Manager Zdravoochranenia 2018 #8

Published: 2018-08-01



    Focus of problem
  • Duties of the doctors and the quality control and safety of medical activity: what to consider in a medical organization

    The article deals with the issues of registration and content of duties of a doctor in connection with the implementation of the state control of quality and safety of medical activities on checklists (lists of control issues). The authors pay attention to the direct requirement of the legislation in the field of health care, concerning the obligatory presence of job descriptions of doctors, as well as justify in detail where and how the medical organization should be prescribed job duties and duties of a doctor. The article shows that in the duties of a doctor it is necessary to document the provisions on compliance with the requirements for ensuring the quality and safety of medical activity.

    Authors: Piven D. V. [59] Kitsul I. S. [59] Ivanov I. V. [30]

    Tags: doctor’s duties1 doctor’s job duties1 employment contract5 job descriptions3 quality and safety of medical activity11

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  • Population and healthcare
  • Base trend on number of Russian children (aged 0–14) require for medical supervision in 2000–2015 years

    Growth of Russian children’s incidence is confirmed with many special researches. As has shown the anal¬ysis of Federal statistical observation (form No. 12) for 2000–2015 years, in Russia the number of children at the age of 0–14 years require for medical supervision has grown from 302,6 to 309,0 cases for 1000 per population of the corresponding age (2,1%). The highest increase took place on classes: new growths (105,3%), congenital anomalies (malformations) (63,0%), injuries, poisonings, etc. (56,3%). Decrease in number of the children (0–14 years) require for medical supervision is noted on the following classes: pregnancy, childbirth and postnatal period (–70,0%), separate conditions of the perinatal period (–60,6%), some infectious and parasitic diseases (–59,5%), mental disorders and disorders of behavior (–43,1%). The balance of number of the studied group of children for 2015 year is 6,1% at the expense of bigger number registered (55,3%), in comparison with number of struck off the register (49,2%). At the same time the maximum plus balance was observed on the following classes of diseases: separate conditions of the perinatal period (46,5%), injuries, poisonings, etc. (80,0%), diseases of respiratory organs (21,3). The minus balance of number is noted on classes: some infectious and parasitic diseases (–11,6%), mental disorders and disorders of behavior (–2,4%). The number of children require for medical supervision in Russia for the studied period has grown. As soon as, the health of children and teenagers defines health of future nation, its preservation is an important task, which real¬ization demands development of measures for treatment of diseases of this contingent, and, above all – holding preventive actions with definition of their address introduction (school, the house, healthcare institutions).

    Authors: Banteva M. N. [9] Matveev E. N. [3] Manoshkina E. M. [7]

    Tags: children13 dispensary observation3 incidence of children2 medical examination of children1 medical supervision1 routine medical inspections1

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  • Analysis of death rates related to hemoblastosis in the population of St. Petersburg for the period of 1990–2016 and the forecast up to 2026

    The authors have analyzed the level and dynamics of mortality in the population of St. Petersburg from malignant neoplasms of lymphoid, hematopoietic and related tissues in the period from 1990 to 2016 and made a forecast for the period of up to 2026. It was established that in 2016 St. Petersburg ranked 3rd in terms of the level of mortality from hemoblastoses among the constituent entities of the Russian Federation. The mortality of men exceeded the mortality of women. The period under study was found to have a death rate decrease by 46.3%, which is due to the introduction of highly effective therapeutic and diagnostic technologies into clinical practice. According to the forecast, the probable reduction in the death rate by 2026 compared to 2016 is 21.1%. As the cost of therapeutic and diagnostic technologies is growing, the work on the enhancement of the results of treatment of hemoblastoses and further reduction of mortality rates from these diseases needs to be done in a comprehensive manner, at the state level

    Authors: L. Yu. Zhiguleva [2]

    Tags: forecast3 hematopoietic and related tissue1 hemoblastosis1 mortality of the population from malignant neoplasms of lymphoid1

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  • Transfusion of blood: there are fewer recipients than it seems

    It is known that in 2016 a total of 1,196,633 patients of Russian clinics received blood transfusion. The correctness of these data is questionable, since Table 3200 of Report Form 30 does not imply a summation of transfusion of different blood components. In 2 hospitals, the number of blood recipients receiving different transfu¬sion products was determined. It is established that about 25% of patients receive complex transfusion therapy with various kinds of blood components. Summation of data on the number of recipients of different transfusion products (Table 3200 of Form 30) leads to a distorted result, 30% higher than the actual number of patients who received a blood transfusion.

    Authors: Zhiburt E. B. [15] Gubanova M. N. [2] Bragina N. I. [1] Shestakov E. A. [6]

    Tags: blood8 plasma3 platelet1 recipient4 red blood cell1 registration2 transfusion3 unit4

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  • Special opinion
  • Use of NPS method for patient loyalty assessment (ICDC experience)

    This article studies the experience of the ‘Interregional clinical and diagnostic center’ (ICDC) in the area of patient loyalty assessment by the Net Promoter Score (NPS) method. The object: to find out the factors, which have an effect on patient loyalty towards a medical establishment. Materials and methods: analysis of scientific literature, ICDC statistic data of patient loyalty assessment by NPS method for 2016–2017 years. Total number of respondents: 1968 patients of ICDC. Results and conclusions: on the basis of analysis of patient responses the three factors that effect on patient loyalty were found out: “diagnostic and treatment processes”, “ethics and deontology of medical staff”, “service in medical establishment”. It is found that the largest proportion of critical remarks of patients is as¬sociated with the service in medical establishment. In turn the important aspects for “promoters” – patients with high loyalty, are the followings: quality of medical service, ethics and deontology of medical staff. Statistically significant differences were determined in medical establishment evaluation by patient groups who pays for medical service itself and who is treated by compulsory health insurance system. Representatives of these groups pay attention in their comments to different aspects of medical establishment activity. Therefore it is necessary to consider specific features of such patient groups in the arrangements considering the increase of patient loyalty

    Authors: Kupriyanov R. V. [6] Zharkova E. V. [3] Khairullin R. N. [6]

    Tags: medical and preventive treatment facilities2 nps1 patient loyalty3 promoters1

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  • Management in healthcare
  • Sanitary aviation in road accidents and its economic feasibility

    Relevance: The organization of emergency medical advice, especially in road accidents is an important as¬pect in preserving the health and life of the victims. Purpose of the study: analysis of the frequency of road accidents and fatalities in the Vologda region for the period from 2006 to 2017. Material and methods: the data of medical documentation on the registration of road accidents and the provision of medical care in their presence. Results and discussion: a list of emergency medical care for road traffic incidents is defined by a number of Government Decrees and orders of the Ministry of Health at various levels. The number of dead children at the scene of the accident increased by 1 case, died at the prehospital stage and in the first seven days after admission was reduced to zero, in the period after hospitalization from 0 to 30 days decreased by 3 cases. Conclusions: during the analyzed peri¬od, the number of deaths in road accidents decreased by 34.0%, the number of deaths in the hospital for the first 7 days after hospitalization by 45.2%, from 0 to 30 days – by 46.3%. Mortality at the prehospital stage is 40.0%.

    Authors: Vankov D. V. [3]

    Tags: activities2 economic expediency1 sanitary aviation1 traffic accidents1

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  • Foreign experience
  • Modern approaches to organization of care to persons of elderly and senile age: a review of international experience

    The research is devoted to the study of international experience in organizing care for people of older age groups. The analysis of literature data has shown that the organization of care for patients of elderly and senile age varies considerably in different countries, reflecting their specific economic, social, cultural conditions. At the same time, the use of structured questionnaires for assessing the health status and social well-being of older people becomes a common approach, making it possible to organize targeted assistance to such patients in the most rational way.

    Authors: Korotkova A. V. [3] A. Sh. Senenko [5] Vorobyev R. V. [2] Nitsenko D. I. [2]

    Tags: aging1 elderly and senile age1 health assessment1 interagency cooperation2 patients aged 60 years and over1 primary health care21 social welfare1 сomprehensive geriatric assessment1

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  • Medical science
  • Causes and models of transformation of strategies for technological development of transnational pharmaceutical companies

    During the last ten years, the largest pharmaceutical manufacturers significantly changed their approaches to the formation of their own strategies for capturing and retaining the leading positions in global markets. One of the key prerequisites was a decline in the return on investment in R & D: if in 2010 among the top 12 pharmaceutical companies of the world this indicator was 10.1%, then in 2017 it fell to 3.2%. At the same time, the cost of devel¬oping and launching new medicines has increased: from $1.2 billion to $2 billion in 2010–2017. The article analyzes the main reasons for the transformation of the strategies of the Big Pharma companies. It has been suggested that, in the context of a decline in payback in R & D, increased competition, a fall in public expen¬diture on the purchase of pharmaceuticals, and tightening of regulatory requirements, it is advisable for domestic companies to reorient the creation of corporate venture funds and investing in start-ups, and actively use the mergers and acquisitions strategy

    Authors: Tsvetkova L. А. [10] Yeremchenko О. А. [1]

    Tags: big pharma1 health sector1 investment strategies1 pharmaceutical companies2 r&d2 return on investment1 start-ups1

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  • The application of leasing in state (municipal) health care institutions

    Difficult economic conditions lead to the fact that the expenditures of budgets of all levels for the purchase of equipment are highly reduced. State (municipal) institutions are forced to look for other sources and channels for financing equipment purchases. In this respect, leasing at the expense of compulsory medical insurance is an interesting, but incomprehensible tool. Especially, given the variety of its forms. Moreover, the use of leasing in the system of compulsory medical insurance encounters a number of serious limitations. Meanwhile, the competent conclusion of leasing contracts, in fact, in a number of cases makes it possible to solve problems of obtaining equipment worth more than 100,000 rubles at the expense of compulsory medical insurance.

    Authors: Kadyrov F. N. [123]

    Tags: compulsory medical insurance18 contract3 financial lease1 leasing2 purchase of equipment1 state procurements1

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  • Questions and answers
  • Questions answered by PhD of Economic F.N. Kadyrov

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