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Manager Zdravoochranenia 2020 #10
Published: 2020-10-04
1151
CONTENT OF THE ISSUE
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Traditional nominees of «Manager of Health Care» Publishing House for the best publications in 2020 year
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Possibilities of application of the toolkit for independent assessment of the quality of service providing conditions by medical organizations for analysis of effectiveness of system transformations at the ambulatory stage
Successful achievement of goals of the national projects «Healthcare» and «Demography» is impossible without the
active participation of subjects of the Russian Federation. At the same time, choice of optimal tools for assessing the transformations carried out on a regional scale is of particular importance. The aim of the study was to analyze the effectiveness of implementation of the Standard for the organization of outpatient care in the Tomsk region using tools for independent assessment of the quality of conditions for the provision of services by medical organizations. The results of the questionnaire survey of patients of medical organizations participating in the implementation of the project were analyzed before (2018, 896 patients from 18 medical organizations) and after (2019, 252 patients from 5 medical organizations) implementation of its main activities using the Questionnaire approved by the Ministry of Health of Russia. The informativeness of the questions of the questionnaire used to assess the effectiveness of a regional project depended on their nature. It is shown that the results of a questionnaire survey on issues affecting technical aspects of the process of receiving services (waiting times for an appointment with a doctor, research) should be interpreted comprehensively in combination with an assessment of technological indicators and data on the resource availability of the processes under study. Questions related to various aspects of patient satisfaction with the services received and the conditions for their provision showed positive dynamics in a number of parameters, indicating the effectiveness of the project implementation. The questions that concretize the object of satisfaction
or dissatisfaction, in comparison with the questions involving an integrated assessment of the institution, were of great
information content. The survey data obtained in the course of an independent assessment of the quality of the conditions for the provision of services in medical organizations can become an effective tool for an integrated assessment of the implementation of regional projects, allowing to determine the correctness of the selected directions of systemic transformations. -
Efficiency indicators of the round-the-clock hospital beds of the oncologic profile in the Russian Federation
The steady growth trend of oncological diseases in Russia in recent years requires a response from the health
care system: development of prevention aimed at early detection of diseases; improvement of methods of diagnostics and treatment of oncopathology; improving the quality and effectiveness of medical care.
A i m : to identify trends in changes of the neoplasms incidence and performance indicators of oncological beds for
round-the-clock stay of the state health care system in the Russian Federation, federal districts and regions of the Russian Federation in dynamics for 2010–2019.
M a t e r i a l s a n d m e t h o d s . Using the data of federal statistical observation (forms NoNo. 12, 30) by the method of
descriptive statistics, the main indicators of the neoplasms incidence in the population are analyzed, as well as the work
of round-the-clock oncological beds in the Russian Federation, federal districts and regions of the Russian Federation in
dynamics for 2010–2019.
R e s u l t s . On the background of an increase in the neoplasms incidence in the population (by 24.9%), including malignant (1.5 times), for the period 2010–2019 in the Russian Federation increased: the absolute number of oncology beds of round-the-clock stay from 30,970 to 36,186 (+ 16.8%), the provision with these beds from 2.17 to 2.47 per 10,000 population (+ 13.8%), hospitalization rate from 6.1 to 9.6 per 1000 population (+ 57.4%), and decreased: the average length of stay in an oncological bed (from 12.1 days to 8.4 – by 30.6%), as well as the average bed occupancy per year (from 345 to 330 days – by 4.3%). The extreme values of the indicators of the hospitalization rate for round-the-clock oncological beds in the regions of the Russian Federation in 2019 differ 12.8 times, the provision of these beds – 9.2 times, the average bed occupancy per year – 1.5 times, the average length of stay in a bed – 2.4 times. Mortality in oncological hospital beds increased from 0.76% in 2010 to 0.95% in 2019 (by 25%).
C o n c l u s i o n . The 24-hour oncological bed capacity, against the background of the growth of oncological morbidity,
has naturally increased, but at the same time it is characterized by an extreme disproportionality of development in the
Federal Districts and the regions of the Russian Federation. Optimization of the bed fund should be carried out based on
the objective needs of a particular region, taking into account its characteristics and with the simultaneous development
of alternative medical services. -
Analysis of practical experience in development and implementation of standard operating procedures in the activity of medical personnel
Innovative technologies use in the daily nurse practice makes their work more professional, comfortable, ensures safety and convenience of performing basic professional duties, reduces labor costs, and allows to quickly and efficiently ensure the implementation of new diagnostic and treatment process.
Aim: analysis of the experience in the development and implementation of SOPs for nurses for 2018–2019. in Central
City Clinical Hospital № 6, Yekaterinburg.
Methods. The work analyzed reporting documents (SOP implementation logs for each subdivision of Central City Clinical Hospital № 6, Yekaterinburg during 2018–2019 period), characterizing the number, type of developed SOPs, depending on their purpose, the timing of their implementation.
Results. During 2018–2019 period there have been all main nomenclatures SOPs developed and implemented into the
nursing practice. The main stages of the development of SOPs are analyzed, illustrative examples are given. Encountered by the staff of the medical institution SOPs development and implementation related difficulties are discussed. Main prospective activity directions in the field are determined.
Conclusion. On the basis of municipal Central City Clinical Hospital № 6, Yekaterinburg, SOPs development and implementation for various types of nursing activities have been successfully carried out. -
The evaluation of epidemiology and the availability of medical care for patients with retina diseases in the Russian Federation
Retinal diseases are significant causes of blindness and vision loss and they take the second place in the structure
of disabilities due to blindness in Russia. Objective: analysis of the official statistical data on the disease and availability
of health care to patients with age-related macular degeneration (AMD) and diabetic retinopathy (DR) that are prescribed intravitreal injection of drugs (IVD) as the first-line therapy for wet age-related macular degeneration and diabetic macular edema, respectively. Materials and methods: Epidemiological parameters were assessed by the data obtained from the form of statistical records № 12 for 2018–2019 years. The availability of IVD was analyzed by the information registered in the form of statistical records № 14 for 2016–2019 with a recalculation per 1000 population. Results: In 2019 in the Russian Federation 330 thousand patients with AMD were registered (0.45% among the population older than 40 years old). The incidence rate was significantly lower than in other countries (8.69%). The data on the number of patients with DR was unavailable for statistical recording because of the absence of the code Н36.0 IDC‑10 in form № 12. However, according to the federal register of diabetes mellitus, the total rate of DR can reach 760 thousand people all over Russia.
The availability of IVD for all-day inpatient health care was 0.39 injections per 1000 population. In 26 subjects of the
Russian Federation, the availability was higher than the average in Russia, while in the rest 59 subjects, the availability
was lower than the average. Presently, there are no data on the number of IVD performed in day-time inpatient facilities.
Conclusions: The current rate of application of IVD in Russia can be estimated as low considering the revealed problems
with the registration and accounting of patients with AMD and DR. It is impossible to perform a complete evaluation of the availability of IVD for the Russian population within obligatory medical health insurance because of the lack of data on the provision of IVD in day-time inpatient facilities. For the rational planning of the volumes of medical care provision to patients with AMD and DR, the form of statistical records should include the data on the indication of IVD in the day-time inpatient facilities in the subjects of the Russian Federation. -
Self-assessment of health and satisfaction with medical care by country people of age 60+ of the Kaliningrad region
With age the state of health worsens, it is necessary to see doctors more often. Availability and quality of the
provided medical care, a set of medical services can differ depending on the place of its rendering. The work purpose – to study a self-assessment of a zdorovyapatsiyentama of age 60+ of rural out-patient clinic of the Zelenograd district of the Kaliningrad region and their relation to the organization of the primary health care (PHC) and satisfaction with it. Survey among 211 patients of rural medical out-patient clinic aged from 60 up to 88 years, within the project of Partnership “Northern measurement” in the field of health care and social wellbeing is conducted (further in the text – the Project). The factors offered in the questionnaire having the greatest impact on health, according to patients, and satisfaction with the PHC organization are studied. The patients living in rural areas often visit the medical organizations with the medical and diagnostic and advisory purposes, pay attention to medical examination passing that can testify to an active position of the general practitioner working in the Project as in answers about the factors having the greatest impact on health, questions of prevention at poll got the last place. The satisfaction with the PHC organization made in general 3.6 points on a five-point system. -
The modern problem of infant mortality in the Russian Federation, an integrated approach to reduction on the example of the Republic of Ingushetia
Infant mortality is an important indicator of the social well-being of society and reflects the state of the national health system as a whole.
According to official statistics, the infant mortality rate in the Russian Federation has reached a significant decrease in recent years, but in comparison with the leading countries of the world it still remains high.
The study found that in the Russian Federation infant mortality has a territorial differentiation, which indicates different policies of the executive authorities of the regions in the direction related to the reduction of infant mortality.
The review article contains data on the dynamics of infant mortality in the Republic of Ingushetia and other republics of the North Caucasus Federal District. A significant decrease in the infant mortality rate in the Republic of Ingushetia is shown as a result of the effective interaction of state authorities at all levels. The need for an integrated approach in the system of management decisions for the development of the perinatal service in the regions of the Russian Federation has been proved. -
Telemedicine in the EAEU countries: reality and prospects
This article is devoted to a comprehensive analysis of telemedicine in the countries of the Eurasian Economic Union:
its legal regulation, methods of implementation and development prospects. The authors pay attention not only to a comparative legal analysis of telemedicine regulation in the EAEU countries, but also to determining the possibility of creating a general agreement on telemedicine between the Russian Federation, the Republic of Belarus, the Republic of Armenia, the Republic of Kazakhstan and the Kyrgyz Republic. Identifying gaps in the national regulation of telemedicine in these countries, the authors point out the aspects in which it is necessary to harmonize the regulatory framework for telemedicine consulting, and also provide for those provisions that must be necessarily disclosed in the agreement on telemedicine within the EAEU. -
Questions related to the procedure for allocating volumes of medical care to regional medical organizations
The arrival of a new wave of the spread of COVID‑19 coronavirus infection made it obvious that the fight
against coronavirus infection will last for quite a long time. For a number of reasons, incentive payments for employees
related to the treatment OF covid‑19 coronavirus infection did not fully suit either employees or the state. Therefore, the
state has made a serious transformation of the system of payments, which have turned from a salary element into a
“non-salary” element of social support. -
Questions related to the procedure for allocating volumes of medical care to regional medical organizations
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DIRECTORY OF ARTICLES, PUBLISHED IN THE MAGAZINE IN 2020 YEAR
