Manager Zdravoochranenia 2020 #4
CONTENT OF THE ISSUE
Jubilee of V. I. Starodubov
Risks that need to be taken into account in the implementation of a new model of a medical organization providing primary health care help
The article analyzes documents (guidelines, drafts of Federal legal acts) that present issues related to criteria and the introduction of a new model of a medical organization that provides primary health care. As a result, it was noted that the analyzed documents lack clear characteristics of the new model, the principles of its organization and functioning, and there is no clear description of the content and structure of the new model. The article draws attention to the fact that the financial and economic justification of the draft Law on the implementation of the new model does not contain any information about the financial and human resources required for the implementation of the new model. The authors emphasize that one of the main criteria for allowing medical organizations to implement the new model should be at least
Perception of a threat to personal security medical professionals in the context of the COVID-19 Pandemic
The article presents the results of an empirical study of the perception of personal safety threats by medical profes- sionals: doctors and nurses. Respondents were medical staff, conditionally divided into two groups: 1) medics in preparation for entering the high-risk zone; 2) medics working in high-risk areas. The resulting text data was processed by IBM Watson Studio (Version 1.1.0–177). Cluster analysis was carried out using the K-Means model. It is shown that the sources of health workers’ fears are determined by the area of actual workspace: preparation for entry to the high-risk zone or working in direct contact with patients infected with COVID-19.
The Structure of hospitalized morbidity of elderly and senile patients
Population aging in the Russian Federation requires is a new challenge for medical and social care, including inpa- tient care, for the elderly. The purpose of this study was to study the structure of morbidity requiring hospitalization of elderly and senile people in the Krasnoyarsk territory. We analyzed data of all 36206 patients aged 60 years and older who were hospitalized to the Krasnoyarsk regional hospital for war veterans in 2014–2019. Age, gender, duration of in-hospital care, main and concomitant diseases were the main studied variables. The proportion of men among the elderly increased while the proportion of women decreased over the study period. It was found that the causes of hospitalization varied considerably between age groups. Thus, among the hospitalized elderly, diseases of the circulatory system and diseases of the genitourinary system were most often identified as the main disease in patients. Diseases of the circulatory system were diagnosed as the main disease more often also in elderly patients and in patients belonging to centenarians. Our results reflect gradual increase in life expectancy of the population. An increase in the proportion of people with advanced age in the population structure warrants structural changes in institutions that specialize in providing medical and social assistance to these categories of the population.
Analysis of the causes of public dissatisfaction with the provision of high-tech medical care to patients with malignant neoplasms in the Moscow region
The article presents the main approaches to analyzing the causes of public dissatisfaction with high-tech medical care for patients with malignant neoplasms on the basis of citizens’ appeals and an independent assessment of the quality of services rendered by medical organizations on websites.
The results of the assessment sometimes show good and very good results of patient satisfaction with the work of medical organi- zations, and the number of substantiated complaints from citizens about dissatisfaction with the medical care for cancer patients in specific medical organizations remains high.
The main causes of public dissatisfaction with medical care are analyzed and specific recommendations on the organization of work with cancer patients and the prevention of patients’ dissatisfaction are given.
Statistics of obesity in children in the Russian Federation for 2014–2018 years
The article presents the statistics of obesity in children for 2014–2018. Over the analyzed period, the overall incidence of obesity in the Russian Federation among children aged 0–17 years increased by 21,4%. In the dynamics for 2014–2018, the primary incidence of obesity among children aged 0–17 years in the Russian Federation increased by 8,7%. The results of the analysis of statistics on obesity among children indicate the need to pay attention to the promotion of breastfeeding, the nutrition of pregnant women, a balanced diet of children and physical activity.
Training in clinical recommendations and assessment of the level of knowledge of doctors involved in providing primary health care, using remote educational technologies
The implementation of clinical recommendations is an urgent task, and it is important to maintain continuity between primary health care and specialized medical care. Distance learning courses were developed for 25 modules, and a testing system was created, which was implemented during the training of 1928 doctors from 128 medical organizations in three regions. The purpose of the work was to analyze and evaluate the effectiveness of the developed and implemented set of measures for training and testing doctors in three regions of Russia who participate in primary health care, on the implemen- tation of clinical recommendations.
Data analysis was performed using the IBM SPSS Statistics 16 software package. The samples were checked for the normality of the distribution using the Kolmogorov-Smirnov method. A nonparametric Wilcoxon test for dependent samples was used to assess the statistical significance of differences in cases where the distribution in the samples differs from the normal one. The level of statistical significance was defined as p ≤ 0.05.
The program of work consisted of five stages and included the development and implementation of distance courses in the format of multimedia lectures for doctors providing primary health care, studying a number of clinical recommendations, as well as conducting primary and repeated testing with automated evaluation of results for groups of clinical recommendations at the level of the region, medical organization and specific doctor.
The original software made it possible to evaluate the initial and received level of knowledge, to get differentiated results online, and on this basis to give reasonable targeted recommendations for further training of a particular employee, as well as for planning training events in the region as a whole.
The developed methodology of distance learning cycles allows to provide training of a significant number of doctors in a rel- atively short time with operational control of the quality of knowledge of doctors of various specialties, which is why the tested system can be easily scaled and adapted to solve any problems to improve professional competence of doctors.
Evaluation of the prospects for developing a vaccine against coronavirus infection by means of patent analysis
A cross-country comparison of the patent activity of various countries in the field of the development of antiviral drugs, in particular vaccines against coronavirus infection, was carried out. The companies with the most voluminous and authoritative portfolios of patent documents have been identified. Particular attention was paid to the practices used by pharmaceutical companies in the face of intense competition. The importance of protecting the rights to technical solutions with patents issued outside the Russian Federation has been shown.
The effect of coronavirus Сovid-19 on the situation in Russian healthcare
The relatively slow initial rate of spread of COVID-19 coronavirus in Russia has its own objective reasons related to the size of the territory, population density, tourist activity of the population, etc. They have played a positive role in making it possible to better prepare for the fight against it, taking into account, among other things, the experience of countries where the rate and scale of the spread of the coronavirus was much higher.
Despite the serious damage to the economy, there are no global financial threats to health care yet. However, it is important that resources arrive in time to medical organizations in the context of large-scale conversion of beds, etc. Unavoidable periods of downtime during periods of re-profiling, being in standby mode, etc., lead to the fact that many medical organizations risk finding themselves in a difficult financial situation, even with sufficient resources in the industry. Therefore, at this stage, it is sometimes more important than serious financial infusions, and mechanisms aimed at com- pensating for the loss of income.
Incentive payments to coronavirus medical workers
Focus of problem
Management in healthcare
Manager of healthcare consults
Questions and answers