Financial management
  • 2016 № 2 Staff time specialist doctors for the provision of medical care in the outpatient setting

    In order to implement the Decree of the President of the Russian Federation dated May 7, 2012 № 598 «On improvement of state policy in the sphere of public health» and in accordance with the Action Plan of the Ministry of Health Labor norms in health care, approved by the Interagency Working Group on the organization of rationing of work, the development of professional standards and skill levels in the health sector conducted observed for 2 working weeks of the working process of two specialists: cardiologist, endocrinologist and dentist-therapist in 20 pilot areas of the country. Data analysis observation revealed the need for regulations to establish standards load specialists providing outpatient care to the population due to an increase in the time to visit a patient.

    Authors: Son I. M. [26] Ivanova M. A. [9] Starodubov V. I. [19] Armashevskaya O. V. [4] Liutsko V. V. [3] Sokolovskaya T. A. [5]

    Tags: amount of time1 doctors1 outpatient care3 photo chronometer watch1

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  • 2015 № 5 Direct costs calculator as a tool for economic justification of health care expenditures for patients with castration-refractory prostate cancer

    The article describes a tool to calculate the direct medical costs of treating patients with castrationre fractory prostate cancer. This tool will allow to assess cost of medical procedures and to justify treatment choice.

    Authors: Son I. M. [26] Kreknina E. A. [4] Gazheva A. V. [4]

    Tags: direct costs4 prostate cancer2

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  • Foreign experience
  • 2017 № 5 Study of workload and working time costs of general practitioners in healthcare organizations in Kazakhstan

    The article presents the results of a chronometric analysis of patients from the Karaganda policlinic, while analyzing and studying the costs of the doctor’s working hours for performing various labor operations. In addition, the main factors influencing the duration of admission of general practitioners of primary care organizations were identified, and we also compiled a forecast of the duration of GPs’ admission, depending on the treatment of some variables. Statistical analysis determined the main factors affecting the duration of admission of patients by GPs. These include the Communicative Factor or Component 1, Operating Procedures or Component 2, and Working with Documentation or Component 3

    Authors: Son I. M. [26] Mergentay A. [1] Kulov D. B. [1] Bekembaeva G. S. [1] Koikov V. V. [1] Omarkulov B. K. [1] Musina G. A. [1]

    Tags: disease3 dispensary observation1 patient3 population2 time of admission1

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  • It management
  • 2016 № 8 Formation records on childhood disability in the Russian Federation for 1980–2016 years

    A retrospective analysis of primary medical records, recording children’s disability. Studied the chronological sequence of changes in accounting forms and prerequisites for these changes, and also features documentation for registration of children with disabilities.

    Authors: Son I. M. [26] Polikarpov V. A. [2] Ogryzko E. V. [6] T. Yu. Golubeva [2]

    Tags: child disability statistics1 form no. 080/u1

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  • Management in health care
  • 2016 № 10 State and tendencies of the organization of medical care by the patient with rheumatic diseases in the orenburg region

    In the Orenburg region there are multidirectional and nonuniform tendencies of incidence of rheumatic diseases, the possibly bound to decrease in availability of the specialized rheumatological help to patients. Medical care by the patient with rheumatic diseases in the Orenburg region does not meet the modern expectations of necessary level to its organization and an operating order of rendering. Level of primary specialized rheumatological help is not provided with necessary quantity of positions, and territorial distribution of available, causes its transport inaccessibility. The specialized stationary help, including hi-tech turns out in one office at regional hospital what is also represented poor. The calculated quantity of necessary established posts of rheumatologists makes from 17 to 32 rates, depending on the applied calculation procedures. The number of necessary beds for rendering the specialized rheumatological help varies from 94 to 250. The organizational model of the rheumatological help to adult population of area developed on the basis of analytical and normative methods includes creation of interdistrict offices of rheumatologists for rendering primary specialized rheumatological help, two interdistrict rheumatological offices for rendering the specialized help taking into account preservation of the office in a regional hospital providing specialized and high-tech medical care to patients. This model is the first stage in development of the concept of development of the rheumatological help in area.

    Authors: Son I. M. [26] Begun D. N. [1] Borshchuk E. L. [2]

    Tags: medical care at rheumatic diseases1 organizational model operation1 scheduling of health care1 the organization of specialized medical care1

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  • 2016 № 9 Modern approaches to an estimation of efficiency and an assessment of quality of medical diagnostic researches

    Perfection of the medical diagnostic help, including its pre-hospital level, demands the working out and the realization of a series of measures on diagnostic interventions’ management and their quality assessment. The list of the common and specific indicators of efficiency of diagnostics is developed on the basis of the researches made and offered, modern approaches to quality management, carrying out of internal and external quality assurance are described, the problems demanding the decision for the further increase of efficiency and quality of medical diagnostics are defined.

    Authors: Son I. M. [26] Vyalkov A. I. [2] Skvirskaja G. P. [1] Serjogina I. F. [1] Bilalov F. K. [1]

    Tags: diagnostic researches1 efficiency indicators1 internal and external quality assessments1 medical1 quality control1 social and economic efficiency1

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  • 2016 № 7 The activities of day hospitals in the Russian Federation in 2000–2014

    The article analyzes legal documents, which that regulate the work of day hospitals in the Russian Federation since the late 90-ies of XX century to the present. Presents an analysis of the performance of activities of day hospitals in health institutions providing medical care in ambulatory and stationary conditions in the country in 2000–2014. Marked increase in the number of beds in day hospitals 2,3 times, which is mainly due to the increase of beds in day hospitals in health institutions providing medical care in ambulatory conditions. Spend the evaluation of use of hospital beds hospitals for 15 years. During the study period the number of beds in hospitals has decreased by 27,7%, the number of discharged patients has almost not changed, which is associated with the intensity of the work beds. Shows the comparison of the number of persons treated in day hospitals and hospitals round-the-clock stay. The total number of patients treated in day hospitals and round hospitals, the proportion of patients treated at a convenience care hospitals declined from 92,5 to 80,3%, the proportion of patients treated in day hospitals increased from 7,5 to 19,7%.

    Authors: Son I. M. [26] Evdakov V. A. [3] Shlyafer S. I. [1] Senenko A. Sh. [1] Melnikov Yu. Yu. [1]

    Tags: beds1 day hospital2 hospital organizations1 the average bed occupancy in a year1 the average duration of treatment1 the medical organizations giving help in out-patient conditions1 turnover (function) bed1

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  • 2016 № 3 Primary Health care. Medical Network organization features and staff provision

    Annotation. Changes of Medical organizations network, providing ambulatory treatment, were studied, for past 10 years. In addition, trends of manning tables formation in outpatient clinic were analyzed, as well as population provision by district doctors (uchastkoviy doctor) and general doctors. The analysis of main indicators of doctors’ activities in medical organizations, providing ambulatory treatment, is provided.

    Authors: Son I. M. [26] Senenko A. S. [4] Kupeeva I. A. [6] Starodubov V. I. [19] Skvirskaya G. P. [3] Gazheva A. V. [4]

    Tags: district doctor1 general doctor1 medical organizations5 outpatient clinic1 primary health care1 providing ambulatory treatment1 regular appointment1 visiting doctor1

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  • 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.

    Authors: Son I. M. [26] Evdakov V. A. [3] Banteva M. N. [2] Kuznetsova V. P. [2]

    Tags: chiropractic1 manual therapy1 medical rehabilitation7 physiotherapy1 provision with doctors for medical rehabilitation1 rehabilitation treatment1

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  • 2015 № 10 Cancer patients routing experience of the Sverdlovsk Region and the Republic of Tatarstan

    In the research, we analyzed the experience of the regions, that have implemented and have been using effective automated routing systems of cancer patients, that allow to optimize the use of resources in the region. We studied and described the key elements of an effective system for the routing of patients with malignant tumors. We propose optimum steps for implementation of the routing system in the regional oncology service.

    Authors: Son I. M. [26] Laricheva I. V. [1] Shamanskiy V. B. [1] Khasanov R. S. [1] Shakirov K. T. [1] Gabitova S. E. [1]

    Tags: cancer patients routing1 informational system1 republican clinical oncological center of republic of tatarstan1 sverdlovsk regional oncology center1 the organization of cancer care system1

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  • 2015 № 9 The condition and renovation of capital assets of TB-institutions in the Russian Federation (2012–2014)

    The state of capital assets of TB organizations in the Russian Federation: buildings and structures, machinery and equipment, motor vehicles evaluated. Discovered increased depreciation of capital assets, imbalance of wear, imbalances of renovation. The ways of harmonization of state assets offer.

    Authors: Son I. M. [26] Obukhova O. V. [8] Sterlikov S. A. [5]

    Tags: anti-tb institutions1 capital assets1 health economics1 tb care1

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  • 2015 № 8 Adult population’s quality clinical examination management in outpatient organizations on the basis of the process approach

    Aim of the study: Development of quality management system in health care organization in periodic health examination of target adult population groups. The developed materials could be exploited in similar institutions engaged in the periodic health examinations.

    Authors: Son I. M. [26] Tyazhelnikov A. A. [1] A. Sh. Senenko [1] Yumukyan A. V. [1] Volkova N. V. [1]

    Tags: periodic health examination1 prevention4 process approach3 quality management system5

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  • 2015 № 4 Supply of general practitioners and their activity in different federal districts of the country in the period from 2007 to 2013 biennium

    In the Russian Federation from 2007 to 2013 biennium. indicator of the availability of general practitioners has steadily increased. The most pronounced positive trend registered in the southern federal district (53,9%), the lowest-in the Siberian federal district (2,6%), along with the indicators of the medical and the coefficients of its rejection had considerable variability (maximum in the North Caucasus federal district: +40,6%, minimum-VLS: +14,6%) Also decreased the number of specialists, particularly in the Northwest and Vls, which contributed to the growth in health care ISSUES for the country as a whole, over the period from 2007 to 2013 biennium. was +31,4%. Increased proportion of patients and GPS at home, especially rural people. The overwhelming number of visits to doctors in that specialty was about diseases. This situation requires re-evaluation of the primary health care for the population in order to increase the availability of care provided by general practitioners, and the basis of the positive experience of a number of constituent entities of the Russian Federation.

    Authors: Son I. M. [26] Kupeeva I. A. [6] Ivanova M. A. [9] Sokolovskaya T. A. [5]

    Tags: . general practitioners1 function of medical posts1 medical services2 rural residents1 security1 staffing3

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  • 2014 № 9 Main morbidity trends of population of the Russian Federation in 2012–2013 (Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia)

    There was conducted an analysis of dynamics of general and primary morbidity rates among Russian population in the period of 2012–2013 years. There was noticed an increase in the general morbidity rates of population in Russian Federation by 5,2% in 2013. The structure of general morbidity of population in Russian Federation hasn't changed significantly: the first place is taken by lung diseases, second — by diseases related to a blood circulation system, third — by diseases of a musculoskeletal system. The level of primary morbidity rates among the whole population of Russian Federation has increased by 0,8%. The structure of general morbidity among Russian population hasn't changed significantly: the first place is taken by lung diseases, second — by the injuries and intoxications, third — by diseases of genitourinary system.

    Authors: Son I. M. [26] Leonov S. A. [11] Vaisman D. Sh. [1]

    Tags: general morbidity1 morbidity6 primary morbidity1

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  • 2014 № 8 Working hours expenses of doctors on an out-patient basis according to photochronometric researches (Federal research institute for health organization and informatics of ministry of health of the Russian Federation, Moscow, Russia)

    For the implementation of the Russian Federation President Decree of May 7, 2012 № 598 «About improvement of a state policy in the health care sphere» and according to the Plan of measures on work rationing in health care of the Interdepartmental working group on the organization of rationing of work, development of professional standards and skill levels in the health care sphere, within 2 working weeks phototime observation over work of two experts — therapists of district police officers, pediatricians of district police officers, general practitioners, neurologists, otorhinolaryngologists, ophthalmologists and obstetricians-gynecologists in 17 pilot territories of the country is made. Results of research testify the need of improvement of normative documents on setting standards for the doctors rendering the out-patient help to the population towards increase in time for visit of one patient.

    Authors: Son I. M. [26] Ivanova M. A. [9] Starodubov V. I. [19] Armashevskaya O. V. [4] Liutsko V. V. [3] Sokolovskaya T. A. [5] Bantyeva M. N. [4]

    Tags: improvement of normative documents1 norms of time1 phototime supervision1

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  • 2014 № 7 Rules and law regulations for the labor of general practitioner in Russian Federation (Federal research institute for health organization and informatics of ministry of health of the Russian Federation, Moscow, Russia)

    The current regulatory framework in a grate measure ignores aspects of the labor of general practitioner, and does not ccorrespond modern requirements for primary health care. In consequence of that, possibility of a general practitioner, capable because of its approachability to the public and competence, cconsiderably attend both primary medical health care and emergency medical services, is used inefficiently. One of the main tools in solving this problem in the process of modernization of health care is the revision of regulations governing the labour of general practitioners and nurses with taking account of changed social conditions of society and the epidemiological situation, as well as a significant improvement of material and technical base of medical organizations and the new requirements to the organization of the diagnostic and treatment process.

    Authors: Son I. M. [26] Ivanova M. A. [9] Armashevskaya O. V. [4] Bantyeva M. N. [4]

    Tags: general practitioner2 law regulations1 medical help2 order2

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  • 2014 № 4 Current rules and law regulations for the labor of ophthalmologist (Federal research institute for health organization and informatics of ministry of health of the Russian Federation, Moscow, Russia)

    Existing normative base does not correspond with modern requirements on providing specialized medical aid and is in need of re-consideration. One of the main instruments for achieving this objective in the process of health care modernization is objectivation of physician's work norms and of the middle-level medical staff with the regards of changed social life conditions of the society and epidemiological situation, as well as significant improvement of material-technical base of medical organizations and new requirements towards organization of aid-diagnostics process. Modernization of medical organizations, implementing innovative methods of diagnostics, suggesting high qualification of specialists along with understaffing of personnel set, and the growth of pressure on physician, require re-consideration of existing normatives.

    Authors: Son I. M. [26] Ivanova M. A. [9] Starodubov V. I. [19] Sokolovskaya T. A. [5] Bantyeva M. N. [4]

    Tags: activity1 aid1 normatives2 ophthalmology1 order2 states1

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  • 2013 № 11 Methodology of calculating industrial registration indicators, diagnostics and efficiency of medical treatment for patients suffering from tuberculosis (Federal Public Health Institute for Health Care Organization and Information of the Ministry of Public Health of Russian Federation, Moscow, Russia)

    There are announced the principal mechanisms affecting the size of registration indicators, diagnostics and treatment efficiency for patients suffering from tuberculosis. There are presented the consequences of a number of management solutions.

    Authors: Son I. M. [26] Sterlikov S. A. [5] Nechaeva O. B. [2]

    Tags: diagnostics2 industrial indicators1 methodology of calculation1 registration1 treatment efficiency1 tuberculosis3

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  • 2013 № 10 Demand of Russian Federation in medical human resources (Ministry of health care of Russian Federation, Moscow, Russia; Federal Research Institute for Health Organization and Informatics of Ministry of Health Development of the Russian Federation, Moscow, Russia)

    Annotation: In the article there are presented results of defining demands of Russian Federation in medical human resources. Base for calculating the number of specialists was volumes of aid set in each subject of Russian Federation while realizing territorial program of state guarantees on provision of medical aid with consideration of age-specific indicators of analogue state guarantees federal program, regional specifics and level of population's morbidity in subjects of Russian Federation. Besides that, methodology called «Calculation of demands of Russian Federation in medical human resources», developed in Federal State Entity of «Central SRI of Organization and Informatization of Health Care», considered territorial specifics of subjects of Russian Federation, — location of the subject in Far North areas and equivalent to the, density of population, proportion of the rural population. With that there were used reducing the pressure coefficients on physicians positions. In the article there is a comparison of actual number of main professions in 2012 year and revised regulatory normative of physicians numbers in 2013–2014 years (per 10 thousand capita), as well as there is described а deviationof normative number of physicians from its actual number (deficit/surplus of physicians) for the main professions.

    Authors: Son I. M. [26] Leonov S. A. [11] Kupeeva I. A. [6] Gazheva A. V. [4] Maev I. V. [1]

    Tags: actual and regulatory number of physicians1 and method for calculating demand in physicians1 deficit of medical human resources1

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  • 2013 № 8 Dynamics of morbidity with a temporary disability in Russian Federation in 2007–2011 years (Federal Research Institute for Health Organization and Informatics of Ministry of Health Development of the Russian Federation, Moscow

    Annotation: In the article there is presented an analysis of cases when there is obtained a disability in different categories of diseases within the past 5 year old period dated from 2007 till 2011 years among men and women. Study of dynamics of this indicator has revealed that there has been noticed an increase of disease cases among men obtaining disability and with women the number of cases when disability was obtained remained almost the same. There is presented a structure of diseases causing temporary disability and analysis of indicator dynamics in all classes and particular groups of diseases in the sex cut. There is evidence of importance of studying diseases causing temporary disability, especially taking in account predicted temporary decrease of number of cases and days of temporary disability in 2018 and 2019 years (compared to 2017 year) due to the unfavorable demographic situation forecast.

    Authors: Son I. M. [26] Leonov S. A. [11] Moravskaya S. V. [1]

    Tags: classes of diseases1 forecast1 morbidity of population2 structure of morbidity of adult population1 temporary disability1

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  • Medical science
  • 2017 № 8 The transition to a model of personalized medicine: barriers and possible solutions

    The transition of the national health system to the model of «personalized medicine» is highlighted in the Strategy of scientific and technological development of the Russian Federation as one of seven priorities (item 20 in"). Analyzed risks and possible barriers of the implementation of this priority. Attention is drawn to the need to assess economic viability, human and infrastructural support, adequacy of legal regulation of development of methods of personalized medicine in the Russian Federation in the format of full project life cycle

    Authors: Son I. M. [26] Kurakova N. G. [13] Petrov А. N. [1]

    Tags: design2 expertise3 personalized medicine1 priorities for research and technological development1 the implementation1 the projects 'full cycle'1

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  • Medical statistics
  • 2017 № 1 Analysis of changes reporting forms of federal statistical observation in terms of children and disability

    Child disability – one of the most acute of medico – social problems of modern society. The level of disability along with infant mortality, morbidity, physical development and health demographic processes is a basic indicator of child health, reflecting the level of economic and social well-being of the country. This article presents a retrospective analysis of the changes in the reporting forms of federal statistical observation of the registration of children with disabilities for the period 1995 to 2015. Studied the chronological sequence of changes in the reporting forms and the background of these changes.

    Authors: Son I. M. [26] Polikarpov V. A. [2] Golubev N. A. [2] Ogryzko E. V. [6] T. Yu. Golubeva [2]

    Tags: childhood disability statistics1 form no 191 form no 7-d (sobes)1 forms of federal statistical observation form no 94 (pensii)1

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  • Modernization of health care
  • 2013 № 5 Evaluation of health care modernization's impact on dynamics of adult population's morbidity (Federal Research Institute for Health Care Organization and Information of the Ministry of Health and Social Development of Russian Federation, Moscow)

    Annotation: There are considered different criteria of evaluating health care's modernization, reflecting structural improvements of the system, current, financing and results of additional prophylactic medical examination service, status of medical equipment and its amortization. There is estimated an economic loss due to population's morbidity.

    Authors: Son I. M. [26] Leonov S. A. [11] Starodubov V. I. [19] Pogonin A. V. [1]

    Tags: correlation regressive and factor analysis1 foreseeable levels of morbidity1 loss of earning capacity1 modernization of health care2

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  • Personnel management
  • 2017 № 6 Working time of doctors-specialists related to visiting one patient with doctor-physician, doctor-surgeon and doctor-dermatovenerologist

    In accordance with paragraph 3 of the Rules for the development and approval of standard labor standards approved by the Government of the Russian Federation on November 11, 2002 No. 804 (Collected Legislation of the Russian Federation, 2002, No. 46, Article 4583) and paragraph 19 of the action plan (“road Card“)” Changes in social sectors aimed at improving the effectiveness of healthcare “approved by the Decree of the Government of the Russian Federation No. 2599-r of December 28, 2012 (Collected Legislation of the Russian Federation, 2013, No. 2, Article 130, No. 45, Articles 5863, 2014, No. 19, Item 2468), in 2016 photo-timing observations of the working process of phthisiatricians, doctors-surgeons and doctors-dermatovenerologists were conducted. The work was conducted in accordance with the methodology of conducting photo-timing studies within ten working days for two physicians in each specialty. The results of the research showed the need to develop new normative documents on setting the time limits for visiting one-patient TB doctors, surgeons and dermatovenereologists who provide primary care in outpatient settings (not providing 24-hour medical supervision and treatment).

    Authors: Son I. M. [26] Ivanova M. A. [9] Starodubov V. I. [19] Armashevskaya O. V. [4] Liutsko V. V. [3] Tsybikova E. B. [1] Sokolovskaya T. A. 1 [1] Tyulkina E. A. [1]

    Tags: medical specialists1 new normative documents1 photo-timing observation1 time norms1

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  • 2017 № 2 Non-medical and other staff working in the medical organizations subordinated to the subject of the Russian Federation

    The demand for increasing efficiency in the use of health resources, including human resources, require improved approaches to demand determination for non-medical personnel of health. Over the past three years, almost half (47.3%) increased the absolute number of «other staff» and medical organizations increased by 24.6%, its share in the total number of health workers. Analyzed data provided by the health authorities of the Russian Federation on the size, composition and the additional requirements of healthcare organizations-medical and other staff. The necessity of developing a unified nomenclature of positions in the non-medical part of the health workforce, clearly defined methodological approaches to the formation of the staffing structure and numbers of non-medical personnel depending on the type and capacity of the medical organization.

    Authors: Son I. M. [26] Gagieva A. V. [1] Senenko A. S. [4] Zakharchenko O. O. [1] Leonov S. A. [11] Kupeeva I. A. [6]

    Tags: calculate the needs of other staff1 health workforce1 medical personnel2 specialists with higher non-medical education1

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  • Technology management
  • 2016 № 3 The level provision with diagnostic equipment in medical organisations, offering medical aid in ambulant conditions

    Annotation. Shift to the provision of medical care in the outpatient setting updates the analysis of the provision of medical equipment and the loading it in the outpatient departments. Condition of medical devices for preventive screening equipment for computer and magnetic resonance tomography, ultrasound and endoscopic diagnostics studied using official reporting statistic data. The technical condition of the buildings outpatient departments was analizing too. Identified the shortages of equipment for mammography, the suboptimal using of the equipment for screening of the chest. The expediency of the certification of health care organizations recommended, as well as the revision of standards studies using computed tomography. A path to optimizing the load on the diagnostic equipment proposed.

    Authors: Son I. M. [26] Senenko A. S. [4] Leonov S. A. [11] Skvirskaya G. P. [3] Gazheva A. V. [4] Sterlikov S. A. [5] Bilalov F. S. [1]

    Tags: ct and mri scans1 health organizations providing assistance to the population in an outpatient setting1 medical equipment2 preventive screening1 technical condition of buildings of medical departments1 ultrasound diagnostic equipment1

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