2020 № 2 Evaluation of the organization and transport accessibility of medical care to rural residents
The basis of the study was the Orenburg region. According to the MIAC health care in the Orenburg region
in 2015, the number of rural settlements was 1036, and the number of FAPs was 945. Sociological studies were conducted
in three pilot rural areas with different populations and distances from the regional center: Abdulinsky, Orenburg, Svetlinsky.
The total number of adults in the three districts is 19,356. The results of a sociological survey indicate a low availability of medical assistance to rural residents, the lack of a preventive focus among doctors on the prevention of exacerbations of chronic pathology, primarily of villagers living in localities attached to FAP. The need to improve the organizational forms of the work of medical organizations in the countryside, the development of mobile field complexes and general medical (family) practices, the development of medical and social assistance in rural areas is determined.
2020 № 1 The effectiveness of the reorganization of dermatovenerological care in the Samara region in terms of “lean production”
By implementing “lean manufacturing”, medical organizations can save on all costs, while improving acces¬sibility and improving the quality of care.
The roadmap “Changes in social sectors aimed at improving the efficiency of health care” set the task of increasing the share of outpatient care costs in the total costs of the “Program of state guarantees of free medical care” from 25.3% in 2013 to 31.7% in 2018. the Share of inpatient care costs should be reduced from 60.3% to 50.3%. In providing effective treatment of patients with dermatovenerological pathology of great importance is the use of the necessary amount of der¬matological care, as well as therapeutic methods of diagnosis and treatment, which determines the need for continuity in the work of PHC and PHC. In 2010. in the Samara region the restructuring of the bed Fund and partial reduction of der-matovenerological beds, improvement of selection of patients for inpatient treatment according to the developed criteria of hospitalization in hospitals of round-the-clock stay and day hospitals on the profile of dermatovenerology were carried out, clinical protocols were introduced at the outpatient stage – all of the above contributed to the efficiency of the use of the bed Fund in dermatovenerology. The reorganization of dermatovenerological care improved the quality of medical care for patients with dermatovenerological diseases and clinical and organizational indicators of dermatovenerological care.
2017 № 1 The incidence of malignant neoplasms
The article provides an analysis of the incidence of malignant neoplasms in Russia in dynamics for 10 years. The main feature of formation and development of cancer care in Russia is its preventive orientation. The experience of early diagnostics of malignant neoplasms expedient from the economic point of view a long-term strategy for the fight against cancer.
2016 № 5 Performance analysis and ways of reforming the health village
Annotation. The analysis of the incidence of the rural population in the Russian Federation and the Federal District. Based on the results of the study developed proposals to reform the health of the village.
2016 № 3 Analysis of the efficiency of the use of hospital beds in the hospital urology department
Annotation. The article presents the results of the examination of the validity of hospitalization in the urology department of City Clinical Hospital (CCH) in Zhukovsky, Moscow region. Carrying out of examination the validity of hospitalization in the urology department of the hospital showed that there had been excessive periods of treatment in 22% of patients. Share unreasonably executed patient days was 15.8%. Of the total number of bed days saved the largest part of the final period of treatment (37.3%), almost the same amount for an initial period (41.7%) and 21.0% – for the period of active treatment of the patient. Calculate the economic effect of follow-up care of patients in day hospital (DS).
2016 № 2 Needs of the population Nizhny Novgorod region in cardiac surgery procedures
The article presents the analysis of security of the population of Nizhny Novgorod region with medical staff and bed capacity cardiology; analyzed actually existing cardiac surgery volumes in the Nizhny Novgorod region; designed neediness of the adult population of the Nizhny Novgorod region in cardiac surgery based on data from a multicenter epidemiological study СТЕРХ.
2019 № 6 Perfection of organizational forms of work in dermatovenerology in conditions of “lean production”
An important part of the activity in dermatovenerological care in the conditions of “lean production” is the improvement of organizational forms of work of medical organizations (MO), providing medical care to patients with dermatovenerological pathology at all stages of its provision.The survey was conducted at the Samara oblast, the dermatovenerologic dispensary (SACVD). Based on the diagnosis of “zones of inefficiency” in the provision of medical care to patients with dermatovenerological pathology, the reorganization of dermatovenerological care was carried out, including: restructuring of the MO network, the creation of mo areas of responsibility for the provision of dermatovenerological care; the organization of an interdistrict center; the reorganization of three city CVD departments; the opening of CVC; the development of regulations for intradepartmental interaction of dermatovenerologists with doctors of other specialties; the organization on the basis of THE; information support of participants of interaction; increase of professional level of medical personnel. The economic effect due to the elimination of duplication of laboratory and diagnostic studies in the medical examination of patients with dermatovenerological pathology was in 2015 1190266,7 rubles. Sociological surveys of patients who applied to the CSQ, showed that the majority of respondents were satisfied with the medical care, positively assessed its availability (90,3%) and quality (96,1%).
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.
2019 № 8 Health condition of a rural population living in different areas of medical aid accessibility
The problem of preserving the health of the rural population is key in the concept of the development of
rural society. Health issues of rural residents are of great social, political and economic importance. Promising areas for
preserving and improving the health of the rural population are raising the level and quality of life of the rural population.
Research methods: statistical, direct observation, sociological. In the course of the study, the analysis of the reporting data of the Ministry of Health of the Russian Federation (Form No. 47) was conducted, as well as the results of copying information from primary medical documentation in the pilot territory of the Orenburg Region.The results of the study indicate the need to improve the improvement of organizational forms of providing medical care to rural residents, intensify preventive and dispensary work in the village, and involve medical and social services in the village. The determining factors of public health are the lifestyle of the rural population, the financing of health care and the system of social protection of the population, the development of the agro-industrial complex that provides employment to the population. The analysis shows the need to improve the availability of care, medical activity, valeological literacy of the rural population and commitment to a healthy lifestyle, especially for residents living in the service area of the FAP.