Focus of problem
  • 2020 № 6 Pregnant technologies in primary health care in rural doctor’s ambulatory

    The priority state project currently being implemented, “Creating a New Model of a Medical Organization Providing Primary Health Care,” is especially relevant for implementation in hard-to-reach areas. Since rural health care is character- ized by a shortage of personnel, a weak medical and diagnostic base, low material and technical equipment, a low level of development of information technologies, and a large territorial extent. Objective: to evaluate the effectiveness of the implementation of lean manufacturing technologies with the participation of nursing specialists in the work of a medical out- patient clinic. Materials and methods. To determine the directions for the implementation of lean manufacturing methods, a questionnaire was conducted among patients (n = 232). Mapping and visualization, as well as timing of the processes before and after the introduction of organizational measures in two areas of the medical ambulance clinic “Reception of healthy children” and “Reception of patients with acute disease and with exacerbation of chronic.” Results and discussions. In order to eliminate (minimize) the revealed losses, re-planning of the premises was carried out, the functions were redistributed and the working hours of the medical staff were structured, templates-forms of documentation were developed. Conclusion and conclusions. The introduction of organizational measures allowed us to significantly reduce the waiting time for admission of a healthy child on the day of the disease without additional financial costs, as well as to increase patient satisfaction.

    Authors: Pyreva E. V. [1] Noskova V.  A. [2] Pozdeeva T.  V. [4]

    Tags: a  medical outpatient clinic1 a  new  organizational  model1 elimination  of  losses1 general practitioner4 implementation effectiveness.1 lean  technologies2 medical care in hard-to-reach areas1 nursing  staff4 primary health care19

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  • Management in health care
  • 2021 № 8 Study of temporary losses of patients when receiving medical services in ambulatory-polyclinic conditions

    The study of the patient’s temporary losses when receiving medical services in an outpatient clinic and their minimization contribute to an increase in patient satisfaction with the quality of medical care.
    Objective of the stud y: to assess the temporary losses of patients when visiting outpatient clinics of the city municipality.
    Methods and materials. The temporary losses of patients were studied by analyzing route maps compiled using a special technique. The analysis of the questionnaires made it possible to assess the patient’s satisfaction with the conditions of providing medical services, the information received in the healthcare institution and the attitude of the nursing staff to the visitor. Statistical processing of the results was carried out using the programs Statistica 5.0 and Microsoft Office Excel.
    Results. As a result of the conducted research, significant time costs of patients were identified when receiving medical care in polyclinics of the district center: when visiting a district doctor, a registry, a treatment room and a laboratory, which directly affected the results of assessing their satisfaction with the temporary criteria for visiting a medical organization.
    Scope of the results. The data obtained during the study can be used as basic information when developing measures to optimize key processes in outpatient health care institutions.

    Authors: Pozdeeva T.  V. [4] Pchelina N. V. [1]

    Tags: lean polyclinic1 lean technologies in healthcare1 patient satisfaction with the provision of medical services1 temporary loss of patients1

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  • Public health
  • 2021 № 9 Borderline functional states of the men’s reproductive system: its influence on health and the quality of life.

    Between the differing frequency of prevalence of sexual dysfunctions, there’s a particular interest in the borderline disorders of the male reproductive system, in which no obvious somatic and mental pathology can be found in the body. The reversibility of functional disorders unveils favorable prognostic prospects and presupposes the development of new approaches in the organization of observation and correction of minimal borderline functional states of the reproductive system.
    P u r p o s e . To identify the frequency of borderline functional states of the reproductive system (BFSDS) among men over a five-year dynamics, their impact on the formation of health outcomes and quality of life.
    M a t e r i a l s a n d m e t h o d s . The study was conducted at the Reproduction Center of the Clinical Diagnostic Center (Nizhny Novgorod) for five years. Two groups of men of reproductive age with BFSDS at the age from 20 to 60 years were tested. We used copy-pair method. The first group (DM) included men with sexual dysfunctions and similar sexual disharmony (BFSDS) who didn’t receive medical benefits. The second group (DM + treatment) consisted of men with BFSDS who received cognitive-behavioral therapy and medicine. All subjects assessed the state of the reproductive system, neurological and hormonal status, as well as the quality of life (according to the SF‑36 questionnaire). To compare the parameters of the quality of life, a control group was selected – healthy men of reproductive age.
    R e s u l t s . The frequency of sexual dysfunctions in both groups is significantly increasing, but the frequency of their detection in men receiving treatment is 2,4 times lower than in the other group. An increase in neurological changes and hormonal disorders was recorded, the prevalence of which depends on the duration of observation and the availability of therapeutic measures. The study proved that the BFSDS have a significant impact on the quality of life of men, especially in the physical and psychological components of health. It was shown that the treatment allowed the patients to preserve the state of physical and, to a greater extent, psychological comfort during the five-year observation period.
    I n c o n c l u s i o n , the authors emphasize the need for new approaches to the organization of observation and correction of the minor BFSDS.

    Authors: Pozdeeva T.  V. [4] Borodacheva I. V. [1] Artemenko A. G. [1] Pogodina T. G. [1] Abanin A. M. [1] Artifeksov S. B. [1]

    Tags: borderline functional states of the reproductive system1 cognitive-behavioral therapy1 hormonal changes1 manifestations of neurasthenia1 quality of life7 sexual dysfunctions1

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  • Sociology of healthcare
  • 2023 № 4 Aspects of the quality of the life of persons of working age with chronic noncommunicable diseases of the respiratory organs

    Chronic noncommunicable diseases (NCD) are widespread and affect people of different age groups in all countries. The fight against this group of diseases is one of the priorities of the modern health care. Non-infectious diseases of the respiratory system as well as other diseases, affect social, physical and mental components of well-being. The qualitative assessment of their influence helps to assess the study of the quality of life.
    P u r p o s e : to assess the quality of life of the working-age population of the Nizhny Novgorod region and to develop measures to reduce the risk factors for chronic non-infectious diseases of the respiratory system in these cohorts.
    M a t e r i a l s a n d m e t h o d s . A one-stage comparative study was carried out using the method of standardized interviewing using the SF‑36 questionnaire. The quality of life of people of various age-gender groups with chronic non-infectious diseases of the respiratory system was assessed. All respondents were stratified into groups by pathology and age.
    R e s u l t s . The scientific article reflects the results of the study of assessing the quality of life of working-age patients with the chronic respiratory system pathology. The analysis of the data revealed statistically significant differences in age, gender and groups of pathologies among the respondents. Differences in indicators reflecting emotional states were revealed among men and women of the working age. Age-related changes in indicators of physical and psychological components of health and on all scales of the quality of life were presented. The obtained values of patient indicators show the need to develop specific measures to reduce behavioral risk factors for chronic non-infectious respiratory diseases of the population of the Nizhny Novgorod region.
    Findings. The comparative analysis of the results of the scales of the quality of life and health components reflects the age-related changes in indicators. The people of the older age group of the working age demonstrate significantly low results. The indicators of physical functioning are statistically significantly different in different pathologies of the respiratory system. Chronic obstructive pulmonary disease (COPD) restricts the physical activity of patients more strongly than other pathologies. Low values of the quality of life reflect the need to develop the measures to reduce the risk factors for chronic non-infectious diseases for the population of the Nizhny Novgorod region.

    Authors: Pozdeeva T.  V. [4] Sheyykhova S. S. [1] Kotova N. V. [1]

    Tags: chronic noncommunicable diseases3 people of working age1 prevention23 quality of life7 risk factors15 sf‑36 questionnaire1

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