Manager Zdravoochranenia 2022 #3

Published: 2022-05-17

76

CONTENT OF THE ISSUE

    Focus of problem
  • Control (Supervision) without interaction with a controlled person, as a new form of control over the provision of paid medical services: what the heads of medical organizations need to know

    Currently, Roszdravnadzor and Rospotrebnadzor in the established areas of state control (supervision) over the provision of paid medical services are entitled to exercise control (supervision) without interaction with a controlled person, in which the following are carried out: monitoring compliance with mandatory requirements and on-site follow-up. Due to the fact that control (supervisory) measures without interaction with the controlled person are implemented without prior notification of the controlled persons, the conduct of these measures by the supervisory authorities is likely to entail an increase in the number of unscheduled inspections of medical organizations, including
    control procurement. The emergence of a new type of control (supervisory) measures without interaction with a controlled person is one of the significant factors that increase the responsibility of medical organizations in terms of compliance with the requirements established by law for the procedure and conditions for the provision of paid medical services.

    Authors: Piven D. V. [50] Kitsul I. S. [50] Ivanov I. V. [25]

    Tags: control (supervision) without interaction1 controlled person1 mandatory requirements2 on-site examination1 paid medical services17 quality and safety of medical activities9 safety monitoring1

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  • HEALTHCARE MARKETING
  • Market Analysis of assisted reproductive Technologies in the Russian Federation and the Republic of Bashkortostan

    The increase in the prevalence of infertility among the population determines the need for further development and use of assisted reproductive technologies. Purpose of the study: to study the state of the market of assisted reproductive technologies in Russian Federation and Bashkortostan Republic. Material and methods: analysis of statistical information in the field of healthcare of Russian Federation and Bashkortostan Republic. Results: the number of ART centers and cycles in Russia are steadily growing, while the part of state centers and cycles performed in them is just 1/3 and tends to decrease. Private clinics, both in Russia and Bashkortostan Republic, actively participate in state guarantee programs and account for more than half of all ART treatment cycles.

    Authors: Fazlyeva E. A. [1] Galieva G. A. [1]

    Tags: assisted reproductive technologies1 medical services market2 private clinics1

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  • Sociology of healthcare
  • Assessment of time spent by patients when visiting a medical organization

    The satisfaction of the population with medical care is considered today as one of the most important indicators of the health care system. At the same time, more and more attention is being paid to the time spent by patients in a medical organization when receiving outpatient care, as a factor affecting satisfaction with medical care in general.
    P u r p o s e of the study is to determine the opinion of patients about their time costs when visiting a medical organization that provides outpatient care.
    M a t e r i a l a n d m e t h o d s . The process of a patient’s referral to a polyclinic, a questionnaire for patients posted on the Internet on an open electronic resource Online Test Pad. The number of questionnaires is 509. Methods: analytical, sociological, descriptive statistics.
    R e s u l t s . During the surveys, respondents subjectively assess the time spent on various actions: communication at the reception desk, searching for an office, waiting for an appointment, etc., as well as the total time spent in a medical organization. In addition, the appearance at the polyclinic may be preceded by an appointment, which also takes time. Respondents were asked to estimate the total time spent in the polyclinic, as well as the time they are willing to devote to visiting it. The respondents’ assessment of the time spent shows significant time reserves: in the organization of an appointment and the work of the registry (clarifications, obtaining background information, obtaining coupons), navigation and, possibly, in the location of offices, in the organization of space in waiting areas.
    C o n c l u s i o n s . A tool for assessing the time spent by patients to receive care in a medical organization providing outpatient care has been developed and tested. There are significant differences in the length of time spent on making an appointment, including by phone and via the Internet. Significant reserves have been identified to reduce the total time required to visit the polyclinic. The developed tool is characterized by a short filling time, contains simple questions and allows you to quickly identify areas of necessary improvements.

    Authors: Senenko A. Sh. [6] Savchenko E. D. [5] Shelgunov V. A. [1]

    Tags: doctor’s appointment1 lean  technologies2 navigation in the polyclinic1 patient satisfaction4 patient survey1 patient time evaluation1 polyclinic3 primary health care12 registry1 waiting for an appointment1

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  • Public health
  • Assessment of preventable health losses in the rural population

    Relevance. The protection of the health of the rural population is especially significant due to the fact that medical and social health problems are maximally concentrated in rural areas. The priorities in the organization of medical care for rural residents are currently the effective use of available health care resources, as well as increasing the availability and quality of medical care. The tasks of the federal and municipal authorities should be to provide software support, resources, as well as the practical solution of strategic problems in rural areas.
    The purpose of the study: development and testing of an automated system of information support for managerial decision-making using estimates of preventable losses in the health of the population of rural areas.
    The base of the study was the Orenburg region. The share of the rural population in the region is 40.1%, there are 35 rural territories (districts) in the region.
    Methodology. The following research methods were used: statistical, analytical, expert assessments.
    The preventable loss of health of the population of rural areas in the Orenburg region was assessed by experts according to the methodology developed by us. Four indicators of the likely preventability of health losses in the rural population were identified: health indicators; territorial availability of medical care; personnel; social well-being of the population.
    The results of the study were used as the basis for the methodological support of an automated information system for supporting managerial decision-making in the organization of primary health care in rural areas of the Orenburg region.
    The use of a software product of information support for managerial decision-making makes it possible to determine priorities for making strategic decisions at the level of heads of medical organizations, health authorities and institutions, as well as heads of administration in a constituent entity of the Russian Federation. The information is presented on the web page of the administrative territory and the administrative apparatus.

    Authors: Kalininskaya A. A. [10] Bayanova N. A. [4] Kizeev M. V. [2] Balzamova L. A. [1]

    Tags: health4 information system3 management decisions1 personnel4 rural population3 rural territories1 territorial accessibility of medical care1

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  • Features of the state of health of students during their training, including in the conditions of COVID‑19

    Purpose: to assess the characteristics of the health status of students in the conditions of education during the pandemic period – 2020–2021. The analysis of the data obtained will form the basis of the developed medical recommendations, organizational measures aimed at maintaining the health of students, including various periods of increased infectious risks.
    Materials and methods: Medical and sociological research was conducted among students of one of the Institutes of the Russian
    State University named after A. N. Kosygin (Technology. Design. Art). The continuous sample of students was 505 people. In the course of the study, socio-hygienic, clinical, statistical, and analytical methods were used.
    Results: It was revealed that in the process of teaching student youth, an increase in the number of people with chronic diseases is determined; diseases of the nervous system, organs of the digestive system, ENT organs and the cardiovascular system prevailed in the structure of chronic diseases of students.
    Findings: It was found that there is no difference between the number of patients with coronovirus infection among students who do not have chronic diseases and among those who have chronic pathology. Among students with chronic diseases and recovering from Covid‑19, the most common were people with chronic diseases of the cardiovascular system, chronic diseases of the upper respiratory tract, and people who often get colds (4 or more times a year). Studying the state of health of students is important, both from the point of view of its comprehensive assessment, and from the standpoint of analyzing subsequent dynamic changes, which makes it possible to identify trends in changes in health in the dynamics of education, as well as to introduce appropriate medical and social adjustments.

    Authors: Mingazova E. N. [12] Gureev S.  A. [5]

    Tags: chronic diseases1 covid-1913 health status1 prevention17 students3

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  • Epidemiology of disability of the able-bodied population in Tver on the example of surgical patients

    The health of the nation is the main marker of the successful development of the state. Maintaining and improving the health of citizens are the main tasks of social policy in every country. Morbidity and disability are among the main indicators of the state of public health. They reflect the demographic situation and the level of socio-economic development of the country.
    Every year the number of persons with disabilities increases, which makes the problem of disability of the able-bodied population extremely relevant. Monitoring of disability, as one of the medical and demographic indicators, is the basis for ensuring the protection of the health of citizens. Research on the epidemiology of disability is the key to preventing an increase in the number of disabled citizens. In addition, it plays an important role in the distribution of the state budget to improve the quality of life of people with an assigned disability group and to carry out preventive measures aimed at reducing the impact of risk factors for disability.
    Purpose. Assessing the degree, structure and dynamics of disability among residents of the city of Tver using the example of surgical patients observed in the “City Clinical Hospital No. 7”, and detection the main number of diseases that caused the setting of a disability group.
    Methods. An analysis was carried out regarding the data on the official reports of the surgical department polyclinic No. 1 of the state budgetary healthcare institution “City Clinical Hospital No. 7” in Tver for the period from 2010 to 2020. The dynamics of the frequency of registration of persons with disabilities was studied among surgical patients, the main groups of diseases that caused disability were identified, the structure of disability by groups was analyzed. The degree of reliability of the obtained data was assessed.
    Results. The growth of citizens with disabilities in the outpatient surgical department increased 3,3 times from 2010 to 2020. The dynamics was wave-like. There was a sharp rise in the number of people who received a disability group for the first time from the beginning of 2010 to the end of 2013. The indicators did not change much from 2014 to 2020. However, the dynamics of the percentage of the working population among persons with disabilities developed in inverse proportion. Those who received a disability group for the first time mainly had pathologies of the musculoskeletal system and vascular diseases.
    Conclusion. Based on the data of the surgical department of the polyclinic in the city of Tver, the number of persons with
    disabilities tends to increase. It requires constant monitoring. The number of persons with disabilities tends to increase. It was illustrated through an example of a study in Tver. All that leads to a decrease in the able-bodied population and an increase in social inequality. It is an urgent problem in the region.

    Authors: Morozov A. M. [3] Zhukov S. V. [3] Pototskaya L. A. [1]

    Tags: disability5 epidemiology3 health care23 monitoring3 public health and healthcare1

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  • Global social challenges in infertility problems

    The problem of infertility remains a global problem of mankind according to WHO and today, infertility affects about 10–
    25% of couples of reproductive age worldwide, estimates vary from 48 to 186 million. When developing recommendations for the diagnosis and treatment of infertility in 2020, WHO did not revise the definition of infertility given in 2009, together with the International Monitoring Committee on Assisted Reproductive Technologies (ICMART) in the “Glossary of Definitions of Infertility and Treatment of Infertility”, where infertility is considered a disease reproductive system, defined as the inability to achieve clinical pregnancy after 12 months or more of regular unprotected intercourse. The same is the definition of male and female infertility in the International Classification of Diseases (ICD11). Higher rates of infertility are found in less developed countries/regions such as sub-Saharan Africa, South Asia, North Africa/Middle East, Central/Eastern Europe and Central Asia. At the same time, the researchers note that geographical differences in the level of infertility are associated with environmental, cultural and social factors. The etiology of infertility has different epidemiological characteristics depending on the region.
    Purpose: to review foreign scientific literature containing information on the prevalence of infertility in countries around the world, the role of social factors in its formation, and the availability of treatment assistance.
    Materials and methods: bibliographic, information-analytical methods and methods of comparative analysis.
    Results: in modern research in the field of studying the social factors of childlessness, special attention is paid to the description and clustering of groups of childless women. The global problem of infertility is associated with adverse physical and mental health outcomes, financial hardship, severe social stigma, increased risk of domestic violence, and marital instability. It has been shown that women with less than secondary education are less likely to seek help for infertility treatment than women with higher education. In high-income countries, immigrant women, uninsured women are less likely to have access to fertility treatment, and they are less informed about their rights, even if they seek treatment at a later age.
    Findings. Geographic differences in the prevalence of infertility in different countries are largely determined by social factors. The study of social factors of infertility in women showed that infertility is associated with a low quality of life. Although the likelihood of infertility in men and women is the same, and male infertility is responsible for more than half of all childlessness in the world, infertility remains primarily a social burden for women, especially in pronatalist societies. Women from wealthy backgrounds are more likely to have access to quality fertility treatment.

    Authors: Tliashinova I. A. [3] Mingazov R. N. [4]

    Tags: access to treatment1 childlessness1 female infertility1 infertility2 male infertility1 population groups1 social factors1

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  • Information management
  • Possible approaches to the implementation of technological solutions in unified electronic healthcare EAEU member states

    In the article, the authors analyze the technical possibility of forming a unified supranational system of electronic interaction in the field of healthcare of the EAEU member states. The authors identify individual and common problems, propose to use a decentralized approach (blockchain), as well as Ethereum distributed registry technologies in order to develop a technical solution for the exchange of medical information by the EAEU member countries.

    Authors: Akulin I. M. [5] Chesnokova E. A. [5] Svirkin M. V. [2] Presnyakov R. A. [5] Guryanova N. E. [6] Balykina Yu. E. [1]

    Tags: digitalization of healthcare2 e-healthcare1 electronic medical record of the patient1 informatization of the eaeu1 legal problems of e-healthcare1

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  • Preparedness of medical personnel to work with medical information systems

    The analysis of administrative and medical personnel equipment of medical organizations in the Arkhangelsk region with computer equipment was presented. The level of computer competence and readiness of medical personnel to work with medical information systems on the basis of the state budget health organisation of Arkhangelsk region “Arkhangelsk city clinical hospital № 7” was studied. Management decisions taken to improve the quality and availability of medical services were shown.

    Authors: Monogarova Y. Y. [3] Varakina Zh. L. [2] Mokhnaheva Т. Е. [1]

    Tags: arkhangelsk region4 computer competence2 medical information systems10 medical personnel5

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  • Consults manager of health care
  • he program of state guarantees of free medical care to citizens for 2022: logic and basic provisions in the fight against coronavirus infection

    Changes in the Program of state guarantees of free medical care to citizens for 2022 and for the planned period of 2023 and 2024 compared to previous years are closely related to the current stage of the fight against the spread of COVID‑19 coronavirus infection. At the same time, given that the logic of the changes being made is not always obvious, it is necessary to start both from the current state of healthcare and from an analysis of how innovations will affect the development of the industry in the coming period.

    Authors: Kadyrov F. N. [108] Obukhova O. V. [24] Bazarova I. N. [12] Endovitskaya  Yu.  V. [8] Sychev Yu. P. [1]

    Tags: compulsory medical insurance13 methods of payment for medical care3 per capita financing2 standards of financial costs1 state guarantees in the field of healthcare1

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Articles
10

Authors
33

Pages
80

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