Manager Zdravoochranenia 2018 #3

Published: 2018-03-23



    Focus of problem
  • Influence of doctors’ patient-orientation on patient involvement in treatment

    In the article it is shown that nowadays in the public health care of different countries researches of patient-orientation are actively conducted. At the same time patient-orientation as a characteristic of the patient’s communication with the doctor is considered the basis of the patient-doctor relationship. All this corresponds with the feasibility of forming in the domestic health care model of 4P medicine, already repeatedly voiced in recent years on various medical forums. The authors carried out an assessment of the patient-oriented corporate culture of the medical organization. For this purpose, two types of questionnaires were developed and analyzed: “Involvement of health workers” and “Patients’ involvement in treatment”. It has been established that the level of the doctor’s involve- ment in achieving the strategic goals of the medical organization directly affects the level of intention of patients to fulfill doctors’ recommendations. The range of this influence is 43.3% on average

    Authors: Piven D. V. [58] Tsaranov K. N. [10] Lindenbraten A. L. [1] Tarbastaev A. G. [9]

    Tags: 4p medicine3 patient adherence  to treatment1 patient-centeredness2 patient-orientation6 physician involvement1

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  • Management in health care
  • On the problem of forming a new model of the primary medico-sanitary management for the patients with pathology of digestion organs in Moscow Region

    The article presents monitoring results of the independent evaluation of the work quality of the Moscow Regional medical institutions as well as medico-statistical analysis of morbidity, hospitalization, and lethality indices in different groups of population with digestion organs diseases in Moscow Region which are necessary to form the new model of the primary medico-sanitary management. The special attention in the presented new model is paid to the standard of polite and careful treatment of patients by the medical staff, to increasing the doctor’s work time with an individual patient, to reducing the registration time, the queue to medical specialists, and the time period of pending one’s turn before the doctor’s room. The same attention is paid to shortening the period of prophylactic medical observation and examination

    Authors: Gurov A. N. [15] Perepelova O. V. [3] Davronov I. V. [2]

    Tags: digestion diseases1 independent evaluation of work1 new model of medical management organization1

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  • Organization of alimentary therapy: outsourcing or own nutrition service? (case study)

    An analysis of experience of alimentary therapy organization in Interregional Clinical Diagnostic Center (ICDC) is presented in the article. The aim of the article is to study conditions and factors of outsourcing efficiency by the organization of alimentary therapy in healthcare institutions. Materials and methods: review of scientific literature, study and analysis of statistical data on ICDC performance in 2007–2016. Specific features of alimentary therapy outsourc- ing are contemplated, reasons for organization transfer to outsourcing and conditions of its efficiency are highlighted in the paper. Two patient feedback instruments to appraise quality of nutrition are proposed and time tested: monitoring of quantity of waste and patient satisfaction assessment. A benchmarking study based on the quality coefficients data of clinical nutrition prepared by own efforts and submitted to outsourcing is conducted. Efficiency of feedback instru- ments for the organization of alimentary therapy for patients of Neurosurgery and Neurology Departments is shown. Conclusions: Outsourcing as an approach to clinical nutrition organization has a right to existence, however before its implementation a comprehensive risk-benefit analysis of this decision should be carried out. As the experience of ICDC has showed, alimentary therapy outscoring is not always the best solution for a healthcare institution. Clinical nutrition outsourcing entails additional risks, which have to be minimized and managed, that is not often possible in real life situations. The experience of ICDC suggests that clinical nutrition organization by own efforts is able to meet competition in comparison with specialized third-party contractors and besides has its advantages as it considerably reduces risks

    Authors: Kupriyanov R. V. [6] Biktimirova O. R. [2] Zulkarnaeva A. R. [1] Khayrullin R. N. [1]

    Tags: alimentary  therapy1 clinical  nutrition  organization1 clinical  nutrition  outscoring1 medical  and  preventive treatment institution1

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  • Personnel management
  • To create a new model of medical organization providing primary health care: characteristics of medical staff of district health services

    The results of the analysis of the provision of the population of the russian federation by district physicians, general practitioners, district pediatricians are presented. Significant differences in the indicators in the subjects of the Russian Federation were established. These differences necessitate a differential approach when planning actions to improve the organization of primary health care in the subjects of the Russian Federation

    Authors: Son I. M. [39] Kupeeva I. A. [7] Gazheva A. V. [6] Senenko A. Sh. [7] Pogonin A. V. [2] Garmaeva A. B. [1]

    Tags: . general practitioners2 district  physicians1 primary health care19 provision  of  the  population  with doctors1

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  • Law
  • Topical issues of arbitration practice in the CHI system (the experience of Saint-Petersburg)

    The current legislation in the system of compulsory health insurance has opened wide opportunities for participation in this system of medical organizations of any organizational and legal form. However, this has led to an increase in the number of economic disputes in the compulsory health insurance system. In particular, the number of lawsuits is increasing on new grounds: the amount of medical care; payment for medical care provided in excess of these volumes. The defendants in the claims are not only the insurance medical organizations and territorial funds of the MLA, but also the Commission, which develop territorial programs of compulsory medical insurance and are not legal entities. Court practice in many cases violates the logic of legislation on compulsory health insurance. This article is devoted to the consideration of these problems for recommendations to improve the legislation

    Authors: Gordeev A. E. [1]

    Tags: commission  on  the  elaboration  of  territorial  programmes1 compulsory medical insurance18 health  insurance  organizations3 litigation1 the  volume  of  medical  care2

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  • Informatization of health care
  • The national segment of the international object identifier tree. OID Registry of the Ministry of Health

    Describes the structure and organization of the international object identifier tree, which includes national OID space segment and of the Ministry of health of Russia. The history and problems of formation of OID Registry of the Ministry of health at an early stage, as well as solutions and current state. The basic aspects of building an arc OID «Actors of the health care system», taking into account the importance for the solution of problems of assessing the level of informatization and formation of Federal registers, as well as taking into account the legislative features of the structure of the health system

    Authors: Starodubov V. I. [40] Sidorov K. V. [2] Zarubina T. V. [3]

    Tags: federal  register  medical  organizations1 register  an  oid1 the integral  evaluation  of  the  level  of  informatization1 the  international  object  identifier  tree1 unified  public  health  information  system1

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  • The design of an automatical inventory management system of irreducible reserves of the pharmacy on the example of a multifield hospital

    The article describes the design of an automatical inventory management system of irreducible reserves of the pharmacy in a multifield hospital in order to follow the principles of lean production. The authors proposes a flexible model of the summary standards formation of medicines reserves of pharmacy using XYZ-, VEN-, ABC-analysis and additional expert evaluation. Conclusions were drawn about the need to automate the inventory management system of irreducible reserves of the pharmacy in a multifield hospital in order to optimize the logistics of movement, accounting and consumption control of medicines and to construct an automatical system of planning and monitoring of purchases of medicines

    Authors: Karpov O. E. [5] Nikitenko D. N. [2] Fateev S. A. [1] Petrova N. V. [1] Nekrasova E. S. [1]

    Tags: abc analysis2 automatical  inventory management  system  of  irreducible  reserves  of  the  pharmacy1 automatical  system  of  planning  and  monitoring  of purchases1 forecasted  demand  for  medicines1 irreducible  reserves  of  the  pharmacy1 lean  production6 medicines  consumption1 ven-analysis1 xyz-analysis1

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  • Manager of health care consults
  • «Other conditions» as the basis for payment of the rendered medical care. Part 2

    The legislation determined that one of the grounds for the provision of medical care for a fee is its provision on other conditions than provided by the state guarantees program. However, the interpretation of «other conditions» is rather ambiguous and requires detailed consideration. For this purpose it is necessary to study not only the state guarantees program itself, but also a number of other regulatory legal acts. Thus it is necessary to distinguish accurately other conditions of rendering medical care from household and service. The article deals with various aspects of medical care for a fee on the basis of its provision on terms different from the state guarantees program

    Authors: Kadyrov F. N. [122]

    Tags: grounds for rendering paid services2 household services2 paid medical services21 service2 the program of the state guarantees of free rendering medical care to citizens2

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