2020 № 5 Availability and staffing of gastroenterologists in the Russian Federation and in pilot regions, 2013–2017
Human resource issues are of high relevance for accessibility of the quality of health care. The aim of the study was to conduct analyses of actual staffing of health care facilities for provision of gastroenterological care on an outpatient basis in the Russian Federation and its subjects. Materials and methods: calculation of occupied positions and physicians-gastroenterologists rate, extensive indicators, method of descriptive statistics. Results. Multidirectional levels and trends in physicians-gastroenterologists coverage rates in the constituent entities of the Russian Federation have been established. In a number of federal districts there is an increase in the studied indicators, in some – levelling. Conclusions. An analysis of the availability of gastroenterologists roviding health care an outpatient basis showed that the supply of gastroenterologists in the federal districts increased or levelled. Moreover, in six of them there was a decrease in the staffing rate by these specialists. The results of the study could be used for the human resources planning and for decision-making.
2023 № 1 Problems of organization of outpatient care for patients with carpal tunnel syndrome
Peripheral nerve diseases occupy an important place in the structure of morbidity, accompanied by temporary disability and invalidation of the population. In addition, these diseases lead to an increase in the citizens’ and state’s expenditure for maintaining health and active lifestyle.
P u r p o s e of the study is to analyze and evaluate the routing of patients with carpal tunnel syndrome, formulate proposals for its improvement.
M a t e r i a l s a n d m e t h o d s . The study used the following methods: analytical, expert assessments of medical organization employees who provide care to patients with diseases of the peripheral nervous system. The analysis of medical documentation of S. P. Botkin City Clinical Hospital have been carried out. The object of the study were patients treated in this hospital from 2007 to 2021.
R e s u l t s . Analyzing the routing stages of a patient with carpal tunnel syndrome, attention is drawn to the violation of the priority of the patient’s interests not only within the rational use of his time, but also the duration of neuropathic pain syndrome. The timeframes of medical care are violated. In addition, in conditions of limited resources and lean production, budgetary funds are unreasonably spent on the examination of the patient.
F i n d i n g s . Optimization of routing of patients with this pathology will contribute to the timely provision of high-quality medical care, which will reduce the time of temporary disability and avoid invalidation of population.
2021 № 8 Ways of optimizing the organization of providing ambulatory coloproctological assistance to the population
The article substantiates the priority directions of optimization of the organization of outpatient coloproctological care to the population of the Perm Region.
The purpose of the study is to substantiate the priority directions for optimizing the organization of outpatient coloproctological care to the population.
Materials and methods. The data on the reasons for 4822 calls to outpatient polyclinic offices for specialized medical care in the profile of «Coloproctology» in the Perm Region in 2018, as well as about 2222 calls to the Center of Coloproctology with a day-long hospital stay were analyzed.
Results. It is shown that the frequency of detection of DND in the center of coloproctology was 22.50%, with the frequency at polyclinic appointments‑11,83%, p<0,001. At polyclinic appointments, the frequency of detection of ZNO was 5,96%, in the center of coloproctology – 12,15%. The results obtained can be explained by the number and quality of diagnostic measures performed at the Coloproctology Center, which allows for almost complete coverage of all patients of the center with rigid rectoscopy – 98,38%, with 33,80% (at outpatient appointments (p<0,001). Sigmoscopy, which is not available in the coloproctologist’s offices at the Coloproctology Center, was performed in 7,02% of patients, FCS was performed in 34,29% of cases, compared to 9.49% in the polyclinic (p<0,001).
The presence of an emergency appointment in the Center of Coloproctology explains the higher frequency of detection of acute hemorrhoids – 7,06%, versus 3,2% in polyclinics; acute paraproctitis – 2,29% and 0,62%, respectively; ECC – 1,53% and 0,5%, respectively; anal itching – 1,44% and 0,64%, respectively; proctitis – 0,99% and 0,16%, respectively; rectocele – 0,99% and 0,18%, respectively; injuries of the colon and rectum – 0,72% and 0,16%, respectively; anal insufficiency – 0,72% and 0,37%, respectively; p<0,005.
Conclusions. The traditional model of providing outpatient coloproctological care (offices in polyclinics) is not effective even in diagnostics, since it does not have its own endoscopic and anesthesiological service, which significantly affects the volume and quality of the necessary studies. It is proposed to reorganize the service in order to organize a primary link on the basis of an outpatient coloproctology center with a day-long hospital, separate or at the coloproctology department of the State Clinical Hospital.
2016 № 10 Experience the reorganization of outpatient ophthalmologic services in the Kaluga region with the participation of the Federal medical institutions
The article presents the experience of the reorganization of the outpatient ophthalmic services in the Kaluga region with the aim of improving the quality of outpatient services; improve the availability and proximity of high-tech eye care in conditions of the respective Federal agencies for the population of the region. To achieve this goal was proposed the algorithm for providing ophthalmological care, which allowed accelerating the provision of specialized high-tech diagnostic and surgical eye care to the needy residents of the city of Kaluga. For today in hospitals of the regional center there are 5 rooms of the IRTC «Eye Microsurgery». For the period 2009–2015 in the outpatient clinics were adopted 587 103 patients of them sent to the Kaluga branch of IRTC «Eye Microsurgery» 23 230 patients (22,4%) with different ophthalmopathology. The cases in the branch was extended to 31 192 medical services, including 7 565 patients underwent surgical treatment. The obtained results testify to the relevance and prospects of the work done, which would merit its continuation in other medical institutions in Kaluga region.
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.
2016 № 9 Рayment of primary health care on per capita financing
Examines conditions and problems of translation of health care organizations on a per capita principle of financing. The material is based on the experience of the constituent entities of the Russian Federation, a long-time practicing activities in terms of per capita funding. Recommendations for minimization of financial risks of healthcare organizations.