All articles by Evdakov V. A.
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2020 № 10 Efficiency indicators of the round-the-clock hospital beds of the oncologic profile in the Russian Federation
The steady growth trend of oncological diseases in Russia in recent years requires a response from the health
care system: development of prevention aimed at early detection of diseases; improvement of methods of diagnostics and treatment of oncopathology; improving the quality and effectiveness of medical care.
A i m : to identify trends in changes of the neoplasms incidence and performance indicators of oncological beds for
round-the-clock stay of the state health care system in the Russian Federation, federal districts and regions of the Russian Federation in dynamics for 2010–2019.
M a t e r i a l s a n d m e t h o d s . Using the data of federal statistical observation (forms NoNo. 12, 30) by the method of
descriptive statistics, the main indicators of the neoplasms incidence in the population are analyzed, as well as the work
of round-the-clock oncological beds in the Russian Federation, federal districts and regions of the Russian Federation in
dynamics for 2010–2019.
R e s u l t s . On the background of an increase in the neoplasms incidence in the population (by 24.9%), including malignant (1.5 times), for the period 2010–2019 in the Russian Federation increased: the absolute number of oncology beds of round-the-clock stay from 30,970 to 36,186 (+ 16.8%), the provision with these beds from 2.17 to 2.47 per 10,000 population (+ 13.8%), hospitalization rate from 6.1 to 9.6 per 1000 population (+ 57.4%), and decreased: the average length of stay in an oncological bed (from 12.1 days to 8.4 – by 30.6%), as well as the average bed occupancy per year (from 345 to 330 days – by 4.3%). The extreme values of the indicators of the hospitalization rate for round-the-clock oncological beds in the regions of the Russian Federation in 2019 differ 12.8 times, the provision of these beds – 9.2 times, the average bed occupancy per year – 1.5 times, the average length of stay in a bed – 2.4 times. Mortality in oncological hospital beds increased from 0.76% in 2010 to 0.95% in 2019 (by 25%).
C o n c l u s i o n . The 24-hour oncological bed capacity, against the background of the growth of oncological morbidity,
has naturally increased, but at the same time it is characterized by an extreme disproportionality of development in the
Federal Districts and the regions of the Russian Federation. Optimization of the bed fund should be carried out based on
the objective needs of a particular region, taking into account its characteristics and with the simultaneous development
of alternative medical services. -
2016 № 7 The activities of day hospitals in the Russian Federation in 2000–2014
The article analyzes legal documents, which that regulate the work of day hospitals in the Russian Federation since the late 90-ies of XX century to the present. Presents an analysis of the performance of activities of day hospitals in health institutions providing medical care in ambulatory and stationary conditions in the country in 2000–2014. Marked increase in the number of beds in day hospitals 2,3 times, which is mainly due to the increase of beds in day hospitals in health institutions providing medical care in ambulatory conditions. Spend the evaluation of use of hospital beds hospitals for 15 years. During the study period the number of beds in hospitals has decreased by 27,7%, the number of discharged patients has almost not changed, which is associated with the intensity of the work beds. Shows the comparison of the number of persons treated in day hospitals and hospitals round-the-clock stay. The total number of patients treated in day hospitals and round hospitals, the proportion of patients treated at a convenience care hospitals declined from 92,5 to 80,3%, the proportion of patients treated in day hospitals increased from 7,5 to 19,7%.
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2016 № 4 Public Health and Formation of the Uniform Preventive Space
Annotation. The task of unifying the efforts of all participants of the preventive process, the whole society in order to create a preventive space became urgent In the last decade. The development of the public health system is suggested as such а unite. A great number of discussions on public health at various levels allowed us to formulate the definition and the core functions of public health. It is crucial to realise the public health system both as a totality of different structures and as their purposeful and coordinated activity. Of particular importance is the municipal level as a place of direct contact of the population, bodies of local self-government, the realization of the actions directed on preservation and strengthening of health of the population, with the active participation of citizens themselves.
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2016 № 3 Provision of medical rehabilitation care for the population of Russian Federation on an outpatient basis
Annotation. Demographic changes in the direction of increasing of older age groups in the population structure, chronicity diseases, disability height, high premature mortality from chronic non-communicable diseases and due to this enormous economic damage to the national economy of the country pose the problem of organizing measures of effective medical rehabilitation of patients to the category modern Russian health priority issues. The results of analysis of medical institutions and professionals activities, that provide assistance for medical rehabilitation in outpatient settings, indicate that there is a low level of cabinets and experts providing assistance on medical rehabilitation in Russia. The low number of visits to the professionals of all profiles in combination with a high coefficient of combining and low understaffing, indicates lack of sending patients for this type of restorative treatment, that is unfairly against a background of increased morbidity, especially chronic and disabling forms of diseases. This, in turn, shows the lack of organizational and legal forms of regulating the flow of patients from the active treatment to the rehabilitation, that leads to the dissatisfaction of the population need for this type of care. The structural analysis of the situation and identify unsolved problems so far give us basis for looking for priority actions for the development of provided medical rehabilitation on an outpatient basis – a necessary condition for the implementation of medical and social functions of the state to preserve and strengthen health of the population.
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2021 № 1 Activity of daily stay oncological hospitals in the Russian Federation and its regions for 2010–2019
Relevance. Oncological diseases both in our country and in other countries of the world make a significant
negative contribution to the overall mortality and disability of the population. Moreover, in the last decade, oncopathology is significantly more often affects the younger, employable population. One of the factors improving medical care is the provision of the population with specialists and hospital beds of oncological profile, including day care, where patients with this class of diseases could undergo a full course of pre-treatment, treatment, rehabilitation and recovery.
Aim. To identify the dynamics of the main activity indicators of daily stay oncological hospitals of the public health sector in the Russian Federation, federal districts and regions of the Russian Federation for 2010–2019.
Materials and methods. Using the data of federal statistical observation (form № 14DS) by the method of descriptive
statistics, the main activity indicators of daily stay oncological hospitals in the Russian Federation, federal districts and
regions of the Russian Federation in dynamics for 2010–2019 were analyzed.
Results and discussion. In General, in the Russian Federation, the absolute number of oncologic hospital beds in daily
stay hospitals of medical organizations providing inpatient care for the period from 2010 to 2019 increased by 3,5 times
(from 1,448 to 5,013 beds), in daily stay hospitals of medical organizations providing outpatient care for the period from
2014 to 2019 by 67,1% (from 2,465 to 4,120 beds). At the same time the number of patients treated in oncological hospital beds in inpatient daily stay hospitals for the period 2010–2019 increased by 405,245 (from 78,120 to 483,365 people), and in outpatient daily stay hospitals for the period from 2014 to 2017 increased by 93939 (from 218,502 to 312,441 people). The average occupancy of an oncological hospital bed per year and the average duration of treatment in Russia in inpatient daily stay hospitals decreased from 409 days in 2010 to 380 days in 2019 and from 7,7 to 5,6 days, respectively, in outpatient daily stay hospitals from 407 days in 2014 to 386 days in 2017 and from 4,7 to 4,6 days, respectively.
Conclusion. The expansion of the bed fund of daily stay hospitals of oncological profile is timely and justified, but its
development in different regions of the Russian Federation is characterized by a pronounced disproportion. At present
there are all the necessary reserves to continue the active development of the network of daily stay hospitals of this profile. -
2022 № 2 Estimation of the impact of trans-regional routing of patients with ST-segment elevation acute coronary syndrome on acute myocardial infarction mortality reduction based on the digital twin of Kurgan region
Reduction of the time required for medical evacuation to the regional vascular center in order to carry out percutaneous coronary intervention in case of ST-segment elevation acute coronary syndrome is an essential factor directly affecting the mortality rate of this condition. The concept of territorial attribution in rendering emergency medical services militates against the effective use of such emergency medical services aimed to promptly deliver patients to the hospital.
Research objective. The research objective is to study the efficiency of trans-regional communication in reducing the time required to deliver patients with ST-segment elevation acute coronary syndrome to hospitals in order to carry out percutaneous coronary intervention and its impact on acute myocardial infarction mortality rate basing on the digital twin of Kurgan region.
Materials and methods. the digital twin of the Kurgan region represents the time required to evacuate patients with ST-segment elevation acute coronary syndrome to regional vascular centers by ambulance crews in pursuance with an applicable order, compared with patient routing in case of trans-regional cooperation with vascular centers of neighboring regions.
Results: due to the implementation of trans-regional cooperation, mean patient evacuation time within the region had been reduced by 21,3 ± 9,84 minutes, and mean time on routes from the localities wherefrom it was faster to deliver patients to vascular centers in neighboring regions had been reduced by 55±25,73 minutes. The estimated myocardial infarction mortality rate on average for the Kurgan region caused by medical evacuation time reduction in case of implementing trans-regional cooperation had been reduced by 5,32%.
Conclusions: the use of resources of neighboring regions when working out regional orders on routing the patients with acute coronary syndrome in a number of instances contributes to the provision of two-hour availability of percutaneous coronary intervention and serves as a significant reserve for acute myocardial infarction mortality reduction.