Articles with tag: «quality of medical care»

    Sociology of health care
  • 2020 № 6 The syndrome of professional emotional burnout in doctors of cancer institutions in Moscow: the prevalence and severity of the syndrome, the factors affecting its development

    The health protection system plays an important role in preserving and developing the country’s economic potential. Features of medical activity are a high degree of use of social contacts, its significant responsibility and stress. High requirements for doctors of professional, organizational and psychological nature contribute to the development of constant work stress, against which there is a decrease in the psychological adaptability of specialists, leading to the development of «professional burnout syndrome».

    The purpose of this study is to assess the prevalence and severity of the syndrome in doctors who provide specialized high-tech medical care to patients with cancer, as well as to identify factors for the development of this syndrome.

    This article presents the results of a survey of 58 doctors. High and extremely high levels of the syndrome were detected in 64% of respondents. Individual, organizational and social factors associated with the development of this condition are identified. As the main methods of prevention and control of this syndrome, preliminary and periodic assessment of the level of employee’s susceptibility to organizational stress, the degree of their satisfaction with organizational factors of work, as well as the social environment is proposed.

    The results obtained can help to optimize the process of working with personnel in medical organizations, as well as in- crease the productivity of medical workers.

    Authors: Moskvicheva  L.  I. [1]

    Tags: doctors7 health care system5 human resource management system1 oncology7 organizational  factors1 quality of medical care21 social consequences1 syndrome  of  professional  emotional  burnout1

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  • Quality of health care management
  • 2016 № 5 Assessment of the quality and effectiveness of health care for medical rehabilitation

    Abctract. The method of evaluating the quality and effectiveness of medical rehabilitation in the parameters is described. The method allows to determine the capabilities of the service, results and quality research. The basis for determining the level of quality of care in health organizations based on three main components: quality of structure; quality of process; quality of the results. This method allows to judge about the possibilities of rehabilitation services in determining logistical base, human resources, technical equipment and the condition of the equipment. Data on the quality and effectiveness of treatment can serve as a basis for performance assessment and volume of the study identified a number of indicators and their conformity to regulatory standards. The Toolkit is designed for health care providers, experts, economists working in health care organizations Federal, regional and municipal levels, as well as researchers and teachers in the field of health planning.

    Authors: Prilipko N. S. [4]

    Tags: medical rehabilitation9 process quality1 quality of medical care21 quality of structure1 quality results and normative values1

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  • Medical sciences
  • 2015 № 3 Cluster principle of efficiency increase of scientific, educational and medical activity

    A brief characteristic of goals of clusters and their role in the innovation development in a health care are presented. The integration process of scientific, educational, medical institutions and businesses in the regional cluster is shown. Illustrated by the example of Kemerovo city the efficiency of a consolidation is evaluated, which is characterized by the creation of scientific production with its subsequent commercialization of high-tech enterprises, continuing vocational education, medical care in cardiovascular diseases on the full-cycle basis.

    Authors: Artamonova G. V. [4] Danilchenko Y. V. [1] Kostomarova T. S. [1] Cherkass N. V. [2] Barbarash L. S. [3]

    Tags: cardiovascular disease4 efficiency of activity1 efficient management1 innovations2 quality of medical care21 scientific and educational medical cluster1

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  • Marketing in health care
  • 2022 № 4 Patient support program as a part of value-based healthcare implementation

    Patient support programs as a new institutional phenomenon take over part of the functions of the Institute of Healthcare in drug provision, diagnostics, clinicians and patients education, infrastructure support.
    Purpose: to evaluate the role of patient support programs (PPMS) by describing the mechanisms of their implementation.
    Materials and methods. On the basis of open sources of information and scientific literature data, the initiatives to launch PPP in Russia of medicines and medical devices were analyzed.
    Results. The most common programs are that combine financial and information mechanisms. The key principle of the development of the PPP is orientation to the patient’s pathway. Typical tools for the implementation of PPP include the following: hotline, SMS-informing, patronage service, online monitoring, patient training, insurance. The effectiveness of the PPP is assessed by four groups of indicators: patient adherence, quality of life and patient experience, clinical outcome indicators, cost savings.
    Conclusions. Health authorities and medical professionals should be aware of the possibilities of programs to achieve the goals of improving the quality and accessibility of medical care, and can also help to systematically assess the effectiveness of such programs from the perspective of public health.

    Authors: Zuenkova Yu. A. [4]

    Tags: esg1 patient adherence1 patient pathway1 patient support program1 quality of medical care21 value-based healthcare3

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  • Management in healthcare
  • 2022 № 5 Application of the VALS and the laddering techniques at shared decision-making

    Patients values are fundamental in the process of health decision-making. The use of PROMs is often difficult in routine clinical practice, which requires the search for simpler methods of determining the patients values, where psychographic segmentation and laddering are one of those.
    The aim of the study was to improve the process of shared-decision-making in patients with non-melanoma skin cancer using the VALS segmentation and the laddering technique.
    Materials and methods. An inclusive, incomparable, prospective, long-term multicenter cohort study of the use of the laddering technique and the VALS technique was conducted in 158 patients (154 (97%) with basal cell skin cancer, 4 (3%) squamous cell skin cancer; 129 (82%) patients with stage I–II diseases, 17 (11%), with IV – 12 (7%); 56 (35%) – men, 102 (65%) – women.
    The results of psychographic segmentation showed: the clinical result of the procedure is important for 96% (n=152), the safety of treatment and adverse reactions – for 91% (n=143), the cosmetic result – for 46% (n=73), convenience and flexibility of the treatment schedule – for 36% (n=57), the painlessness of the treatment procedure – for 34% (n=54), the ability to lead a habitual lifestyle during treatment – for 23% (n=36), the comfort of the treatment procedure – for 14% (n=22), the financial costs associated with treatment – for 9% (n=14), preservation of organ function after treatment – for 3% (n=5).
    Conclusions. The method of psychographic segmentation can be adapted to the tasks of communication between the doctor and the patient. The scope of application of the VALS methodology and the laddering technique can be considered situations when a doctor is unable to use validated quality of life questionnaires due to limited resources or the absence of such questionnaires.

    Authors: Zuenkova Yu. A. [4]

    Tags: laddering1 patient behavior1 psychographic segmentation1 quality of medical care21 shared decision making1 vals1 value-based healthcare3

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  • 2022 № 9 The role of naming in healthcare. From a psychiatric hospital to a mental health center.

    An urgent issue today is to increase the confidence of citizens in the healthcare system. Moreover, the issue of trust is of particular importance in the provision of psychiatric care, due to the high level of stigmatization of this area of medicine.
    The purpose of the study was to assess the significance for patients of the names of medical organizations in the profile of «psychiatry».
    Materials and methods. In 2021 Kirov Regional Clinical Psychiatric Hospital named after Academician V.M. Bekhterev changed its name and became the Center for Psychiatry and Mental Health Academician V.M. Bekhterev. A survey was conducted of 216 patients who applied or are undergoing treatment at the Center of Psychiatry and Mental Health named after Academician V.M.
    Bekhterev, using a specially designed questionnaire consisting of 24 questions. The results obtained were statistically processed.
    Results. A large proportion of the respondents had one or another mental disorder, and more than half are worried because of this, to one degree or another. One-fifth of the respondents indicate that their rights were violated due to their mental disorders.
    All this points to the problems that exist to this day associated with the stigmatization of patients with mental disorders, as well as the stigmatization of the psychiatric service itself. 43% of respondents noted that the name of a medical organization has an impact on their trust in a medical organization. The patients surveyed gave the highest rating to the name «Mental Health Center».
    Conclusions. Thus, the name of a medical organization directly affects the trust of patients in it. In addition, the name also affects the subjective assessment of the quality of medical care provided in a medical organization.

    Authors: Neznanov N. G. [1] Kochorova L. V. [2] Skripov V. S. [1] Nabatov I. F. [1] Martovetskaya G. A. [1]

    Tags: branding in healthcare1 name of a medical organization1 naming1 patient survey3 quality of medical care21

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  • 2019 № 4 The improvement of specialized medical care for patients injured in road traffic accidents based on information technology

    The information system was developed as a part of a Uniform State Health Information System (USHIS) in Mos- cow Region. It enables to perform a statistical and economic analysis, to simulate the work of trauma centers, resulting in an improved quality of medical care, as well as to decrease unreasonable economic loss and the road traffic mortality. It also helps to support patients after limbs amputation with prostheses without any delays.

    Authors: I.  M.  Dementyev [1] A.  N.  Gurov [1]

    Tags: information system3 passportization2 prevented economic loss.1 qaly1 quality of medical care21 road traffic accidents1 trauma center1

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  • 2013 № 4 Ensuring the rights of the patient and the need to develop a medical organization necessary internal regulatory documents (Sankt-Peterburg, Irkutsk, Russia)

    The questions related to patients' rights in health care. Detail the mechanisms to ensure patients' rights to information about their rights and responsibilities, their health status. The authors emphasize that the rights of the patient in health care is impossible without a clear regulation of this work relevant internal documents of the medical organization. Specific recommendations on the content of these documents.

    Authors: Piven D. V. [59] Kitsul I. S. [59]

    Tags: patient information2 patient rights3 quality of medical care21 regulatory documents2

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  • 2019 № 4 On the criteria for evaluating the activities of medical organizations in the new patient-oriented healthcare system

    The patient-oriented approach will allow taking into account individual preferences and needs of patients in the process of providing medical care. The study is devoted to the system analysis of the main provisions and conditions for their implementation in the patient-oriented model. The paper presents the composition of evaluation criteria in the developed model. The introduction of a new patient-oriented model implies a broader application of modern methods and technologies for their personal information support at various stages of medical care.

    Authors: R.  A.  Khalfin [1] V.  V.  Madyanova [1] A.  P.  Stolbov [1]

    Tags: concept of the patient-centered model1 patient-oriented healthcare system1 quality of medical care21

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  • 2023 № 10 Analysis of practical experience in the development and implementation of standard operating procedures in the activities of nursing medical staff.

    The article addresses issues of quality of care and the implementation of standard operating protocols (SOPs) to improve patient safety. As part of the “High 5’s” project, WHO developed SOPs to address 5 priority patient safety issues, which were implemented in 5 countries around the world. In Russia, the implementation of SOPs is closely related to the performance of functional responsibilities of nursing specialists, who play an important role in improving the quality of medical care, including patient care. The main functions of SOPs for nurses are training medical personnel, conducting examinations and assessing the quality of care provided, planning measures to improve the provision of medical care, protecting the rights of patients and staff when resolving controversial and conflict situations. The article also
    discusses the implementation of standard operating procedures (SOPs) to improve patient safety and analyzes the experience of developing and implementing SOPs for nurses in public medical organizations in Tambov. The introduction of standard operating procedures (SOPs) into the work of nursing staff can improve the quality of work and reduce the risk of errors. A survey of nurse practitioners found that the most requested SOPs were the prevention of healthcare-associated infections and nursing procedures. The main requirements for the drafters of SOPs are a deep understanding of processes and manipulations, the ability to analyze risks and knowledge of the regulatory
    framework and reference literature. In general, the implementation of SOPs is an effective tool for improving the quality of work of medical personnel and ensuring patient safety. In general, the implementation of SOPs is an effective tool for improving the quality of work of medical personnel and ensuring patient safety. The results obtained can be used to develop new SOPs and improve existing ones, as well as to train medical personnel and improve their skills.

    Authors: Kalugina M. G. [2]

    Tags: improvement of medical care delivery1 nursing  staff5 quality of medical care21 standard operating procedures (sop)1 training of medical personnel1

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  • Management in health care
  • 2020 № 9 Improving the technology of work of heads of therapeutic departments of Central district hospitals

    The article presents the results of studying the organization of work of heads of departments of central district hospitals (CRH) and the quality of therapeutic care for the rural population. The study was conducted in 2017–2019. on the basis of
    26 Central District Hospital of the Republic of Dagestan. The quality of therapeutic care was studied through an expert assessment
    of 1,085 inpatient and 748 outpatient patient records. The timing of the working time spent by the heads of the departments of
    the Central District Hospital for 845 hours. It was found that under the current conditions the heads of departments devote up to
    50.7% of their working time to the fulfillment of the main duties. Waste of time is 15.1%.
    In the therapeutic departments of the Central District Hospital, an untimely and complete examination of a significant part of the
    patients took place; treatment is not always complete and complete, there is no continuity in the examination and treatment of
    the patient between the clinic and the hospital.
    On the basis of the research materials, a set of recommendations was developed to improve the technology of work of heads of
    departments of the Central District Hospital and improve the quality of medical care. Experimental verification of the recommendations confirmed their effectiveness: the time spent on the main work increased from 51.2% to 72.4%, the share of time spent on organizing and managing the treatment and diagnostic process increased by 15.5%. Improving the organization of work of heads of departments during the experiment had a positive effect on the quality of medical care: the proportion of patients examined at the prehospital stage increased by 25.4%; the number of those fully surveyed increased from 58.4% to 90.3%; the number of patients who received full treatment increased by 14.7%.

    Authors: R.  S. Gadzhiev [1] L.  S. Agalarova [1]

    Tags: department head1 expert assessment2 information support1 labor organization.3 organizational experiment1 quality of medical care21

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  • 2020 № 10 Analysis of practical experience in development and implementation of standard operating procedures in the activity of medical personnel

    Innovative technologies use in the daily nurse practice makes their work more professional, comfortable, ensures safety and convenience of performing basic professional duties, reduces labor costs, and allows to quickly and efficiently ensure the implementation of new diagnostic and treatment process.
    Aim: analysis of the experience in the development and implementation of SOPs for nurses for 2018–2019. in Central
    City Clinical Hospital № 6, Yekaterinburg.
    Methods. The work analyzed reporting documents (SOP implementation logs for each subdivision of Central City Clinical Hospital № 6, Yekaterinburg during 2018–2019 period), characterizing the number, type of developed SOPs, depending on their purpose, the timing of their implementation.
    Results. During 2018–2019 period there have been all main nomenclatures SOPs developed and implemented into the
    nursing practice. The main stages of the development of SOPs are analyzed, illustrative examples are given. Encountered by the staff of the medical institution SOPs development and implementation related difficulties are discussed. Main prospective activity directions in the field are determined.
    Conclusion. On the basis of municipal Central City Clinical Hospital № 6, Yekaterinburg, SOPs development and implementation for various types of nursing activities have been successfully carried out.

    Authors: Bernatovich O. A. [1] Borzunov I. V. [1] Popov A. A. [1] Prokopyeva E. R. [1] Chernysheva E. U. [1]

    Tags: nurses7 quality of medical care21 standard operating procedures1

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  • 2020 № 8 Improving rural health care through business process management

    Meeting the needs of the rural population in all types of primary health care (pre-medical and general medical
    care), as well as specialized medical care, improving the quality of medical care for the rural population is an important
    public health problem that is difficult to solve and is of particular concern to government structures at all levels of government. The article presents an analysis of the literature on the use of business processes in modern healthcare, the main tasks of which are the creation and development of effective models for the provision of medical care that increase not only its accessibility and quality, but also the satisfaction of the population. As part of the activities of the modernization program for the implementation of information technology in healthcare, it is planned to create information resources and services that would allow, using this system tool, to move to a qualitatively new level of organization of industry management. It is noted that at present, at the level of management of the medical organization as a whole, and in the management of individual areas of its activity, the application of the process approach is becoming relevant, in which the medical organization can be considered as a separate business system, which is a related set of business processes, the ultimate goal which, undoubtedly, is the provision of quality medical services. It is shown that the development and modeling of business processes will increase the relevance of management information, will make it possible to focus on rationalizing cross-functional processes to significantly reduce time and / or costs, increase revenue, improve service quality and reduce risks, the information system allows you to simulate processes and carry them out further optimization.
    The analyzed works examine the experience of process-oriented management in medical organizations and its role in ensuring the improvement of the quality of medical services provided. In addition, the introduction of a process approach will allow the application of certain managerial decisions necessary in each specific situation, including in the field of medical services for the rural population.

    Authors: Mingazova E. N. [30] Bakirova E. A. [5]

    Tags: business process reengineering1 business processes1 management17 process approach7 quality of medical care21 rural health care2

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  • 2015 № 10 About formation of new content of work of the head of the medical organization to ensure and control the quality and safety of medical activity

    The article deals with the problems and issues that impede the implementation of legislative requirements on ensuring and monitoring the quality and safety of medical activities in medical organizations. The article presents and justifies a specific list of the main activities of the head of the medical organization to ensure and control the quality and safety of medical activity. Proposed and substantiated the areas of control that should be reflected in the internal control of quality and safety of medical activity. Reasonable changes in the activities of medical commissions. Emphasized the need for active and systematic participation of the health authorities and the territorial departments of Roszdravnadzor in the formation of a new content of the work of the head of the medical organization to ensure and control the quality and safety of medical activity.

    Authors: Piven D. V. [59] Kitsul I. S. [59]

    Tags: head of medical organization1 health authorities1 medical commission6 medical organization53 quality and safety of medical activity11 quality of medical care21 territorial departments of roszdravnadzor1

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  • 2016 № 8 Family-oriented approach to child health care

    In this review article you can consider the parent involvement in children medical care, because in paediatric practise precisely parents can influence good relationship with parents and whole healthcare system, what is more they can influence the compliance on attitude between patient (parents or legal representatives) and health provider. The last decade researches indicate the necessity of parent involvement in all stages of medical assistance to children, moreover the last surveys showed that family-centred approaches are highly-efficient. The competence of paediatricians in working with parents and the concept of family-oriented approach in foreign literature are being considered in this topic. Moreover, the advantages of using family-centred approach and barriers, including staff shortages, interrupting the process of using this model, are being under special control in this topic. There are many variants of changing and ways of implementation offering in this article. In conclusion, there is a statement that implementation family-centered medical care to children in whole medical care system requires comprehensive changes in all stages of medical care quality ensuring, including medical care organizers professional outlook, adjusting the regulatory framework and standards of training specialists.

    Authors: Bebchuk M. А. [1]

    Tags: children13 family psychologist1 family-centered medical care1 parental training1 parents1 pediatrician1 physician training standard1 quality of medical care21

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  • 2020 № 3 Standard operating procedures as the nursing acitivies quality and safety assurance system component

    Nursing is a cornerstone component of the high-quality medical care organization assurance within a medical institution general activity. Standard operating procedures (SOP) when implemented into the nurse practice helps to standardize the performance of individual medical procedures. The SOP related activities results can be easily monitored and assessed. The most frequent activities to be assigned to SOPs are subcutaneous, intradermal, intravenous, intramuscular administration of drugs and solutions, taking blood from a finger, administering drugs with enemas, etc. The main advantages SOPs application include minimizing the risk of a contractor misunderstanding their duties, comparability and compliance with regulatory requirements assurance. International standards, Russian federal state standards (GOST), industry standards (procedures medical care, medical standards assurance), regional regulatory documents (orders, orders, regulations) are used as the basis to create a SOP. SOPs implementation in conjunction with the continuous nurses training, comprehensive material and technical equipment provision of medical institutions will contribute to improving the quality and safety of their activities.

    Authors: O.  A.  Bernatovich [1] I.  V.  Borzunov [1] A.  A.  Popov [1] N.  L.  Shkinder [1]

    Tags: continuing  medical  education3 manipulations1 nurse2 quality of medical care21 standardization2 standard  operating  system1

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  • Law
  • 2017 № 6 Regulatory framework for providing high-technology ophthalmological medical care under outpatient treatment

    The article analyzes the existing legal basis for providing high-technology ophthalmological medical care through a systematic review of regulatory enactments that directly regulate this type of activity (14 regulatory enactments, including 2 federal laws).
    High-technology medical care is a separately licensed type of medical activity carried out by approved federal or regional medical organizations, financed by subsidy or directly from federal budget, provided for approved types of medical care in a hospital. The source of funding for healthcare determines essential conditions. The existing legal framework creates significant restrictions for providing high-technology ophthalmological medical care under outpatient treatment in the case of healthcare covered by Compulsory Health Insurance or an appropriate budget. The article outlines the ways of solving this problem proposed by the authors, including for a medical institution, without violating the current legislation. Healthcare covered by other sources of funding can be provided in any conditions, including outpatient

    Authors: Borshchuk E. L. [4] Chuprov A. D. [4] Lositskiy A. O. [1]

    Tags: compulsory medical insurance fund1 medical organization53 quality and safety of medical activity11 quality of medical care21 regulatory body of public health service1

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  • Informatization of healthcare
  • 2023 № 4 Evaluation of the effectiveness of using remote monitoring of blood pressure in the dispensary observation of patients with arterial hypertension

    Arterial hypertension (AH) is by far the most important risk factor for cardiovascular disease. An effective method of dealing with high blood pressure (BP) is dispensary observation. Of particular relevance is the search for new tools to improve the dispensary observation of patients with hypertension, one of which may be remote monitoring of blood pressure, as an option for providing medical care using telemedicine technologies.
    Purpose of study – Analysis of the effectiveness of using remote monitoring of blood pressure in the dispensary observation of patients with hypertension.
    Methods. A non-randomised, open-label, generalized, single-centre, retrospective, longitudinal, parallel, applied study included 78 patients who completed a remote blood pressure monitoring program who were subsequently divided into 2 groups depending on the degree of achievement of target values of blood pressure (<135/85 mm Hg).
    Results. During the observation period, all patients (n=78) experienced a decrease in SBP by 8.2 mmHg, DBP at 3.8 mmHg. Group 1 consisted of 35 patients who reached target levels of blood pressure, group 2 included 43 patients who did not reach target levels of blood pressure. Initially, the groups did not differ in sex and age, while in the second group, the initial values of SBP and DBP were higher. The study found that the degree of achievement of target levels of blood pressure is influenced by the following factors: the level of SBP and DBP at the beginning of observation, the proportion of extraordinary measurements with blood pressure levels above 135/85 mmHg during the observation period, the proportion of missed blood pressure measurements during the observation period, as well as the duration of remote monitoring.
    Conclusions. Remote monitoring of blood pressure is an effective tool for improving the dispensary observation of patients with arterial hypertension and can improve the availability and quality of medical care.

    Authors: Nemkov A. G. [3] Reshetnikova I. S. [1] Brynza N. S. [1] Kurmangulov A. A. [2] Kononykhin A. A. [1]

    Tags: accessibility of medical care3 arterial hypertension2 dispensary observation3 medical information system7 quality of medical care21 remote monitoring3 telemedicine11

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  • Focus of problem
  • 2017 № 2 New tasks and directions of work of the medical commision in the system of providing and controlling the quality and safety of medical activities

    The article deals with the reasons of insufficiently work of medical commissions of medical organizations. It was noted that today the medical Commission, continuing to be the third level of quality control of medical care in medical organization, often is the third level of quality control and safety of medical activities. In the publication of the proposals to improve the efficiency of the medical Commission, including revealed the contents of its work in accordance with the objectives and functions set by law, which often remain outside the purview of heads of medical organizations.

    Authors: Piven D. V. [59] Kitsul I. S. [59] Ivanov I. V. [30]

    Tags: medical commission6 medical organization53 quality and safety of medical activities9 quality of medical care21 safety of medical activities2

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  • 2017 № 6 Metamorphosis standardization of medical care

    The article discusses a bill regulating the development and use of clinical guidelines in public health practice. The authors believe that the bill makes clinical recommendations to the regulatory option binding standards of сare. This approach only superficially converts the ways of ensuring the quality of medical care. From the point of view of the authors of the health care system fell into the organizational trap of technological regulation of the actions of the physicians, while the traditional values of the medical profession is gradually devalued. The authors propose to reconfigure relationships in the industry, not only by importing foreign countries, but in accordance with the usual Russian professional medical community’s leadership in the field of cultural, spiritual and intellectual development

    Authors: Perkhov V. I. [20] Grechko A. V. [2] Yankevich S. D. [1]

    Tags: compulsory health insurance17 quality of medical care21 standards of care order medical care. clinical recommendations1

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  • Financial management
  • 2016 № 10 Аnalysis of the application of standards of care

    The article addresses the problem of application of standards in the provision of medical care, and also when exercising control and expert activities. Set out grounds for revision of the paradigm of quality assessment of medical aid in system of obligatory medical insurance based on the comparison of the standardized and the actual performance of medical-diagnostic process.

    Authors: Perkhov V. I. [20] Gorin S. G. [3]

    Tags: compulsory health insurance17 quality of medical care21 standards of care4

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