All articles by Senenko A. Sh.
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2019 № 7 To the 10th anniversary of the health centers
The article analyzes the main performance indicators of health centers for the period 2014–2018. Shows the coverage of comprehensive surveys in health centers per 10000 population; distribution of citizens recognized as healthy and with risk factors; presents indicators characterizing preventive work with the surveyed citizens. In the context of Federal districts and subjects of the Russian Federation, indicators for the last two years – 2017 and 2018 were analyzed. According to the provided results, conclusions are drawn about the absence of significant positive dynamics of the indicators characterizing the activities of health centers over the past 5 years. Thus essential divergences of indicators at the level of Federal districts and subjects of the Russian Federation are revealed. Analysis of indicators of activities of health centers indicates the lack of a unified organizational methodology of their activities. Improvement of organizational processes in health centers should go in parallel with the improvement of accounting and reporting documentation, these processes should be inextricably linked and aimed at solving the strategic problem – ensuring the quality of preventive work with the population, including the formation of management decisions based on them.
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2018 № 1 The Department of Medical and Social Assistance to the Adult Population and the Department of Nursing: the concept and principles of organization
The concept of the organization of medical and social assistance to the most socially vulnerable population contingents (people in the residential and senile age, the disabled and citizens with a temporary restriction of the ability to move and self-care after the transferred diseases and injuries) is proposed. This includes the creation departments of medical and social assistance in medical organizations that provide assistance to the adult population on an outpatient basis
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2016 № 7 The activities of day hospitals in the Russian Federation in 2000–2014
The article analyzes legal documents, which that regulate the work of day hospitals in the Russian Federation since the late 90-ies of XX century to the present. Presents an analysis of the performance of activities of day hospitals in health institutions providing medical care in ambulatory and stationary conditions in the country in 2000–2014. Marked increase in the number of beds in day hospitals 2,3 times, which is mainly due to the increase of beds in day hospitals in health institutions providing medical care in ambulatory conditions. Spend the evaluation of use of hospital beds hospitals for 15 years. During the study period the number of beds in hospitals has decreased by 27,7%, the number of discharged patients has almost not changed, which is associated with the intensity of the work beds. Shows the comparison of the number of persons treated in day hospitals and hospitals round-the-clock stay. The total number of patients treated in day hospitals and round hospitals, the proportion of patients treated at a convenience care hospitals declined from 92,5 to 80,3%, the proportion of patients treated in day hospitals increased from 7,5 to 19,7%.
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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. -
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. -
2018 № 3 To create a new model of medical organization providing primary health care: characteristics of medical staff of district health services
The results of the analysis of the provision of the population of the russian federation by district physicians, general practitioners, district pediatricians are presented. Significant differences in the indicators in the subjects of the Russian Federation were established. These differences necessitate a differential approach when planning actions to improve the organization of primary health care in the subjects of the Russian Federation
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2022 № 3 Assessment of time spent by patients when visiting a medical organization
The satisfaction of the population with medical care is considered today as one of the most important indicators of the health care system. At the same time, more and more attention is being paid to the time spent by patients in a medical organization when receiving outpatient care, as a factor affecting satisfaction with medical care in general.
P u r p o s e of the study is to determine the opinion of patients about their time costs when visiting a medical organization that provides outpatient care.
M a t e r i a l a n d m e t h o d s . The process of a patient’s referral to a polyclinic, a questionnaire for patients posted on the Internet on an open electronic resource Online Test Pad. The number of questionnaires is 509. Methods: analytical, sociological, descriptive statistics.
R e s u l t s . During the surveys, respondents subjectively assess the time spent on various actions: communication at the reception desk, searching for an office, waiting for an appointment, etc., as well as the total time spent in a medical organization. In addition, the appearance at the polyclinic may be preceded by an appointment, which also takes time. Respondents were asked to estimate the total time spent in the polyclinic, as well as the time they are willing to devote to visiting it. The respondents’ assessment of the time spent shows significant time reserves: in the organization of an appointment and the work of the registry (clarifications, obtaining background information, obtaining coupons), navigation and, possibly, in the location of offices, in the organization of space in waiting areas.
C o n c l u s i o n s . A tool for assessing the time spent by patients to receive care in a medical organization providing outpatient care has been developed and tested. There are significant differences in the length of time spent on making an appointment, including by phone and via the Internet. Significant reserves have been identified to reduce the total time required to visit the polyclinic. The developed tool is characterized by a short filling time, contains simple questions and allows you to quickly identify areas of necessary improvements.