Management in health care
  • 2020 № 8 Improving rural health care through business process management

    Meeting the needs of the rural population in all types of primary health care (pre-medical and general medical
    care), as well as specialized medical care, improving the quality of medical care for the rural population is an important
    public health problem that is difficult to solve and is of particular concern to government structures at all levels of government. The article presents an analysis of the literature on the use of business processes in modern healthcare, the main tasks of which are the creation and development of effective models for the provision of medical care that increase not only its accessibility and quality, but also the satisfaction of the population. As part of the activities of the modernization program for the implementation of information technology in healthcare, it is planned to create information resources and services that would allow, using this system tool, to move to a qualitatively new level of organization of industry management. It is noted that at present, at the level of management of the medical organization as a whole, and in the management of individual areas of its activity, the application of the process approach is becoming relevant, in which the medical organization can be considered as a separate business system, which is a related set of business processes, the ultimate goal which, undoubtedly, is the provision of quality medical services. It is shown that the development and modeling of business processes will increase the relevance of management information, will make it possible to focus on rationalizing cross-functional processes to significantly reduce time and / or costs, increase revenue, improve service quality and reduce risks, the information system allows you to simulate processes and carry them out further optimization.
    The analyzed works examine the experience of process-oriented management in medical organizations and its role in ensuring the improvement of the quality of medical services provided. In addition, the introduction of a process approach will allow the application of certain managerial decisions necessary in each specific situation, including in the field of medical services for the rural population.

    Authors: Mingazova E. N. [27] Bakirova E. A. [5]

    Tags: business process reengineering1 business processes1 management14 process approach7 quality of medical care20 rural health care2

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  • Management in healthcare
  • 2023 № 7 The current state and prospects for the development of rural health care.

    The article discusses current trends in the development of primary health care in the Russian Federation. The reasons that caused in the 90s. of the last century, the destruction of rural health care, as well as the effectiveness of restorative measures. A comparative description of the main indicators of the health of rural and urban residents is given. The mortality rate for rural residents is much higher than for urban residents with a steady upward trend. There is a disproportion between the relatively low morbidity rates of the rural population with cardiovascular and oncological pathologies and mortality from the same diseases, which may be due to insufficiently effective detection
    of these categories of diseases. The concept of a geriatric contact center is proposed, aimed at eliminating the shortage of personnel and resource support for rural healthcare.

    Authors: Bakirova E. A. [5] Gorenkov R. V. [3] Vasiliev M. D. [3] Yakushin M. A. [1] Yarotsky S. Yu. [1] Vorobieva A. V. [1]

    Tags: contact center1 elderly doctor1 geriatric contact center1 geriatric service2 primary health care19 rural health care2

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  • 2023 № 3 Scientific substantiation of proposals for improving medical care for villagers.

    P u r p o s e o f t h e s t u d y : based on the analysis of the medical and demographic situation and the staffing of the rural population, develop proposals for improving medical care for the villagers.
    M a t e r i a l s a n d m e t h o d s : statistical, analytical, direct observation. The article used the forms of state statistical observation of the Ministry of Health of the Russian Federation. The results of the actual research.
    Materials and methods: statistical, analytical, direct observation, the forms of state statistical observation of the Ministry of Health of the Russian Federation were used.
    R e s u l t s . The rural population in the Russian Federation (2021) is 36,9 million people (25,2% of the country’s population). The proportion of the rural population of working age was 53,8%, which is lower than in Russia as a whole – 56%. A 21-year analysis showed that the birth rate of the rural population increased until 2012, while mortality rates decreased, in 2013 the mortality and birth rates became equal and amounted to 14,5‰ each, in 2020 the death rate increased to 15,4‰ due to the COVID‑19 pandemic. The average (expected) life expectancy of the rural population (70,7 years) is lower than that of the urban population (71,8 years); the indicator for rural men is extremely low (66 years). The
    overall incidence of the rural population is 1,4 times lower than that of the urban population, 117993,2 and 166901,5‰oo respectively. Primary morbidity is also 1,5 times lower (55082,4 and 83002,2‰oo, respectively). The difference in primary morbidity rates of the rural population in the federal districts (2020) was 1,3 times, in the constituent entities – 8,3 times. The incidence of COVID‑19 in the rural adult population (2020) was 1986,0‰oo, which is 2 times lower than in the Russian Federation as a whole (3913.9‰oo). There was a significant difference in these indicators (by 59 times) in the subjects of the Russian Federation, which can be associated with a lower density of the rural population,
    low availability of medical care in the countryside, as well as the ambiguity of COVID‑19 coding. For 6 years (2016–2021), the provision of doctors in medical organizations in rural areas in the Russian Federation decreased from 14,8 to 13,6‰o, and of nurses – from 54,6 to 49,3‰o. The number of nursing staff individuals working for feldsher-obstetric station decreased by 12,5%, paramedics – by 9,4%. Given the special importance of paramedical assistance in the countryside, the reduction in the number of paramedics should be considered a negative.
    C o n c l u s i o n . The unfavorable medical and demographic situation in the countryside requires the development of organizational and managerial decisions aimed at increasing the availability of medical care to the villagers.
    C o n c l u s i o n s . Proposals have been developed to improve the provision of medical care to the population of rural areas.

    Authors: Kalininskaya A. A. [15] Lazarev A. V. [6] Shlyafer S. I. [5] Kizeev M. V. [6] Bakirova E. A. [5] Balzamova L. A. [3]

    Tags: covid-1927 doctors8 medical and demographic situation4 medical organizations23 medical personnel7 morbidity (general2 mortality21 paramedic3 primary health care19 primary pre-medical health care1 primary)2 rural population5

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  • POPULATION HEALTH
  • 2022 № 10 Problems of medical support for persons over working age (by the example of the Republic of Tatarstan)

    Currently, most countries are showing a demographic trend characterized by an increase in the number of older people. In Russia, there is also a significant aging of the population, in connection with which, the number of people older than working age seeking medical care is growing every year. At the same time, the need is growing not only for treatment and rehabilitation, but also for the prevention of diseases, the implementation of active longevity programs. All this emphasizes the relevance and necessity of high-quality and sufficient medical support for this category of people.
    Purpose: to study the features of medical support for people older than working age on the example of the Republic of Tatarstan.
    Materials and methods: the data of official statistics, including those of the Ministry of Health of the Republic of Tatarstan, were used in the work. Analytical, statistical, mathematical research methods were used.
    Findings: To create optimal resource provision in the provision of medical care to people older than working age, it is necessary to: introduce new indicators of the state of health, increase the number of geriatricians, increase the number of geriatric beds, not reduce therapeutic beds, constantly increase the coverage of preventive medical examinations, medical examinations of people older than working age age, based on their share in the population structure (at least 25%).

    Authors: Bakirova E. A. [5]

    Tags: health status2 medical support1 morbidity11 people older than working age2

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  • 2022 № 7 Analysis of morbidity and staffing of the population of rural areas in the Russian Federation

    Rural health care is the most important socio-economic resource in the system of the agrarian economy.
    Purpose of the study. Based on medical and demographic indicators and analysis of morbidity and staffing of the rural population, develop proposals for improving the organization of medical care for rural residents.
    M a t e r i a l s a n d m e t h o d s : analytical, statistical, direct observation. The article used the forms of federal statistical observation of the Ministry of Health of the Russian Federation.
    R e s u l t s . The mortality rate of the rural population over the 20 years of analysis for all the years has been and remains higher than that of the urban population. In 2020, there was a sharp increase in the mortality of the population: urban – from 11,9 to 14,3‰, rural – from 13,3 to 15,4‰, which is associated with the COVID‑19 pandemic. The indicators of the general and newly diagnosed morbidity of the rural population are lower than those of the urban population, which is associated with the low availability of medical care to the rural population.
    The ranking of indicators of the general incidence of the rural population in the federal districts of the Russian Federation (2020) showed that the difference in indicators was 1,5 times. The highest indicator was noted in the Volga Federal District – 142220,6‰00, the lowest in the Far Eastern Federal District – 96922,8‰00. In the subjects of the Russian Federation, the difference in indicators is 8 times. Lower rates of primary morbidity in the rural population than in the urban population were noted for all classes of diseases. The incidence of COVID‑19 among rural residents was 2151,9‰00, lower than in urban areas – 4539,5‰00, in the Russian Federation the figure was 3384,5‰00. In 2020, the primary morbidity rate of the rural population decreased for all classes of diseases, except for respiratory diseases. In dynamics (2014–2020), the provision of medical organizations located in rural areas increased with doctors from 12,1 to 14,0‰0, with nurses from 44,4 to 50,3‰0, the number of physical EMS persons decreased by 14,8%, paramedics – by 11,6%, the number of FAPs and AFs decreased by 8,9%. The analysis shows that the Decree of the Government of the Russian Federation dated 02.02.2015 No. 151-r “Target indicators of the strategy for sustainable development of rural areas of the Russian Federation for the period up to 2030” is not being implemented.
    C o n c l u s i o n . Proposals for providing medical care to the population of rural areas are presented

    Authors: Kalininskaya A. A. [15] Lazarev A. V. [6] Shlyafer S. I. [5] Kizeev M. V. [6] Bakirova E. A. [5]

    Tags: covid-1927 doctors8 medical and demographic situation4 morbidity (general2 mortality21 paramedic3 primary health care (phc)2 primary premedical health care (pfmsp)1 primary)2 rural population5 staffing11

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