subscribe
Manager Zdravoochranenia 2018 #2
Published: 2018-02-20
1167
CONTENT OF THE ISSUE
-
The dynamics of morbidity of the population over working age with malignant skin tumors and mortality from them for the period from 2012 to 2016
The article presents an analysis of the incidence of malignant neoplasms of the skin and mortality from them among the population over working age. Subjects with high rates of morbidity and mortality due to malignant neoplasms of the skin are identified. The need to improve the work of the observation rooms of the polyclinic health care unit and primary oncology offices in the system of oncological care for the population was noted
-
Potential years of a life lost and economic losses due to the alcohol-attributable mortality in the near-arctic regions of the european north of Russia
Background. High level of premature alcohol-attributable mortality and associated economic losses are the con- sequences of considerable alcoholization of the population of the near-arctic regions in Russia. Aim of the study is to assess potential years of a life lost and economic losses due to the alcohol-attributable mortality in the Murmansk, Arkhangelsk regions and the Komi Republic in 2006–2015 years. Methods. Potential years of a life lost due to the premature deaths from alcohol-attributable conditions were calculated using brief tables of mortality (survival) for the five-year age intervals. This data was used to estimate the scale of the “actual” (annual) and “prospective” economic losses. Results. Distribution of the potential years of a life lost due to the premature deaths from alcohol-attributable conditions had the inverse “po- lar-equatorial gradient” (the maximum values of the indicator were in the Arkhangelsk region and the Komi Republic; and the minimum values were in the Murmansk region). Men and women aged 30–49 were at the group of a high risk. Positive dynamics in the values of the indicator in the group of elderly persons was associated with an increase in the life expec- tancy of the population. In 2006–2015 total “perspective” economic losses due to premature alcohol-attributable mortality in Murmansk region amounted to 5.5 billion rubles, Arkhangelsk region – 9 billion rubles, Republic of Komi – 11.7 billion rubles. Conclusions. In 2006–2015 alcohol-attributable mortality remained a leading cause of a significant demographic and economic damage to the population of the near-arctic regions of the European North of Russia. Application of the results. Obtained results can be used to develop programs for medical prevention and the healthy lifestyle formation, justi- fication of measures aimed at increasing the efficiency of regulation of the regional alcohol market.
-
Analysis of CT utilization for primary care clinics of the large city
We studied the use of CT scans in forty-five polyclinics in a large city. The maximum load per unit was 657 exams per month. The average load was 220 exams per month (CI 95% 208–231). No direct correlation was found between the exam volume and the size of the population served by the polyclinic (r = 0.47). The average CT utiliza- tion was 14.4 exams per 1000 adults inhabitants (CI 95% 12.4–16.5). The age-specific patterns of CT usage were revealed. For population within the age group of 18 to 45 years the frequency of CT usage gradually increased from 4.24 to 5.94 per 1000 people. Most often CT was used within the age group of 70-year-olds. Within this group, the number of tests reached 30.6 per 1000 adults inhabitants. In the older age groups, the number of exams was lower. In polyclinics without an MRI scanner, the structure of CT exams differed. The share of brain exams among all CT exams was 18% (compared to 10.8% in MRI equiped polyclinics), the share of spine exams was 17.7% (compared to 9.5% in MRI equiped polyclinics). Evidence is obtained of a multiple increase in the frequency of use of contrast media for CT in response to a complex of educational, control and economic interventions
-
Development and implementation of a standard for the organization of work of registries medical organizations: the project «Entrance group»
Regional project “Front-office” was set up and implemented in Tomsk oblast (Siberia, Russia). The aim of the project was launch a front-office of out-patients departments standard for improvement patients satisfaction in medical institutes. There are five directions in the project: providing affordable telephone service, front-office infrastructure, staff training, medical documents logistic, corporative style creation. Using of holistic project approach has led to significant improvement of availability and quality of health care in Tomsk oblast
-
Financing of Informatization of Public Health in Russia in 2013–2016
The analysis of state purchases of software and services for the informatization of health care for the period 2013-2016 was carried out. As the study materials, public data from the public procurement portal on procurement of software and health information services, which were conducted under Federal Law No. 44-FZ of 5.04.2013, were used. Data on procurement of hardware, activities to ensure information security or provision of communication channels in this study have not been studied. The work analyzes the main statistical indicators of competitive procedures, data on the winners of tenders and auctions, data on the main areas of financing, the distribution of funding by region, types of costs and types of software. In general, for informatization of health care, at least in terms of software and related services, Russia spent about 4-5 billion rubles over the past 4 years. in year. In 2015, the volume of financing decreased significantly - by 44.4% to the level of 3.6 billion rubles, in 2016 showed an increase of 10%. Financing of health informatization is carried out mainly through regional budgets, extrabudgetary funds and MHI. Over the past time, the situation with developers and applied solutions has generally stabilized. The main funding is allocated to regional systems with a 61% share of costs, as well as medical information systems of an institutional level with a 27% share of costs
-
The Insurance representative level 3-a new figure of the system of mandatory medical insurance
-
«Other conditions» as a basis for payment of medical care. Part 1
The legislation determined that one of the grounds for the provision of medical care for a fee is its provi- sion on other conditions than provided by the state guarantees program. However, the interpretation of «other con- ditions» 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
-
Questions answered by PhD of Economic F.N. Kadyrov
