were used to assess, analyze and optimize the sanitary-epidemiological situation at the regional and municipal levels (55 municipalities, 2.9 million people, 40 thousand production facilities, 19 classes of diseases and causes of death, about 10 years of observations, 50.0 thousand health studies, etc, a total of 1.5 billion units of information). The territorial distribution of the total risk of causing potential harm to the health of the population has been quantified with geoinformation binding, and a shift in priorities towards the location of the activities of economic entities has been revealed. The zones of aerotechnogenic impacts on the population were digitized, the maxima of the spread of diseases associated with the risk of harm to the health of the exposed population were estimated. There are obtained digital parameters of models of dependence of morbidity of the population on the total risk of harm to the health of the population formed by subjects of various types of aactivity. With the use of digital technologies, at the regional level there is substantiated an effective model of the system of socio-hygienic monitoring, based on the combination with risk-oriented control and supervisory activities. Their optimal interaction in relation to the sanitary-epidemiological situation is ensured by a cyclical interconnected planning process that eliminates zones of excessively high or unacceptably low intensity of observations. Limitations. The results of the conducted research on the use of digital technologies for processing dynamic spatially distributed information for the assessment, analysis and optimization of the sanitary-epidemiological situation are applicable only in the territories of federal districts, regional and municipal levels of the Russian Federation. Conclusion. The potential for optimizing the sanitary-epidemiological situation at the regional and municipal levels is quite high. Digitalization provides efficiency, high accuracy, and selection of scenario management decisions to minimize risks to public health.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46602759","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-275-281
M. A. Miloserdov, N. E. Maslov, Anna S. Erochina, E. I. Khamtsova
Introduction. The stroke was the leading reason for disability and mortality of the Russian population. In recent years, the influence of socio-economic factors on the health of the population has been actively studied. In this regard, it is important to study the relationship of these indicators in the subsidized region, which includes the Smolensk region, where the incidence of stroke is higher than in the whole country. The purpose of the investigation is to assess the relationship between the incidence of stroke in the Smolensk region and socio-economic factors and indicators of the health system in the region. Materials and methods. Using the methods of nonparametric statistics, the official statistical information was analyzed as trend for 10 years. A survey of stroke patients was conducted to determine their material wealth. Results. There is an annual gain in the incidence of brain infarctions and intracerebral hemorrhages, a decline in the incidence of undifferentiated strokes, a decrease in the availability of doctors of all specialties, as well as neurologists, internists and emergency physicians, and an increase in the availability of general practitioners. The relationship between the incidence of the stroke and the actual final consumption of households, the ratio of the average monthly nominal accrued wages of employees of institutions to the subsistence minimum of the working-age population, the deficit of monetary income from the total monetary income of the population, the consumer price index for goods and services, the Gini index, the average amount of accrued pensions, the average per capita monetary income of the population, the integral indicator of the quality of life, the availability of general practitioners, therapists, emergency physicians. Limitations. The study was carried out on the basis of generalized aggregated information without any primary data, the results reveal statistical rather than causal relationships, and are valid only for the territory of the Central Federal District and are comparable with the results of similar work. Conclusions: the greatest impact on the level of stroke incidence in the Smolensk region is caused by the deficit and inequality in the distribution of monetary income, the low level of quality of life of people, the personnel shortage and the insufficient volume of preventive work of outpatient clinics.
{"title":"Prevalence of acute disorders of cerebral circulation in the Smolensk region in terms of the role of socio-economic factors and the state of the health care system","authors":"M. A. Miloserdov, N. E. Maslov, Anna S. Erochina, E. I. Khamtsova","doi":"10.47470/0044-197x-2022-66-4-275-281","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-275-281","url":null,"abstract":"Introduction. The stroke was the leading reason for disability and mortality of the Russian population. In recent years, the influence of socio-economic factors on the health of the population has been actively studied. In this regard, it is important to study the relationship of these indicators in the subsidized region, which includes the Smolensk region, where the incidence of stroke is higher than in the whole country. The purpose of the investigation is to assess the relationship between the incidence of stroke in the Smolensk region and socio-economic factors and indicators of the health system in the region. Materials and methods. Using the methods of nonparametric statistics, the official statistical information was analyzed as trend for 10 years. A survey of stroke patients was conducted to determine their material wealth. Results. There is an annual gain in the incidence of brain infarctions and intracerebral hemorrhages, a decline in the incidence of undifferentiated strokes, a decrease in the availability of doctors of all specialties, as well as neurologists, internists and emergency physicians, and an increase in the availability of general practitioners. The relationship between the incidence of the stroke and the actual final consumption of households, the ratio of the average monthly nominal accrued wages of employees of institutions to the subsistence minimum of the working-age population, the deficit of monetary income from the total monetary income of the population, the consumer price index for goods and services, the Gini index, the average amount of accrued pensions, the average per capita monetary income of the population, the integral indicator of the quality of life, the availability of general practitioners, therapists, emergency physicians. Limitations. The study was carried out on the basis of generalized aggregated information without any primary data, the results reveal statistical rather than causal relationships, and are valid only for the territory of the Central Federal District and are comparable with the results of similar work. Conclusions: the greatest impact on the level of stroke incidence in the Smolensk region is caused by the deficit and inequality in the distribution of monetary income, the low level of quality of life of people, the personnel shortage and the insufficient volume of preventive work of outpatient clinics.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47548028","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-336-341
A. Timurzieva, A. L. Lindenbraten
Improving efficiency is one of the important aspects in the health care system. One of the key issues today is the improving the quality of management institution of medical care to the population. The study of the satisfaction of all participants in the diagnostic and treatment process and their interaction during medical care process is very important aim. The satisfaction of patients and employees of a medical institution during the treatment and diagnostic process is influenced by many factors. Achieving the maximum level of satisfaction of patients and employees of a medical institution and the quality of the management of medical care is possible with appropriate indicators of the structure, process and result, but it depends strongly on the effective interaction between all elements both within one medical institution and at the level of the healthcare system. A search of literature was performed with databases Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RSCI. This review provides information on the factors affecting the satisfaction of participants in the diagnostic and treatment process and their interaction during providing the medical care. Both the satisfaction of employees and patients, and the successful interaction of all participants of the diagnostic and treatment process positively affect the efficiency in the healthcare system. The purpose of the presented work is to analyze experience regarding the factors affecting social efficiency, satisfaction and interaction of participants in the treatment and diagnostic process. According to the results of this analysis, the factors influencing the interaction of the parties of the treatment and diagnostic process, improving the quality of the management of medical care and efficiency in the healthcare system as a whole,were noted to be correlated to each other and could be managed by the development of special algorithms and strategies.
提高效率是医疗卫生系统的一个重要方面。当前的关键问题之一是提高人口医疗保健管理机构的质量。研究所有参与者在诊疗过程中的满意度以及他们在医疗过程中的互动是一个非常重要的目标。医疗机构的患者和员工在治疗和诊断过程中的满意度受多种因素的影响。通过适当的结构、过程和结果指标，实现医疗机构患者和员工的最大满意度和医疗保健管理质量是可能的，但这在很大程度上取决于医疗机构内部和医疗保健系统层面所有要素之间的有效互动。通过Scopus、Web of Science、MedLine、The Cochrane Library、EMBASE、Global Health、CyberLeninka、RSCI等数据库进行文献检索。本综述提供了在诊断和治疗过程中影响参与者满意度的因素以及他们在提供医疗护理过程中的相互作用的信息。员工和患者的满意度，以及诊断和治疗过程中所有参与者的成功互动，都对医疗保健系统的效率产生积极影响。本研究的目的是分析在治疗和诊断过程中影响社会效率、满意度和参与者互动的因素。根据分析结果，影响治疗和诊断过程各方互动，提高医疗保健管理质量和整个医疗保健系统效率的因素是相互关联的，可以通过开发特殊的算法和策略来管理。
{"title":"Factors influencing on the interaction of participants in the treatment and diagnostic process and efficiency in the healthcare system (literature review)","authors":"A. Timurzieva, A. L. Lindenbraten","doi":"10.47470/0044-197x-2022-66-4-336-341","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-336-341","url":null,"abstract":"Improving efficiency is one of the important aspects in the health care system. One of the key issues today is the improving the quality of management institution of medical care to the population. The study of the satisfaction of all participants in the diagnostic and treatment process and their interaction during medical care process is very important aim. The satisfaction of patients and employees of a medical institution during the treatment and diagnostic process is influenced by many factors. Achieving the maximum level of satisfaction of patients and employees of a medical institution and the quality of the management of medical care is possible with appropriate indicators of the structure, process and result, but it depends strongly on the effective interaction between all elements both within one medical institution and at the level of the healthcare system. A search of literature was performed with databases Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RSCI. This review provides information on the factors affecting the satisfaction of participants in the diagnostic and treatment process and their interaction during providing the medical care. Both the satisfaction of employees and patients, and the successful interaction of all participants of the diagnostic and treatment process positively affect the efficiency in the healthcare system. The purpose of the presented work is to analyze experience regarding the factors affecting social efficiency, satisfaction and interaction of participants in the treatment and diagnostic process. According to the results of this analysis, the factors influencing the interaction of the parties of the treatment and diagnostic process, improving the quality of the management of medical care and efficiency in the healthcare system as a whole,were noted to be correlated to each other and could be managed by the development of special algorithms and strategies.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49024269","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-342-346
R. S. Serebryany, D. V. Kamelskikh
This article discusses the emergence of the idea of Lend-Lease, as a method with the implementation of which, in conditions of force majeure, there was an opportunity to optimally solve important pressing problems. A fragment is given - the quintessence of the correspondence of the British Prime Minister Sir Winston Churchill, calling on the President of the United States of America Franklin Roosevelt and insisting on the need to introduce Lend-Lease. On the basis of archival documents and sources of literature, the role and share of medical products received during the Great Patriotic War in the USSR under Lend-Lease was established. The great importance of lend-lease is confirmed by a letter from F. Roosevelt dated November 4, 1941, addressed to Joseph Vissarionovich Stalin. The author discloses not the decisive, but significant, assistance provided in the provision of medicines, medical and sanitary products to the Soviet Union, especially over the first period of the war in 1941-1942, when some of the medical enterprises remained in the territories occupied by the Nazis. The largest number of deliveries was shown to be made by the United States of America, in comparison with the UK and Canada. The ways and logistics of incoming supplies are investigated. Products were proven to be received not free of charge, but under certain conditions. The USSR had to pay for the goods received until 2030. The Russian Federation, the legal successor of the USSR, managed to repay the debt in 2006. The role of public organizations that came to the aid of the Soviet people earlier than the governments of Western countries fighting Germany was emphasized. Behind the decisions taken on this issue, the policy of the Anglo-American allies in relation to the USSR, to the state, which must be helped in the fight against the common enemy, but in moderation, without strengthening its potential, is seen.
{"title":"Lend-Lease: delivery of medical products from the United States of America to the USSR during the Great Patriotic War","authors":"R. S. Serebryany, D. V. Kamelskikh","doi":"10.47470/0044-197x-2022-66-4-342-346","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-342-346","url":null,"abstract":"This article discusses the emergence of the idea of Lend-Lease, as a method with the implementation of which, in conditions of force majeure, there was an opportunity to optimally solve important pressing problems. A fragment is given - the quintessence of the correspondence of the British Prime Minister Sir Winston Churchill, calling on the President of the United States of America Franklin Roosevelt and insisting on the need to introduce Lend-Lease. On the basis of archival documents and sources of literature, the role and share of medical products received during the Great Patriotic War in the USSR under Lend-Lease was established. The great importance of lend-lease is confirmed by a letter from F. Roosevelt dated November 4, 1941, addressed to Joseph Vissarionovich Stalin. The author discloses not the decisive, but significant, assistance provided in the provision of medicines, medical and sanitary products to the Soviet Union, especially over the first period of the war in 1941-1942, when some of the medical enterprises remained in the territories occupied by the Nazis. The largest number of deliveries was shown to be made by the United States of America, in comparison with the UK and Canada. The ways and logistics of incoming supplies are investigated. Products were proven to be received not free of charge, but under certain conditions. The USSR had to pay for the goods received until 2030. The Russian Federation, the legal successor of the USSR, managed to repay the debt in 2006. The role of public organizations that came to the aid of the Soviet people earlier than the governments of Western countries fighting Germany was emphasized. Behind the decisions taken on this issue, the policy of the Anglo-American allies in relation to the USSR, to the state, which must be helped in the fight against the common enemy, but in moderation, without strengthening its potential, is seen.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48200526","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-320-328
A. A. Birkun, L. Frolova
Introduction. To reduce mortality from out-of-hospital cardiac arrest it is necessary to maximally involve lay public into the process of first aid (FA) provision. Whereas teaching staff constitute an extensive group of potential FA providers, little is known about real coverage of teachers with training in first aid for cardiac arrest and about efficiency of such training. Purpose. To investigate coverage with training in FA for cardiac arrest, evaluate knowledge and readiness to get trained among teachers of general education institutions on the level of a constituent unit of the Russian Federation. Materials and methods. An anonymous online survey of teaching staff of general education institutions was carried out in the Republic of Crimea in February-March 2021 with the assistance of the Ministry of Education of the Crimea. Results. The final sample consisted of five thousand nine hundred twenty one respondent (35.7% of the whole general education teaching staff of the Republic). Of all survey participants, 90.8% were females, 68.4% - individuals aged below 50 years, 67.7% - currently working in a rural area. The median work experience as a teacher was 14 years. 63.6% respondents had ever received some training in basic cardiopulmonary resuscitation (CPR). Of them, 54.8% completed CPR training more than one year ago. 36.4% surveyed teachers had never been trained in CPR. The level of knowledge regarding CPR was low. The choice of correct answers to the test questions and a higher self-rating of knowledge were associated with the experience of previous CPR training and less time interval since last CPR training (p < 0.001). 53.7% respondents stated that they would like to attend CPR training. Limitations. The survey methodology excluded the possibility of randomized selection of participants, which limits the representativeness of the study sample. Conclusions. The existing system of FA training does not provide proper coverage of teachers with training and retraining in CPR. Coordinated managing adjustments are necessary to increase readiness of the teaching staff to provide help in cardiac arrest. These adjustments should be primarily focused on improvement of legal regulation in the area of FA training, increase in availability and accessibility of the training and implementation of procedures for overseeing the effectiveness of the training.
{"title":"Current status of training of the general education teaching staff in first aid for cardiac arrest: results of a regional survey in the Republic of Crimea","authors":"A. A. Birkun, L. Frolova","doi":"10.47470/0044-197x-2022-66-4-320-328","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-320-328","url":null,"abstract":"Introduction. To reduce mortality from out-of-hospital cardiac arrest it is necessary to maximally involve lay public into the process of first aid (FA) provision. Whereas teaching staff constitute an extensive group of potential FA providers, little is known about real coverage of teachers with training in first aid for cardiac arrest and about efficiency of such training. Purpose. To investigate coverage with training in FA for cardiac arrest, evaluate knowledge and readiness to get trained among teachers of general education institutions on the level of a constituent unit of the Russian Federation. Materials and methods. An anonymous online survey of teaching staff of general education institutions was carried out in the Republic of Crimea in February-March 2021 with the assistance of the Ministry of Education of the Crimea. Results. The final sample consisted of five thousand nine hundred twenty one respondent (35.7% of the whole general education teaching staff of the Republic). Of all survey participants, 90.8% were females, 68.4% - individuals aged below 50 years, 67.7% - currently working in a rural area. The median work experience as a teacher was 14 years. 63.6% respondents had ever received some training in basic cardiopulmonary resuscitation (CPR). Of them, 54.8% completed CPR training more than one year ago. 36.4% surveyed teachers had never been trained in CPR. The level of knowledge regarding CPR was low. The choice of correct answers to the test questions and a higher self-rating of knowledge were associated with the experience of previous CPR training and less time interval since last CPR training (p < 0.001). 53.7% respondents stated that they would like to attend CPR training. Limitations. The survey methodology excluded the possibility of randomized selection of participants, which limits the representativeness of the study sample. Conclusions. The existing system of FA training does not provide proper coverage of teachers with training and retraining in CPR. Coordinated managing adjustments are necessary to increase readiness of the teaching staff to provide help in cardiac arrest. These adjustments should be primarily focused on improvement of legal regulation in the area of FA training, increase in availability and accessibility of the training and implementation of procedures for overseeing the effectiveness of the training.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48224863","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-269-274
A. Kozhevnikov
Introduction. Measures implemented in the form of a project to change the activities of medical instituions are recognized as successful if, on the basis of intensive diagnostic and treatment methods, the maximum possible amount of medical care is provided in compliance with licensing requirements. The purpose of the study was, taking into account the trends in the attitude of the population towards the activities of private medical institutions, to conduct not only an analysis of the activities carried out by the authorities and management to improve the model of the state medical institution, but also to identify possible problems that, against the background of optimizing the health system, can impede the successful implementation of appropriate management decisions. Materials and methods. The material for the comparative analysis was the normative legal acts of state authorities and management bodies, as well as the results of measures taken in the Kemerovo region to optimize the regional health care system and the information obtained by questionnaire of patients of a private medical institution. The analysis database was created in the IBM SPSS Statistics 22 license statistical package. Statistical comparison of ordinal and qualitative traits in independent groups was carried out using the chi-square test (χ2) and the Z-test. Differences are statistically significant at the difference level p < 0.05. Results. Patients who took part in the survey as respondents gave a higher rating to a private medical institution on the following indicators: management of work, quality of prescribed treatment, staff attitude to patients, waiting time for admission, sanitary condition of the institution, satisfaction with the quality of services. Differences are statistically significant. Limitations. As part of the study of the results of the implementation of a new model of a medical institution providing primary health care in the context of optimizing the healthcare system, an analysis of regulatory documents on the problem under consideration and a survey of two hundred nineteen residents of Novokuznetsk who sought medical help at the clinic of Grand Medica LLC were carried out. Conclusions. The conclusions contain not only an assessment of the declared level of the priority project being implemented, but also possible management decisions, the implementation of which will contribute to a positive change in the health system.
{"title":"Challenges of developing a new model of a medical institution providing primary health care in conditions of optimizing the health system","authors":"A. Kozhevnikov","doi":"10.47470/0044-197x-2022-66-4-269-274","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-269-274","url":null,"abstract":"Introduction. Measures implemented in the form of a project to change the activities of medical instituions are recognized as successful if, on the basis of intensive diagnostic and treatment methods, the maximum possible amount of medical care is provided in compliance with licensing requirements. The purpose of the study was, taking into account the trends in the attitude of the population towards the activities of private medical institutions, to conduct not only an analysis of the activities carried out by the authorities and management to improve the model of the state medical institution, but also to identify possible problems that, against the background of optimizing the health system, can impede the successful implementation of appropriate management decisions. Materials and methods. The material for the comparative analysis was the normative legal acts of state authorities and management bodies, as well as the results of measures taken in the Kemerovo region to optimize the regional health care system and the information obtained by questionnaire of patients of a private medical institution. The analysis database was created in the IBM SPSS Statistics 22 license statistical package. Statistical comparison of ordinal and qualitative traits in independent groups was carried out using the chi-square test (χ2) and the Z-test. Differences are statistically significant at the difference level p < 0.05. Results. Patients who took part in the survey as respondents gave a higher rating to a private medical institution on the following indicators: management of work, quality of prescribed treatment, staff attitude to patients, waiting time for admission, sanitary condition of the institution, satisfaction with the quality of services. Differences are statistically significant. Limitations. As part of the study of the results of the implementation of a new model of a medical institution providing primary health care in the context of optimizing the healthcare system, an analysis of regulatory documents on the problem under consideration and a survey of two hundred nineteen residents of Novokuznetsk who sought medical help at the clinic of Grand Medica LLC were carried out. Conclusions. The conclusions contain not only an assessment of the declared level of the priority project being implemented, but also possible management decisions, the implementation of which will contribute to a positive change in the health system.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48255642","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-296-301
Gennadij M. Orlov, N. S. Romanenkov, P. Alekseev, K. N. Movchan, Vladimir P. Dolgov, Mariya G. Daryina, A. V. Zharkov, Olga I. Yakovenko, R. M. Gedgafov
Introduction. Breast cancer (BC) incidence is on the top positions among women cancer diseases. Medical care (MC) organization improvement to BC patients - an important problem of healthcare management. Research purpose. To estimate the results of routing patients with suspected BC. Methods. A cohort study conducted at the St. Petersburg Medical Information and Analytical Center from January 1, 2017 to December 31, 2019. Analysis the data on 14 629 BC suspected women, accumulated in the automatic accounting system “City register of routing maps” (AAS CRRM), considering the age and diagnostic timing. Results. Interquartile range of patients waiting time to receive a level 1 oncologist consultation decreased from 1-8 to 1-3 days (p = 0.0000). In 2017-2019 yr. Patients with suspected BC were to wait 8 days to receive a level 2 oncologist consultation (p = 0.1629). Clinical diagnosis in suspected BC cases in St. Petersburg in 2017-2019 yr. was confirmed in 21 days (p = 0.5141). Limitations. Cohort nature of the study. Conclusion. The AAS CRRM use in BC suspected women allows better control MC providing and the timing of diagnosis of BC at all levels of medical care provision.
{"title":"Results of the implementation of information and analytical systems for routing monitoring patients with suspected breast cancer in medical institutions","authors":"Gennadij M. Orlov, N. S. Romanenkov, P. Alekseev, K. N. Movchan, Vladimir P. Dolgov, Mariya G. Daryina, A. V. Zharkov, Olga I. Yakovenko, R. M. Gedgafov","doi":"10.47470/0044-197x-2022-66-4-296-301","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-296-301","url":null,"abstract":"Introduction. Breast cancer (BC) incidence is on the top positions among women cancer diseases. Medical care (MC) organization improvement to BC patients - an important problem of healthcare management. Research purpose. To estimate the results of routing patients with suspected BC. Methods. A cohort study conducted at the St. Petersburg Medical Information and Analytical Center from January 1, 2017 to December 31, 2019. Analysis the data on 14 629 BC suspected women, accumulated in the automatic accounting system “City register of routing maps” (AAS CRRM), considering the age and diagnostic timing. Results. Interquartile range of patients waiting time to receive a level 1 oncologist consultation decreased from 1-8 to 1-3 days (p = 0.0000). In 2017-2019 yr. Patients with suspected BC were to wait 8 days to receive a level 2 oncologist consultation (p = 0.1629). Clinical diagnosis in suspected BC cases in St. Petersburg in 2017-2019 yr. was confirmed in 21 days (p = 0.5141). Limitations. Cohort nature of the study. Conclusion. The AAS CRRM use in BC suspected women allows better control MC providing and the timing of diagnosis of BC at all levels of medical care provision.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46240164","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-313-319
R. Goloshchapov-Aksenov, Raphik I. Shaburov, O. Rukodaynyy, Vyacheslav O. Starikov
Introduction. An important principle of improving cardiovascular care is to increase the compliance of patients to optimal drug therapy. Purpose. To identify compliance in patients with cardiovascular diseases to optimal drug therapy. Materials and methods. Direct continuous questioning of patients with cardiovascular diseases (n = 1,018) was carried out using a modified Morisky D. questionnaire (1986). The survey was carried out by cardiovascular surgeons (n = 3) of the Central Clinical Hospital "Russian Railways Medicine". The degree of adherence of patients to the implementation of the recommendations of doctors at the stage of the initial interview and in 6 and 24 months was compared (p < 0.05). Results. At the stage of the first consultation low compliance of patients to antihypertensive therapy (23.8%); high compliance to dual antiplatelet therapy was established in patients after endovascular arterials stenting (99%), anticoagulant therapy in patients with atrial fibrillation (86%) and hypoglycemic therapy in patients with diabetes (98%). After follow-up for six months, including the provision of endovascular and surgical care, compliance to optimal drug therapy in patients of all groups increased up to 99.9% (p < 0.05). After follow-up for 24 months, the compliance degree to antihypertensive and anticoagulant therapy slightly decreased to 93.8 and 97.5%, respectively (p > 0.05). Limitations. To assess compliance to the recommendations of doctors, the results of outpatient follow-up of one thousand eighteen patients with cardiovascular diseases over two years were analyzed, which is a sufficient reference sample. Conclusion. Compared with the initial consultation of patients, their compliance to optimal drug therapy increased during the 12 months of follow-up. Clinical management in the treatment-and-prophylactic process optimizes control over the effectiveness of the implementation of medical prescriptions, including self-control by patients of hemodynamic and other indicators. The formation of trusting relationships in the “doctor-patient” system is the most important principle of the continuity compliance of clinical management of the process of improving public health.
{"title":"Compliance of patients with cardiovascular diseases to optimal drug therapy","authors":"R. Goloshchapov-Aksenov, Raphik I. Shaburov, O. Rukodaynyy, Vyacheslav O. Starikov","doi":"10.47470/0044-197x-2022-66-4-313-319","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-313-319","url":null,"abstract":"Introduction. An important principle of improving cardiovascular care is to increase the compliance of patients to optimal drug therapy. Purpose. To identify compliance in patients with cardiovascular diseases to optimal drug therapy. Materials and methods. Direct continuous questioning of patients with cardiovascular diseases (n = 1,018) was carried out using a modified Morisky D. questionnaire (1986). The survey was carried out by cardiovascular surgeons (n = 3) of the Central Clinical Hospital \"Russian Railways Medicine\". The degree of adherence of patients to the implementation of the recommendations of doctors at the stage of the initial interview and in 6 and 24 months was compared (p < 0.05). Results. At the stage of the first consultation low compliance of patients to antihypertensive therapy (23.8%); high compliance to dual antiplatelet therapy was established in patients after endovascular arterials stenting (99%), anticoagulant therapy in patients with atrial fibrillation (86%) and hypoglycemic therapy in patients with diabetes (98%). After follow-up for six months, including the provision of endovascular and surgical care, compliance to optimal drug therapy in patients of all groups increased up to 99.9% (p < 0.05). After follow-up for 24 months, the compliance degree to antihypertensive and anticoagulant therapy slightly decreased to 93.8 and 97.5%, respectively (p > 0.05). Limitations. To assess compliance to the recommendations of doctors, the results of outpatient follow-up of one thousand eighteen patients with cardiovascular diseases over two years were analyzed, which is a sufficient reference sample. Conclusion. Compared with the initial consultation of patients, their compliance to optimal drug therapy increased during the 12 months of follow-up. Clinical management in the treatment-and-prophylactic process optimizes control over the effectiveness of the implementation of medical prescriptions, including self-control by patients of hemodynamic and other indicators. The formation of trusting relationships in the “doctor-patient” system is the most important principle of the continuity compliance of clinical management of the process of improving public health.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48807870","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-302-307
L. Karamova, M. K. Gainullina, G. Basharova, N. Vlasova, A. Khafizova
Introduction. One of the reasons for the increase in the prevalence and incidence of cancer is anthropogenic pollution of the environment. In the Republic of Bashkortostan, there are regions that clearly differ with the predominant concentration of certain types of industries, which form a kind of geochemical province. The study of the formation of cancer incidence in regions with different environmental situations is a prerequisite for corporate and regional programs for the prevention and public health care. Purpose. To determine the epidemiological and dynamic features of the formation of cancer incidence in various ecological regions of the republic. Materials and methods. The paper analyzes and summarizes materials from organizations and institutions of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing, the Ministry of Nature and Ecology, the Ministry of Health for 2002-2018. Results. The level of cancer incidence in the Republic of Bashkortostan for 2002-2018 increased by 1.2 times (from 266.1 in 2002 to 329.3 in 2018 per 100 thousand population). The gain in the number of cancer patients occurred in all regions of the Republic in different ways, depending on their production and industrial orientation and environmental characteristics. Over all years of observation, the highest incidence rates are recorded among the population of cities in which petrochemical plants are located with an average annual level of 321.70/000, which is 30.8-36.40/000 higher than the national indicators. Cancer patients are registered in the region with large metallurgical production somewhat more often than in the Republic. Average annual levels in areas with the predominant development of oil production (290.50/000), mining production (253.00/000), agriculture (232.60/000) for 2002-2016 remain below the population indicator (285.30/000). Over following 2017-2018 years, in almost all of the above regions, the number of cancer patients continues to increase. Limitations. The dynamics of the development of oncological morbidity for 2002-2018 in the Republic of Bashkortostan. Conclusions. The revealed features of the dynamic development of oncological morbidity and the patterns of its formation in regions with different production and industrial development must be taken into account when developing comprehensive and corporate programs for protecting public health and preventing cancer.
{"title":"Cancer incidence in the Republic of Bashkortostan for 2002–2018","authors":"L. Karamova, M. K. Gainullina, G. Basharova, N. Vlasova, A. Khafizova","doi":"10.47470/0044-197x-2022-66-4-302-307","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-302-307","url":null,"abstract":"Introduction. One of the reasons for the increase in the prevalence and incidence of cancer is anthropogenic pollution of the environment. In the Republic of Bashkortostan, there are regions that clearly differ with the predominant concentration of certain types of industries, which form a kind of geochemical province. The study of the formation of cancer incidence in regions with different environmental situations is a prerequisite for corporate and regional programs for the prevention and public health care. Purpose. To determine the epidemiological and dynamic features of the formation of cancer incidence in various ecological regions of the republic. Materials and methods. The paper analyzes and summarizes materials from organizations and institutions of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing, the Ministry of Nature and Ecology, the Ministry of Health for 2002-2018. Results. The level of cancer incidence in the Republic of Bashkortostan for 2002-2018 increased by 1.2 times (from 266.1 in 2002 to 329.3 in 2018 per 100 thousand population). The gain in the number of cancer patients occurred in all regions of the Republic in different ways, depending on their production and industrial orientation and environmental characteristics. Over all years of observation, the highest incidence rates are recorded among the population of cities in which petrochemical plants are located with an average annual level of 321.70/000, which is 30.8-36.40/000 higher than the national indicators. Cancer patients are registered in the region with large metallurgical production somewhat more often than in the Republic. Average annual levels in areas with the predominant development of oil production (290.50/000), mining production (253.00/000), agriculture (232.60/000) for 2002-2016 remain below the population indicator (285.30/000). Over following 2017-2018 years, in almost all of the above regions, the number of cancer patients continues to increase. Limitations. The dynamics of the development of oncological morbidity for 2002-2018 in the Republic of Bashkortostan. Conclusions. The revealed features of the dynamic development of oncological morbidity and the patterns of its formation in regions with different production and industrial development must be taken into account when developing comprehensive and corporate programs for protecting public health and preventing cancer.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44146023","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 : 2022-08-30DOI: 10.47470/0044-197x-2022-66-4-347-350
I. V. Egorysheva, E. Sherstneva
{"title":"Significant and anniversary dates in the history of healthcare in 2023","authors":"I. V. Egorysheva, E. Sherstneva","doi":"10.47470/0044-197x-2022-66-4-347-350","DOIUrl":"https://doi.org/10.47470/0044-197x-2022-66-4-347-350","url":null,"abstract":"","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45416303","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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