CONTENT OF THE ISSUE
Amendments to the Federal law “On the basics of public health in the Russian Federation” on matters of clinical guidelines: what to do and what to expect medical organizations
The article deals with an analysis of certain provisions of the legislation on health care in connection with the changes made to the Federal law “on the basics of public health in the Russian Federation” on clinical guidelines.” In the context of the adopted changes, the authors consistently and clearly justify the obligation of medical organizations to comply with both the standards of medical care and the current clinical recommendations (treatment protocols). The sig- nificantly increased role of criteria for assessing the quality of medical care, approved by the Ministry of health of Russia, is emphasized and justified.
On the criteria for evaluating the activities of medical organizations in the new patient-oriented healthcare system
The patient-oriented approach will allow taking into account individual preferences and needs of patients in the process of providing medical care. The study is devoted to the system analysis of the main provisions and conditions for their implementation in the patient-oriented model. The paper presents the composition of evaluation criteria in the developed model. The introduction of a new patient-oriented model implies a broader application of modern methods and technologies for their personal information support at various stages of medical care.
About citizens with limited mobility in the context of health care
Abstract. The article highlights the development of regulatory support for the provision of primary health care at home to people with limited mobility. The content of this concept is analyzed in various spheres of life. The ways of improving the terminology in the acts regulating the activities of nursing services are proposed.
The improvement of specialized medical care for patients injured in road traffic accidents based on information technology
The information system was developed as a part of a Uniform State Health Information System (USHIS) in Mos- cow Region. It enables to perform a statistical and economic analysis, to simulate the work of trauma centers, resulting in an improved quality of medical care, as well as to decrease unreasonable economic loss and the road traffic mortality. It also helps to support patients after limbs amputation with prostheses without any delays.
The experience and results of lean manufacturing introduction in health care
The World Health Organization gives notice an increasing demand for medical service on the one hand and a tendency toward deterioration of financial conditions in the healthcare system on the other that is the cause of the main concern in modern medical management. The article is considerate feasibility of using principles and methods of lean production for the purposes of organizing practical healthcare. Analyzed the results of lean production implementation of over the past few decades, the main early successes achieved using the tools and methods of lean production, as well as the basic limitations of the application are evaluated. Special attention is given to potential roles of the leader of healthcare institutions in lean production adaptation as well as evaluating the success of a strategy. A deep analysis of modern economic indicators of lean production successful implemen- tation in medical clinics abroad is presented, the key points of the effective introduction of lean production are being updated. In additional to economic indicators, the impact of lean production implementation in medical organizations on reducing mortality rates, transmission of nosocomial infections, mortality from hospital infections, reducing waiting times for medical services (especially in the admission department) is estimated. The current task facing the health care system in the Russian Federation is updated. The main conclusion is made about a huge amount of positive results after introducing lean production, including the positive economic effect and the increase in the quality of medical care after the introduction of the principles and methods of lean production, and also the entity of lean production as a separate method of organizing processes.
Prevention of chronic non-infectious diseases prevention in Russia: possibilities of optimization
Chronic non-communicable diseases (CNCD) remain the cause of three-fourths of deaths in Russia, but their control is not productive enough. Achieving of planned mortality reduction to 2025 among employable persons by 25,4%, from cardiovascular diseases – by 16,5% and from cancer – by 6% is possible only due to CNCD prevention. However, the costs on the «Centers of Health» activity are not justified from the point of view of their effectiveness, and dispanser- ization is not yet fully balanced in structure and volume. The analysis of some financial, organizational, methodological, legal and reporting documents makes will be it possible to identify problems and to offer systemic measures to optimize CNCD prevention.
Activities of departments and offices of functional diagnostics in the Russian Federation, 2012–2017
Relevance. Functional diagnostics is widely used in all branches of practical public health. The purpose of the study was the activities of the departments and offices of functional diagnostics of the Russian Federation. Material and methods. The calculation of intensive indicators of the activity of the departments and cabinets of functional diagnostics according to the number of surveys conducted among the population of the Russian Federation in the outpatient setting among the population of the Russian Federation for the period from 2012 to 2017 has been carried out. Results: analysis of the number of persons examined in total in the units providing medical care on an outpatient basis, by a functional diagnostics doctor per inhabitant of the Russian Federation for the period from 2012 to 2017. showed their growth. Conclusion: the number of surveyed in the offices and departments of functional diagnostics per inhabitant of the Russian Federation for the period analyzed increased by 14.2%. The highest coverage of functional diagnostics is noted in the Volga and Ural federal districts.
Morbidity of young doctors in connection with the characteristics of professional socialization
Relevance. The presence of chronic diseases leads to deterioration of health, and also affects the quality of life, professional development, socialization. The occurrence of chronic diseases in young doctors is associated not only with age and sex characteristics, but also with the characteristics of professional socialization.
Purpose. Analyze the causes and conditions of the development of chronic diseases in young doctors in connection with gender, age and professional socialization.
Materials and methods. The presence of chronic diseases in young doctors was analyzed according to official data provided by the Tver regional organization of the trade union of medical workers and according to their own research. In order to determine professional socialization, we conducted a sociological survey and psychodiagnostic examination. Results. The prevalence of chronic diseases among men is less than among women, regardless of age group. Also, with increasing age, an increase in these indicators is observed, regardless of gender. The doctors with chronic diseases are more in the group with no characteristics of professional socialization.
Findings. The smallest number of people suffering from chronic diseases was found among young male doctors who are in the age group up to 29 years old, and also possessing characteristics of professional socialization. In general, the presence of chronic diseases depends on gender and age, as well as on the presence or absence of characteristics of professional socialization.
Organization of medical and social assistance to the population at the level of the subject of the Russian Federation
The unstable social and economic situation in Russia leads to an increase in families from groups of high medical and social risk, which has a negative impact on the health of children. The purpose of the study is to study the organization of medical and social assistance to children at the regional level. Sociological and expert methods were used to achieve this goal. The assessment of the degree of consistency of expert opinions was carried out using the concordance coefficient, the reliability of the results – using the method of calculation of Chi-square. According to the results of the study it was found that medical and social assistance is provided in the framework of primary health care to minors mainly by specialists in Pediatrics and social work. Taking into account regional peculiarities, the presented direction includes the following tasks: provision of medical and social patronage of families from risk groups, antenatal protection of the fetus, preservation of reproductive health of the child population. Expert evaluation allowed to identify the main problems in the system of maternal and child health, which reduce the effectiveness of medical and social care. As the main problem areas noted: the insufficient level of professional competence of specialists in the provision of medical and social assistance, the low degree of continuity between the medical organizations of the system of protection of motherhood and childhood, the low efficiency of interdepartmental cooperation in the provision of medical and social assistance. The presented problems are manageable and require improvement of appropriate organizational and managerial mechanisms both at the level of the Ministry of health and at the level of social protection bodies.
Clinical pharmacologist: basic employment functions and their need in medical organization
The article describes the main labor functions of a clinical pharmacologist in a medical organization. The neces- sity of a clinical pharmacologist for a multidisciplinary medical organization according to normative acts, the project of a professional standard of clinical pharmacologist, is shown.
Independent examination of patient's medical records in the new bill
The review of judicial practice on the payment of over-planned volumes of medical care in the system of compulsory health insurance
Despite rather rigid legislative norms concerning payment of the medical care rendered over the volumes allocated by the Commission on development of the territorial program of CHI, and also the developed practice of rela- tionship between the medical organizations – on the one hand and the insurance medical organizations, territorial funds of CHI – on the other hand, judicial practice often demonstrates other approaches. Although the current legislation does not imply payment of over-planned volumes of medical care, the courts often take the side of medical organizations. Thus, the current judicial practice illustrates the existence of problems in this area. This article is devoted to the review of judicial practice in the matter of payment for over-planned volumes of medical care in the system of compulsory health insurance.
Some issues of the provision of payment medical services
Focus of problem
Management in healthcare
Social aspects of health
Manager of healthcare consults
Questions and answers