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. [25] Ivanova M. A. [9] Starodubov V. I. [18] 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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  • Management in health care
  • 2016 № 4 Public Health and Formation of the Uniform Preventive Space

    Annotation. The task of unifying the efforts of all participants of the preventive process, the whole society in order to create a preventive space became urgent In the last decade. The development of the public health system is suggested as such а unite. A great number of discussions on public health at various levels allowed us to formulate the definition and the core functions of public health. It is crucial to realise the public health system both as a totality of different structures and as their purposeful and coordinated activity. Of particular importance is the municipal level as a place of direct contact of the population, bodies of local self-government, the realization of the actions directed on preservation and strengthening of health of the population, with the active participation of citizens themselves.

    Authors: Senenko A. S. [4] Leonov S. A. [11] Starodubov V. I. [18] Evdakov V. A. [3] Son I. A. [1] Korotkova A. V. [1] Сheshkovsky M. S. [1] Bondarenko A. A. [1]

    Tags: a single preventive space1 function of public health1 health promotion1 interagency cooperation1 local authorities1 public health1 the formation of a healthy lifestyle1

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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. [25] Senenko A. S. [4] Kupeeva I. A. [6] Starodubov V. I. [18] 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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  • 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. [25] Ivanova M. A. [9] Starodubov V. I. [18] 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 № 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. [25] Ivanova M. A. [9] Starodubov V. I. [18] Sokolovskaya T. A. [5] Bantyeva M. N. [4]

    Tags: activity1 aid1 normatives2 ophthalmology1 order2 states1

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  • 2013 № 12 New criteria of Birth: medical and demographical outcomes and organizational problems of obstetric services (Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia)

    Annotation. The paper defines the characteristics of the obstetric services organization in modern conditions. In April 2012, Russia introduced new birth criteria — birth weight 500 grams and 22 weeks of gestation. According to this criteria termination of pregnancy at 22–27 weeks of gestation that used to be termed as «late abortion» before 2011 should be considered and registered as extremely premature birth starting April 2012. This reform has been accompanied by reorganization of outcomes of registered pregnancies — births and abortions as well as the number of births and deaths by body weight.

    Authors: Starodubov V. I. [18] Sukhanova L. . P. [1]

    Tags: abortion1 birth1 birth criteria1 extremely low birth weight neonates1 infant deaths1 perinatal mortality2 pregnancy outcome1 still birth1

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  • 2013 № 3 Efficient contract in health care: opportunities and risks (Central Research Institute for Health Organization and Informatization, Ministry of Healthcare, Moscow, Russia)

    Article is dedicated to problems of implementing efficient contract into health care. Currently, there are created descent conditions for implementing efficient contract into health care, what provides circumstances for its future successful realization. But, on the other hand, there is required a flexible policy not only towards terms, included in labor contracts with employees but towards the process of implementing efficient contract itself. Especially, when health care is characterized by great diversity: not everywhere the same approaches for stimulation are acceptable and reasonable. In the article there is given an analysis of opportunities and threats, related to implementing efficient contract, there are suggested measures countering these threats.

    Authors: Kadyrov F. N. [47] Starodubov V. I. [18]

    Tags: efficient contract9 evaluation of employee's activity1 financial stimulation2 labor compensation4 stimulation payouts1

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  • 2013 № 2 Transformation problems of existing labor payment system in aim of implementing efficient contract into the health care (Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia)

    The article is dedicated to problems of implementing efficient contract into the health care. Despite the presence of definite normative base, all necessary conditions for implementing efficient contract are not yet created. Moreover, approved and planned for approval normative acts do not consider a number of important issues, related to efficiency of material stimulation measures in such specific field as health care. Therefore, this article is dedicated to its analysis, as well as proposals for increase of productivity while implementing efficient contract in the field.

    Authors: Kadyrov F. N. [47] Starodubov V. I. [18]

    Tags: efficient contract9 evaluation of employees performance1 incentive type of payments1 material stimulation2 payment for labor1

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  • Manager of health care consults
  • 2017 № 4 Paradoxes of law: the guarantee of free medical aid often limit the rights of patients to improve quality

    The legislation of the Russian Federation, recognizing the rights of citizens on free medical aid and paid medical services, however, makes clear the roll the side free of charge. At the same time guarantee free of charge formulated in such a way that often limit the rights of citizens to receive medical care with the use of drugs, medical devices, etc., not provided for in the programme of state guarantees of free rendering to citizens of medical aid. Moreover, if the rights of citizens to receive paid medical services directly spelled out in the law, the right of citizens to self-purchase of medicines, medical devices, etc. did not say anything. There is no outright bans, which in practice leads to numerous conflict situations. The article provides specific suggestions for improving the legislation in this field.

    Authors: Kadyrov F. N. [47] Starodubov V. I. [18]

    Tags: accessibility of care1 free medical care2 guarantees in the health sector2 medical products2 medications3 paid medical services5 quality of care3 standards of care3 the legislation in the sphere of health care1

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  • 2015 № 9 Provision of medical aid within a medical approbation

    Currently there are developed legal and methodological principals for medical aid provision within a clinical approbation of prevention methods, diagnostics, treatment and rehabillitation. Despite the imperfections of the developed system, it allows to eccelerate the process of implimenting new medical technologies into the health care system, having simultaneously provided financial support to federal clinics, experiencing serious economical burdens due to budget cuts for the most common types of medical care in circumstances of economical instability. The article analyses the issues and provides recommendations for improving organizational mechanisms of clinical approbation.

    Authors: Kadyrov F. N. [47] Obukhova O. V. [7] Perkhov V. I. [8] Starodubov V. I. [18]

    Tags: clinical approbation1 clinical experiments1 clinical research1 clinical-economical analysis1 effectiveness1 financial support of medical activity1 medical aid2

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  • 2015 № 5 Issues related to utilizing standards of medical aid in the mandatory medical insurance system

    The article is dedicated to analysis of legislation, other normative acts, related to application of regulations on providing medical aid and standards of medical aid, medical aid quality control and enforcement of penalty sanctions towards medical organizations in the system of mandatory medical insurance.

    Authors: Kadyrov F. N. [47] Starodubov V. I. [18]

    Tags: criteria for evaluating medical aid quality1 mandatory medical insurance6 medical-economic expertise1 penalty sanctions1 quality expertise of medical aid1 regulation on providing medical aid1 standards of medical aid3

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  • Medical science
  • 2017 № 5 Place of clinical medicine in the disciplinary structure of Russian science

    The article Considers the disciplinary structure of science in the world and Russia It is shown that the share of publications on clinical medicine accounted for 26% of the total number of publications indexed in 2015 in the Web of Science database, and 35.3% of publications indexed in Scopus for 2011–2015, the conclusion about the growing importance of clinical medicine in global science. It is noted that the RF power developed in the last century, and not changing the quota system of public sector support for civil science, for research of medical subjects, is no more than 3.2% of domestic expenditure on research and development by socio-economic objectives. It is projected that the underfunding of medical science in Russia will not allow to achieve a substantial increase scientometric indicators reflecting the efficiency and productivity of Russian science in General.

    Authors: Starodubov V. I. [18] Kurakova N. G. [11]

    Tags: clinical medicine2 disciplinary structure2 medical research funding1 science1 scientometric indicators1 world science2

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  • 2016 № 2 Structure and challenges of the medical division of the new programme of fundamental scientific research of state science academies

    The article considers the questions of planning and financing the scientific-research activity in the field of medical science, realized at the cost of the state budget. Authors demonstrate that disintegration of scientific processes leads to a decrease of intensity of scientific search and implementation of achievements in medical sciences in the health care practice. Authors conclude that it is necessary to increase the effectiveness of the management of scientific research and more clearly define the priorities of the medical sciences development.

    Authors: Perkhov V. I. [8] Starodubov V. I. [18] Nefedova E. V. [1]

    Tags: health care8 medical science1 scientific research1 state financing1

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  • 2014 № 3 Funding medical science: new principles and financial instruments (Federal Research Institute for Health Care Organization and Information of the Ministry of Health and Social Development of Russian Federation, Moscow)

    Annotation. There is conducted an analysis of selection criteria on projects of Russian medical research centers for funding in Russian scientific fund and Federal program «Research and innovations». There is noted a high degree of uncertainty of such concepts as «priority direction», «applied» and «search» research and «industrial partner» in regards to research of biomedical theme. There is completed an analysis of classified «Medicine and health care» «Forecast of scientific-technological development of Russian Federation till 2030 year».

    Authors: Starodubov V. I. [18] Kurakova N. G. [11]

    Tags: federal budgetary programs1 grant funding1 industrial partners1 medical research studies1 priorities1 russian scientific fund1

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  • Medical sciences
  • 2015 № 8 Operation mechanisms, priorities and volumes of financial support of research in health care in Russia and in the USA

    The article demonstrates that Russia’s amount of finance in research and development is less than 2,5% from the global budget, while the amount of financing of only three countries – USA, China and Japan takes up to 50%. It was suggested that incomparability of Russia’s internal amount of financing in development of the citizens science sector compared to developed countries allows to identify a limited number of research areas as priorities of scientific-technological development of the country. There was compared and contrasted the amount of spending on research and development in biomedicine in USA and in Russia. It is demonstrated that the basic amount of financing of 27 research centers, included in the US National Health Institutes network, in 2014 exceeded the amount of financing of 104 Russian medical scientific-research institutes subordinate to Russian Minisry of Health care and Federal Agency of scientific organizations by 173 times. A conclusion was drawn about the appropriateness of substantial increase of the amount of state financing in fundamental, exploration and related research in the field of biomedicine in case the life sciences are preserved as priority areas for scientific-technological and social development in Russia. There is emphasized the necessity to eliminate all administrative and tax barriers, preventing active participation of domestic industrial entities in co-financing the development of Russian drug substances and medical equipment.

    Authors: Starodubov V. I. [18] Kurakova N. G. [11]

    Tags: biomedical scientific research and development1 choice criteria1 government funding1 priority areas1 russia7 scientific-technological development1

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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. [25] Leonov S. A. [11] Starodubov V. I. [18] 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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  • Organization of health care
  • 2014 № 10 Russian and regional parameters of activity of general practitioners (Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia)

    Annotation. The total number of general practitioner's visits within the studied period has increased in Russia and other federal regions, and in some states — significantly. There is noticed a trend of decrease in the number of preventative visits at home, relative share of visits among country side residents. There is a considerable increase in coefficient of double job holding against a general trend for decrease of practitioner's staffing. There is demonstrated a high demand in general practitioners, in their ability to provide first medical aid and high accessibility of their services to the public. Therefore, development of the institute of general practice should be considered as a perspective path for managing medical-sanitary aid.

    Authors: Ivanova M. A. [9] Starodubov V. I. [18] Sorokina U. A. [2] Bantyeva M. N. [4]

    Tags: general practitioner2 home visits1 job holding1 number of visits1 preventive visits1 staffing3 visits of villagers1

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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. [25] Ivanova M. A. [9] Starodubov V. I. [18] 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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