2020 № 10 Efficiency indicators of the round-the-clock hospital beds of the oncologic profile in the Russian Federation
The steady growth trend of oncological diseases in Russia in recent years requires a response from the health
care system: development of prevention aimed at early detection of diseases; improvement of methods of diagnostics and treatment of oncopathology; improving the quality and effectiveness of medical care.
A i m : to identify trends in changes of the neoplasms incidence and performance indicators of oncological beds for
round-the-clock stay of the state health care system in the Russian Federation, federal districts and regions of the Russian Federation in dynamics for 2010–2019.
M a t e r i a l s a n d m e t h o d s . Using the data of federal statistical observation (forms NoNo. 12, 30) by the method of
descriptive statistics, the main indicators of the neoplasms incidence in the population are analyzed, as well as the work
of round-the-clock oncological beds in the Russian Federation, federal districts and regions of the Russian Federation in
dynamics for 2010–2019.
R e s u l t s . On the background of an increase in the neoplasms incidence in the population (by 24.9%), including malignant (1.5 times), for the period 2010–2019 in the Russian Federation increased: the absolute number of oncology beds of round-the-clock stay from 30,970 to 36,186 (+ 16.8%), the provision with these beds from 2.17 to 2.47 per 10,000 population (+ 13.8%), hospitalization rate from 6.1 to 9.6 per 1000 population (+ 57.4%), and decreased: the average length of stay in an oncological bed (from 12.1 days to 8.4 – by 30.6%), as well as the average bed occupancy per year (from 345 to 330 days – by 4.3%). The extreme values of the indicators of the hospitalization rate for round-the-clock oncological beds in the regions of the Russian Federation in 2019 differ 12.8 times, the provision of these beds – 9.2 times, the average bed occupancy per year – 1.5 times, the average length of stay in a bed – 2.4 times. Mortality in oncological hospital beds increased from 0.76% in 2010 to 0.95% in 2019 (by 25%).
C o n c l u s i o n . The 24-hour oncological bed capacity, against the background of the growth of oncological morbidity,
has naturally increased, but at the same time it is characterized by an extreme disproportionality of development in the
Federal Districts and the regions of the Russian Federation. Optimization of the bed fund should be carried out based on
the objective needs of a particular region, taking into account its characteristics and with the simultaneous development
of alternative medical services.
2020 № 7 Productivity indicators of the daily stay bed fund in the Russian Federation
The process of reducing round-the-clock bed fund with simultaneous development of hospital-replacing technologies, namely
daily stay hospitals, has been going on in the Russian Federation, for more than twenty-five years, a similar trend has been observed in recent decades in most developed countries of the world. From 2010 to 2018 provision of the population with beds of daily stay hospitals in the Russian Federation moderately increased from 15.4 per 10,000 to 17.0 (an increase of 10.7%). Hospitalization rate of the population in daily stay hospitals in the country increased from 41.9 per 1,000 population in 2010 to 56.3 in 2018 (an increase of 34.5%). At the same time, the average bed occupancy per year in daily stay hospitals for the study period decreased from 311 days to 301 days (the decrease was 3.1%). The average length of stay in daily hospitals bed decreased from 11.4 to 10.1 days (the decrease was 11.7%). The positive dynamics of most of the studied indicators testifies to the development of the network of daily stay hospitals in the Russian Federation, the negative point is the reduction of average bed occupancy per year, what may indicate a decrease of the intensity of use of the bed fund of daily stay hospitals in the country.
2020 № 2 Dynamics of indicators of the hospital bed fund of round-the-clock and daily stay in the Russian Federation
For the period 2010–2018 the number of hospitals in the Russian Federation decreased from 5705 to 4323
(by 24.2%), both due to the reduction in the number of beds and in connection with the unification of medical organizations.
The number of beds of round-the-clock stay decreased from 1250120 to 1044875 (by 16.4%); the following
indicators decreased: provision with these beds (from 87.5 to 71.1 per 1000 population – by 18.7%), the average treatment
duration (from 12.6 days to 10.7 – by 15.1%) and, unfortunately, average bed occupancy per year (from 325 to
313 days – by 3.7%). In 2018, the extreme values of the indicator of hospitalization rate for 24-hour hospital beds in
the regions of the Russian Federation differ 1.8 times, provision with hospital beds – 2.9 times, average bed occupancy
per year – 1.2 times, average treatment duration – 1.8 times. The revealed differences are significant, what indicates
the imbalance of the ongoing structural transformations. The overall hospital mortality rate in the Russian Federation increased:
from 1.5% in 2010 to 1.9% in 2018 (by 28.4%), similar dynamics – in all Federal Districts. The provision of the
population of the Russian Federation with places in day time hospitals increased from 15.4 per 10 000 in 2010 to 17.0
in 2018 (by 10.7%). Multidirectional tendencies are noted, both toward increasing and decreasing the number of places
in day hospitals both in the Federal Districts and in the regions of the country; the extreme values of the indicator of the
provision of places for day hospitals in the constituent regions of the Russian Federation differ by 30 times, what reflects the
disproportionate organization of the network of day time hospitals in the country’s regions. During the observation period
in the Russian Federation the level of hospitalization in round-the-clock hospitals decreased from 222.0 to 203.5 per 1000
population (–8.3%), while the level of hospitalization in day time hospitals steadily increased from 26.4 to 35.0 per 1000
population (by 32.8%), what indicates the implementation of the expected hospital-replacing function of day time hospitals
in the country. The issue of further structural and functional optimization of the bed fund of the country remains relevant.
2016 № 3 Provision of medical rehabilitation care for the population of Russian Federation on an outpatient basis
Annotation. Demographic changes in the direction of increasing of older age groups in the population structure, chronicity diseases, disability height, high premature mortality from chronic non-communicable diseases and due to this enormous economic damage to the national economy of the country pose the problem of organizing measures of effective medical rehabilitation of patients to the category modern Russian health priority issues. The results of analysis of medical institutions and professionals activities, that provide assistance for medical rehabilitation in outpatient settings, indicate that there is a low level of cabinets and experts providing assistance on medical rehabilitation in Russia. The low number of visits to the professionals of all profiles in combination with a high coefficient of combining and low understaffing, indicates lack of sending patients for this type of restorative treatment, that is unfairly against a background of increased morbidity, especially chronic and disabling forms of diseases. This, in turn, shows the lack of organizational and legal forms of regulating the flow of patients from the active treatment to the rehabilitation, that leads to the dissatisfaction of the population need for this type of care. The structural analysis of the situation and identify unsolved problems so far give us basis for looking for priority actions for the development of provided medical rehabilitation on an outpatient basis – a necessary condition for the implementation of medical and social functions of the state to preserve and strengthen health of the population.
2017 № 6 Peculiarities of the morbidity of teenagers 15–17 years old in Russian Federation for the period 2000–2015
Adolescent population’s health determines the formation of the nation’s health for the future. Tendency of the general morbidity of adolescents in the dynamics for 2000–2015 in Russia is presented. For the period of study, a significant increase in the overall incidence of adolescents was revealed: from 1730 to 2193 cases per 1000 of the corresponding population (an increase of 26.8%). At the same time, the average annual growth for five-year periods (2000–2005–2010–2015) was 0.4; 5.1; and –0.2%, respectively. The growth trend is also traced for the incidence detected in adolescents for the first time in life: from 1046 to 1341 per 1000 of the respective population (by 28.2%), while the average annual growth over the five-year periods indicated above was 0.5; 5.5; –0.4, respectively. The study showed that the last 15 years were characterized by negative dynamics of the health indicators of the adolescent population. The share of diagnoses registered for the first time in life, from the total morbidity of children of 15–17 years in general for all diseases has not changed (61% in both 2000 and 2015 years), that indicates growth of both acute and chronic pathology in the population
2019 № 9 The problem of personnel shortage of the doctors for medical prevention
The Federal Law of November 21, 2011 № 323-FL «About the basis of the protection of public health in the Russian Federation» defined the priority of prevention in the field of health protection (Article 12). However, a number of problems in staffing of the system of medical prevention remain. Aim: to investigate the dynamics of the number of posts for doctors for medical prevention (positions, occupied positions, individuals), as well as their staffing level and combination rate for the period from 2014 until 2017 in the Russian Federation and its regions. Methods: based on the data of the Federal Statistic (form № 30), the article presents a statistic analysis of the number of posts for doctors for medical prevention for the period from 2014 until 2017 in the Russian Federation and its regions. Results: There is a low staffing level for doctors for medical prevention in the Russian Federation, which decreased even more over the study period: from 73.2% to 64.0% (by 12.5%). This is explained both by an increase in the staff positions of these doctors in the country from 1031 to 1526 (by 48.0%), while the number of occupied posts increased only by 29.50% (from 754.25 to 976.75), and by a simultaneous decrease in the part-time combination rate from 2.1 to 1.7 (19.0%), which continues to be high. At the same time, the num¬ber of regions with 100.0% staffing level of these personnel decreased by 76.9% (from 13 to 3). Conclusion: The low staffing level (64.0%) and the high part-time combination rate of doctors for medical prevention (1.7) in the Russian Federation in 2017 indicate a shortage of individuals for doctors for medical prevention – the main workers in the occupied positions and their replacement by doctors – co-workers of other specialties. This largely takes place due to the absence of the specialty «medical prevention», which necessity of the introduction needs to be discussed by the medical community.
2018 № 8 Base trend on number of Russian children (aged 0–14) require for medical supervision in 2000–2015 years
Growth of Russian children’s incidence is confirmed with many special researches. As has shown the anal¬ysis of Federal statistical observation (form No. 12) for 2000–2015 years, in Russia the number of children at the age of 0–14 years require for medical supervision has grown from 302,6 to 309,0 cases for 1000 per population of the corresponding age (2,1%). The highest increase took place on classes: new growths (105,3%), congenital anomalies (malformations) (63,0%), injuries, poisonings, etc. (56,3%). Decrease in number of the children (0–14 years) require for medical supervision is noted on the following classes: pregnancy, childbirth and postnatal period (–70,0%), separate conditions of the perinatal period (–60,6%), some infectious and parasitic diseases (–59,5%), mental disorders and disorders of behavior (–43,1%). The balance of number of the studied group of children for 2015 year is 6,1% at the expense of bigger number registered (55,3%), in comparison with number of struck off the register (49,2%). At the same time the maximum plus balance was observed on the following classes of diseases: separate conditions of the perinatal period (46,5%), injuries, poisonings, etc. (80,0%), diseases of respiratory organs (21,3). The minus balance of number is noted on classes: some infectious and parasitic diseases (–11,6%), mental disorders and disorders of behavior (–2,4%). The number of children require for medical supervision in Russia for the studied period has grown. As soon as, the health of children and teenagers defines health of future nation, its preservation is an important task, which real¬ization demands development of measures for treatment of diseases of this contingent, and, above all – holding preventive actions with definition of their address introduction (school, the house, healthcare institutions).
2019 № 7 The main trends of the incidence in girls of 15–17 years on the background of high level of chronic pathology
The health condition of the Russian Federation children, including adolescents, has been characterized by negative trends in the past thirty years. The aim of the study is to identify the main trends in the total and for the first time in the life registered incidence in girls 15–17 years old in the Russian Federation, as well as to track the quantity and dynamics of the indicator of chronicity of diseases. The data of form N12 of the federal statistical observation for the period 2000–2017 are analyzed, using the method of descriptive statistics. A significant increase was revealed both in the total incidence of girls (by 56.9%) and for the first time in the life registered incidence (by 63.0%). The maximum increase in total incidence is observed for the most classes of diseases, for example: neoplasms (2.4 times), injuries, poisoning and some other consequences of external causes (2.4 times), congenital anomalies (malformations) (2.3 times), cardiovascular system diseases (2 times), diseases of the musculoskeletal system and connective tissue (2 times). The growth for the first time in life registered incidence was revealed for the overwhelming majority of classes of diseases, for example: injuries, poisoning and some other consequences of exposure to external causes (2.5 times), diseases of the nervous system (2.2 times), cardiovascular system diseases (2 times), neoplasms (2 times), diseases of the ear and mastoid process (2 times), diseases of the musculoskeletal system and connective tissue (1.9 times). High figures of the chronicity index aggregative for all classes of diseases reflect the initially high level of chronic pathology in girls 15–17 years old, what is an unfavorable characteristic of their health condition. An analysis of the chronization index of the diseases among girls aged 15–17 years over the study period revealed its maximum growth for classes of congenital anomalies (malformations) (by 31.1%) and tumors (for 23.0%), and for certain nosologies: menstrual disorders (5.8 times) and renal failure (4.2 times). The health of children, and especially adolescents, determines the health of the nation in the nearest future; therefore, the issues of its preservation and improvement require thorough attention.