
Manager Zdravoochranenia 2017 #9
Published: 2017-09-08
1576
CONTENT OF THE ISSUE
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Postoperative mortality in the Federal cardioke-rulechecker clinics. the Hamburg account
The article is devoted to the comparative analysis of indicators of postoperative mortality in the most frequently performed cardiac surgical procedures. Revealed extraordinary heterogeneity of hospitals for postoperative mortality when the same types of surgical interventions. This may indicate the existence of serious problems of quality of care in the individual Federal clinics. Ranking distribution of clinics by indicators of postoperative mortality are shown. The proposed methodological approach to assess the results of surgical interventions in patient groups, comparable in age, sex, diagnoses, and applied technologies
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Credit for accreditation of the specialist: some results of the «credit fever» in the russian health system
The authors indicate that the main reason is over the past two years, the health system of Russia «credit fever» (the desire of doctors to earn credits and points for the upcoming accreditation) is the commercial interest of those who sell doctors credits for participation in conferences and seminars. The article noted that the process of providing doctors with credits was the most ambitious business project in the Russian healthcare system over the past 25 years. Getting doctors of points, credits, hours, credit units for participation in workshops and conferences on a commercial basis is unacceptable as this scheme does not increase the professional level of doctors, constrains and limits of their professional interests, undermines the state system of additional professional education of doctors, limits the availability of doctors to free conferences and seminars
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Problems of rendering paid medical services from the position of heads of medical institutions
In accordance with the legislation in the field of health care, every citizen of the Russian Federation has the right to receive medical care, which is implemented by providing a guaranteed volume of free medical care and the possibility of obtaining paid medical services. Despite the legally established procedure and conditions for the provi- sion of paid medical services, medical institutions of state and non-state forms of ownership have a large number of problems when providing paid medical services. The object of this study was an expert evaluation of the organization of paid medical services at the level of the administrative center of the subject of the Russian Federation. The experts were the manager of medical institutions that have a certificate on the specialty «Public Health and Health Care». To eliminate the random nature of the comments, a study was conducted to determine the homogeneity of the sample using the nonparametric Cochran criterion. The results confirmed the existence of problems in the organization of paid medical services and allowed to identify the most significant problem areas
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Versions of restructuring the standards of medical care in order to optimize the costs of continued high-tech treatment
An approach to restructuring of medical care standards is proposed. The example of the restructuring of standards for the provision of outpatient care to solid organs transplant recipients is considered. The structure of the standards is described in terms of mathematical model based on oriented graphs. The need of introduction of the changes in the system of Russian Federation medical standards is pointed out
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Audit of the local programme of state guarantees implementation in the subject of the federation on the example of the Zabaykalsky krai
In order to evaluate healthcare accessibility under the Local Programme of State Guarantees in Zabaykalsky Krai in 2016, the analysis of the scope of provided medical services, their types and conditions of delivery was carried out. The comparison of actual data on the types of health services provided by healthcare institutions according to the standard indicators, recommended by the Federal authorities, revealed the structural and organizational disparities in the local health care system
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Clinical and economic efficiency of carotid endarterectomy and stenting of carotid arteries in specialized surgical clinic
The article presents and justifies list of economic expenses for performance of this surgical methods. Also the article presents and justifies list of economic expenses for patient’s rehabilitation after surgical treatment to revascularization of brain. The article presents comparative analysis of this surgical methods with examination of clinical and economic efficiency. The article presents advantages of both methods of surgical treatment
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Experience of the participation of the Clinical Diagnostic Laboratory in external systems for assessing the quality of laboratory research: Federal Center of Traumatology, Orthopedics and endoprosthesis replacement
The article presents the experience of participation of the Clinical Diagnostic Laboratory of the Federal State Budgetary Institution Federal Center of Traumatology, Orthopedics and endoprosthesis replacement of Ministry of Health of the Russian Federation (Cheboksary) in Russian and foreign external systems for assessing the quality of laboratory research
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About standards of medical care again: who needs them?
Recently, the standards of care are constantly subjected to criticism from clinicians, but are protected by the professionals working in the enforcement agencies, insurance medical institutions, funds of CMI. The article pro- vides additional arguments about the voluntary application of standards. These arguments will help leaders of health organizations and practitioners to understand the complex conflict
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The discussion about mandatory compliance with medical organizations standards of medical care
The authors in the order of discussion into details justify and prove that currently approved and put into effect in the prescribed manner the standards of medical care mandatory for medical organizations and doctors
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Questions answered by PhD of Economic F.N. Kadyrov
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Practical aspects of regulation of labor in the state (municipal) institutions health
Labor regulation is a major work in the initial stages and requires systematic monitoring of compliance, assessment of their validity, need to review them in the future. With sufficient elaboration of the regulatory framework, methodological issues of labor regulation at the level of medical organizations covered clearly enough. «Guidelines for the development of systems of rationing of work in the state (municipal) institutions», approved by the Ministry of labour and social protection of the Russian Federation dated 30 September 2013 N504, do not give detailed algorithms for the valuation. The orders of Ministry of health of Russia approving the model time norms relate only to certain aspects of the practical application of labour standards. So there is a need to assess the capabilities and limitations of different techniques of work measurement-level medical associations to offer «step-by-step algorithms» implementation of labor standards, to develop practical recommendations. The tasks and focus of this publication