Manager Zdravoochranenia 2016 #10
CONTENT OF THE ISSUE
Accreditation specialist: myths, realities, risks, proposals
The article analyzes into detail the situation related to the newly introduced procedure of accreditation experts, caused by the professional community a set of questions. The authors show convincingly that doctors do not need to be mandatory to get collecting credits in order to in the future be accredited. In the publication are listed and thoroughly analysed risks relevant to the requirements for the procedure of accreditation of specialist. One of the risks named a possible limitation of the availability for doctors free conferences and seminars. The article contains a large block of proposals concerning the accreditation of specialist, including the formation of the system of continuous medical education.
Some results of modernization programms in health system in the Russian Federation
The article presents the estimation of the results of health care system’s modernization programs in 2011–2013 from the point of view of infrastructure changes, health care availability and results. On the base of the Ministry of Health’ statistics data the analyses of structure, staff, main results of health institutions and some medico-demographic indices as well was run before the modernization programs (2009–2010), in the last year of the programs (2013), and in 2014. The number of the health institutions decreased following their integration up on 1,9 thousands accordingly to the modernization programs. Primary health care was developed, the number of day-surgery beds increased up on 34 thousands. The number of district doctors decreased by 10%, number of ambulance doctors decreased by 3,2 thousands. In the same time number of general practitioner increased up to 9838 doctors. The number of out-patient’s visits decreased to 9,1 per year, the number of ambulance calls became normative, hospitals’ results followed to optimize. Standardized mortality rate decreased up on 16% including reasons of circulatory diseases and of external factors. Morbidity has practically not changed. Conclusion: The modernization programs have optimized health care system’ infrastructure including primary health care development. Modernization programs failed to solve the medical staff problems of the Russian health system. Availability and quality of health care increased as diseases were educed actively but the mortality rate decreased.
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.
Experience the reorganization of outpatient ophthalmologic services in the Kaluga region with the participation of the Federal medical institutions
The article presents the experience of the reorganization of the outpatient ophthalmic services in the Kaluga region with the aim of improving the quality of outpatient services; improve the availability and proximity of high-tech eye care in conditions of the respective Federal agencies for the population of the region. To achieve this goal was proposed the algorithm for providing ophthalmological care, which allowed accelerating the provision of specialized high-tech diagnostic and surgical eye care to the needy residents of the city of Kaluga. For today in hospitals of the regional center there are 5 rooms of the IRTC «Eye Microsurgery». For the period 2009–2015 in the outpatient clinics were adopted 587 103 patients of them sent to the Kaluga branch of IRTC «Eye Microsurgery» 23 230 patients (22,4%) with different ophthalmopathology. The cases in the branch was extended to 31 192 medical services, including 7 565 patients underwent surgical treatment. The obtained results testify to the relevance and prospects of the work done, which would merit its continuation in other medical institutions in Kaluga region.
Аnalysis of the application of standards of care
The article addresses the problem of application of standards in the provision of medical care, and also when exercising control and expert activities. Set out grounds for revision of the paradigm of quality assessment of medical aid in system of obligatory medical insurance based on the comparison of the standardized and the actual performance of medical-diagnostic process.
Administrative penalty applicable to protection of citizens from exposure to tobacco smoke
Annotation. The integrated policy of dealing with the harm caused due to tobacco use is administrative penalty for the violating the restrictions. The article provides analysis of the regulatory and enforcement issues of administrative sanctions for violation of the «anti-smoking legislation» (Art. 6.24 and 6.25 of the Administrative Code of the Russian Federation).
Traditional nominees of «Manager of Health Care» Publishing House for the best publications in 2016 year
The history of the development of breakthrough biomedical areas: lessons for Russia
An analysis was conducted of a model for accelerating the life cycle of research and development, as well as temporary parameters for transforming fundamental industrial perspective using an example of reprogramming technologies for obtaining induced pluripotent stem cells. It is shown that the key role in accelerating the industrial life cycle is played by the fast growing medium high technological companies and large industrial companies, interested in diversification of their business strategies. There has been recorded a significant deceleration in the development of the life cycle in this area in Russia, and its causes have been identified.
Practical aspects of implementation of the professional standard «Junior medical staff»
The appearance of professional standards is a new stage in the development of professional competencies. Often this process is accompanied by difficulties of applying professional standards in practice. This is true for the professional standard «Junior medical staff». The standard requires nurses training in the appropriate positions. Previously, this requirement did not exist. The training system is not yet developed. This is one of the key problems of implementation considered the professional standard. Differences of professional standard «Junior medical staff» of qualifications «Nurse» associated with the need to implement the provisions of the Federal law of 21.11.2011 No. 323-FZ «About bases of health protection of citizens in the Russian Federation», defining the term «health worker».
Questions answered by PhD. of Economic F.N. Kadyrov
Actual normative document
Focus of problem
Management in health care
Manager of health care consults
Questions and answers
Actual normative document