Articles from rubric: «Sociology of healthcare»
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2023 № 12 Asessment of healthcare workers’ perceptions on the effectiveness of medical care in the profile of psychiatry in the Moscow region.
Relevance. The reorganization and modernization of the psychiatric service in Moscow (from 2010) and in Moscow region (from 2021) was carried out. The reforms were carried out in accordance with WHO regulations and consisted in reducing the medical care provided in a hospital setting and expanding the outpatient link.
Aim. Asessing the perceptions of employees on the effectiveness of providing assistance in the profile of “psychiatry” in the Moscow region after its restructuring.
Methods. An anonymous survey of employees of the psychiatric service in the Moscow region was conducted regarding the transformations carried out (N=236).
Results and discussions. The reforms have been positively assessed by the healthcare workers interviewed. According to them, the provision and equipment of clinics with modern examination methods and equipment has improved. The reorganization has led to a better quality of medical care and accessibility at the local level, the number of beds in day hospitals has increased and the conditions of patients’ stay in medical organizations improved. Existing protocols for the provision of mental health services to the public need to be regularly updated, as most respondents indicated. Also, as mentioned by interviewees, both the psychiatric care service as a whole and psychiatric care in a hospital separately needed an increase in funding. In the course of the study, respondents noted that further modernization of the psychiatric service should primarily be carried out in the following areas: unification into a single complex of a psychoneurological dispensary and a psychiatric hospital, expansion of the volume of outpatient care, development and improvement of coordination between general somatic care and help in the “psychiatry” profile, development of medical care based on general somatic hospitals.
Conclusion. The majority of respondents positively assessed the reforms carried out in the Moscow region in the field of assistance in the profile of “psychiatry”. Further modernization of the psychiatric service should include the development and improvement of coordination between general somatic care and assistance in the “psychiatry” profile, the expansion of the volume of outpatient care, the best use of resources based on the needs of the population. -
2023 № 12 Opinion of the parent community on the availability of pediatric otorhinolaryngological care.
The prevalence of ENT diseases in the pediatric population remains an urgent problem in practical pediatrics, otorhinolaryngology and healthcare, which is associated with their high level of occurrence in all age groups of children and the frequent development of various complications. One of the prerequisites for solving this problem is to ensure the availability of otorhinolaryngological care for children in primary health care.
The purpose of the study was to study the opinion of the parent community on the availability of otorhinolaryngological care for children aged 0 to 14 years.
Materials and methods. The study was conducted on the basis of state children’s clinics and private children’s ENT offices in the city of Ramenskoye, Moscow region in 2023; A survey of parents of children aged 0–14 years was conducted (1200 respondents). Statistical processing of the material involved processing and creating a database in electronic tables.
The results and conclusions of the analysis of a survey of the parent community showed that the general priority areas for increasing the availability of care for children for public and private health care systems are improving the organization of care, overcoming the obstacles of geographic remoteness of health care facilities, improving the level of medical information for patients, developing telemedicine technologies and the availability of allied health care specialists. -
2023 № 11 Socio-hygienic parameters, lifestyle and medical activity of the elderly according to the results of the survey (on the example of the Tambov region).
The purpose of our study was to study the lifestyle and medical activity of elderly people in the Tambov region in order to form a scientific understanding of the possibilities of a comprehensive medical and social corrective effect on this contingent. Materials and methods. The observation unit of our study is an elderly person who has reached the age of 60 years. A total of 412 people took part in the survey. The study was conducted from September 2022 to January 2023. The average age of respondents is 68.9 years. Among the respondents – 53.2% (219 people) are women, 46.8% (193 people) are men. Results and conclusion. One of the leading socio-hygienic factors affecting the health of the elderly
and lifestyle should be considered the low-income level of a large number of respondents. 22% live close to poverty, 16% of the elderly people in the sample live below the poverty line (10% qualify as «Poverty», and 6% as «super-poverty»). The conducted research allows you to see the rea. -
2023 № 9 The referral of children to medical organizations as a criterion for the medical activity of parents.
An important component of the lifestyle of the population is medical activity, which plays a significant role in maintaining and strengthening the health of not only the adult population, but also children.
Purpose of the study: evaluation of the influence of the social characteristics of families in the Chechen Republic on the appeal of children to medical organizations.
Materials and methods. The collections “The incidence of the Russian child population (0–14 years old) with a diagnosis established for the first time in life” of the Federal State Budgetary Educational Institution of Central Research Institute of Health and Human Health for 2017–2021 were analyzed. A subjective assessment of children’s referral to medical organizations was carried out on the basis of the results of a survey of 536 parents, which was carried out using the «Questionnaire of the parents of a child under the age of 7 years»
in 2021 in 9 districts of the Chechen Republic. Mathematical data processing was carried out using spreadsheets of the MS Office‑2016 software package (Word, Excel) and the StatSoft-Statistica 10.0 statistical software package.
Results. Primary morbidity, according to the data on the appealability of the children’s population of the Chechen Republic, is 3.7 times lower than the national average. The number of children in the family, the education of the parents and the financial situation of the family influence the number of children in the family. In families with 5 or more children, parents are less medically active in terms of seeking medical care than in families with 1–2 children and 3–4 children (p<0.05). Families where the mother or father have an incomplete secondary education compared to families where the father or mother has a complete secondary or higher education, including incomplete higher education, parents are significantly more likely to show less medical activity (p<0.01). Families where the funds for the normal
material support of the child are not fully enough or not enough at all, more often do not seek medical help or seek medical help only in case of a serious illness of the child, compared with financially secure families (p <0.01). The medical activity of parents is not affected by the age of the parents, family residence in the city or countryside, whether the child is organized or not, and he is also brought up in a family where mothers work or are housewives (p> 0.05).
Conclusion. One of the most significant subjective reasons for low attendance to medical organizations in the event of a child’s illness is the low medical activity of parents, which largely depends on the social characteristics of the family. Families with 5 children or more, families where one of the parents has an incomplete secondary education, and families with a low financial situation are more likely to show poor medical care.
Scope of the results. Development of organizational measures aimed at improving the quality and availability of medical care in organizations of the children’s healthcare system. -
2023 № 9 Algorithm for working with citizens’ appeals: the experience of a regional ophthalmological center.
Relevance. At present, the institution of citizens’ appeals is a dynamically developing model of interaction between the population and state and municipal authorities, including medical organizations. In the legislation of the Russian Federation, for the purpose of a comprehensive, timely and objective procedure for considering citizens’ appeals related to receiving medical care, a three-level hierarchy of regulatory legal regulation has been formed. Determination of the officials of the organization, forms and methods of working with appeals, analysis of the results of consideration of citizens’ appeals and the introduction of measures that correct the activities of employees of a medical organization (medical and non-medical personnel), the implementation of organizational and legal changes are an indispensable element of an effective management system of a modern healthcare institution.
The purpose of the study: аnalysis of the organization and conduct of work with citizens’ appeals related to obtaining medical care for the adult population in the field of «ophthalmology» in the regional center of the Republic of Tatarstan – the state autonomous healthcare institution «Republican Clinical Ophthalmological Hospital of the Ministry of Health of the Republic of Tatarstan named after Professor E. V. Adamyuk» (GAUZ “RKOB MH RT named after prof. E. V. Adamyuk”), and the development of measures to improve the
efficiency of the ophthalmological clinic.
Materials and methods. The analysis of modern requirements of normative legal acts of quality control and safety of medical activity has been carried out, the main tools used in conducting external audits in the system of compulsory medical insurance have been systematized. We used mathematical and statistical analytical methods (quantitative, comparative, structural, expert).
Results. A routing scheme for citizens’ appeals is presented, taking into account the channels of their receipt, and an algorithm for working with written appeals sent to the regional ophthalmological center of the Republic of Tatarstan. The trend of modern feedback services with applicants is noted, characterized by the active use of new Internet resources, social networks and instant messengers, various mobile applications for registering citizens’ appeals, and «fan» distribution of complaints about the activities of a medical organization.
According to the statistics for 2021–2022 in the structure of the reasons for written appeals of the GAUZ “RKOB MH RT named after prof.
E. V. Adamyuk” were in the lead in requests for the provision of medical documentation, which amounted to 2021. 45,4%, 2022 – 55,9% of all received applications. In second place were issues related to the organization of medical care, the share of which amounted to 2021 in 2021. 32,5%, in 2022 – 26,3%. Requests for assistance in the provision of medical care were made in 2021. 12,1%, in 2022 – 8,4% of the total considered appeals.
Conclusions. Based on the results of consideration of citizens’ appeals by officials of the GAUZ “RKOB MH RT named after prof.
E. V. Adamyuka, managerial decisions are made to increase the satisfaction of the adult population of the Republic of Tatarstan with the quality and availability of medical care in the field of ophthalmology, including changes in the organization of the clinic, the implementation of measures that correct the activities of medical and non-medical personnel. -
2023 № 9 Self-assessment of reproductive health by future doctors.
The reproductive health of the younger generation is of particular medical and social importance. The state of health of today’s youth, their reproductive potential and attitudes will be reflected in the demographic situation of Russia’s future. To maintain and improve the reproductive health of young people, a whole range of medical measures is being implemented. Of interest is the state of reproductive health of future doctors who receive a comprehensive education in the field of health care and have the highest level of knowledge about risk factors and health-saving technologies.
T h e p u r p o s e o f t h e s t u d y : to analyze the responses of medical students to assess their reproductive health and commitment to maintaining it.
M a t e r i a l s a n d m e t h o d s . An anonymous survey of 460 medical students studying at medical universities in St. Petersburg was conducted (September-October 2022). Methods of analytical and descriptive statistics were used.
R e s u l t s . There is a low effectiveness of activities to inform adolescents about sexual education and reproductive health. Most students do not consider their own health as a priority for the coming years, give a low assessment of their physical condition, rarely go in for sports or do not do it at all, every second eats irregularly. A third of young people suffer from acute and chronic extragenital diseases, and every fifth has a pathology of the reproductive system. 72.6% of girls and only 21.4% of boys visit a gynecologist/urologist/andrologist at least once a year, more often for preventive purposes. During sexual intercourse, respondents prefer barrier contraceptives that meet the requirements of availability, reliability and ease of use.
C o n c l u s i o n s . When developing strategies for improving and maintaining reproductive health, gender differences, medical and social characteristics and motivation of young people should be taken into account. To improve reproductive health-saving behavior, it is necessary to increase the availability of preventive measures, incl. anonymous counseling. -
2023 № 6 Behavioural risk factors for chronic noncommunicable diseases in health care workers.
Low physical activity, smoking and alcohol consumption are among the leading behavioural factors contributing to high morbidity and excess mortality from noncommunicable diseases. It can be assumed that health-care workers should be in the mainstream of population behavioural patterns. However, greater awareness of both the principles of healthy lifestyles and the harms of not following them may distinguish this population group in terms of behavioural responses.
Purpose: to estimate the prevalence of behavioural risk factors for chronic noncommunicable diseases among health-care workers.
Materials and methods. Study type: case-control study. Data source: results of the survey of the 28th wave of the Russian National Research University Higher School of Economics’ Monitoring of Economic Situation and Health, representative sample by individuals, survey year 2019. Responses received from respondents – health care workers about their use of tobacco, alcohol and exercise were analysed comparatively. Pearson Chi-square test at significance level p≤0,05 was used to find differences.
Results. A sociological survey of 55 male and 257 female health workers of working age was carried out. We found that the incidence of a positive smoking response was lower in both male and female working-age health professionals than in the general population of working-age individuals. Compared with the general populations of men and women, no significant differences were found in responses to questions about alcohol consumption and exercise.
Findings. We found that of the three behavioural factors (smoking, alcohol consumption, physical activity), only the first was significantly less prevalent among health professionals. The overall trends identified need to be investigated in more detail. -
2023 № 6 Opinion of pediatric otorhinolaryngologists on the main problems in the organization of medical care and priority areas of activity of the professional medical community.
A medical and sociological study was carried out in order to determine the opinion of specialists on current problems in the organization of children’s otorhinolaryngological care and on the priority areas of activity of the professional medical community. Five main medical and organizational problems in the organization of children’s otolaryngological care are identified: maintaining and developing human resources, stimulating the work of medical workers; improvement of resource support for assistance, stimulation of investments in the development of the material, technical and technological base; increasing the availability of qualified assistance; management optimization;
improvement of methodological support and introduction of modern technologies for rendering assistance. Pediatric otorhinolaryngologists consider the main activities of the professional community to be: representing the legitimate interests of the Association members, promoting the protection of their professional and social rights; assistance and participation in advanced training and professional retraining of specialists; professional consolidation, strengthening and development of relations between specialists; meeting the needs of specialists in obtaining knowledge about the latest achievements, advanced domestic and foreign experience. -
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. -
2022 № 6 Satisfaction of parents with the availability of preferential drug provision for minors
The health and well-being of children is in the first place in the social policy of any state. In relation to children with chronic diseases, a lot of state support measures are being developed, including preferential drug provision. At the same time, the availability and volume of benefits for each particular child can affect the further prognosis of the disease, the social and economic efficiency of the measures taken. The purpose of the study was to identify the reasons for parents' dissatisfaction with the availability and quality of the organization of preferential drug provision for minors. The study was conducted by anonymous questioning of 455 parents of children admitted for inpatient treatment at the FSBEI HE SPb SPMU and the G.I. Turner in 2020, belonging to the preferential category. The study showed that there are restrictions at all stages of the provision of drug benefits. Most parents have low awareness of the child's right to benefits, as well as low legal activity in situations where the child's right is violated.
A third of parents prefer not to use the benefit, fearing obstacles to its implementation. For children eligible for a federal benefit, the availability of drug coverage is significantly higher than for children with a regional benefit. -
2022 № 6 Features of relationships in the family among teenagers at risk group of using psychoactive substances and the role of their study in psychological and pedagogical prevention of the Udmurt Republic
The article presents an analysis of the preventive medical examination of teenagers to identify risk factors for non-drug use of narcotic and psychotropic substances in educational institutions of the Udmurt Republic. Risk factors for a healthy lifestyle have been identified through a survey of teenagers and their parents, types of families and specifics of upbringing have been identified, groups for family psychological and pedagogical prevention have been formed. Training sessions were held with parents of teenagers and the data of the results are presented, allowing them to be used in the preventive work of health care institutions.
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2022 № 3 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. -
2022 № 2 Adaptation and initial reliability testing of the Russian-language version of the safety attitudes questionnaire for medical organizations
The article presents the results of adaptation and initial reliability testing of the Russian version of the safety attitudes questionnaire (SAQ) for medical organizations. The reliability of using the questionnaire has been proven: all scales have high internal consistency and correlate with original factors. Using exploratory and confirmatory factor analysis, the features of the seven-factor structure of the Russian version of the questionnaire are shown: 1. teamwork climate; 2. safety climate; 3. job satisfaction; 4. stress recognition; 5. perceptions of management (department level); 6. perceptions of management (hospital level); 7. working conditions.
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2014 № 12 «Informal healthcare»: outcomes of the project ran by Fund of social research «Hamovniki»