Manager Zdravoochranenia 2020 #7
CONTENT OF THE ISSUE
Legal regulation of involuntary hospitalization of persons with coronavirus infection what needs to be done
The article presents an analysis of legal acts regulating the procedure for hospitalization and / or isolation in cases of
coronavirus infection. It is shown that currently, in accordance with the law, medical intervention is allowed without the consent of a citizen in respect of persons suffering from diseases that pose a danger to others. At the same time, the authors prove that the concepts of “medical intervention” and “hospitalization” are not identical. In turn, the legislation does not provide for involuntary hospitalization and involuntary isolation of persons suffering from diseases that pose a danger to others. The lack of clear legal regulation of these issues makes it difficult to implement effective measures to prevent the spread of coronavirus infection. The article proposes to define and legislate the procedure for involuntary hospitalization and involuntary isolation in cases of diseases that pose a danger to others.
Covid‑19 pandemic: the realized decisions and the forthcoming tasks in the sphere of public health care
The response measures taken in the Russian Federation allowed to avoid the “explosive” nature of epidemic of a
new coronavirus and also a critical overload of the health care system weakened by spontaneous “optimization”. The flash
of COVID‑19 reminds that modern society is extremely vulnerable before threats of infectious pandemics. Important not
only to support and strengthen infrastructure of the medical organizations, but also to provide the mobilization readiness
of a health care system reflecting ability of the industry effectively to react to emergency situations.
Modern approaches to the construction of an effective model of preventive work with children
The approaches to the analysis of the information of the medical information system about the child population
attached to the medical organization (22,950 children) are described to identify homogeneous groups in order to build a
preventive work plan with each. The team of experts of the medical organization has developed an electronic work plan for
4,745 options for monitoring a child, which is implemented as a computer program that allows you to automatically rearrange
the plan. It is considered as a sequence of standard operating procedures. The program automatically “restructures”
the calendar plan of work with the child, allowing you to complete the missed work in an acceptable time for the child
and the performer. The use of such planning is especially necessary for work in the conditions of prevention of COVID‑19.
On the question of the organization of outpatient psychiatric care in the city of Moscow
The article analyzes the organization and financing of psychiatric care in in-hospital conditions and hospital-replacing care for patients in the dispensary. The results of the study of the composition of patients on the basis of GBUZ “PB No. 13 DZM” for 2015–2017 years are given. The number of patients treated in a dispensary, a day hospital by nosological forms for the last period of time, the number of patients treated by gender were analyzed; considered age categories of patients, the structure of the professional status of patients. During the analyzed period, the main indicators of day hospital were investigated: the average duration of stay of patients, bed turnover, number of bed-days.
Productivity indicators of the daily stay bed fund in the Russian Federation
The process of reducing round-the-clock bed fund with simultaneous development of hospital-replacing technologies, namely
daily stay hospitals, has been going on in the Russian Federation, for more than twenty-five years, a similar trend has been observed in recent decades in most developed countries of the world. From 2010 to 2018 provision of the population with beds of daily stay hospitals in the Russian Federation moderately increased from 15.4 per 10,000 to 17.0 (an increase of 10.7%). Hospitalization rate of the population in daily stay hospitals in the country increased from 41.9 per 1,000 population in 2010 to 56.3 in 2018 (an increase of 34.5%). At the same time, the average bed occupancy per year in daily stay hospitals for the study period decreased from 311 days to 301 days (the decrease was 3.1%). The average length of stay in daily hospitals bed decreased from 11.4 to 10.1 days (the decrease was 11.7%). The positive dynamics of most of the studied indicators testifies to the development of the network of daily stay hospitals in the Russian Federation, the negative point is the reduction of average bed occupancy per year, what may indicate a decrease of the intensity of use of the bed fund of daily stay hospitals in the country.
Pharmacoepidemiological analysis of the safety of therapy for chronic diseases of the mental group as a tool for improving the efficiency of the public proc urement system
The material presents regional problems of drug’s treatment complication and results of pharmacoepidemiological analysis of the safety of therapy for chronic diseases of the mental group in the Pskov region. Basing on real author’s practice in pharmacovigilance centre in Pskov, it also includes analyses of main factors and key elements of pharmacovigilance activity. Proposals have been developed to optimize interchangeability in the field of public procurement, prescribing and dispensing of medicines of this group.
On the issue of legal protection of adolescent girls ‘ reproduc tive health
The article presents an overview of modern approaches to legal protection of reproductive health of adolescent girls
in the Russian Federation. The system aspects of health protection of girls and adolescent girls, as well as prevention of violations
of reproductive health formation, are taken into account. The research was based on Federal laws, regulatory and legislative acts
of individual subjects of the Russian Federation, and relevant scientific publications. The legal priority in ensuring the reproductive
health of girls and adolescent girls is determined by the availability and quality of specific medical care, as well as relevant sections of the main legal documents.
Medical rehabilitation: the state of the domestic flow
The purpose of the work is to assess the state of flow of Russian scientific publications on medical rehabilitation
in high-rating international databases. The growth of publications of Russian researchers in the database “Web of Science”
by 68%, in the database “Scopus” – 86%, while the growth of the world publication flow was 43% and 40% respectively.
A model of the forecast of the dates of Russia reaching the 5th place in databases is presented. The reasons and problems
of the low level of Russian publication scientific flow have been identified and the necessary measures to eliminate them
have been identified.
Issues of regulation of handling of medical products in the mar kets
The work outlines some of the provisions of the Project of the Commission of the Eurasian Economic Union: “On Amending the Rules for Registration and Examination of the Safety, Quality and Efficiency of Medical Devices”, provides an analysis of the prospects of the Project, its impact on the efficiency of circulation of medical devices in the territories of the countries of the Eurasian Economic Union. Based on the results of the analysis, conclusions are drawn on the applicability and significance of the considered provisions of the Project. The aim of the work is to analyze the main provisions of the Project of the Commission of the Eurasian Economic Union: “On Amending the Rules for Registration and Examination of the Safety, Quality and Efficiency of Medical Devices” and the possibilities of their practical application. The following methods were used in the work, namely, general scientific: analysis and synthesis, systemic, profile-economic: marketing, controlling methods. The scientific novelty of the work lies in the generalization, analysis of the materials considered and in the formation of proposals for certain areas of the Project and conclusions on the development of integration in the medical industry of the countries of the Eurasian Economic Union, according to the results of the analysis.
Possibility of transboundary transfer of health-personal
In the article, the authors analyze the possibility of cross-border transfer of personal data related to health, separately considering
the possibility of such a transfer within the EAEU. The authors pay special attention to the analysis of the correlation of the concepts of medical confidentiality and personal data related to the state of health, the peculiarities of regulating the cross-border transfer of this information according to Russian legislation, as well as the consideration of the Unified State Information System in the field of health care created in the Russian Federation (hereinafter – the Unified State Health Insurance System, a unified system). The authors also consider the possibility of using a single system for cross-border data transfer, indicate the main risks of such use, and also determine the set of necessary additions for Russian legislation in order to use the EGISP in cross-border data transfer. Separately, the authors analyze the possibility of transferring personal data related to the state of health in the framework of the Eurasian Economic Union, which is often discussed within the EAEU digital agenda. The authors analyzed the permissibility of such transfer under the EAEU as a whole, the proposals put forward in its support, namely the adoption of a separate agreement about the delivery of health care by participating countries of the EAEU any citizens of member States of the Union, the adoption of the act on transfer of personal data about the health of the citizens of the EAEU member States and the creation of a single digital platform for the provision of such transfer (including, subject to the establishment
of safety requirements the transfer of such data and penalties for violation of these requirements), as well as the identification of
specially authorized state bodies in each of the EAEU countries in order to ensure responsibility for the transfer of this category of data.
Preparedness of medical personnel to work
The analysis of administrative and medical personnel equipment of medical organizations in the Arkhangelsk region with computer equipment was presented. The level of computer competence and readiness of medical personnel to work with medical information systems on the basis of the state budget health organisation of Arkhangelsk region “Arkhangelsk city clinical hospital № 7” was studied. Management decisions taken to improve the quality and availability of medical services were shown.
Management in health care