Management in healthcare
  • 2022 № 8 Self-assessment of health and conditions for receiving medical care by residents of the Russian Federation

    In the context of higher interest of healthcare executives in patient-centeredness, development of value-based healthcare and increasing public satisfaction with medical care, it is very important to have access to detailed information about how people evaluate the care provided, as well as to specify problems associated with receiving care. Such detailed information can provide directions for further development of organizational technologies and serve basis for developing management decisions.
    T h e p u r p o s e of the study is to analyze results of sociological surveys of the Russian population on self-assessment of health and conditions for receiving medical care.
    M a t e r i a l a n d m e t h o d s . The study used data available from the Rosstat (Federal State Statistics Service) official website – “Comprehensive monitoring over living conditions of the Russian population” (conducted in 2014, 2016, 2018 and 2020) in terms of questions related to receiving medical care by the survey respondents, based on a sample survey of representatives of various groups and population strata covering 10 thousand households. Analysis of the presented data was carried out using descriptive statistics methods by the following sections: respondents’ self-assessment of health, smoking and alcohol consumption, receiving outpatient care, receiving dental care, seeking emergency medical care, receiving inpatient care, non-care seeking if medical care is needed.
    R e s u l t s . The share of those who rated their health as “excellent” and “good” has increased. It should be noted here that males were more optimistic in assessing their health status than females. The share of the respondents reporting a chronic disease diagnosed by a doctor decreased from 30.2% in 2014 to 27.2% in 2020. There is no significant difference between urban and rural population.
    The share of non-smokers and those who have never smoked decreased from 63.5% in 2014 to 62.1% in 2020. The share of male alcohol consumers remained stable adding up to 70%, while the female share tended to increase from 49.5% in 2014 to 52.1% in 2020.
    Assessment of an average time spent on making an appointment with a doctor in outpatient settings has not changed in dynamics and equaled to about 18 minutes. The share of those receiving timely medical care out of those applied for care increased from 92.6% in 2016 to 95.1% in 2020.
    The share of those calling an ambulance tended to decrease: from 10.8% in 2014 to 10.1% in 2020. According to the surveys’ results, every year some 7–8% of the population receive specialized medical care in inpatient settings.
    The analysis of cases of non–care seeking if medical assistance is needed showed a decreased share of such respondents: 33.6% in 2014, 33.0% in 2016, 34.5% in 2018, and 29.2% in 2020. The share of those failing to get to or experiencing difficulty getting to a health care facility equaled to 3.3%, 2.5%, 2.8% and 1.9%, respectively. 7.2% of the respondents had “no time” for care seeking in 2014, 8.2% in 2016 and 2018, and 4.7% in 2020. A significant decrease in this indicator is rather logical and unsurprising in the context of the pandemic caused by a new coronavirus infection.
    C o n c l u s i o n s . From 2014–2020, self-assessment of health has improved; in general, males rate their health higher compared to females.
    Men smoke 5 times more often than women. Generally, they start smoking during the teen years. As a positive trend, we can point out an increasing share of people who quit smoking.
    Men drink alcohol 9 times more often than women. The share of the female alcohol consumers tends to increase.
    Negative trends in care delivery are as follows: increased waiting time for emergency medical care; increased average number of days waiting for hospital admission; decreased share of those admitted to the hospital on the day of the visit.
    Positive trends in care delivery include the following: decreased denials of outpatient care due to lack of necessary equipment or medicines, shorter lines in waiting premises to see a doctor; decreased offers of payed services; decreased waiting time for a doctor’s appointment; increased share of those receiving timely dental care.
    A tendency among the respondents towards self-medication and not seeking medical care due to lack of time has decreased.

    Authors: Starodubov V. I. [40] Senenko A. Sh. [7] Menshikova L. I. [6] Zubko A. V. [2]

    Tags: alcohol consumption2 conditions for receiving medical care1 lifestyle3 medical care13 not seeking medical care1 public opinion1 self-assessment by residents of the russian federation1 smoking2 sociological survey1

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  • 2018 № 4 Comparative characteristic of victims in road transport accidents in the arctical zone of the arkhangelsk region depending on the alcohol factor

    Road traffic trauma nowadays remains an urgent medical and socio-economic problem in Russian Federation. For the purpose of comparative analysis of characteristics in groups of victims with alcohol intoxication in road accidents that occurred in the Arctic zone of the Arkhangelsk region, a continuous, analytical, population study was conducted – documentary observation. A sample of 518 medical cards (f.003/у) of victims in road traffic accidents, who received medical care in hospitals, was analyzed in Severodvinsk from 2012 to 2016. It was found that up to 30% of injured in accidents were in a state of alcohol intoxication; young men predominated among victims, and severe concomitant trauma predominated in the structure of all injuries. The results of the research may be in demand in the development of regional programs to prevent and reduce the number of accidents and prevention of road traffic trauma

    Authors: Menshikova L. I. [6] Petchin I. V. [1] Baranov A. V. [1] Barachevskiy Y. E. [1] Klyuchevsky V. V. [1] Modyanov N. Y. [1]

    Tags: alcohol intoxication1 arctic zone1 arkhangelsk region4 injury severity1 traffic accident1

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  • Marketing in health care
  • 2021 № 9 Health care organizers about the possibility of using outsourcing in medical organizations.

    I n t r o d u c t i o n . The ratio of the number of administrative and administrative and auxiliary personnel to the main staff, as well as the share of their remuneration in the total cost structure, is one of the criteria for the effective use of resources of medical organizations.
    The use of the outsourcing mechanism allows us to solve a number of problems that arise when such a ratio is observed, without reducing the quality and availability of medical care.
    T h e p u r p o s e o f t h e s t u d y is to study the opinion of health care organizers about the possibility of transferring certain areas of activity of a medical organization to outsourcing.
    M a t e r i a l s a n d m e t h o d s . The following methods were used in the study: statistical, sociological and analytical.
    R e s u l t s a n d d i s c u s s i o n . More than half of health care organizers believe that the introduction of outsourcing in a medical organization is necessary (66,1%). The study participants believe that it is possible to outsource such positions as cleaning of territories (94,4%), security of a medical organization (93,5%), laundry services (91,1%), maintenance of vehicles of a medical organization and maintenance of non-medical equipment and communications (87,1% each), etc. In their opinion, it is impossible to outsource such functions as planning and economic activities (69,4%), personnel records management (68,5%), procurement / contracts (58,1%), accounting (57,3%), legal support of the activities of a medical organization (37,9%), etc. Most often, the following functions have already been outsourced in medical organizations: laundry services (64,3%); maintenance of medical equipment (57,3%), motor transport of the Ministry of Defense (46,4%), non-medical equipment and communications (46,4%); cleaning of territories (35,7%).
    C o n c l u s i o n . Outsourcing allows you to focus on the profile activities of a medical organization and improve the quality of services provided to the population. Before transferring certain functions of a medical organization to outsourcing, the head needs to analyze the practical experience of regions and other medical organizations, which will help to avoid the negative aspects of outsourcing, expand its scope and the range of functions transferred to outsourcing companies.

    Authors: Menshikova L. I. [6] Ivanov A. V. [1] Burkovskaya Yu. V. [1]

    Tags: functions of a medical organization1 medical organization53 outsourcing4

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  • Personnel management
  • 2021 № 1 The role of local governments in solving the problems of providing primary health care personnel

    The problem of staffing in healthcare remains relevant for a long time. The article considers the possibilities of participation of local self-government bodies in attracting and securing medical workers, primarily primary care. The
    analysis of normative legal acts of the Federal level is presented. Amendments to Federal laws № 131-FZ and № 323-FZ related to specifying the powers of local self-government bodies in terms of health personnel are proposed. The necessity of a comprehensive assessment of the implemented measures of social support for medical workers to identify the most effective measures and select the best practices is justified.

    Authors: Son I. M. [41] Senenko A. Sh. [7] Menshikova L. I. [6] Flagler N. A. [1] Rugles L. V. [1]

    Tags: health  personnel2 local governments1 medical staff7 primary health care21 social support measures3

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  • Quality of medical aid
  • 2014 № 5 Assessment of reliability of patients' opinion about quality of inpatient care (Ministry of Health care of the Arkhangelsk region, Northern state medical university, Arkhangelsk, Russia)

    The problem of evaluation of patients' satisfaction with quality of healthcare is relevant in the process of modernization of national health care system. In order to assess the validity of patients' opinions about the quality of inpatient care 1960 patients aged 18 to 81 years were interviewed. Respondents' satisfaction with the quality of inpatient care is not affected with socio-demographic characteristics of respondents. Respondents' satisfaction is determined by effectiveness of the treatment and satisfaction with some components of the process of providing of inpatient care.

    Authors: Menshikova L. I. [6] Dyachkova M. G. [1] Mordovsky E. A. [1]

    Tags: inpatient medical care1 patients' satisfaction2

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  • Sociology of healthcare
  • 2023 № 6 Behavioural risk factors for chronic noncommunicable diseases in health care workers.

    Low physical activity, smoking and alcohol consumption are among the leading behavioural factors contributing to high morbidity and excess mortality from noncommunicable diseases. It can be assumed that health-care workers should be in the mainstream of population behavioural patterns. However, greater awareness of both the principles of healthy lifestyles and the harms of not following them may distinguish this population group in terms of behavioural responses.
    Purpose: to estimate the prevalence of behavioural risk factors for chronic noncommunicable diseases among health-care workers.
    Materials and methods. Study type: case-control study. Data source: results of the survey of the 28th wave of the Russian National Research University Higher School of Economics’ Monitoring of Economic Situation and Health, representative sample by individuals, survey year 2019. Responses received from respondents – health care workers about their use of tobacco, alcohol and exercise were analysed comparatively. Pearson Chi-square test at significance level p≤0,05 was used to find differences.
    Results. A sociological survey of 55 male and 257 female health workers of working age was carried out. We found that the incidence of a positive smoking response was lower in both male and female working-age health professionals than in the general population of working-age individuals. Compared with the general populations of men and women, no significant differences were found in responses to questions about alcohol consumption and exercise.
    Findings. We found that of the three behavioural factors (smoking, alcohol consumption, physical activity), only the first was significantly less prevalent among health professionals. The overall trends identified need to be investigated in more detail.

    Authors: Son I. M. [41] Menshikova L. I. [6] Shelygin K. V. [1]

    Tags: alcohol consumption2 chronic noncommunicable diseases3 exercise1 health workers1 risk factors15 smoking2

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