Focus of problem
  • 2021 № 8 Study of quality of life related to health in patients with COVID19 on the first day of admission to hospital

    The COVID‑19 pandemic has resulted in exceptional social disruption and consequent changes in quality of life. Assessment of the health-related quality of life in patients infected with the SARS-CoV‑2 (2019-nCoV) virus in a covid hospital is an urgent public health issue that affects the organization of medical care processes and the planning of rehabilitation programs.
    Purpose of the study is to determine the level of health-related quality of life in patients with COVID‑19 on the first day of inpatient treatment for comparison with pre-pandemic norms and planning targeted rehabilitation programs.
    Materials and methods. A study of the quality of life was carried out using the EuroQol EQ‑5D‑5L questionnaire assessing the Index EQ and EQ VAS indicators. Using the method of simple random sampling, the data of patients were collected for three sets having following features: “Both sexes”, “Men”, “Women”. The analysis was carried out using descriptive statistics methods.
    Results. The indicators of health-related quality of life in patients with COVID‑19 on the first day after admission are lower than the pre-pandemic population norms for Moscow residents according to Index EQ by 20%, according to EQ VAS by 29%, on average. Women have more health limitations than men in all EQ‑5D‑5L domains, which is proportionally lower than population norms. In 3,7% of patients on admission to the hospital, the type of quality of life corresponded to “a condition worse than death”, which was practically not observed in the pre-pandemic period in Moscow residents. The greatest losses are observed in the “Self-Care” and “Mobility” domains, both for men and women. On admission to the hospital, no differences were found in the pre-pandemic and pandemic levels of health limitations in the “Anxiety/Depression” domain.
    Conclusions. The results of the study can be used by specialists from various branches to plan clinical, service, educational, economic, and other public health programs related to the rehabilitation of patients who have had COVID‑19. And it also represents an indispensable additional material for further sociological and clinical research.

    Authors: Tsaranov K. N. [8] Tarbastaev A. G. [8] Ayupova I. I. [3] Protsenko D. N. [3]

    Tags: covid-1921 eq vas3 eq‑5d‑5l3 gbuz “city hospital no. 40 dzm”1 hrqol3 index eq2 kommunarka3 quality of life5 sars-cov‑2 (2019-ncov)3

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  • 2018 № 3 Influence of doctors’ patient-orientation on patient involvement in treatment

    In the article it is shown that nowadays in the public health care of different countries researches of patient-orientation are actively conducted. At the same time patient-orientation as a characteristic of the patient’s communication with the doctor is considered the basis of the patient-doctor relationship. All this corresponds with the feasibility of forming in the domestic health care model of 4P medicine, already repeatedly voiced in recent years on various medical forums. The authors carried out an assessment of the patient-oriented corporate culture of the medical organization. For this purpose, two types of questionnaires were developed and analyzed: “Involvement of health workers” and “Patients’ involvement in treatment”. It has been established that the level of the doctor’s involve- ment in achieving the strategic goals of the medical organization directly affects the level of intention of patients to fulfill doctors’ recommendations. The range of this influence is 43.3% on average

    Authors: Piven D. V. [53] Tsaranov K. N. [8] Lindenbraten A. L. [1] Tarbastaev A. G. [8]

    Tags: 4p medicine3 patient adherence  to treatment1 patient-centeredness1 patient-orientation4 physician involvement1

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  • Management in healthcare
  • 2022 № 7 Dynamics of patient loyalty before and during the COVID-19 epidemic on the example of Children’s Polyclinic

    The COVID-19 has had an enormous impact on the entire Russian health care system, including a significant impact on both the provision of medical services and the relationship between the doctor, the patient, and patient’s legal representatives. On this basis, the research is interested in issues related to the adaptation of medical organizations to the new working conditions with patients and their legal representatives. Aim of the study: to test long-term monitoring of the NPS Loyalty Index by a simplified methodology in patient’s legal representatives of pediatric polyclinic patients before and during the COVID-19 epidemic. Materials and Methods. The empirical material based on patient legal representative scores (n=22098) collected using the simplified NPS (Net Promoter Score) methodology during the two periods: 14.05.2019 -13.06.2020 and 18.06.2021 – 23.08.2021, as well as comments and predictions from lead outpatient clinic staff (n=19) collected by brainstorming to obtain additional interpretations of dynamics of patient legal representative loyalty index during the periods. The Results. According to the results of the study, the NPS patient legal representatives in pediatric polyclinics has increased significantly since the beginning of the coronavirus
    epidemic and after a year was fixed at a level almost one and a half times higher than the values from the first measurement.
    According to the initiative group, this growth was due not only to measures taken by the management of polyclinics, but also to cultural and psychological characteristics of the population; when the epidemic is over, the loyalty index of legal representatives of pediatric polyclinic patients is likely to return to its initial values. Conclusions. The use of a simplified method to measure the loyalty level (NPS) of patients and their legal representatives is a rather effective tool. An important condition in this case is to provide feedback to dissatisfied patients and their legal representatives. The professionalism and dedication of the medical staff play and will play a role in ensuring a high level of loyalty regardless of the epidemiological situation.

    Authors: Tsaranov K. N. [8] Tarbastaev A. G. [8] Markov D. I. [1] Komolova O. A. [1]

    Tags: covid-19 pandemic6 customer-oriented healthcare1 nps loyalty index1 patient loyalty3 patient- oriented2

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  • 2020 № 4 Perception of a threat to personal security medical professionals in the context of the COVID-19 Pandemic

    The article presents the results of an empirical study of the perception of personal safety threats by medical profes- sionals: doctors and nurses. Respondents were medical staff, conditionally divided into two groups: 1) medics in preparation for entering the high-risk zone; 2) medics working in high-risk areas. The resulting text data was processed by IBM Watson Studio (Version 1.1.0–177). Cluster analysis was carried out using the K-Means model. It is shown that the sources of health workers’ fears are determined by the area of actual workspace: preparation for entry to the high-risk zone or working in direct contact with patients infected with COVID-19.

    Authors: Tsaranov K. N. [8] Tarbastaev A. G. [8] Zhiltsov V. A. [1] Klimova E. M. [3]

    Tags: covid-19 pandemic6 fears1 medical professionals1 personal safety1

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  • POPULATION HEALTH
  • 2022 № 8 Prediction of disease outcomes in patients with COVID-19 based on the EQ 5D 5L questionnaire

    In order to provide effective medical care to patients with COVID-19 in hospitals, the disease outcome prognosis is of
    considerable importance. The authors of the study suggested a relationship between health-related quality of life indicators and the outcomes of the disease of patients hospitalized because of COVID-19.
    P u r p o s e . Retrospective study of the relationship between health-related quality of life in patients with COVID-19 on the first day of hospitalization with the outcomes of the disease in a hospital and at the stages of rehabilitation up to 180 days following the discharge to predict outcomes at the early stages of the disease.
    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 “Kommunarka” Moscow Multidisciplinary Clinical Center of the Moscow City Health Department from March 2021 to April 2022. Data collection was carried out using a paper-and-pencil Russian version of the EQ-5D-5L questionnaire (Tracking Number: 41183), on the first day of admission of patients to the hospital. Additional patient data was extracted from electronic health records. Two types of EQ-5D-5L questionnaire results were evaluated: Index EQ and the Visual Analog scale (VAS) EQ. All calculations of the regression model were carried out using the R 4.2.1 language in the RStudio 2022.02.3 Build 492 software environment.
    F i n d i n g s . In the obtained logistic regression model, the extremely high statistical significance of the variable “Index EQ” (p<0.01) was demonstrated, the greater the value of the variable “Index EQ” is, the less the probability of a fatal outcome is.
    At the same time, there is no statistically significant relationship between the variable VAS EQ under study and the probability of a fatal outcome.
    C o n c l u s i o n s . An extremely significant relationship between the calculated health-related quality of life index, Index EQ, and outcomes of COVID-19 when patients were admitted to the hospital was revealed, which makes it possible to use it as a predictor of disease outcomes at early stages. No significant relationship between the VAS EQ and the outcomes of the disease in patients with COVID-19 on the first day of hospitalization was revealed, which makes it impossible to use it as a predictor of disease outcomes at the early stages. Application of the health-related quality of life index, Index EQ can be used to make medical decisions in order to early predict tactics of patient management in hospital treatment and rehabilitation.

    Authors: Kobyakova O. S. [13] Tsaranov K. N. [8] Tyufilin D. S. [2] Ayupova I. I. [3] Tyurin I. N. [1]

    Tags: covid-1921 disease outcome prognosis1 eq vas3 eq‑5d‑5l3 hrqol3 index eq2 kommunarka3 quality of life5 sars-cov‑2 (2019-ncov)3

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  • Personnel management
  • 2022 № 9 Intentional potential of scientific and clinical heads as a strategic resource of a healthcare organization

    R e l e v a n c e . The healthcare management system requires high-quality and rational use of the organization’s workforce, i. e. the skills of employees. The intentional potential of an employee is a set of needs, motives, etc., the «core» of the personality driving it to achieve a meaningful goal. The N. V. Sklifosovsky Research Institute for Emergency Medicine is a leading multidisciplinary medical institution with an established multi-level system and management culture, the quantitative assessment of the intentional potential of which is of great interest.
    P u r p o s e : to study the intentional potential of the heads of clinical and scientific departments.
    M e t h o d s . An anonymous survey was conducted among the heads of the scientific and clinical departments of the N. V. Sklifosovsky
    Research Institute for Emergency Medicine (2021), including two methods of S. Schwartz: assessment by the level of normative ideals (SVS) and by individual priorities (PVQ). The procedures of centering and ranking by the average values of each valuemotivational type were carried out. Next, the value-intentional consistency (VIC) and the coefficient of value oppositions (Cvo) were investigated.
    F i n d i n g s . No statistically significant differences in the VIC at the SVS and PVQ levels, as well as no differences in the Cvo at the SVS level in the groups of heads of clinical and scientific departments were revealed. Intrapersonal contradictions between the value oppositions «Security» and «Stimulation» at the PVQ level (p<0.05) were revealed, they are less pronounced in the group of heads of scientific departments. There were also no statistically significant differences in the other oppositions of value orientations of the PVQ level.
    C o n c l u s i o n s . The presented results can be used as additional factors in the planning and implementation of measures of sociopsychological management of scientific and clinical departments. In the professional selection for the relevant positions, the Cvo indicator is more informative. Differences between the groups of scientific and clinical heads in the «Security – Stimulation» Cvo were shown, the distribution of this indicator tends to be more pronounced among the group of scientific heads.

    Authors: Tsaranov K. N. [8] Tarbastaev A. G. [8] Petrikov S. S. [1] Zavaliy L. B. [1] Kanibolotsky A. A. [1] Tsuleiskiry B. T. [1]

    Tags: intentional potential1 pvq1 schwartz questionnaire1 svs1 value consistency indicator1 value opposition coefficient1 value profile1

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  • Social aspects of health
  • 2020 № 9 Value orientations of the doctor as predictor of efficiency of activity of the medical organization

    The article presents the results of an empirical study of the value orientations of dental clinic employees. It is
    suggested that gaps in human values are factors that influence professional activities in terms of communication (in the
    production team) and ultimately the profitability of the individual in the teams. The initial data is obtained from the reports
    of the clinic’s medical information system and the Schwartz’s Value Survey (SVS) and Portrait Values Questionnaire (PVQ).
    In addition, we used a retrospective analysis and a questionnaire survey. Doctors were divided into two groups based on
    the impact of value gaps on the share of revenue plan fulfillment (type one and type two groups). Attention is drawn to the
    direction of relationships in the group of the first type, all correlations of average strength are direct, in the group of type
    2 – reverse. In the structure of the profile of value orientations, there are differences between the groups on the second
    place in importance for the respondents in the group of the first type are the value orientation (VO) “Achievement” and
    secondly, “Self-Direction”, third place in the group of the first type is “Benevolence”, whereas in the group of the second
    type of “Benevolence” in 4th place. To increase economic efficiency, managers of medical institutions need to organize
    activities to create cultural artifacts about the normative ideals of those values that affect the workflow, take into account
    the data of the employee’s value profile for optimal selection of the team composition (work shift).

    Authors: Tsaranov K. N. [8] Tarbastaev A. G. [8] Klimova E. M. [3] Akimov T. V. [1] Zvansky A. B. [1]

    Tags: effective team formation1 human resource1 personnel management4 raise of patient treatment effectiveness1

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  • Sociology of healthcare
  • 2022 № 2 Adaptation and initial reliability testing of the Russian-language version of the safety attitudes questionnaire for medical organizations

    The article presents the results of adaptation and initial reliability testing of the Russian version of the safety attitudes questionnaire (SAQ) for medical organizations. The reliability of using the questionnaire has been proven: all scales have high internal consistency and correlate with original factors. Using exploratory and confirmatory factor analysis, the features of the seven-factor structure of the Russian version of the questionnaire are shown: 1. teamwork climate; 2. safety climate; 3. job satisfaction; 4. stress recognition; 5. perceptions of management (department level); 6. perceptions of management (hospital level); 7. working conditions.

    Authors: Khayrullin I. I. [7] Tsaranov K. N. [8] Tarbastaev A. G. [8] Klimova E. M. [3] Protsenko D. N. [3] Rakhmatullin R. E. [2] Kononov A. N. [1]

    Tags: adaptation of the questionnaire1 approbation of the questionnaire1 confirmatory and factor analysis1 medical organizations22 safety attitude1

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