All articles by Morozov A. M.
2022 № 1 Assessment of economic losses due to the development of infection in the surgical intervention area
The development of infection in the field of surgical intervention is inextricably linked with financial costs and the public reputation of the institution. The medical and preventive institution needs to allocate additional funds from the hospital budget for diagnostic studies, as well as for medicines for the treatment of frolicking purulent-septic complications. As a result, medical and preventive institutions experience annual additional economic losses.
P u r p o s e of the study is to assess the economic damage caused to medical and preventive institutions due to the development of infections in the field of surgical interventions.
M a t e r i a l s a n d m e t h o d s . In the course of this study, an analysis of domestic and foreign literature sources on the issue of economic damage from purulent-septic complications in surgical practice was carried out.
R e s u l t s . The damage caused by the development of infections in the area of surgical intervention is quite significant, and even the introduction of new technologies and therapies does not relieve patients from their possible appearance. The estimated costs of infection of the surgical intervention area vary depending on the region, the type of operation and the degree of infection.
Economic analysis in this case is necessary to study the activities of organizations from the point of view of evaluating their work in order to monitor and subsequently better manage the processes of supplying the institution itself with material resources, as well as the use of internal reserves and their rational use.
F i n d i n g s . The distribution of funds in medical and preventive facilities should be carried out rationally to ensure the full-fledged activity of the institution. In the absence of measures taken to prevent the development of nosocomial infections, infections of the surgical intervention area may occur after a certain period of time after the patient is discharged from the hospital, thereby contributing to the spread and contamination of healthy people, which from a socio-economic point of view is unprofitable.
2023 № 1 Review of the work of the state dental service of the Tver region in 2021
Taking care of the health of the population of the Tver region is an important direction of social regional policy. The main task of the dental service of the Tver region is to preserve and strengthen the health of the citizens of the Tver region, to increase the role of preventive care of dental diseases, to form a model of organization of the dental industry that ensures the availability and quality of dental care, to increase the efficiency of dental services, the volume, types and quality of which should correspond to the level of morbidity and the needs of the population, advanced achievements of medical science. The aim of the research is the analysis of the statistical data of the stomatological service of the state public health institutions of the Tver region.
Materials and methods. Analysis of the statistical data reflecting demographic indexes, statistics of the stomatological service structure, staffing, distribution of dentists among the institutions of the Tver region, quality of dental care, the main indexes of the stomatological service of the Tver region, indexes of treatment and preventive work.
Results. The present study is devoted to the analysis of the activity of state medical institutions of health care of the Tver region that provide dental care to the population of the Tver region. The indices of the provision of dentists in this region (not taking into account orthopedists and orthodontists) makes 3,82 posts for 10 thousand population (426,25 rates in total). Indicators of provision of the region’s population with dentists are 4,3 positions per adult population of the region. The deficit specialties have been revealed: pediatric dentists, orthodontists, in the regional institutions there is a shortage of orthopedists. The share of occupied staff positions in the specialty of pediatric dentistry was 49%, which reflects the need for training in this area. The difficulties in the organization of preventive examinations of the
children’s population were revealed, and the low percentage of the examined persons.
Conclusions. The municipal, district and regional medical institutions of health care rendering dental treatment to the population are functioning on the territory of the city of Tver and the Tver region in general. The statistical analysis has revealed a number of difficulties that require further action on the part of the medical community and public organizations. It is necessary to develop comprehensive measures to solve the shortage of pediatric dentists at the level of the Ministry of Health and educational institutions. The difficulties of preventive examinations among the population of different groups are highlighted. It is important to strengthen the preventive profile in order to reduce the cases of complicated caries, tooth extraction. Development of hygienic direction will increase awareness of the population
about the peculiarities of dental and oral hygiene, methods of prevention and treatment of dental diseases.
2022 № 5 Clinical aspects of medical-social examination of tuberculosis in adults
The epidemiological situation with tuberculosis in the Russian Federation in the current socioeconomic conditions continues to be quite tense. In addition to all kinds of introductions from practicing physicians to combat tuberculosis, a significant contribution comes from the activities of administrative bodies aimed at creating and implementing new draft laws on disability related to tuberculosis, including methods of social expertise and safety, various support measures for disabled citizens, and methods of rehabilitation for persons with a disability group assigned.
All persons with tuberculosis are guaranteed the right to a medical and social expert evaluation. In connection with the release of the new order, there are actual data, which require attention not only of social security workers, but also of medical personnel.
P u r p o s e : to reveal actual aspects of medical and social examination for tuberculosis in adults.
Methods. Regulatory documents on social security of population were analyzed and the main reasons influencing the expert evaluation and decision of commission for medical and social protection in tuberculosis in adult stratum of population were singled out.
R e s u l t s a n d d i s c u s s i o n . As of January 1, 2020, Order No. 585n of the Ministry of Labor and Social Protection of the Russian Federation of August 27, 2019, came into force. “On the classifications and criteria used in the implementation of medical and social expert assessment of citizens by federal state medical and social expert assessment institutions. The expert evaluation for tuberculosis is based on an analysis of the totality of persistent impairments of body functions, containing significant clinical components, due to the pathological process and the severity of restrictions to vital functions, which are affected by the localization and prevalence of the specific process, the degree of activity, MBT sensitivity to antituberculosis drugs, the nature of complications and the possibilities of surgical treatment. Presence or absence of mycobacterial discharge in a patient is one of the major criteria
of therapy efficacy and favorable prognosis.
C o n c l u s i o n . The medical and social expert evaluation is an important component in the evaluation of a person’s state of health, in the assignment of a disability group, and in the analysis of the leading medical criteria, which characterize the degree of restriction of vital functions. The aspect of reviewing normative-legal acts concerns not only employees of social protection, but also acting clinicians for a better understanding of all the socio-economic consequences assigned when making this or that diagnosis.
Disability of the population due to tuberculosis remains a relevant area of analysis, requiring attention from both a clinical and legal perspective.
2022 № 3 Epidemiology of disability of the able-bodied population in Tver on the example of surgical patients
The health of the nation is the main marker of the successful development of the state. Maintaining and improving the health of citizens are the main tasks of social policy in every country. Morbidity and disability are among the main indicators of the state of public health. They reflect the demographic situation and the level of socio-economic development of the country.
Every year the number of persons with disabilities increases, which makes the problem of disability of the able-bodied population extremely relevant. Monitoring of disability, as one of the medical and demographic indicators, is the basis for ensuring the protection of the health of citizens. Research on the epidemiology of disability is the key to preventing an increase in the number of disabled citizens. In addition, it plays an important role in the distribution of the state budget to improve the quality of life of people with an assigned disability group and to carry out preventive measures aimed at reducing the impact of risk factors for disability.
Purpose. Assessing the degree, structure and dynamics of disability among residents of the city of Tver using the example of surgical patients observed in the “City Clinical Hospital No. 7”, and detection the main number of diseases that caused the setting of a disability group.
Methods. An analysis was carried out regarding the data on the official reports of the surgical department polyclinic No. 1 of the state budgetary healthcare institution “City Clinical Hospital No. 7” in Tver for the period from 2010 to 2020. The dynamics of the frequency of registration of persons with disabilities was studied among surgical patients, the main groups of diseases that caused disability were identified, the structure of disability by groups was analyzed. The degree of reliability of the obtained data was assessed.
Results. The growth of citizens with disabilities in the outpatient surgical department increased 3,3 times from 2010 to 2020. The dynamics was wave-like. There was a sharp rise in the number of people who received a disability group for the first time from the beginning of 2010 to the end of 2013. The indicators did not change much from 2014 to 2020. However, the dynamics of the percentage of the working population among persons with disabilities developed in inverse proportion. Those who received a disability group for the first time mainly had pathologies of the musculoskeletal system and vascular diseases.
Conclusion. Based on the data of the surgical department of the polyclinic in the city of Tver, the number of persons with
disabilities tends to increase. It requires constant monitoring. The number of persons with disabilities tends to increase. It was illustrated through an example of a study in Tver. All that leads to a decrease in the able-bodied population and an increase in social inequality. It is an urgent problem in the region.