2019 № 6 Medical staff resources of the Moscow psychiatric service during its reform
Medical staff resources of the Moscow psychiatric service during its reform. Since 2010, a modernization of the psychiatric service has been carried out in Moscow. Reforms affect both outpatient and inpatient units. An analysis of the staff resources of the service reflects the effectiveness of the reforms. The aim of the study was to improve the quality of psychiatric care based on the analysis of staff resources of the Moscow psychiatric service. The article presents data on the staff resources of the psychiatric service in 2008-2017. During the modernization of the psychiatric service, the number of psychiatrists was at a high level, the provision of psychiatrists to the Moscow population of was higher than the average provision to the Russian Federation. Growth in the number and staffing of ambulatory rates in psychiatric institutions in Moscow in 2015-2017 partially compensated for the decrease in the number and staffing rates in psychiatric hospitals, however, there is currently a staff shortage in the psychiatric service of Moscow, as indicated by the excess of job-sharing coefficients in individual institutions. During the study period, there was a positive change in the number of visits per 1 psychiatrist.
2019 № 7 Improving the system of organizing the psychiatric aid of the megapolis
Abstract. Currently, a restructuring of the psychiatric service is carried out in Moscow. The changes are implemented accordingto the concept of socially-oriented psychiatry based on a biopsychosocial approach. Reforms include the reductionof inpatient and the development of an outpatient unit of the psychiatric service. Psychiatric hospitals were merged with outpatient units on a territorial basis.
The aim of the study was a comprehensive analysis of the psychiatric service functioning in Moscow during the period of
A retrospective analysis of the demographic characteristics of the Moscow population and clinical and epidemiological
indicators characterizing the incidence of mental disorders, as well as an analysis of the functioning of inpatient and
outpatient units of the Moscow psychiatric service and its staff, was made. The evaluation of the conversion efficiency
indicators was made. A sociological survey about the reforms (questionnaire) of specialists and relatives of persons with mental disorders being carried out through questionnaires was also conducted.
During the transformation of the psychiatric service, the incidence of mental disorders, hospital mortality and the number of cases of disability decreased. The provision of the population with places in day hospitals, the number of places in day hospitals and patients who received assistance in day hospitals, the staffing level of outpatient rates, and the number of visits to district psychiatrists increased. The share of persons involuntarily examined and recognized as in need of inpatient treatment increased from 70% to 100%. According to a sociological survey, most of the heads of structural units of the psychiatric service, psychiatrists, and users of the service positively assess the reforms that have been carried out.
For a large city, the cluster-modular system of psychiatric service, currently organized in Moscow, is a priority.
Results of this work have found application in the organization of psychiatric care in Moscow, Vladimir, and Tula regions
and the city of Sevastopol, and can be put into practice in other major cities of the Russian Federation.