Management in health care
  • 2022 № 1 Features of the state of the network and the provision of a bed fund of medical organizations in Russia

    The implementation of the healthcare development strategy, effective management of the healthcare system is impossible without monitoring and comprehensive comparative analysis at various levels of the state and development of the network, resources and activities of medical organizations, individual services and the healthcare system as a whole.
    P u r p o s e of the study is scientific assessment of the state of the network of medical organizations providing medical care in outpatient and inpatient settings, as well as analysis of the provision of beds for the population of the Russian Federation in 2012–2019.
    M a t e r i a l s a n d m e t h o d s . Within the framework of the conducted research, official statistics data were analyzed, modern trends and trends in the provision of beds and the state of the network of medical organizations in Russia at the regional level were determined. Statistical data processing was carried out using SPSS, Excel‑2007 packages. Such methods as analytical, statistical methods, study and generalization of experience, comparative analysis were used.
    R e s u l t s . The analysis has shown that the unevenness and the level of high differentiation of indicators of provision of beds by subjects of the Russian Federation remains. Thus, over the period 2012–2019, the provision of specialized beds for all the main profiles of beds is decreasing, the largest reduction affected socially significant beds – dermatovenerological – by 1,5 times, as well as therapeutic – by 32,5%, gastroenterological – by 28,2%, pediatric – by 24,4%, and infectious – by 20,3%.
    F i n d i n g s . The results of this study confirm the reduction in the number of beds of the main profiles, as well as the conversion of part of the bed stock, especially in the context of a pandemic of a new coronavirus infection, which showed the need for structural and functional transformations of health resources in general and the bed stock in particular.

    Authors: Zagoruychenko A. A. [8] Karpova O. B. [5]

    Tags: bed fund4 medical organizations23 provision of beds for the population1

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  • 2020 № 7 On the question of the organization of outpatient psychiatric care in the city of Moscow

    The article analyzes the organization and financing of psychiatric care in in-hospital conditions and hospital-replacing care for patients in the dispensary. The results of the study of the composition of patients on the basis of GBUZ “PB No. 13 DZM” for 2015–2017 years are given. The number of patients treated in a dispensary, a day hospital by nosological forms for the last period of time, the number of patients treated by gender were analyzed; considered age categories of patients, the structure of the professional status of patients. During the analyzed period, the main indicators of day hospital were investigated: the average duration of stay of patients, bed turnover, number of bed-days.

    Authors: Grishina N. K. [6] Belostotskiy A. V. [3] Zagoruychenko A. A. [8] Ter-Israelyan A. Yu. [1]

    Tags: compliance1 day hospital4 mental disorders2 paradigm2 psychiatric outpatient module1

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  • 2020 № 1 Aspects of medical rehabilitation in the reform of psychiatric services

    This article examines the medical documentation of patients and materials of the medical rehabilitation depart¬ment at the base of the Psychiatric Hospital of the Moscow Department of Health for the period April-December 2018. The results of the quality of treatment of 352 patients who were treated in the medical and rehabilitation department of the psychiatric hospital № 13 were evaluated.

    Authors: Grishina N. K. [6] Belostotskiy A. V. [3] A. Yu. Ter-Israelyan [3] Zagoruychenko A. A. [8]

    Tags: cognitive function1 medical care and rehabilitation department1 psychiatric rehabilitation1 quality control4 rehabilitation programs1

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  • Management in healthcare
  • 2023 № 7 On the issue of peculiarities of organization of preventive measures for patients with cardiovascular diseases.

    The problem of prevention of chronic non-communicable diseases in Russia is particularly acute, among which diseases of the circulatory system occupy the first place, becoming widespread.
    O b j e c t i v e : to analyze and study the features of the organization of preventive measures for patients with cardiovascular diseases, especially the elderly population.
    M a t e r i a l s a n d m e t h o d s . For the analysis were literary sources, statistical reporting data, regulatory documents, and electronic resources. In the context of this study, such methods as: studying and generalizing experience, content analysis, a systematic approach, and statistical analysis were used.
    R e s u l t s . In the framework of the study revealed a high overall and primary morbidity of BSK in older age groups, so you need to increase the interest of the population in activities of preventive medicine, in which medical services are provided free of charge; analyzed the main preventive measures in the world and the example of some of the subjects of the Russian Federation; the main role of physical activity of the population in the fight against CVD is determined; the main problems in the framework of prevention at the regional level are identified: low interest of the population in health care and low the problem of distribution of preventive measures in the framework of VHI programs is studied.
    C o n c l u s i o n . Higher common and primary morbidity of CVD in elderly age groups of population requires as priority-driven active enhancement of commitment of population in effective medical prevention on the basis of free-of-charge medical care and services. The key role of physical activity of population in prevention of CVD is approved. Among regional problems of CVD prevention of priority importance are critically low commitment of population in one’s own health care and inadequate exploration of prevalence of preventive activities within the framework of implementation of VMI programs.

    Authors: Zagoruychenko A. A. [8] Karpova O. B. [5] Nechaev V. S. [2]

    Tags: adult population4 cardiovascular diseases3 diseases of the circulatory system2 prevention23 risk factors15

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  • 2023 № 5 On certain topical issues of development of preventive activities of centers of public health and medical prevention.

    In actual conditions, increasing of health risks for population determines actuality of exploration of organization of preventive activities of centers of public health and medical prevention.
    Objective: to analyze particular actual issues of development of preventive activity of centers of public health and medical prevention in Russia.
    Material and methods. The topical selection of publications, analytical method, comparative analysis and systemic approach were applied.
    Results. The key measures required for effective preventive activity in centers of public health and medical prevention were established and aggregated. Within the framework of task of active involvement of population into unified preventive environment the implementation of new health care mobile technologies into activities of medical personnel of centers of public health and medical prevention is claimed to monitor patients with the purpose of treatment of various chronic non-communicable diseases and elimination of risk factors of their development.
    Conclusion. The provision of medical and preventive services to population on a free-of-charge basis is among advantages of preventive activities of centers of public health and medical prevention. The development of unified preventive environment in centers of public health and medical prevention applying mobile health care technologies permits to increase interest of population in health self-control and conscious implementation of medical recommendations about healthy life-style. The implementation of marketing measures can promote
    increasing of organizational and reputation status of “health center” among population.

    Authors: Zagoruychenko A. A. [8] Nechaev V. S. [2]

    Tags: center of public health and medical prevention1 healthy life-style1 non-communicable diseases1 preventive activity1 risk factor1

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  • 2022 № 9 Methodological foundations of forecasting the spread of diseases in the world (review)

    In modern conditions, the prediction of the morbidity of the population is becoming one of the most urgent tasks of public health worldwide. For state and international health services, with the help of forecasting the possible incidence and prevalence of various diseases in the general population, it becomes necessary to improve the system of providing specialized care due to the possibility of an updated calculation of the necessary resources.
    Purpose of the study is to analyze the methodological basis for predicting the morbidity of the population based on the study and generalization of literary sources.
    Materials and methods. The materials for the analysis were scientific publications on the issues of forecasting and modeling of morbidity in various subgroups of the population and territories of the Russian Federation and other countries. In the course of the research, such methods as comparative analysis, study and generalization of experience, bibliographic were used.
    Results. Currently, there are a number of studies devoted to disease prediction, and the number of methodological approaches to predicting possible changes in the epidemiological situation in various territories is growing. The study provides an overview of existing methodological approaches to predicting the morbidity of the population in Russia and in the world community.
    Findings. Thus, the analysis of the experience of predicting morbidity made it possible to determine the features of the use of certain mixed methods of forecasting different classes, groups and types of diseases, especially when identifying new viruses and infectious diseases.

    Authors: Shchepin V. O. [5] Zagoruychenko A. A. [8] Karpova O. B. [5]

    Tags: classes of diseases2 forecasting1 forecasting methods1 health care24 population morbidity1

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  • Personnel management
  • 2021 № 8 Regional features of the provision of medical personnel in Russia

    The article analyzes the regional features of the provision of medical personnel in Russia in the context of various subjects and federal districts.
    P u r p o s e of the study is to analyze the features of staffing of medical organizations in the constituent entities of the Russian Federation in modern conditions and the main directions of policy to improve the staffing situation at the regional level.
    M a t e r i a l s a n d m e t h o d s . According to the official statistics, an analysis of the staffing of medical and paramedical personnel was carried out in the context of the constituent entities of the Russian Federation; in the course of the study, methods were used such as: analytical, statistical, study and generalization of experience.
    R e s u l t s . The analysis showed that the provision of doctors and the provision of emergency medical services for different regions of the Russian Federation is different. The lowest values of the indicator of the provision of doctors in 2019 were recorded in the Ural FD, the Southern FD and the North Caucasian FD, while in the constituent entities of the Russian Federation the most pronounced tendency towards a decrease in the level of provision nursing staff was noted in Moscow, Tyumen region, Chukotka Autonomous Okrug, Republic of Kalmykia, Udmurt Republic, as well as in Yaroslavl, Murmansk, Novgorod and Kirov regions, which emphasizes the need to take appropriate management measures, both at the local and federal levels.
    F i n d i n g s . The existing imbalance in the country between the provision of the population with doctors and nurses in various regions (the difference between low and high rates is more than 2.3 times), as well as between the provision of medical workers in the city and rural areas is the main problem of staffing the system. To overcome this situation, further implementation of new measures of social support and moral incentives for medical personnel in Russia is required.

    Authors: Zagoruychenko A. A. [8] Karpova O. B. [5]

    Tags: health workforce2 medical personnel7 planning3 staffing11

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  • Public health

    The article discusses the medical and organizational aspects of conducting preventive examinations of minors as part of new state initiatives of a post-COVID‑19 orientation. The main positions of the Draft Order of the Ministry of Health of May 19, 2021, which will enter into force on September 1, 2021, have been studied, where a structural algorithm has been developed for conducting preventive examinations of minors in the context of an epidemic situation. The regulated positions presented in the document have been studied in the aspect of general medical tasks declared by the state during the modern period of development of the healthcare industry. Such directions, formed in the Project, as diagnostics of post-COVID‑19 complications from various systems of the body of minors, issues of monitoring of reproductive health and physical development are considered. The continuity is shown in the implementation of measures to level violations of the health status of minors within the framework of legislative, managerial
    and organizational initiatives.
    Purpose: analysis of modern legislative materials initiated by the State in the field of preventive examinations of minors, including during the period of the new coronavirus infection COVID‑19; characteristics of the concept of new directions of the program of preventive examinations of minors.
    Materials and methods. The analytical sources of the study were the legal framework, scientific literature data on the issues of preventive examinations of minors. Methods were used in the work: bibliographic, analytical, statistical, comparative analysis.
    Results. A comprehensive analysis showed that the algorithm for conducting preventive examinations of minors is determined by the legislative branch level and checked by the time factor, but is not a constant. Changing living conditions dictate new challenges, determine the inclusion of additional items in the survey of the contingent – laboratory and diagnostic directions, as well as change in time parameters in the examination and organizational support for preventive examinations of minors. The changes introduced undoubtedly require monitoring analysis of indicators on the problem, including comparative scientific analysis and prompt response to new tasks that are determined by time, issues of the medical and social environment.
    Findings. The main organizational directions in the structure of preventive examinations of minors are: diagnostics of post-COVID‑19 complications, monitoring of physical development and the formation of reproductive health, determination of scientifically grounded approaches to admitting the contingent to physical education, the formation of a “data bank” of the results of basic and additional research methods. A comparative analysis of the prevalence of the distribution of minors by health groups based on the results of preventive medical examinations showed the lack of dynamics of indicators in the time period 2014–2020. Undergoing preventive medical examinations, as well as targeted regional policy in this direction, purposefully forming a “healthy childhood environment”, taking into account the development of the local industrial infrastructure.

    Authors: Shchepin V. O. [5] Mingazova E. N. [27] Zagoruychenko A. A. [8] Mingazov R. N. [11] Gasajnieva M. M. [3]

    Tags: health groups2 legislative acts1 minors1 physical health1 post-covid‑19 measures1 preventive medical examinations1 reproductive health2

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