Management in healthcare
  • 2022 № 7 Features of national account of donor platelets collection

    Based on the analysis of the practice of donor platelet concentrates collection in 16 Russian blood service organizations, it was
    established that:
    - the term “unit” is used in relation to 4 concepts, which leads to a misreporting of the blood component “Platelet concentrate
    from a blood unit”,
    - the blood component “Leuco-reduced platelet concentrate from a blood unit” is not produced at all due to the lack of clinical need and excessively high cost,
    - ANOVA analysis of variance revealed significant differences in the volumes of both therapeutic doses (p=0,038) and units of platelet concentrates (p<0,001) prepared by eight studied methods,
    - indicators of the volume of pooled platelet concentrates are higher than similar indicators of apheresis products: a) treatment dose – by 36,1% (p=0,001), b) unit – by 35,5% (t-test – 4,771, p<0,001),
    - the current system for accounting for the volume of collection of 11 types of donor platelet concentrates does not allow assessing either the number of prepared therapeutic doses or the degree of implementation of technologies for their additional processing,
    - a form of the blood establishment report on the collection of platelets was proposed, which characterizes: a) the number of received therapeutic doses, b) the use of the processes for preparing these doses.

    Authors: Zhiburt E. B. [15] Averyanov E. G. [6] Shestakov E. A. [6] Khamitov R. G. [1]

    Tags: account2 apheresis4 blood8 blood transfusion10 platelets5 pooling4 unit4 volume4

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  • 2022 № 9 Features of national account of donor platelets collection

    Based on the analysis of the practice of collection and the volume of units of donor red blood cells, plasma and cryoprecipitate in 13 Russian blood service organizations, it was established:
    - volumes of units of 9 received types of erythrocytes differ significantly: H-test of Kruskal-Wallis – 32,071 with a critical value of 15,507 (p < 0,001);
    - the volume of red blood cells suspension exceeds the volume of red blood cells suspension mass by 28,8% (p = 0,004);
    - removal of the buffy-coat reduces the volume of red blood cells suspension suspension – by 14,8% (p = 0,002);
    - leukodepletion does not reduce the volume of red blood cells suspension and mass;
    - the volume of washed red blood cells is the most variable (median absolute deviation = 33), since it is determined by an arbitrary amount of saline added to the final product;
    - pathogen inactivation does not affect the plasma volume, which allows us to recommend the production of pathogen-reduced cryoprecipitate;
    - there is no unequivocal qualification of cryosupernatant plasma as a therapeutic product or a vastage in cryoprecipitate production (out of 12 organizations collected cryoprecipitate, 5 indicated the preparation of cryosupernatant plasma);
    - 3 out of 13 participants in the study have already implemented the production of pooled cryoprecipitate – a technology that significantly reduces labor costs and 92% – unproductive consumption of the medical product (p < 0,001);
    - the current system for accounting for the volume of red blood cells and plasma collection does not allow estimating the number of prepared therapeutic units;
    - it is proposed to account donor red blood cells, plasma for transfusion and cryoprecipitate in units, and plasma for the production of medicines – in liters.

    Authors: Zhiburt E. B. [15] Averyanov E. G. [6] Shestakov E. A. [6] Pokhabov D. S. [1]

    Tags: account2 blood8 blood collection5 plasma3 red blood cells3 unit4 volume4

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  • 2017 № 10 Benchmarking of blood transfusion in regions of the Russian Federation

    Blood transfusion statistics in Russia has been evaluated. In 2016 about 1.2 million patients of Russian clinics received more than 3.2 million transfusions of blood and its components in a total volume of about 1 million liters. About 0.5% of Russian doctors certified in the specialty «Transfusiology». The practice of transfusion of blood components in the RF subjects is very variable. The degree of heterogeneity of the clinical transfusion has been determined: the decile coefficient of some indexes in the regions of Russia in 2016 amounted to: transfusionists provision – 5.31; the number of recipients of blood on 1 transfusionist – 4.91; the part of transfusionists among doctors – 3.70; the part of recipients of blood among the population – 3.04, the volume of blood transfusion for 1 recipient 1–2.43; the volume of 1 blood transfusion – 2.29; the number of blood transfusions for 1 patient – 1.74. It seems appropriate for further statistics of clinical transfusion evaluation: the term «transfusion» replaced by the term «unit»; to evaluate the practice of transfusion of different blood components separately

    Authors: Zhiburt E. B. [15] Chemodanov I. G. [1] Averyanov E. G. [6] Kozhemyako O. V. [1]

    Tags: benchmarking2 blood service5 recipient4 transfusinist1 transfusion3 unit4 volume4

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  • Management in health care
  • 2021 № 10 AVAILABILITY OF HIGH-TECH MEDICAL CARE TO THE POPULATION OF THE ASTRAKHAN REGION

    I n t r o d u c t i o n . In article problems of availability of high-tech medical care for residents of separately taken region are considered.
    Communication of an increase of the rendered medical care depending on sources of financing and a regulation of a level cofinancing is analyses.
    T h e p u r p o s e o f t h e s t u d y : a background of principles of realization of the program of the state guarantees of free rendering of medical aid at availability of insufficient financing the region, based on the analysis of existing problems in the organization of maintenance of availability of high-tech medical care.
    M a t e r i a l s a n d m e t h o d s . In research were used a database of a subsystem of monitoring of realization of the state task on rendering high-tech medical care of information-analytical system of Ministry of Health of Russia and regulatory legal documents.
    The statistical, analytical method and a content-analysis were applied.
    R e s u l t s a n d d i s c u s s i o n . It is revealed, that at a quadruple increase of medical institutions rendering the given type of the help in territory of region, the percent of its rendering decreases, not leaving for its limits. Since 2012, decrease in grants from the federal budget almost twice is ascertained. Thus during last four years financing from means of the budget of the Astrakhan area remains at a constant level.
    C o n c l u s i o n . For the big percent of the patients leaving for limits of region, the given type of the help in fact is not at all «free» as there is an indispensability of payment of additional inspection and travel. And absence of a precise regulation of a level cofinancing provides the way to allocate money resources from the federal budget by «a residual principle».

    Authors: Naberezhnaya I. B. [2]

    Tags: availability3 financing13 high-tech medical care11 structure2 volume4

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