2020 № 6 Pregnant technologies in primary health care in rural doctor’s ambulatory
The priority state project currently being implemented, “Creating a New Model of a Medical Organization Providing Primary Health Care,” is especially relevant for implementation in hard-to-reach areas. Since rural health care is character- ized by a shortage of personnel, a weak medical and diagnostic base, low material and technical equipment, a low level of development of information technologies, and a large territorial extent. Objective: to evaluate the effectiveness of the implementation of lean manufacturing technologies with the participation of nursing specialists in the work of a medical out- patient clinic. Materials and methods. To determine the directions for the implementation of lean manufacturing methods, a questionnaire was conducted among patients (n = 232). Mapping and visualization, as well as timing of the processes before and after the introduction of organizational measures in two areas of the medical ambulance clinic “Reception of healthy children” and “Reception of patients with acute disease and with exacerbation of chronic.” Results and discussions. In order to eliminate (minimize) the revealed losses, re-planning of the premises was carried out, the functions were redistributed and the working hours of the medical staff were structured, templates-forms of documentation were developed. Conclusion and conclusions. The introduction of organizational measures allowed us to significantly reduce the waiting time for admission of a healthy child on the day of the disease without additional financial costs, as well as to increase patient satisfaction.
2021 № 8 Study of temporary losses of patients when receiving medical services in ambulatory-polyclinic conditions
The study of the patient’s temporary losses when receiving medical services in an outpatient clinic and their minimization contribute to an increase in patient satisfaction with the quality of medical care.
Objective of the stud y: to assess the temporary losses of patients when visiting outpatient clinics of the city municipality.
Methods and materials. The temporary losses of patients were studied by analyzing route maps compiled using a special technique. The analysis of the questionnaires made it possible to assess the patient’s satisfaction with the conditions of providing medical services, the information received in the healthcare institution and the attitude of the nursing staff to the visitor. Statistical processing of the results was carried out using the programs Statistica 5.0 and Microsoft Office Excel.
Results. As a result of the conducted research, significant time costs of patients were identified when receiving medical care in polyclinics of the district center: when visiting a district doctor, a registry, a treatment room and a laboratory, which directly affected the results of assessing their satisfaction with the temporary criteria for visiting a medical organization.
Scope of the results. The data obtained during the study can be used as basic information when developing measures to optimize key processes in outpatient health care institutions.
2021 № 9 Borderline functional states of the men’s reproductive system: its influence on health and the quality of life.
Between the differing frequency of prevalence of sexual dysfunctions, there’s a particular interest in the borderline disorders of the male reproductive system, in which no obvious somatic and mental pathology can be found in the body. The reversibility of functional disorders unveils favorable prognostic prospects and presupposes the development of new approaches in the organization of observation and correction of minimal borderline functional states of the reproductive system.
P u r p o s e . To identify the frequency of borderline functional states of the reproductive system (BFSDS) among men over a five-year dynamics, their impact on the formation of health outcomes and quality of life.
M a t e r i a l s a n d m e t h o d s . The study was conducted at the Reproduction Center of the Clinical Diagnostic Center (Nizhny Novgorod) for five years. Two groups of men of reproductive age with BFSDS at the age from 20 to 60 years were tested. We used copy-pair method. The first group (DM) included men with sexual dysfunctions and similar sexual disharmony (BFSDS) who didn’t receive medical benefits. The second group (DM + treatment) consisted of men with BFSDS who received cognitive-behavioral therapy and medicine. All subjects assessed the state of the reproductive system, neurological and hormonal status, as well as the quality of life (according to the SF‑36 questionnaire). To compare the parameters of the quality of life, a control group was selected – healthy men of reproductive age.
R e s u l t s . The frequency of sexual dysfunctions in both groups is significantly increasing, but the frequency of their detection in men receiving treatment is 2,4 times lower than in the other group. An increase in neurological changes and hormonal disorders was recorded, the prevalence of which depends on the duration of observation and the availability of therapeutic measures. The study proved that the BFSDS have a significant impact on the quality of life of men, especially in the physical and psychological components of health. It was shown that the treatment allowed the patients to preserve the state of physical and, to a greater extent, psychological comfort during the five-year observation period.
I n c o n c l u s i o n , the authors emphasize the need for new approaches to the organization of observation and correction of the minor BFSDS.