Financial management
  • 2016 № 2 Staff time specialist doctors for the provision of medical care in the outpatient setting

    In order to implement the Decree of the President of the Russian Federation dated May 7, 2012 № 598 «On improvement of state policy in the sphere of public health» and in accordance with the Action Plan of the Ministry of Health Labor norms in health care, approved by the Interagency Working Group on the organization of rationing of work, the development of professional standards and skill levels in the health sector conducted observed for 2 working weeks of the working process of two specialists: cardiologist, endocrinologist and dentist-therapist in 20 pilot areas of the country. Data analysis observation revealed the need for regulations to establish standards load specialists providing outpatient care to the population due to an increase in the time to visit a patient.

    Authors: Son I. M. [38] Ivanova M. A. [12] Starodubov V. I. [35] Armashevskaya O. V. [4] Liutsko V. V. [4] Sokolovskaya T. A. [5]

    Tags: amount of time1 doctors7 outpatient care5 photo chronometer watch1

    Read more >

  • Focus of the problem
  • 2022 № 1 Portrait of regional health authority manager

    Competent management is crucial condition for the development and functioning and requires qualified managers. In the Russian Federation over the past few years Federation there were many rotations in management of regional health authorities. These changes will be followed by lack of continuity in management decision-making, high degree of uncertainty and a low level of population and professional community trust.
    T h e a i m o f t h e s t u d y was to give a detailed information about regional health authorities managers in Russian Federation.
    M a t e r i a l s a n d m e t h o d s . This research was designed as observational study with the use of questionnaire which included the characteristics of the age and gender of the respondents, the level of their basic and additional education, additional competencies, occupational background in leadership position.
    R e s u l t s . We achieved a response from 81 respondents. We founded that rotation of managers and extremely short occupation period had significant impact on managers’ qualifications. The culture of purposeful formation of the professional skills by the respondents was poor. Only 7% of managers paid attention to their education. About 40% did not have professional retraining for management in healthcare.
    C o n c l u s i o n s . It is necessary to develop a standard set of Russian region health managers competencies and responsibilities.

    Authors: Starodubov V. I. [35] Khodakova O. V. [4] Kobyakova O. S. [13] Deev I. A. [8] Chigrina V. P. [2]

    Tags: characteristics1 manager2 regional health authority1

    Read more >

  • Informatization of health care
  • 2018 № 3 The national segment of the international object identifier tree. OID Registry of the Ministry of Health

    Describes the structure and organization of the international object identifier tree, which includes national OID space segment and of the Ministry of health of Russia. The history and problems of formation of OID Registry of the Ministry of health at an early stage, as well as solutions and current state. The basic aspects of building an arc OID «Actors of the health care system», taking into account the importance for the solution of problems of assessing the level of informatization and formation of Federal registers, as well as taking into account the legislative features of the structure of the health system

    Authors: Starodubov V. I. [35] Sidorov K. V. [2] Zarubina T. V. [2]

    Tags: federal  register  medical  organizations1 register  an  oid1 the integral  evaluation  of  the  level  of  informatization1 the  international  object  identifier  tree1 unified  public  health  information  system1

    Read more >

  • It management
  • 2017 № 8 Assessment principles of informatization level of medical organization

    The article is about assessment principles of informatization level of the regional segment of The Unified State Health System. This approach is based on an assessment of informatization level of the healthcare organizations. Scale building is based on the calculation of indicators, combined into functional segments, which form an integral evaluation for the medical organization. In 2016, the developed scale in the questionnaire form was presented to experts of regional Medical Information and Analytical Centers of eight Russian constituent entities, the experts took a favourable view of 90% indicators. There was implemented a test survey of medical organizations of three pilot regions

    Authors: Starodubov V. I. [35] Sidorov K. V. [2] Zarubina T. V. [2] Shvyrev S. L. [1] Koroleva Y. I. [1] Rauzina S. E. [1]

    Tags: e-health3 efficiency of informatization1 medical information system5 result-oriented approach1

    Read more >

  • Law
  • 2018 № 10 Problems of normative support of health care institutions in the context of structural reforms

    The results of the analysis of the effectiveness of structural reforms in health care, their validity, compliance with the Program of state guarantees of free medical care to citizens of the Russian Federation, adequate provision of medical organizations with resources. It is proved that the formation of a network of medical organizations should be justified by the objective needs of the population in medical care, confirmed by the data of monitoring the health status of the population and the study of consumer demand. It is also necessary to take into account the forecast of changes in the needs of the population in the volumes and types of care, as well as to scientifically justify the profiling, typing and staffing of medical organizations.

    Authors: Son I. M. [38] Starodubov V. I. [35] Rugol L. V. [2]

    Tags: a network of medical organizations1 regulatory support1 structural reforms1 the program of state guarantees of free medical care to citizens of the russian federation1

    Read more >

  • Management in health care
  • 2018 № 10 To the issue of strengthening and preserving health of employees in the enterprises of the russian Federation

    Тhe problem of strengthening and preserving the health of workers at the enterprises of the Russian Federation is сonsidered. It is shown that improving the effectiveness of preventive measures to strengthen and preserve the health of workers is possible with the active participation of employers. This requires control by the trade Union organization, the medical service of the enterprise and preventive organizations of the region (center for medical prevention, health centers).

    Authors: Starodubov V. I. [35] Soboleva N. P. [4] Savchenko E. D. [5] Salagay O. O. [1]

    Tags: employers2 prevention at enterprises1 strengthening and preservation of workers ' health1 trade union organizations2

    Read more >

  • 2018 № 1 To the question about the strengthening and preservation of health of employees in the enterprises (on the example of the Central Federal district)

    Considered the issues of strengthening and preservation of health of people working in enterprises. Studied the role of the leader and trade Union organization in the preventive measures aimed at risk factors that influence the development of chronic noncommunicable diseases. Studied prevention of specific diseases associated with the specific activities of the enterprise, the provision of sanatorium-resort treatment. Examined measures to strengthen and preserve the health of the population, conducted in the territory of the project location. The scheme of interaction of all structures of the region in strengthening health work force

    Authors: Starodubov V. I. [35] Soboleva N. P. [4] Savchenko E. D. [5]

    Tags: prevention in enterprises1 reduction of risk factors at work1 strengthening and maintaining the health of workers1

    Read more >

  • 2016 № 4 Public Health and Formation of the Uniform Preventive Space

    Annotation. The task of unifying the efforts of all participants of the preventive process, the whole society in order to create a preventive space became urgent In the last decade. The development of the public health system is suggested as such а unite. A great number of discussions on public health at various levels allowed us to formulate the definition and the core functions of public health. It is crucial to realise the public health system both as a totality of different structures and as their purposeful and coordinated activity. Of particular importance is the municipal level as a place of direct contact of the population, bodies of local self-government, the realization of the actions directed on preservation and strengthening of health of the population, with the active participation of citizens themselves.

    Authors: Senenko A. S. [4] Leonov S. A. [14] Starodubov V. I. [35] Evdakov V. A. [6] Son I. A. [1] Korotkova A. V. [3] Сheshkovsky M. S. [1] Bondarenko A. A. [1]

    Tags: a single preventive space1 function of public health1 health promotion1 interagency cooperation2 local authorities1 public health8 the formation of a healthy lifestyle1

    Read more >

  • 2016 № 3 Primary Health care. Medical Network organization features and staff provision

    Annotation. Changes of Medical organizations network, providing ambulatory treatment, were studied, for past 10 years. In addition, trends of manning tables formation in outpatient clinic were analyzed, as well as population provision by district doctors (uchastkoviy doctor) and general doctors. The analysis of main indicators of doctors’ activities in medical organizations, providing ambulatory treatment, is provided.

    Authors: Son I. M. [38] Senenko A. S. [4] Kupeeva I. A. [7] Starodubov V. I. [35] Skvirskaya G. P. [5] Gazheva A. V. [6]

    Tags: district doctor1 general doctor1 medical organizations22 outpatient clinic1 primary health care14 providing ambulatory treatment1 regular appointment1 visiting doctor1

    Read more >

  • 2014 № 8 Working hours expenses of doctors on an out-patient basis according to photochronometric researches (Federal research institute for health organization and informatics of ministry of health of the Russian Federation, Moscow, Russia)

    For the implementation of the Russian Federation President Decree of May 7, 2012 № 598 «About improvement of a state policy in the health care sphere» and according to the Plan of measures on work rationing in health care of the Interdepartmental working group on the organization of rationing of work, development of professional standards and skill levels in the health care sphere, within 2 working weeks phototime observation over work of two experts — therapists of district police officers, pediatricians of district police officers, general practitioners, neurologists, otorhinolaryngologists, ophthalmologists and obstetricians-gynecologists in 17 pilot territories of the country is made. Results of research testify the need of improvement of normative documents on setting standards for the doctors rendering the out-patient help to the population towards increase in time for visit of one patient.

    Authors: Son I. M. [38] Ivanova M. A. [12] Starodubov V. I. [35] Armashevskaya O. V. [4] Liutsko V. V. [4] Sokolovskaya T. A. [5] Bantyeva M. N. [4]

    Tags: improvement of normative documents1 norms of time1 phototime supervision1

    Read more >

  • 2014 № 4 Current rules and law regulations for the labor of ophthalmologist (Federal research institute for health organization and informatics of ministry of health of the Russian Federation, Moscow, Russia)

    Existing normative base does not correspond with modern requirements on providing specialized medical aid and is in need of re-consideration. One of the main instruments for achieving this objective in the process of health care modernization is objectivation of physician's work norms and of the middle-level medical staff with the regards of changed social life conditions of the society and epidemiological situation, as well as significant improvement of material-technical base of medical organizations and new requirements towards organization of aid-diagnostics process. Modernization of medical organizations, implementing innovative methods of diagnostics, suggesting high qualification of specialists along with understaffing of personnel set, and the growth of pressure on physician, require re-consideration of existing normatives.

    Authors: Son I. M. [38] Ivanova M. A. [12] Starodubov V. I. [35] Sokolovskaya T. A. [5] Bantyeva M. N. [4]

    Tags: activity1 aid1 normatives2 ophthalmology1 order2 states1

    Read more >

  • 2013 № 12 New criteria of Birth: medical and demographical outcomes and organizational problems of obstetric services (Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia)

    Annotation. The paper defines the characteristics of the obstetric services organization in modern conditions. In April 2012, Russia introduced new birth criteria — birth weight 500 grams and 22 weeks of gestation. According to this criteria termination of pregnancy at 22–27 weeks of gestation that used to be termed as «late abortion» before 2011 should be considered and registered as extremely premature birth starting April 2012. This reform has been accompanied by reorganization of outcomes of registered pregnancies — births and abortions as well as the number of births and deaths by body weight.

    Authors: Starodubov V. I. [35] Sukhanova L. . P. [1]

    Tags: abortion1 birth1 birth criteria1 extremely low birth weight neonates1 infant deaths1 perinatal mortality2 pregnancy outcome1 still birth1

    Read more >

  • 2013 № 3 Efficient contract in health care: opportunities and risks (Central Research Institute for Health Organization and Informatization, Ministry of Healthcare, Moscow, Russia)

    Article is dedicated to problems of implementing efficient contract into health care. Currently, there are created descent conditions for implementing efficient contract into health care, what provides circumstances for its future successful realization. But, on the other hand, there is required a flexible policy not only towards terms, included in labor contracts with employees but towards the process of implementing efficient contract itself. Especially, when health care is characterized by great diversity: not everywhere the same approaches for stimulation are acceptable and reasonable. In the article there is given an analysis of opportunities and threats, related to implementing efficient contract, there are suggested measures countering these threats.

    Authors: Kadyrov F. N. [116] Starodubov V. I. [35]

    Tags: efficient contract9 evaluation of employee's activity1 financial stimulation2 labor compensation4 stimulation payouts1

    Read more >

  • 2013 № 2 Transformation problems of existing labor payment system in aim of implementing efficient contract into the health care (Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia)

    The article is dedicated to problems of implementing efficient contract into the health care. Despite the presence of definite normative base, all necessary conditions for implementing efficient contract are not yet created. Moreover, approved and planned for approval normative acts do not consider a number of important issues, related to efficiency of material stimulation measures in such specific field as health care. Therefore, this article is dedicated to its analysis, as well as proposals for increase of productivity while implementing efficient contract in the field.

    Authors: Kadyrov F. N. [116] Starodubov V. I. [35]

    Tags: efficient contract9 evaluation of employees performance1 incentive type of payments1 material stimulation2 payment for labor1

    Read more >

  • 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. [35] Senenko A. Sh. [7] Menshikova L. I. [5] Zubko A. V. [2]

    Tags: alcohol consumption1 conditions for receiving medical care1 lifestyle1 medical care12 not seeking medical care1 public opinion1 self-assessment by residents of the russian federation1 smoking1 sociological survey1

    Read more >

  • 2018 № 7 On strengthening and preservation of health of employees at enterprises

    The issues of strengthening and maintaining the health of persons working at the enterprises of the Volga Federal district are Considered. The role of employers and trade Union organizations in this direction is studied

    Authors: Starodubov V. I. [35] Soboleva N. P. [4] Savchenko E. D. [5]

    Tags: employers2 prevention at the enterprises1 strengthening and preservation of health of workers1 trade union organizations2

    Read more >

  • Manager of health care consults
  • 2020 № 6 Assessment of public policy in relation to certain issues of healthcare functioning during the spread of COVID-19 Coronavirus 

    Health care, as a predominantly public system, is objectively subject to serious regulation in special operating conditions, which include the spread of COVID-19 coronavirus infection. It is also important that the private healthcare system is also subject to direct or indirect regulation. At the same time, public authorities are sometimes forced to resort to "manual management", the consequences of which are not always clear for both public and private health care.

    Authors: Kadyrov F. N. [116] Obukhova O. V. [26] Bazarova I. N. [12] Starodubov V. I. [35] Endovitskaya  Yu.  V. [10]

    Tags: coronavirus3 covid-1921 crisis3 financing12 health care24 mandatory health insurance5 medical organizations22

    Read more >

  • 2017 № 4 Paradoxes of law: the guarantee of free medical aid often limit the rights of patients to improve quality

    The legislation of the Russian Federation, recognizing the rights of citizens on free medical aid and paid medical services, however, makes clear the roll the side free of charge. At the same time guarantee free of charge formulated in such a way that often limit the rights of citizens to receive medical care with the use of drugs, medical devices, etc., not provided for in the programme of state guarantees of free rendering to citizens of medical aid. Moreover, if the rights of citizens to receive paid medical services directly spelled out in the law, the right of citizens to self-purchase of medicines, medical devices, etc. did not say anything. There is no outright bans, which in practice leads to numerous conflict situations. The article provides specific suggestions for improving the legislation in this field.

    Authors: Kadyrov F. N. [116] Starodubov V. I. [35]

    Tags: accessibility of care1 free medical care2 guarantees in the health sector2 medical products2 medications3 paid medical services19 quality of care4 standards of care4 the legislation in the sphere of health care1

    Read more >

  • 2015 № 9 Provision of medical aid within a medical approbation

    Currently there are developed legal and methodological principals for medical aid provision within a clinical approbation of prevention methods, diagnostics, treatment and rehabillitation. Despite the imperfections of the developed system, it allows to eccelerate the process of implimenting new medical technologies into the health care system, having simultaneously provided financial support to federal clinics, experiencing serious economical burdens due to budget cuts for the most common types of medical care in circumstances of economical instability. The article analyses the issues and provides recommendations for improving organizational mechanisms of clinical approbation.

    Authors: Kadyrov F. N. [116] Obukhova O. V. [26] Perkhov V. I. [20] Starodubov V. I. [35]

    Tags: clinical approbation1 clinical experiments1 clinical research1 clinical-economical analysis1 effectiveness5 financial support of medical activity1 medical aid2

    Read more >

  • 2015 № 5 Issues related to utilizing standards of medical aid in the mandatory medical insurance system

    The article is dedicated to analysis of legislation, other normative acts, related to application of regulations on providing medical aid and standards of medical aid, medical aid quality control and enforcement of penalty sanctions towards medical organizations in the system of mandatory medical insurance.

    Authors: Kadyrov F. N. [116] Starodubov V. I. [35]

    Tags: criteria for evaluating medical aid quality1 mandatory medical insurance10 medical-economic expertise1 penalty sanctions1 quality expertise of medical aid1 regulation on providing medical aid1 standards of medical aid3

    Read more >

  • Manager of healthcare consults
  • 2020 № 5 Russian Health Care in the background coronavirus COVID-19: Opportunities and Threats

    The effectiveness of any public system, including health care, is determined by the adequacy of its legal regulation. The situation with coronavirus exposed many problems in this area, a number of which were quickly resolved with varying degrees of success. However, there are still many unresolved issues and the need to further improve the legal regulation of health care. This applies, among other issues, to the remuneration of medical workers engaged in providing medical care to patients who have been diagnosed with COVID‑19 coronavirus infection. The article presents an analysis of the procedure for implementing incentive payments at the expense of Federal funds, and suggests measures to improve it. The article presents a SWOT analysis of the state of Russian healthcare against the background of the spread of COVID‑19 coronavirus.

    Authors: Kadyrov F. N. [116] Obukhova O. V. [26] Bazarova I. N. [12] Starodubov V. I. [35] Yu. V. Endovitskaya [6] N. Ya.  Nesvetailo [2]

    Tags: coronavirus3 covid-1921 crisis3 financing12 health care24 mandatory health insurance5 medical organizations22

    Read more >

  • 2018 № 5 The procedure for the formation of staff lists of state (municipal) health care institutions

    The staff schedule determines the composition and structure of positions, is an important tool for regulating labor relations in the team. At the same time, it is an important economic tool. The powers of the head of the medical organization depend on its rights on the formation of the staffing structure. Often the staff list becomes the object of disputes and conflicts with the founders and various regulatory authorities. The article discusses the legal basis for the formation of staffing in state (municipal) health care institutions

    Authors: Kadyrov F. N. [116] Starodubov V. I. [35]

    Tags: powers of state (municipal) institutions1 regulation2 staff list1 staff standards1

    Read more >

  • Manager of heath care consults
  • 2021 № 5 New system of control measures in relation to medical organizations within the framework of compulsory health insurance

    One of the most serious innovations in the system of compulsory health insurance is the change in the procedure for conducting control measures. In accordance with the new version of Federal Law No. 326-FZ (in accordance with the provisions of the Federal Law of December 8, 2020 № 430-FZ On Amendments to the Federal Law "On Compulsory Medical Insurance in the Russian Federation"), the procedure for monitoring the volume, timing, quality and conditions of providing medical care for compulsory medical insurance to insured persons, as well as its financial support, is now established not by the Federal Fund for Compulsory Medical Insurance, but by the Ministry of Health of the Russian Federation. At the same time, both the participants of the CMI system who have the authority to conduct control measures, and the procedure for conducting control, are changing.

    Authors: Kadyrov F. N. [116] Obukhova O. V. [26] Bazarova I. N. [12] Starodubov V. I. [35] Kobyakova O. S. [13] Chililov A. M. [21] Endovitskaya  Yu.  V. [10] Mitroshin P. V. [2]

    Tags: compulsory medical insurance14 control of the volume and quality of medical care1 federal cmi fund1 insurance medical organizations4 medical organizations22 territorial cmi funds1

    Read more >

  • 2021 № 4 NEW SYSTEM OF CONTRACTS WITHIN THE FRAMEWORK OF COMPULSORY HEALTH INSURANCE

    The system of compulsory health insurance is regulated by a large number of regulatory legal acts. Nevertheless, many issues related to the relationship between the participants of the MHI system, and above all – financial, are determined by the content of the contracts concluded between them. This article analyzes the new system of contracts that has developed in the system of compulsory medical insurance in connection with the adoption of Federal Law No. 430-FZ of December 8, 2020 “On Amendments to the Federal Law “On Compulsory Medical Insurance in the Russian Federation”, as well as other related regulatory legal acts. There have been changes not only in the content of the contracts, but also in the composition of their participants. In addition, there is a new, previously absent type of contract. The purpose of the work is to analyze changes in contracts in the MHI system and their possible consequences.

    Authors: Kadyrov F. N. [116] Obukhova O. V. [26] Bazarova I. N. [12] Starodubov V. I. [35] Kobyakova O. S. [13] Chililov A. M. [21] Endovitskaya  Yu.  V. [10]

    Tags: compulsory medical insurance14 contracts in the mhi system1 federal chi fund2 medical insurance organizations5 medical organizations22 powers of mhi participants1 territorial chi funds1

    Read more >

  • 2017 № 10 Financial reserves of the state (municipal) institutions health

    . The difficult economic situation makes to search for possible variants of optimization of resources and reserves in the state (municipal) institutions. Many heads of agencies believe that the reserves for salary increases in accordance with the «Мay» decrees of the President have been exhausted. However, they did not start the process of normalization, the introduction of professional standards and effective contracts. On the other hand, the legal environment in which agencies are often not allowed to implement the legislation provided for the possibility of attracting additional resources. These issues are discussed in this publication

    Authors: Kadyrov F. N. [116] Starodubov V. I. [35]

    Tags: human resources4 mandatory medical insurance10 optimization6 paid services1 promotion1 regulation2 saving resources1

    Read more >

  • Medical science
  • 2020 № 1 Planning the subject of dissertations in the specialty «public health and healthcare»: problems and solutions

    Over the last 20 years, the professional values of applicants for a degree in the specialty «Public health and health care» have shifted from health issues to disease issues, which does not meet the needs of modern society. There is a disappearance from the considered discipline, the ancestor of which is the medical police, of knowledge and competencies necessary for the successful implementation of management activities for the implementation of one of the most important social functions of the state-the prevention of threats to public health and safety. It is necessary to clarify the essence of the basic concept of the scientific specialty “Public health and healthcare”, as well as to improve the planning procedures of dissertation research.

    Authors: Son I. M. [38] Perkhov V. I. [20] Starodubov V. I. [35]

    Tags: dissertation1 health policy1 medical science2 organization of health care1 organization of medical care4 public health and health care2 state system of scientific certification1

    Read more >

  • 2019 № 6 Assessment of attainability of fifth place in the global ranking of the publishing activity on priority areas in biomedicine

    During 2012-2018 in the Russian Federation, pursuant to Presidential Decree No. 599 of 05/07/2012, a set of state support measures was implemented aimed at increasing the specific gravity of Russian publications indexed in international databases. The national project “Science” (NPS) designed to realize the goals set by Presidential Decree No.204 of 05/07/2018 “On the National Goals and Strategic Tasks for Development of the Russian Federation until 2024” continues and develops the theme of increasing the publication activity of the Russian Federation in the internationalized space. One of the six NPS targets is “The place of the Russian Federation in terms of specific gravity in the total number of articles in areas defined by the priorities of scientific and technological development in publications indexed in international databases”. The purpose of this study was to evaluate the basic value of this indicator for biomedical disciplines related to the priority direction (paragraph 20c) of the Strategy for Scientific and Technological Development of the Russian Federation. We compared volumes of publication flows of the Russian Federation in 20 biomedical disciplines with a similar indicator of countries ranked fifth in the number of publications on the subject area under consideration, indexed in the Web of Science Core Collection (WoS CC). A 5-10 fold lag of the Russian Federation was recorded for the most part of the priority areas in the field of biomedicine identified by the NTS passport. The impact of public policy measures aimed at increasing the national biomedical publication stream for the period of 2012-2018 was estimated as insufficient to meet the considered NTS target.

    Authors: Starodubov V. I. [35] Tsvetkova L. А. [9] Kurakov F. A. [2] Polyakova Yu. V. [3]

    Tags: articles1 biomedicine1 national  project  “science”1 priority  areas  of  scientific  and  technological  development1 publication activity3 specific  gravity1 targets1 web of science4

    Read more >

  • 2017 № 5 Place of clinical medicine in the disciplinary structure of Russian science

    The article Considers the disciplinary structure of science in the world and Russia It is shown that the share of publications on clinical medicine accounted for 26% of the total number of publications indexed in 2015 in the Web of Science database, and 35.3% of publications indexed in Scopus for 2011–2015, the conclusion about the growing importance of clinical medicine in global science. It is noted that the RF power developed in the last century, and not changing the quota system of public sector support for civil science, for research of medical subjects, is no more than 3.2% of domestic expenditure on research and development by socio-economic objectives. It is projected that the underfunding of medical science in Russia will not allow to achieve a substantial increase scientometric indicators reflecting the efficiency and productivity of Russian science in General.

    Authors: Starodubov V. I. [35] Kurakova N. G. [14]

    Tags: clinical medicine2 disciplinary structure2 medical research funding1 science1 scientometric indicators2 world science2

    Read more >

  • 2016 № 2 Structure and challenges of the medical division of the new programme of fundamental scientific research of state science academies

    The article considers the questions of planning and financing the scientific-research activity in the field of medical science, realized at the cost of the state budget. Authors demonstrate that disintegration of scientific processes leads to a decrease of intensity of scientific search and implementation of achievements in medical sciences in the health care practice. Authors conclude that it is necessary to increase the effectiveness of the management of scientific research and more clearly define the priorities of the medical sciences development.

    Authors: Perkhov V. I. [20] Starodubov V. I. [35] Nefedova E. V. [1]

    Tags: health care24 medical science2 scientific research1 state financing1

    Read more >

  • 2014 № 3 Funding medical science: new principles and financial instruments (Federal Research Institute for Health Care Organization and Information of the Ministry of Health and Social Development of Russian Federation, Moscow)

    Annotation. There is conducted an analysis of selection criteria on projects of Russian medical research centers for funding in Russian scientific fund and Federal program «Research and innovations». There is noted a high degree of uncertainty of such concepts as «priority direction», «applied» and «search» research and «industrial partner» in regards to research of biomedical theme. There is completed an analysis of classified «Medicine and health care» «Forecast of scientific-technological development of Russian Federation till 2030 year».

    Authors: Starodubov V. I. [35] Kurakova N. G. [14]

    Tags: federal budgetary programs1 grant funding1 industrial partners1 medical research studies1 priorities1 russian scientific fund1

    Read more >

  • Medical sciences
  • 2015 № 8 Operation mechanisms, priorities and volumes of financial support of research in health care in Russia and in the USA

    The article demonstrates that Russia’s amount of finance in research and development is less than 2,5% from the global budget, while the amount of financing of only three countries – USA, China and Japan takes up to 50%. It was suggested that incomparability of Russia’s internal amount of financing in development of the citizens science sector compared to developed countries allows to identify a limited number of research areas as priorities of scientific-technological development of the country. There was compared and contrasted the amount of spending on research and development in biomedicine in USA and in Russia. It is demonstrated that the basic amount of financing of 27 research centers, included in the US National Health Institutes network, in 2014 exceeded the amount of financing of 104 Russian medical scientific-research institutes subordinate to Russian Minisry of Health care and Federal Agency of scientific organizations by 173 times. A conclusion was drawn about the appropriateness of substantial increase of the amount of state financing in fundamental, exploration and related research in the field of biomedicine in case the life sciences are preserved as priority areas for scientific-technological and social development in Russia. There is emphasized the necessity to eliminate all administrative and tax barriers, preventing active participation of domestic industrial entities in co-financing the development of Russian drug substances and medical equipment.

    Authors: Starodubov V. I. [35] Kurakova N. G. [14]

    Tags: biomedical scientific research and development1 choice criteria1 government funding1 priority areas1 russia7 scientific-technological development1

    Read more >

  • Modernization of health care
  • 2013 № 5 Evaluation of health care modernization's impact on dynamics of adult population's morbidity (Federal Research Institute for Health Care Organization and Information of the Ministry of Health and Social Development of Russian Federation, Moscow)

    Annotation: There are considered different criteria of evaluating health care's modernization, reflecting structural improvements of the system, current, financing and results of additional prophylactic medical examination service, status of medical equipment and its amortization. There is estimated an economic loss due to population's morbidity.

    Authors: Son I. M. [38] Leonov S. A. [14] Starodubov V. I. [35] Pogonin A. V. [2]

    Tags: correlation regressive and factor analysis1 foreseeable levels of morbidity1 loss of earning capacity1 modernization of health care2

    Read more >

  • Organization of health care
  • 2014 № 10 Russian and regional parameters of activity of general practitioners (Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia)

    Annotation. The total number of general practitioner's visits within the studied period has increased in Russia and other federal regions, and in some states — significantly. There is noticed a trend of decrease in the number of preventative visits at home, relative share of visits among country side residents. There is a considerable increase in coefficient of double job holding against a general trend for decrease of practitioner's staffing. There is demonstrated a high demand in general practitioners, in their ability to provide first medical aid and high accessibility of their services to the public. Therefore, development of the institute of general practice should be considered as a perspective path for managing medical-sanitary aid.

    Authors: Ivanova M. A. [12] Starodubov V. I. [35] Sorokina U. A. [2] Bantyeva M. N. [4]

    Tags: general practitioner4 home visits1 job holding1 number of visits1 preventive visits1 staffing10 visits of villagers1

    Read more >

  • Personnel management
  • 2017 № 6 Working time of doctors-specialists related to visiting one patient with doctor-physician, doctor-surgeon and doctor-dermatovenerologist

    In accordance with paragraph 3 of the Rules for the development and approval of standard labor standards approved by the Government of the Russian Federation on November 11, 2002 No. 804 (Collected Legislation of the Russian Federation, 2002, No. 46, Article 4583) and paragraph 19 of the action plan (“road Card“)” Changes in social sectors aimed at improving the effectiveness of healthcare “approved by the Decree of the Government of the Russian Federation No. 2599-r of December 28, 2012 (Collected Legislation of the Russian Federation, 2013, No. 2, Article 130, No. 45, Articles 5863, 2014, No. 19, Item 2468), in 2016 photo-timing observations of the working process of phthisiatricians, doctors-surgeons and doctors-dermatovenerologists were conducted. The work was conducted in accordance with the methodology of conducting photo-timing studies within ten working days for two physicians in each specialty. The results of the research showed the need to develop new normative documents on setting the time limits for visiting one-patient TB doctors, surgeons and dermatovenereologists who provide primary care in outpatient settings (not providing 24-hour medical supervision and treatment).

    Authors: Son I. M. [38] Ivanova M. A. [12] Starodubov V. I. [35] Armashevskaya O. V. [4] Liutsko V. V. [4] Tsybikova E. B. [1] Sokolovskaya T. A. 1 [1] Tyulkina E. A. [2]

    Tags: medical specialists1 new normative documents1 photo-timing observation1 time norms2

    Read more >

  • Population and health
  • 2022 № 6 Risk-Based Approaches to Endoscopic Diagnosis of Gastrointestinal tract сancer in the medical organizations of primary healthcare (on the example of GAUZ SO GB № 1, Nizhny Tagil)

    Early detection of gastrointestinal cancer is an actual public health problem. The implementation of the modern endoscopic diagnostic methods based on the progressive digital technologies significantly reduce the risks of diagnostic errors and contributes to the effective solution of that problem.
    P u r p o s e : to clarify the possibilities of the early detection of gastrointestinal cancer by equipping the endoscopy unit of the city district hospital with the modern digital endoscopes, including devices with zoom functions – ZOOM.
    M a t e r i a l s a n d m e t h o d s . The article analyzes the statistical data of the work of the endoscopy unit of Nizniy Tagil State city hospital № 1 from 2013 to 2022 (except 2020–21, when the hospital was completely redesigned as a COVID-hospital).
    R e s u l t s . A clear relationship between the increase in the number of detected oncopathologies of the gastrointestinal tract and the modern technical equipment of the endoscopic units under the modernization of primary health care program in the Sverdlovsk region in 2021 is presented. Based on risk-based approaches and evidence-based medicine data, the importance expert-class equipment in the routine endoscopic practice in the primary healthcare district hospital for diagnosing gastrointestinal cancer at an early stage is shown. Modern approaches to optical endoscopic diagnostics are analyzed, as well as the potential risks of diagnostic errors associated with technical equipment and possible measures to reduce these risks for further improvement of primary endoscopic diagnostics aimed at detecting gastrointestinal cancer in the early stages are determined, the expediency of equipping endoscopic units of primary care medical organizations with endoscopes inreached magnification functions – ZOOM, as well as photo and video
    recording of digital images with the possibility of archiving, color printing and further expert analysis of endoscopic images.
    C o n s e q u e n c e . From the presented statistical data, it is clearly seen how with the improvement of the equipment quality, the detection of gastrointestinal cancer of various localizations is growing.

    Authors: Starodubov V. I. [35] Ivantsova M. A. [1] Khain V. V. [1] Pavlovskikh A. Yu. [1]

    Tags: colonoscope1 colorectal cancer1 early cancer1 endoscopy2 esophageal cancer1 gastroscope1 oncopathology of the gastrointestinal tract1 stomach cancer1 zoom1

    Read more >