Manager Zdravoochranenia 2019 #5

Published: 2019-05-28



    Management in healthcare
  • The main trends in the incidence of young men (15–17 years) in the context of the growth of chronic pathology

    An increase in the incidence of the population, including children and adolescents occurs in recent decades in the Russian Federation. The growth rates of the total and the first time registered incidence of young men aged 15–17 years are analyzed for the period 2000–2017, according to the data of the Federal Statistical Observation. An increase in the overall incidence of young men by 35.8% was detected, for the first time registered incidence – by 35.4%. The maximum increase in overall morbidity is observed in the following classes: neoplasms (up to 2,6 times), diseases of the blood and blood-forming organs (2 times), congenital anomalies (malformations) (1,8 times), diseases of the circulatory system (1,7 times), diseases of the musculoskeletal system and connective tissue (1,6 times), diseases of the endocrine system, metabolic disorders (1,5 times). The indicator of “chronicity” of diseases was calculated, based on the data of the total and for the first time registered incidence. With a general growth rate of this indicator – 0.3%, there is a significant increase for some of classes of diseases: mental disorders and behavioral disorders (110.6%), congenital anomalies (mal- formations) (90.6%), diseases of the endocrine system, metabolic disorders (46.9%).

    Authors: E.  M.  Manoshkina [1] E.  N.  Matveev [1] M.  N.  Banteva [1]

    Tags: chronical  diseases  of  young  men1 morbidity  of  young  men1 morbidity  of  teenagers1 the  morbidity  of  young  men  within  classes  of  diseases.1

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  • The number of the examined doctors of functional diagnostics in calculation per one resident of the Russian Federation

    Relevance. Functional research methods are one of the most demanded and important directions in the diagnosis of health care. The purpose of the study was to analyze the number of surveys among the population conducted by doctors of functional diagnostics. Material and methods. Extensive and intensive indicators of the activity of doctors of functional diagnostics in the Russian Federation were calculated according to the forms of federal statistical observation for the period from 2012 to 2017. Results: analysis of the total number of persons examined in the units that provide medical care on an outpatient basis, by a functional diagnostics doctor per resident of the Russian Federation, for the period from 2012 to 2017 showed their growth. Conclusion: the number of functional diagnostics examined by physicians per inhabitant of the Russian Federation increased by 14.2% during the period under review. The highest coverage of functional diagnostics is noted in the Volga and Ural federal districts.

    Authors: D.  A.  Tolmachev [2]

    Tags: doctors7 examinations2 functional diagnostics2 height2 per resident2

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  • Organizational, clinical and epidemiological approaches in antiretroviral therapy and tuberculosis chemoprophylaxis and tuberculosis incidance among people living with HIV

    Antiretroviral therapy continues to play a major role in reducing the spread of tuberculosis among HIV-positive population, especially with chemoprophylaxis of tuberculosis while intensifying systematic screening and fulfilling the requirements of tuberculosis infectious control in places where are staying people living with HIV. In order to assess the availability of antiretroviral therapy and prophylactic treatment of tuberculosis among people living with HIV, and to determine the tendency of the HIV/tuberculosis incidence North-West of Russia, a clinical and epidemiological analysis was conducted from 2007–2017. The analysis was based on data from Rosstat № 61 reporting form on HIV infection and on information from a form which was additionally developed by the author for the territories of the North-West of Russia. Additional information, along with data on the economic and human resources of the system to tackle HIV/tuberculosis issues in the regions, on systematic screening of tuberculosis, includes data on antiretroviral therapy and chemoprophylaxis of tuberculosis among patients with HIV-infection. Results. During the review period, the coverage of HIV-positive antiretroviral therapy increased in Russia more than 10 times, in North-West of Russia) more than 8 times, the availability of tuberculosis chemoprophylaxis increased in Russia in 7.7 times, among people in the proficient stages of HIV-infections – in 2.8 times, in the North-West of Russia – in 16.9 and 4.2 times, respectively. On this background, in the North-West of Russia in recent years there has been a decrease in the incidence of HIV/tuberculosis coinfection from 10.1 per 100 thousand population to 6.6 and 7.3, respectively in 2016 and 2017. Conclusion. In the whole Russia and in the North-West of Russia in recent years, due to the updating or development of new regulatory acts that change organizational, clinical and epidemiological approaches to the treatment of HIV infection and prevention of tuberculosis, the availability of antiretroviral therapy and chemoprophylaxis of tuberculosis has significantly increased among the HIV-positive population. With this background, in the North-West of Russia in recent years there has been a tendency towards a decrease in the HIV/tuberculosis incidence.

    Authors: Z.  M.  Zagdyn [1]

    Tags: art1 hiv/tb  coinfection1 tuberculosis  chemoprophylaxis.1

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  • Modern aspects of marking of medicinal products: organization model introduction marking «DataМatrix» drug

    The introduction of an automated system for monitoring the movement of drugs from the manufacturer to the end user is one of the priorities of the “Health”, which in the future will provide full protection of the population from counterfeit drugs and prompt removal from circulation of counterfeit and substandard drugs. Many participants in the commodity distribution chain are not fully aware of the peculiarities of registration in the system of monitoring the movement of medicines, the purchase of equipment for their labeling and subsequent inclusion in the life cycle of the goods. The aim of the study is to develop an organizational model for the introduction of “DataMatrix” labeling on the drug, which is a modern element of the system for monitoring the movement of the drug from the manufacturer to the end user and contributes to the proper step-by-step inclusion of “DataMatrix” marking at each stage of the commodity chain.
    In the course of the research the methods of analysis and synthesis, the method of observation were used, the monitoring of legal documentation in the current edition was carried out, the algorithm was compiled using logical modeling.
    As a result of the work, an organizational model for the implementation of a system for monitoring the movement of medicines was created, which provides preventive measures for the entry into circulation and simultaneous withdrawal from circulation in an automated mode of counterfeit, substandard and counterfeit medicines at any stage of their circulation; control of the targeting of the movement of drugs purchased from the budget, the cost of their acquisition; monitoring of pricing and maximum retail prices for medicines from the list of vital and essential medicines.

    Authors: Melnikova V. V. [1]

    Tags: automated  system1 datamatrix.1 drug2 health care24 labeling1

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  • Financial management
  • Providing income activities as a conscious necessary for functioning of the state (municipal) medical providers

    Realization of the rights of citizens to health care and medical care free of charge, enshrined in the Constitution of the Russian Federation, carried out by state and municipal health care institutions «… at the expense of the relevant budget, insurance premiums and other income». Analysis of the dynamics of the volume of financial sources for 2014–2017 showed a significant increase in revenues of medical organizations, which are state budgetary institutions, funds from income-gener- ating activities.
    The article describes the main financial sources that a medical organization – a state (municipal) institution may have for providing medical care, as well as for implementing the Program of state guarantees of free medical care to citizens. The rationale for the insufficiency of public funds to ensure the necessary level of wages for medical workers is given on the example of comparing tariffs of the compulsory health insurance system and prices (tariffs) of private medical organizations in the city of Moscow.
    The regulatory and legislative conditions for obtaining funds from various financial sources by a public institution are con- sidered, the relevance of developing measures to attract additional financial sources, which include revenues from providing paid medical services to the population, including through voluntary medical insurance, is justified.

    Authors: A. Sh. Senenko [5] O.  V.  Obukhova [3] D.  I.  Nitsenko [1] V. Ch.  Tsydypov [1] A.  M.  Chililov [2]

    Tags: compulsory medical insurance14 financial  sources1 incomegenerating  activities1 paid medical services19 state  provider1 the  program  of  state  guarantees  of  free  medical  care  to  citizens1 voluntary medical insurance2

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  • Social aspects of health
  • Satisfaction of the population with the organization of clinical examination of certain groups of the adult population on the example of a constituent entity of the Russian Federation

    One of the criteria for the quality and availability of clinical examinations is the satisfaction of the population with the obtained preventive care. The subject of the study was the level of satisfaction of citizens who underwent medical examination, accessibility and quality of its organization. The following methods are used in the work: content analysis of scientific literature and regulatory documents; statistical method; analytical method. The reliability of the results obtained was evaluated by the method of calculating confidence limits. Applied correlation analysis. A sociological survey of 568 respondents who have undergone clinical examination of the adult population. Identified a number of subjective and objective problems in the organization of clinical examination. The degree of satisfaction of the population with the availability and quality of the organization of clinical examination of the adult population is determined. A correlation was found between the satisfaction of citizens with clinical examination and its availability. Proposed measures aimed at improving the organization of medical examination.

    Authors: Khodakova O. V. [4] N.  V.  Koshevaya [1]

    Tags: citizens’  satisfaction1 clinical  examination  of  the  adult  population1 correlation  interrelation.1 prevention17

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  • Law
  • Current organization of drug maintenance for certain patient groups. Role of drug lists

    Nowadays there is established legal basis for drug maintenance of certain patient groups. Based on it there are several individual categories, diseases and drug lists. Despite the division on federal and regional levels, some rules and regulations are duplicated that lead to organizational problems and also influence the negative budget issues. In order to determine directions for improvement, one should analyze current legal basis in Russian healthcare.

    Authors: I.  A.  Komarov [1] O. Yu.  Aleksandrova [1] O.  A.  Nagibin [1]

    Tags: clinical-economy  analysis2 drugs1 drug  maintenance1 edl2 essential  drug  list2 federal  law2 government  order  8902 healthcare  system2 high  cost  nosologies2 legal  acts2 life-threatening  committee2 onlp2 orphan  diseases2 pharmacoeconomics1 regional  procurement2 russian  regions2 special  patient  groups2 state  guarantee  program2

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  • International experience
  • Stages of formation and development of a single payer in health system of the Kyrgyz Republic

    The article revels the formation and development of a single payer in health system of the Kyrgyz Republic. On the basis of analysis of legislation it has been highlighted four phases of this long term process: 1-st (1996–2000) – organizational, 2-nd (2001–2006) – becoming of a single payer in health system, 3 (2007–2015) – creation of a single payer in health system and 4-th (since 2016) – further development and improvement of a single payer in health system. It has been achieved fair and equal allocation of financial resources in health sector (single per capita financing of primary care and single cost of case based financing of hospitals) at national level.

    Authors: M.  T.  Kaliev [1]

    Tags: health  system2 single  payer.1 the  kyrgyz  republic1

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  • Special opinion
  • Formation of the system of protection of patients‘ rights – an applied task of insurance medical organizations in the framework of the National project «Health»

    Authors: A.  A.  Starchenko [2]

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  • Manager of healthcare consults
  • The procedure for co-financing of salary for newly hired employees in primary care

    In his Decree No. 204 of May 7, 2018 “On the national goals and strategic objectives of the development of the Russian Federation for the period up to 2024”, the President set the task to ensure the achievement of a number of goals and targets in the health sector. These include the elimination of personnel shortages in medical organizations that provide primary health care.
    To help solve this problem, a mechanism has been developed to co-Finance the salary costs of state (municipal) institutions, which provide an increase in the staffing of employees.
    Corresponding changes were made to Federal Law of November 29, 2010 № 326-ФЗ “On Compulsory Medical Insurance in the Russian Federation” (Part 6.6. Of Article 26).
    This article is devoted to the order of formation, the conditions of provision to medical organizations of the state health system and the municipal health care system, providing primary health care in accordance with the territorial programs of compulsory health insurance, the funds of the normalized insurance stock of the territorial Fund of compulsory medical insurance provided for co-financing of expenses of the medical organizations for compensation of doctors and average medical personnel.

    Authors: F.  N.  Kadyrov [9]

    Tags: co-financing1 compulsory medical insurance14 health  personnel2 normalized  insurance  reserve1 state  (municipal)  health  care  institutions.1 territorial  funds  of  compulsory  medical  insurance1

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  • Questions and answers
  • Issues of the documentation of paid medical services

    Authors: F.  N.  Kadyrov [9]

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