2022 № 7 Issues related to changing the procedure for providing state guarantees to employees of medical organizations working with COVID-19
Emergency and rather extraordinary measures aimed at increasing the degree of social protection of medical workers in connection with the spread of COVID‑19 have been repeatedly changed. At the current stage, characterized by a decrease in the spread of coronavirus infection, these measures have undergone quite drastic changes, the essence of which is discussed in this article.
2021 № 8 Questions implementation of incentive payments to medical workers for vaccination against Covid -19
In order to financially support medical workers and further motivate them to increase the rate of vaccination against COVID‑19, the Russian Government has introduced special incentive payments for additional workload for medical workers. The established mechanism of financial support and the procedure for making payments is quite complex, since it is aimed at achieving specific practical vaccination indicators. This publication explains some of the issues that arise in connection with the implementation of these payments.
2022 № 10 Issues of taxation of compensation payments for treatment of COVID-19 with personal income tax
Previously existing payments for the treatment of coronavirus infection (incentive payments, special social benefits) were not taxed on personal income. Therefore, the question naturally arises whether compensation payments to certain categories of persons at risk of contracting a new coronavirus infection are subject to taxation with this income. This problem is all the more urgent because, in accordance with the Tax Code, a number of types of compensation payments are exempt from taxation.
The article analyzes the positions of the tax authorities on the problem under consideration, taking into account judicial practice, and concludes that compensation payments related to the treatment of COVID‑19 are an element of remuneration, act as a form of compensation surcharges for work in harmful working conditions, and therefore are subject to personal income tax in a general manner.
2022 № 3 Features of the state of health of students during their training, including in the conditions of COVID‑19
Purpose: to assess the characteristics of the health status of students in the conditions of education during the pandemic period – 2020–2021. The analysis of the data obtained will form the basis of the developed medical recommendations, organizational measures aimed at maintaining the health of students, including various periods of increased infectious risks.
Materials and methods: Medical and sociological research was conducted among students of one of the Institutes of the Russian
State University named after A. N. Kosygin (Technology. Design. Art). The continuous sample of students was 505 people. In the course of the study, socio-hygienic, clinical, statistical, and analytical methods were used.
Results: It was revealed that in the process of teaching student youth, an increase in the number of people with chronic diseases is determined; diseases of the nervous system, organs of the digestive system, ENT organs and the cardiovascular system prevailed in the structure of chronic diseases of students.
Findings: It was found that there is no difference between the number of patients with coronovirus infection among students who do not have chronic diseases and among those who have chronic pathology. Among students with chronic diseases and recovering from Covid‑19, the most common were people with chronic diseases of the cardiovascular system, chronic diseases of the upper respiratory tract, and people who often get colds (4 or more times a year). Studying the state of health of students is important, both from the point of view of its comprehensive assessment, and from the standpoint of analyzing subsequent dynamic changes, which makes it possible to identify trends in changes in health in the dynamics of education, as well as to introduce appropriate medical and social adjustments.
2022 № 4 Physical activity of students during the COVID‑19 pandemic as a health-saving perspective
According to the WHO, physical activity contributes to the prevention and treatment of noncommunicable diseases. Lack of fitness is considered an important cause of future lifestyle-related diseases, including metabolic syndrome, diabetes, hypertension, and cardiovascular disease. People with low levels of physical activity have higher body mass index, higher waist circumference and fat mass than those with high levels of physical activity. In recent decades, especially during the COVID‑19 pandemic, physical inactivity and sedentary lifestyles have become a major global public health problem, even among younger populations. All this suggests the special importance of the physical activity of students in difficult life situations, including the conditions of the COVID‑19 pandemic.
Purpose: to review foreign scientific literature containing information about the characteristics of physical activity of students during the COVID‑19 pandemic and their impact on health indicators, about risk factors and ways to level them.
Materials and methods: bibliographic, information-analytical and methods of comparative analysis.
Results: during the COVID‑19 lockdown, students, regardless of baseline fitness scores, reduced time spent in moderate to vigorous physical activity, increasing sedentary lifestyle and screen time. At the same time, first-year students turned out to be the most vulnerable to lifestyle changes due to isolation due to the difficulties of adapting to the conditions of study at the university and to the new realities during the COVID‑19 pandemic. During the lockdown, there has been an increase in the positive relationship observed before the pandemic between students’ physical activity indicators and gender, weight, psychological state and year of study. There is a greater adaptability of women to the conditions of isolation, women more often retained physical activity due to concern for health and shape. Women were more sociable, more often used social networks when doing physical exercises.
Findings: when developing strategies to stimulate physical activity and create a favorable environment for its implementation during isolation, one should take into account gender differences, socio-cultural factors, the role of the family and close circle, the role of educational organizations. Promoting physical activity among students during the COVID‑19 pandemic requires the joint efforts of the family, the public, the state, health organizations and educational institutions.
2021 № 9 Elimination of preventable child mortality as a global task of the XXI century, including in the context of the COVID‑19 pandemic
Despite a sharp reduction (by almost 60 percent) over the past 30 years in the mortality of children and young people, including those under the age of five, the global burden of this problem, according to the UN, remains enormous. The paper provides information on the analysis of data from foreign scientific literature on the indicators of child mortality and its causes in foreign countries, including in the conditions of the COVID‑19 pandemic. It is during the pandemic that many countries experience interruptions in the provision of maternal and child health services, such as medical examinations, vaccination, prenatal and postpartum care due to lack of resources. Studies show that the overall risk of death from COVID‑19 in children is quite low. The causes of infant mortality are mainly factors associated with neonatal mortality: premature birth, low birth weight, complications during childbirth, neonatal sepsis, as well as infectious diseases, more often pneumonia, diarrhea and malaria, and insufficient vaccination. In order to prevent and reduce global child mortality, strategies are needed to provide adequate medical and social services to the population, as well as poverty eradication programs.
P u r p o s e o f t h e s t u d y : to review foreign scientific literature containing information on the analysis of child mortality rates and its causes in foreign countries, including in the conditions of the COVID‑19 pandemic.
M a t e r i a l s a n d m e t h o d s of research: bibliographic, information and analytical methods and methods of comparative analysis were used.
R e s u l t s . Studies have shown that only 122 countries were able to achieve the target of mortality of children under the age of five, designated in the “Sustainable Development Goals (SDGs) ” – 25 or less deaths per 1,000 live births by 2019. The death rate of young children is highest in areas where the poor, ethnic or religious minorities, indigenous peoples and people who are discriminated against live. Studies conducted in 2020 showed that the overall risk of death from COVID‑19 in children is quite low.
The COVID‑19 pandemic has led to serious disruptions in the work of health services, which threaten to negate efforts to eliminate child mortality.
F i n d i n g s . In order to prevent and reduce global child mortality, strategies are needed to provide adequate medical and social services to the population, programs to eradicate poverty, and provide access to obstetric and prenatal services. Many countries are experiencing disruptions in the provision of maternal and child health services, such as medical examinations, vaccination, prenatal and postnatal care due to a lack of resources during the pandemic. Due to failures in the health system during the COVID‑19 pandemic, additional deaths of children are possible as a result of potential disruption of health systems.
2023 № 2 Epidemiology of tuberculosis in Russia and Rno-Alania during the COVID-19 pandemic
The study of the combination of diseases at the present stage of development of medicine is extremely relevant. Among the combined effect of various pathologies on humans and populations, two main concepts are distinguished: comorbidity (the combined effect of diseases on a patient or group), including the underlying and concomitant diseases, and syndemia (the combined effect of diseases at the population level).
P u r p o s e : to analyze the epidemiology of tuberculosis during the COVID‑19 pandemic to identify trends in Russia as a whole and in North Ossetia-Alania.
M e t h o d s : a theoretical analysis of the current research situation in Russia in relation to the tuberculosis and COVID‑19 syndemics was carried out. The data sources were annual forms of federal statistical observation.
R e s u l t s : Significant factors that slow down the dynamics of improving the epidemic situation for tuberculosis in Russia and North Ossetia-Alania are the reduction in the coverage of the population with preventive examinations for tuberculosis. In general, a clear syndemic between the epidemiology of TB and the COVID19 pandemic has not been identified both for Russia and according to the results of the analysis of statistics in RNO Alania. There are social trends to reduce the coverage of the population and belated primary treatment of patients with a general practitioner and phthisiatrician, as well as persons removed from the dispensary, so there is an increase in the proportion of severe forms of TB (with lung tissue destruction, fibrous-cavernous type).
C o n c l u s i o n s : The identified trends indicate a later appeal of patients during the pandemic and a decrease in population coverage in Russia and in the analysis of data for North Ossetia-Alania. The increase in the proportion of severe forms of tuberculosis is more likely to be associated with the above trends, and not with syndemic. Trends in the dynamics of TB indicators in Russia and North Ossetia-Alania are similar in terms of comparing negative or positive increases in indicators.
2022 № 9 Health related quality of life as a predictor of the transfer of patients with COVID‑19 to the intensive care unit
Understanding the results of self-assessment of health-related quality of life in patients with COVID‑19 is an important part of the full and objective picture of the medical condition on the first day of hospitalization when making decisions to start early intensive care in the resuscitation and intensive care unit.
H y p o t h e s i s : the values of health-related quality of life indicators in patients with COVID‑19 on the first day of hospitalization are interrelated with the fact of their stay in the resuscitation and intensive care unit.
P u r p o s e : a retrospective study of the relationship of health-related quality of life in patients with COVID‑19 on the first day of hospitalization and the necessity of treatment in the resuscitation and intensive care unit.
M a t e r i a l s a n d m e t h o d s . The study was conducted on the basis of 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). Additional patient data was extracted from electronic medical records. Two types of EQ‑5D‑5L questionnaire results were evaluated: the EQ index and the visual-analogEQ scale. All calculations of the regression model were carried out using the language R4.2.1 in the software environment RStudio 2022.02.3 Build 492.
F i n d i n g s . This study is the first work where health-related quality of life indicators measured during the first 24 hours of hospitalization in order to predict the transfer of patients with COVID‑19 to the intensive care unit. The best results of self-assessment of their medical condition in the course of hospitalization were revealed in those patients who did not require further treatment in the intensive care unit. The worst results of self-assessment of their medical condition were revealed in lethal patients hospitalized in the intensive care unit on the first day. Two logistic regression models demonstrated a significant relationship of the EQ Index and the Mobility domain with the probability of transferring patients to the intensive care unit. The results obtained prove that subjective indicators of health-related quality of life reflecting the perception of one’s illness “here and now” along with objective clinical indicators are independent predictors of the transfer of patients with COVID‑19 to the resuscitation and intensive care unit.
C o n c l u s i o n . Health-related quality of life indicators (EQ Index and MO) can be used to predict the early use of preventive measures to prevent the deterioration of patients’ condition and reduce the load on the intensive care unit
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.
2022 № 7 Analysis of morbidity and staffing of the population of rural areas in the Russian Federation
Rural health care is the most important socio-economic resource in the system of the agrarian economy.
Purpose of the study. Based on medical and demographic indicators and analysis of morbidity and staffing of the rural population, develop proposals for improving the organization of medical care for rural residents.
M a t e r i a l s a n d m e t h o d s : analytical, statistical, direct observation. The article used the forms of federal statistical observation of the Ministry of Health of the Russian Federation.
R e s u l t s . The mortality rate of the rural population over the 20 years of analysis for all the years has been and remains higher than that of the urban population. In 2020, there was a sharp increase in the mortality of the population: urban – from 11,9 to 14,3‰, rural – from 13,3 to 15,4‰, which is associated with the COVID‑19 pandemic. The indicators of the general and newly diagnosed morbidity of the rural population are lower than those of the urban population, which is associated with the low availability of medical care to the rural population.
The ranking of indicators of the general incidence of the rural population in the federal districts of the Russian Federation (2020) showed that the difference in indicators was 1,5 times. The highest indicator was noted in the Volga Federal District – 142220,6‰00, the lowest in the Far Eastern Federal District – 96922,8‰00. In the subjects of the Russian Federation, the difference in indicators is 8 times. Lower rates of primary morbidity in the rural population than in the urban population were noted for all classes of diseases. The incidence of COVID‑19 among rural residents was 2151,9‰00, lower than in urban areas – 4539,5‰00, in the Russian Federation the figure was 3384,5‰00. In 2020, the primary morbidity rate of the rural population decreased for all classes of diseases, except for respiratory diseases. In dynamics (2014–2020), the provision of medical organizations located in rural areas increased with doctors from 12,1 to 14,0‰0, with nurses from 44,4 to 50,3‰0, the number of physical EMS persons decreased by 14,8%, paramedics – by 11,6%, the number of FAPs and AFs decreased by 8,9%. The analysis shows that the Decree of the Government of the Russian Federation dated 02.02.2015 No. 151-r “Target indicators of the strategy for sustainable development of rural areas of the Russian Federation for the period up to 2030” is not being implemented.
C o n c l u s i o n . Proposals for providing medical care to the population of rural areas are presented
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.
2020 № 9 State measures to support the budget and budget institutions at the current stage of the spread of coronavirus infection
Despite the fact that the main source of financial support for health care is currently the means of compulsory
medical insurance, the importance of the Federal budget and the budget system as a whole for the functioning of the
industry cannot be overestimated. In the context of the spread of coronavirus infection, budget legislation is undergoing major changes, with many changes being temporary and aimed at ensuring the budget process in specific conditions related to the fight against COVID‑19.
2020 № 4 The effect of coronavirus Сovid-19 on the situation in Russian healthcare
The relatively slow initial rate of spread of COVID-19 coronavirus in Russia has its own objective reasons related to the size of the territory, population density, tourist activity of the population, etc. They have played a positive role in making it possible to better prepare for the fight against it, taking into account, among other things, the experience of countries where the rate and scale of the spread of the coronavirus was much higher.
Despite the serious damage to the economy, there are no global financial threats to health care yet. However, it is important that resources arrive in time to medical organizations in the context of large-scale conversion of beds, etc. Unavoidable periods of downtime during periods of re-profiling, being in standby mode, etc., lead to the fact that many medical organizations risk finding themselves in a difficult financial situation, even with sufficient resources in the industry. Therefore, at this stage, it is sometimes more important than serious financial infusions, and mechanisms aimed at com- pensating for the loss of income.
2022 № 1 Financing of the compulsory health insurance system in 2022
The most important factor affecting the amount and methods of financial support of the compulsory medical insurance system, as in the last two years, continues to be the spread of coronavirus infection COVID‑19.
In the proposed paper discusses not only the indicators of the budget of the Federal compulsory medical insurance Fund, but the dynamics of indicators, including, in comparison with the rate of inflation, and other factors.
New directions of the use of compulsory medical insurance funds are identified, the reasons for their appearance are considered.
2022 № 9 About some methodological approaches to the assessment of the salary level of medical workers.
The article deals with methodological issues of assessing the level of salaries of medical workers by official statistics bodies (Rosstat) and within the framework of surveys of medical workers themselves.
The main methodological differences are shown in the methods of calculating the indicators characterizing wages used by statistical authorities and survey organizers. The main reasons leading to the discrepancy between the results of such assessments are shown. Among them, first of all, it is necessary to name different approaches to accounting for personal income tax, restrictions in the sample, etc.
In addition, official statistics take into account not only wages, but also some other expenses in favor of employees. At the same time, the concept of "average number" is used, which is not taken into account in the framework of the conducted surveys.
At the same time, the salaries of medical workers in order to assess the achievement of the targets set by the May Presidential
Decrees should be correlated not with the average salary for the subject of the Russian Federation, but with the average monthly income from work.
Such methodological differences create an objective basis for the discrepancy between the survey results and official statistical data and should be taken into account when interpreting the data obtained.
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.
2022 № 7 Issues related to the replacement of special social payments for work with COVID-19 with compensation payments
The article discusses issues related to the suspension of special social payments for work with COVID‑19 and their replacement with compensation payments. Problems such as the procedure for completing existing payments, lists of employees who are subject to compensation payments, measures that need to be taken by medical organizations in a new situation are considered.
2022 № 8 About some methodological issues of remuneration of medical workers
The article discusses a number of methodological issues of remuneration that arose against the background of the suspension of special social payments for work with COVID‑19 and their replacement with compensation payments, as well as the postponement of pilot projects that were to be implemented in order to prepare for the introduction of a new system of remuneration for medical workers.
2022 № 10 Features of the organization of work of paramedical personnel of emergency medical care in the conditions of COVID‑19
In recent years, the ambulance service in our country has been undergoing changes in the direction of reducing the number of stations, medical personnel, as well as persons who have been assisted on trips, which has increased the burden on this healthcare sector in the context of the spread of a new coronavirus infection.
The purpose of the study is to develop proposals to improve the organization of the work of the ЕMС in the conditions of the spread of a new coronavirus infection.
Materials and methods. To study the organization of work, information was copied from call cards (n=134 before the
pandemic, during the pandemic n=2058), the study of the frequency and validity of ЕMС calls was carried out using a developed questionnaire.
Statistical processing of the material was carried out using the Statistika 10.0 software package. Statistical differences were considered significant at p<0.05.
Results and discussions. It was found that in the conditions of the spread of a new coronavirus infection, the number of calls and the time spent on their full processing increased, and factors affecting the duration of the call were also identified. In addition, an increase in the number of unreasonable calls was detected and their causes were determined.
Findings. The developed proposals for improving the work of the ЕMС will reduce time losses when making a call and increase public awareness of the reasons for calling an ambulance
2023 № 3 Scientific substantiation of proposals for improving medical care for villagers.
P u r p o s e o f t h e s t u d y : based on the analysis of the medical and demographic situation and the staffing of the rural population, develop proposals for improving medical care for the villagers.
M a t e r i a l s a n d m e t h o d s : statistical, analytical, direct observation. The article used the forms of state statistical observation of the Ministry of Health of the Russian Federation. The results of the actual research.
Materials and methods: statistical, analytical, direct observation, the forms of state statistical observation of the Ministry of Health of the Russian Federation were used.
R e s u l t s . The rural population in the Russian Federation (2021) is 36,9 million people (25,2% of the country’s population). The proportion of the rural population of working age was 53,8%, which is lower than in Russia as a whole – 56%. A 21-year analysis showed that the birth rate of the rural population increased until 2012, while mortality rates decreased, in 2013 the mortality and birth rates became equal and amounted to 14,5‰ each, in 2020 the death rate increased to 15,4‰ due to the COVID‑19 pandemic. The average (expected) life expectancy of the rural population (70,7 years) is lower than that of the urban population (71,8 years); the indicator for rural men is extremely low (66 years). The
overall incidence of the rural population is 1,4 times lower than that of the urban population, 117993,2 and 166901,5‰oo respectively. Primary morbidity is also 1,5 times lower (55082,4 and 83002,2‰oo, respectively). The difference in primary morbidity rates of the rural population in the federal districts (2020) was 1,3 times, in the constituent entities – 8,3 times. The incidence of COVID‑19 in the rural adult population (2020) was 1986,0‰oo, which is 2 times lower than in the Russian Federation as a whole (3913.9‰oo). There was a significant difference in these indicators (by 59 times) in the subjects of the Russian Federation, which can be associated with a lower density of the rural population,
low availability of medical care in the countryside, as well as the ambiguity of COVID‑19 coding. For 6 years (2016–2021), the provision of doctors in medical organizations in rural areas in the Russian Federation decreased from 14,8 to 13,6‰o, and of nurses – from 54,6 to 49,3‰o. The number of nursing staff individuals working for feldsher-obstetric station decreased by 12,5%, paramedics – by 9,4%. Given the special importance of paramedical assistance in the countryside, the reduction in the number of paramedics should be considered a negative.
C o n c l u s i o n . The unfavorable medical and demographic situation in the countryside requires the development of organizational and managerial decisions aimed at increasing the availability of medical care to the villagers.
C o n c l u s i o n s . Proposals have been developed to improve the provision of medical care to the population of rural areas.
2022 № 9 The evaluation of the provision of specialized medical care to patients with COVID‑19 in the conditions of the central district hospital
Planning and managing the activities of a medical organization in the context of a biological challenge associated with the spread of a new coronavirus infection (COVID‑19) is an urgent task for the healthcare system, determining the possibilities of its functioning in the conditions of transformation and re-profiling of the bed fund, mobilization of human, material and technical resources. Based on the results of assessing the parameters of the activities of a medical organization, it is possible to systematize and streamline the work of its structural divisions.
P u r p o s e of the study is to determine the optimal burden on medical workers, to establish factors that affect the duration of hospitalization and determining the outcomes of the disease among patients with COVID‑19.
M a t e r i a l s a n d m e t h o d s . The retrospective continuous study of hospitalizations of 7576 patients was planned and conducted with an analysis of the duration of hospitalization, the dependence of the results of hospitalization on gender and age, as well as the impact on this indicator of the severity of the disease (using Pearson’s linear correlation coefficient (r-Pearson)) and analysis of survival by evaluating Kaplan-Meier.
R e s u l t s . The results of the analysis showed that the average number of patients per doctor per month was 28,23 ± 13,27 patients [IQR: 16,93; 41,25]. The dependence of the duration of hospitalization on sex and age showed the absence of statistical significance between these indicators (r-Pearson = 0,079; p < 0,001). The dependence of the duration of hospitalization on the severity of the course of the disease showed no statistical significance between these indicators (r-Pearson = 0,04; p < 0,001). The risk of death was increased with the length of hospitalization.
C o n c l u s i o n . The results of study are relevant for public health specialists who plan the resources of medical organizations and assess the possibilities of using the bed fund.
2020 № 5 Blood collection during the period of COVID‑19 infection
We evaluated the work of the Samara Regional Clinical Blood Transfusion Station, the collection and delivery
of blood components in January-April 2019 and 2020 changes in activity at the beginning of the COVID‑19 pandemic
infection. The need for blood components decreased: red blood cells – by 16,7%, platelets – by 13,0%, plasma – by 25,6%, cryoprecipitate – by 32,5%. SOKPSK provides the needs of the region’s healthcare in blood components and preparations, as well as the safety of donors and staff. For this: a) new donor recruitment methods have been introduced; b) plasma donors have been transferred to blood and platelet donors. A common pattern is the reduction in the use of medical technologies that require transfusion of blood components. According to the results of the first 4 decades of work, such a reduction in the Samara region is two time less than in other developed countries.
2020 № 9 Donor platelets collection in a pandemic of COVID‑19 infection
The work of the Samara Regional Clinical Blood Transfusion Station, the collection and delivery of platelet concentrates in
2018, 2019 and in the first 6 months of 2020 was assessed. The annual demand for platelet concentrates in 2019 increased by 22.9%, and in the first half of 2020 the issue of platelet concentrate decreased by 12.1%, which is associated with a change in treatment work during the period of infection COVID‑19. The proportion of platelets isolated from whole blood in the first half of 2020 decreased from 24.7% (the end of 2019) to 17.4%, (p <0.001). This maneuver made it possible to accept all donors wishing to donate apheresis platelets.
2023 № 4 The possibilities of redistributing the functions of the city clinic at the opening of the Distant consultation center unit.
Goal. To evaluate the interim results of a pilot project on the organization of an independent unit of a city clinic that provides remote support to citizens – the Distant Consultation Center of the Government Autonomous Organization Healthcare “City Clinic No. 8” (hereinafter referred to as the DCC).
M e t h o d s o f w o r k . To assess the effectiveness of the pilot project, a number of indicators of the work of the medical organization were analyzed before the start of the project and 12 months after the start of its implementation. The analysis was carried out in two way of work of the Distant Consultation Center: 1. the process of providing medical care to patients with acute respiratory viral infections / Influenza / COVID‑19; 2. the process of providing medicines to the Subsidized category of citizens. The volumes of work that can be transferred to the Distant Consultation Center
from the department of primary care physicians care and from the emergency medical care are analyzed.
The source of the data was the medical information system of the medical organization “URMO TO” (modules Registry, Control of realization, doctor’s ARM, Disability sheets, Additional processing). The period of work of the medical organization from 01.01.2022 to 31.12.2022 is analyzed.
Statistical processing of the results was carried out using the Statistica 6.0 application software package.
Distance consultation was carried out via IP telephony, as well as using specialized Telemedicine software.
R e s u l t s o f t h e w o r k . Before the organization of the DCC, the median indicator of the actual workload per hour of the covid team was 2,5 [2,3–2,7] patients, p<0,07. While the doctor of DCC carried out an average of 56,9 [44–68] remote consultations, which is an average of 8,8 patients per hour, p< 0,07.
The median value of patients for prescriptions for Subsidized medicines before the start of the project was 4 [3–6] patients per day (p<0,07), on average 22.2% time of the initial consultation falls on patients requiring a Subsidized medicine. The median value of applications for the purpose of providing Subsidized categories of citizens with medicines when discharged by a medical assistant at the DCC was 1 [0–3] (p<0,08). Thus, this section began to occupy 0,06% in the structure of reasons for the initial appointment to the primary care physician.
C o n c l u s i o n s . The organization of the work of the DCC allowed us to develop approaches, approve and adapt them to the processes of filling out the schedule of primary care doctors in order to increase accessibility to the primary consultations of the primary care physician’s department.
Scaling up the organizational model and processes of the Distance consultation center of the Municipal Polyclinic No. 8 can serve as an effective tool in achieving the goals announced within the framework of the pilot project of the Ministry of Health of the Russian Federation “Incident 38” launched in 2022.
T h e s c o p e o f t h e r e s u l t s . The presented experience shows the possibility of managing patients with respiratory viral diseases in outpatient polyclinic conditions on an ongoing basis, as well as the telemedicine format of care can be extended and adapted to non-infectious nosologies.
2022 № 10 Approaches to developing an information resource for managing patient flows in a medical organization during a global biological challenge (on the example of COVID-19)
Patient flow management in medical organizations and rational use of human, material, medical and technical resources during the period of global biological challenge are the key to the effective functioning of the health care system.
The formation of a set of indicators and criteria that allow the organization, planning and management of hospitalizations should be carried out with using of modern information aggregators integrated with medical information systems both at the level of a single hospital and in general across a network of medical organizations in the region that provide specialized medical care in hospitals.
Purpose of the study is to develop an information system architecture that allows assessing the level of use of the resources of a medical organization during a global biological challenge (on the example of COVID-19) and distributing patient flows depending on its current capabilities.
Materials and methods. Based on the data on the results of hospitalization of 7576 patients with COVID-19 in the Noginsk Central District Hospital, 6 consecutive stages of developing an information system were formed, including user stratification and determining roles and levels of access to information for them, classifying the resources of a medical organization, developing digital models of databases data, standardization and mapping of work processes in the structural divisions of the hospital, compiling a list of input (accounting) and output (reporting) indicators correlated with each other through the use of directories and registers, as well as on the basis of logical links.
Results. Digital layouts of 4 registration cards were developed (data of medical workers; data of patients, medical services provided to them and the time for their implementation; use of medical equipment and time spent on research; registration of hospitalizations in hospital departments), 10 reporting forms (on the activities of medical workers and medical services rendered by them; on the structure of hospitalized and diagnostic tests carried out by them; on the use of medical equipment; on hospitalizations and the use of hospital beds) and templates of analytical reports for making management decisions based on the data of reporting forms for 6 categories of users (for medical workers of the relevant structural units of the hospital heads of structural subdivisions, deputy heads of a medical organization and head of a medical organization, a specialist of a public authority of a constituent entity of the Russian Federation in the field of health protection).
Conclusion: The information resource proposed for development makes it possible to carry out a current assessment of the workload of medical workers and medical equipment, the employment of the bed fund, compliance with time parameters when performing standard operating procedures in the structural divisions of the hospital and ensure operational management of patient flows.
2020 № 6 Blood collection during the period of COVID-19 infection
We searched Google Trends using terms in Russian and English: “coronavirus”, “blood transfusion”, “plasma transfusion”, “donate blood”. Object of study – requests submitted from February 15 to May 25, 2020 in the world, Russia and the USA. Anomalous increase in demand in the USA was revealed corresponding to the booming demand for plasma donors – convalescents of COVID-19: a) for “plasma transfusion” – March 30 – May 2, b) for “donate blood” March 17 – April 7. The studied Russian Google Trends indicators correspond to the reliable work of the blood service, which during the pandemic period solved the main task to provide hospitals with effective and safe components of donated blood. These data provide additional evidence of differences in the scientific validity of blood services in developed countries, and show that Google Trends can serve as a tool to track trends in blood donation.
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.