Manager Zdravoochranenia 2017 #7

Published: 2017-07-18



    Focus of problem
  • The duty of medical organizations inform about the doctors: what is informing and how to organize it

    The article deals with the responsibility of medical organizations to provide information on doctors, their level of education and qualifications. Presented and substantiated list of specific information about doctors who have to post every medical organization on the official site in a network “the Internet”, as well as on the stands. The authors demonstrated that even if the doctor your consent to the placing of personal data (information about the doctor), which in accordance with legislation, obliged to submit medical organization, the placement of these data on its official site in a network “the Internet”, as well as on the stands should be continued. Stressed that the problem of placing medical organizations and maintaining up to date information about doctors, including their level of education and qualification, necessary water supply amount, and in strict accordance with the established requirements is one of the most important ways of ensuring and monitoring the quality and safety of medical activity

    Authors: Piven D. V. [58] Kitsul I. S. [58] Ivanov I. V. [29]

    Tags: certificate of accreditation1 graduate certificate1 information about the doctor1 level of education and qualifications1 medical organization52 medical organization site1 personal data3 the quality and safety of medical practice1

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  • Management in healthcare
  • Pharmacoeconomic analysis of breast cancer prevention in women with BRCA1/2 mutation

    The article deals the problems of using preventive surgical interventions (preventive mastectomy, preventive adnexectomy) in patients carrying BRCA mutations. The article presents and justifies economic efficiency of methods of surgical prevention compared to the observational method estimation. The most preferable tactics of management these patients offer, according to pharmacoeconomic analysis. Five models (decision trees) were developed to assess the cost of every tactics of patient management. The following health statuses were considered: no disease, primary disease, remission, and death. Based on the results of these models, pharmacoeconomic analysis was conducted to compare preventive surgical interventions with the observational method. Life years saved was the measure of effectiveness. The cost assessment was conducted for a medical facility. The modelling horizon was the age of 25–70 years. Preventive surgical interventions enabled to save 9–88 additional years of life in the cohort of 100 women with BRCA1/2 mutation compared to the observational method. Bilateral prophylactic mastectomy and preventive adnexectomy performed in the whole cohort of 50 year-old women instead of observation resulted in additional cost of 70 323 RUB for one saved year of life. Other considered approaches connected with the preventive surgical interventions were found to be more economically effective than observation. According to pharmacoeconomic analysis, the most preferable tactics of management is bilateral prophylactic mastectomy and preventive adnexectomy in the age of 40, which allow achieving greater results with fewer costs by 70 years old.

    Authors: Solodkiy V. A. [2] Khodorovich O. S. [1] Derkach Ye. V. [1]

    Tags: brca1/2 mutations1 life years saved1 pharmacoeconomic analysis1 preventive adnexectomy1 prophylactic mastectomy1

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  • Comparative analysis and integrated assessment economic efficiency of the developed three-level system of provision of urological care to the population in the region compared to the traditional approach

    Medico-economic efficiency of functioning of the regional urological service at the modern stage of healthcare development is not optimal. In article the analysis of work-level system and the restructuring of urological care in Voronezh region for the total amount of direct costs for diagnosis and treatment of all patients and the cost of diagnosis and treatment in terms of a particular patient, for example urolithiasis, benign prostatic hyperplasia and prostate cancer. The study included two stages: a traditional system of provision of urological care to the implementation of the system restructuring, and after implementing three-tier system of care for patients with urological disorders. The results demonstrate a strong statistically significant objective reduction of economic costs of diagnosis and treatment for the vast majority of patients in all three nosological forms presented in this study reflect the ultimate performance of the regional urological service (on the example of Voronezh region), in terms of its functioning in the format developed a three-tiered system of medical care in comparison with the traditional approach.

    Authors: Esaulenko I. E. [3] Zolotukhin O. V. [3] Apolikhin O. I. [2] Avdeev [1] A. I. [1] Madykin Y. Y. [1] Kochetov M. V. [2] Anosova [1] Y. A. [1] Shaderkin I. A. [1]

    Tags: benign prostatic hyperplasia2 direct costs5 economic efficiency7 medical care13 prostate cancer4 restructuring2 urolithiasis2

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  • Information management
  • Information management public health interface: the history of the system-analytical development

    The article presents the stages of formation and development of system approach and system analysis as the methodological basis for the development of automated control systems in healthcare. Given the contribution of the most well-known industry experts in the development of this activity. The results of the analysis of the development of organizational support Informatization of healthcare of the country in recent fiftieth anniversary. Shows examples of effective and ineffective-products of decisions. Described the experience of theoretical and experimental substantiation of creation of regional medical information-analytical center.

    Authors: Chechenin G. Y. [1] Gasnikov V. K. [1]

    Tags: adoption of conceptual solutions1 an automated management system in health care1 designing organizational structures1 modeling3 system analysis1 system approach3

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  • Medical statistics
  • The condition of traumatism problem according to data of official statistics and scientific foundation for its control

    Traumatism is the priority problem of Health Protection in Russia. The questions of statistics and organization of specialized help are not yet decided. The results of analyses of the main data in the Astrakhanian region according to official medical statistics for 2005–2015 years are represented in the article. There were studied the intensive data, their dynamics, meaning of difference according to statistic criteria t. The limit of possibilities in investigation of traumatism and mortality because of external factors in connection with not quite full control of their parameters in the forms of federal statistic observation was found out. The necessity of perfection of control in traumatism and medical help to victims by creation of regional and federal specialized informative systems and adoption of normative documents were confirmed. The introduction of worked-out regional informative systems gives the possibility to improve control of traumatism and specialized medical help

    Authors: Grechuhin I. V. [1]

    Tags: analysis2 data of traumatism1 informative system1 official medical statistics1 perfection1

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  • Medical science
  • Patent disputes about the rights to the technology for genome editing as a new model of scientific communication

    The history of the patent war between a group of authors who carried out joint development of technology for genome editing. Questioned the cogency of the thesis that in the conditions of globalization of science will take place the rejection of narrow corporate research network international projects of the open type. It is suggested that the formation of centers of competence that determine the global competitiveness of companies, will inevitably aggravate the competition for talent and unique expertise. The economic feasibility of the use of these talents will lead to new types of interactions: the Imperative of unselfishness scientist will be replaced by the imperative of economic efficiency of scientific activities. This will form new norms and patterns of behavior scientists

    Authors: Kurakov F. A. [2]

    Tags: and centres of excellence1 basic research1 license rights1 patent wars1 patents1 results1 technology for genome editing1

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  • Special opinion
  • «Patient oriented model»: iatrogenic factors in Russia – «associated costs» or «good» for the patient

    Authors: Starchenko A. A. [34]

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  • Manager of health care consults
  • The issues of creation and functioning of centralized laboratories in the system of compulsory medical insurance

    Centralization of laboratory diagnostics is a time commitment associated with the benefits it provides. However, the appeal to this topic is also connected with the new factors that are considered in the article. The difference in the regional features of the organization of health care, the availability of various sources of financial support for medical organizations, etc., suggest a distinction between specific models of centralization, the system of financial relationships, etc. In addition, the centralization of the laboratory service, having undoubted merits, also carries certain risks and threats that must be taken into account. This article addresses these and other issues related to the practical aspects of the centralization of the laboratory service.

    Authors: Kadyrov F. N. [122]

    Tags: centralized laboratories1 compulsory health insurance17 efficiency11 healthcare management4 laboratory diagnostics3 outsourcing4 paying for medical care1

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  • Questions and answers
  • Questions answered by PhD of Economic F.N. Kadyrov

    Authors: Kadyrov F. N. [122]

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