2017 № 6 Regulatory framework for providing high-technology ophthalmological medical care under outpatient treatment
The article analyzes the existing legal basis for providing high-technology ophthalmological medical care through a systematic review of regulatory enactments that directly regulate this type of activity (14 regulatory enactments, including 2 federal laws).
High-technology medical care is a separately licensed type of medical activity carried out by approved federal or regional medical organizations, financed by subsidy or directly from federal budget, provided for approved types of medical care in a hospital. The source of funding for healthcare determines essential conditions. The existing legal framework creates significant restrictions for providing high-technology ophthalmological medical care under outpatient treatment in the case of healthcare covered by Compulsory Health Insurance or an appropriate budget. The article outlines the ways of solving this problem proposed by the authors, including for a medical institution, without violating the current legislation. Healthcare covered by other sources of funding can be provided in any conditions, including outpatient
2016 № 10 State and tendencies of the organization of medical care by the patient with rheumatic diseases in the orenburg region
In the Orenburg region there are multidirectional and nonuniform tendencies of incidence of rheumatic diseases, the possibly bound to decrease in availability of the specialized rheumatological help to patients. Medical care by the patient with rheumatic diseases in the Orenburg region does not meet the modern expectations of necessary level to its organization and an operating order of rendering. Level of primary specialized rheumatological help is not provided with necessary quantity of positions, and territorial distribution of available, causes its transport inaccessibility. The specialized stationary help, including hi-tech turns out in one office at regional hospital what is also represented poor. The calculated quantity of necessary established posts of rheumatologists makes from 17 to 32 rates, depending on the applied calculation procedures. The number of necessary beds for rendering the specialized rheumatological help varies from 94 to 250. The organizational model of the rheumatological help to adult population of area developed on the basis of analytical and normative methods includes creation of interdistrict offices of rheumatologists for rendering primary specialized rheumatological help, two interdistrict rheumatological offices for rendering the specialized help taking into account preservation of the office in a regional hospital providing specialized and high-tech medical care to patients. This model is the first stage in development of the concept of development of the rheumatological help in area.
2021 № 1 Emotional burnout of a district doctor
Based on the results of assessments of the dependences of the level of psychoemotional load of a primary care
physician (PHC) (district physician) on medical and social problems related to the conditions of his activity, measures have been developed for stress resistance and health saving of a district physician (VTU). The Orenburg region with a population of almost 2 million people was the pilot territory (base) for the study. The region has 12 cities and 35 rural districts, the share of the rural population is 40.1%.
Research materials und methods: sociological, direct observation, statistical: 1014 questionnaires of survey of district
physicians (93% of the total number of VTU) were subjected to statistical processing. The study included 4 stages. At the first stage, sociological surveys of district physicians working in medical organizations located in urban and rural settlements were carried out (568 and 446 VTU, respectively). At the second stage of the study, the level of psychoemotional burnout was assessed using the modified method of V. V. Boyko (2010) “Diagnostics of the level of emotional burnout”. At the third stage of the study, we calculated the statistically significant correlation of the symptom of professional burnout (SPEV) with factors related to medical and social problems of the professional activity of the local GP. At the fourth stage of the study, a set of measures has been developed and is being implemented to increase emotional stability in the professional activity of the local GP.
Relevance. WHO classifies occupational stress as a disease of the twentieth century, which can manifest itself in any
profession and can reach the size of a “global epidemic”. The accumulation of negative emotions in the profession of a
doctor can lead to psycho-emotional exhaustion and the formation of the syndrome of “emotional burnout”. A necessary quality of a primary care physician is emotional stability. This is the ability to overcome a state of excessive emotional arousal. Of particular importance is the development of professional burnout and the assessment of professional stability for district physicians who make first contact with the patient.
Results. Measures have been developed to increase the effectiveness of emotional (professional) stability in the activities of VTU.
Conclusion: Emotional stability in the doctor’s work allows you to maintain and further increase the effectiveness of professional activities. The obtained research results were used for the development of the “program for the modernization of health care in the Orenburg region”. They were used in the development of the Software product of the Ministry of health of the Orenburg region.