2019 № 3 Prevalence of socio-biological risk factors in pregnant women of Krasnoyarsk region and their impact on adverse pregnancy outcomes
The aim of the study was to study the prevalence of socio-biological risk factors in pregnant women of the Krasnoyarsk territory and their impact on the risk of adverse pregnancy outcomes. The analysis includes data on 122 250 cases of pregnancy in the period from 2014 to 2017 in the Krasnoyarsk region. All analyzed cases of pregnancy were divided into 2 groups: group I – cases of pregnancy with unfavorable outcomes (8 290 cases), group II – cases of pregnancy with favorable outcomes (113 960 cases). The paper analyzes the following factors: mother’s age less than 18 years or 40 years or more, father’s age 40 years or more, the presence of the mother and father of occupational hazards, bad habits (smoking 1 pack of cigarettes a day, alcohol abuse), mother’s height 158 cm or less, as well as the mother’s body weight 25% higher than normal. To assess the impact of the studied factors on the risk of adverse pregnancy outcomes, the odds ratio was calculated. The results of the study indicate that the presence of occupational hazards in the mother and her age less than 18 years do not affect the risk of adverse pregnancy outcomes. To the greatest extent, this risk is influenced by the presence of bad habits in the mother (smoking and alcohol abuse) and the father (alcohol abuse), as well as the presence of occupational hazards in the father. The use of information on the impact of various factors on the risk of adverse pregnancy outcomes will allow the most effective routing of pregnant women by levels of care to reduce, ultimately, the number of these outcomes. The results show that the risk of adverse pregnancy outcomes is influenced by a fairly wide range of factors. In this case, each factor has a different degree of impact on the risk. Given these circumstances, it is necessary to further develop an integrated assessment of the risk of adverse pregnancy outcomes.
2019 № 1 To the question of volume reducing of dispansserization and preventive examinations
The beginning of mass prophylactic medical examination in Russia was accompanied by an excessive inclusion of screening methods and additional diagnostic interventions. Such tactic was not justified from the financial, economic and organizational point of view. Although in 2017 the volume of medical examination was significantly reduced, analysis of official documentation and reporting forms shows that imbalance in its structure is still preserved, and some methodic, used for screening and additional diagnostic, are not justified from position of evidence-based medicine. In 2015, only due to optimization of clinical examination structure on the first stage it would possible to reduce costs by more than 10 billion rubles, increasing the effectiveness of preventive interventions through rational reallocation of funds.
2019 № 4 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.
2015 № 5 Risk factor for mortality from cardiovascular diseases: the expert estimation doctors of various specialties
No statistically significant differences in the average score evaluation by physicians of different specialties of each indicator (p > 0,05 for each item). Average effect on mortality from cardiovascular diseases comorbid somatic pathology according to the doctors is 3,5±1,5, and more than a third of experts evaluated the contribution of comorbid somatic pathology in maximum 5 points. Average impact of comorbid psychopathology — 2,7±1,4; comorbid diseases caused by alcohol and drug use — 3,5±1,5; failure to doctor's recommendations — 4±1,3; ignorance of the major risk factors for the Ivory Coast, or the rejection of their correction — 3,8±1,4; ignorance of the main manifestations (symptoms) of life-threatening diseases or complications requiring first aid and emergency medical services — 3,9±1,4. Almost 50% of specialists have put the maximum score in the answers to the last two questions. Аccording to doctors at the level of regional mortality from BSK is strongly influenced by physical and mental comorbid pathology, ignorance of the risk factors, symptoms and methods of providing emergency assistance in the Ivory Coast.
2014 № 12 Regional experience of the organization of work of the Centers of health on the example of the Smolensk region (Department of health care, Smolensk, Russia)
Annotation. This review presents regional experience of improving preventive measures in the Smolensk region on the example of the organization of the health center. The results of analysis of sectoral statistical monitoring indicators of different categories of patients visiting health centers Smolensk region for the period 2010–2014. (2014 results are presented for the first 9 months). The dynamics of the number of persons trained in healthy lifestyles in-depth individual prevention counseling and thematic School of Health, the number of patients who visited the Health Centre in the Smolensk region in 2010–2014, represented the organization of exit work Regional Health Center. The role of health centers in improving the system of medical prevention in primary care Smolensk region.