No 2 (2020)

Full Issue

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Articles
TO THE QUESTION OF THE ORGANIZATION OF INTERNAL QUALITY CONTROL OF MEDICAL CARE IN MEDICAL ORGANIZATIONS
Kharisov A.M., Berseneva E.A., Bereznikov A.V., Efimov M.D., Shkitin S.O.
Abstract
The purpose of the study is to develop a methodology for organizing quality control of medical care within the framework of internal quality control and safety of medical activities. The subject of the study was internal quality control of medical care for diseases of therapeutic profile, methods of ensuring the quality of medical care, and risks of the medical organization. The object of the study was the method of organization of quality control of medical care. The analysis of normative acts regulating the issues of assessing the quality of medical care was carried out. The criteria to be met by the internal control methodology are defined. Based on these criteria, a methodology for organizing internal control in a medical organization has been developed. Conclusions. The methods of organization of internal control includes conformity assessment of medical assistance submitted for payment to the registry accounts of reference and filling in the primary medical documentation, compliance with medical assistance records in accounting documents of the medical organization and evaluation of the quality of care. Implementation of the internal control methodology in the practice of a medical organization contributes to ensuring the patient's rights to receive quality medical care and risk management of the medical organization.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):4-15
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INNOVATIVE TECHNOLOGIES IN HEALTH CARE AND POPULATION HEALTH PROMOTION: METHODOLOGICAL ASPECT
Vasilyeva T.P., Nechaev V.S.
Abstract
The publication considers actual characteristics of organization of involvement of innovative technologies in health care to be applied to health promotion of population. The decision-making in this field requires systemic consolidation of organization of research studies, professional training, production of medical innovative technologies, information support on the basis of integrated system of protection and promotion of population health to ensure efficient intersectoral management of development and implementation of innovative technologies in health care. It is established that assessment of innovative technologies on the basis of systematic interdisciplinary analysis on all stages of their application is recommended to wide-spread implementation by many international structures and organizations, the WHO included. The full-fledged usage of advantages of innovative technologies in health care is ensured by applying methods of prospective planning of medical care on the basis of prognostic assessment of corresponding needs and possibilities of market of medical technologies itself.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):16-21
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MODERN INFORMATION TECHNOLOGIES FOR PUBLIC HEALTH INDICATORS AND HEALTHCARE SYSTEM ACTIVITIES MONITORING (REVIEW)
Berseneva E.A., Stepura O.B.
Abstract
A new state program of the Russian Federation "Development of healthcare" has entered into force on th1 1st of January 2018, approved by the Government Resolution No. 1640 of the 26th of December 2017 (with changes on the 30th of November 2019). Among the 9 directions of the Program are "Information technologies and management of industry development." The development of information technologies at the present stage allows mankind to solve the most difficult tasks, practically not solved with the use of standard approaches. This is also facilitated by the emerging possibilities of electronic data accumulation. A separate aspect of the introduction of information technologies is certainly the use of artificial intelligence capabilities. This publication provides an overview of the main trends of information technologies using in the health system and their possibilities in the world and Russian Federation.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):22-29
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BASIC PRINCIPLES OF BUILDING A SYSTEM OF CRITERIA AND INDICATORS FOR EVALUATING THE QUALITY AND EFFECTIVENESS OF MEDICAL ACTIVITIES
Lindenbraten A.L., Grishina N.K., Serdyukovsky S.M., Kolomiychenko M.E., Ludupova E.Y.
Abstract
In order to assess the quality of medical activity, it is necessary to analyze not only the quality of medical care, but also the quality of organization. Assessment of medical activity (including its components) should be carry out using a system of criteria and indicators. The article presents basic principles and methodological approaches to building a system of criteria and indicators for assessing the quality and effectiveness of medical activities. The use of this system will make it possible to objectively evaluate the quality of medical activity, as well as the healthcare management system at various hierarchical levels, to identify problem areas and determine how to correct them. This system can also be used to conduct a comprehensive comparative assessment of the effectiveness of various technologies. The article contains links to normative legal acts of the Russian Federation and publications on the subject under study.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):30-35
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INFORMATION SUPPORT FOR ADMINISTRATIVE DECISION-MAKING BY AN EXPERTS IN QUALITY EXAMINATION OF MEDICAL CARE TO PREGNANT WOMEN
Vasileva T.P.
Abstract
The article presents an analysis of the possibilities of supporting management decisions by experts using an automated information resource that works in real time. The results of the study showed that the information resource automates the search for expert violations of perinatal prophylaxis during the examination of the primary medical documentation of a pregnant woman, providing him with a formalized list of possible most frequent violations and identifying some of the violations according to expert algorithms, which increases the efficiency of the expert’s information support during the examination of perinatal quality prevention. A decrease in the complexity of the examination was noted due to the formation in the automatic mode of the final expert opinion on the quality of fulfilling the individual plan for managing pregnant women from risk groups for perinatal and obstetric pathology, perinatal and maternal mortality. A real-time set of forms of information on the frequency and structure of perinatal prophylaxis disorders by type, type and severity of disorders, by the levels and causes of their occurrence on the part of all participants of perinatal prophylaxis (doctor-patient institution) reduces the complexity of obtaining information, and due to personalization of the doctor’s records of violations, identified by the expert, ensures the focus on the selection of individual control measures.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):36-41
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TO THE QUESTION OF MEDICAL-SOCIAL PREVENTION OF INFLAMMATORY GYNECOLOGICAL DISEASES AMONG GIRLS AND GIRLS-ADOLESCENTS (LITERATURE REVIEW)
Mingazova E.N., Zhelezova P.V.
Abstract
The article analyzes the materials of domestic and foreign publications on the current features of medical and social prevention of inflammatory gynecological diseases among girls and teenage girls. An example of the analysis of the prevention of vulvovaginitis shows the influence of various factors contributing to the occurrence of gynecological inflammatory diseases among children and adolescents. Protecting children and adolescents from health risks is of great importance for preventing the problems of the development of diseases during the adult period of life, as well as for maintaining reproductive functions, which in turn determines the economic and labor potential of the country's development and its national security. To this end, the issue of the need for comprehensive studies of the influence of various risk factors on the development of inflammatory gynecological diseases in girls and adolescent girls is considered.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):42-47
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UPGRADE TRAINING OF ULTRASONIC MEDICAL INVESTIGATION SPECIALISTS
Krotov I.A., Konovalov O.E., Vasilieva T.P.
Abstract
The article analyzes the forms of postgraduate education most in demand by doctors of ultrasound diagnostics and the difficulties of their implementation. The results of survey of 196 ultrasonic specialists, working in medical organization of Moscow, were analyzed. The results of our research allow us to conclude that the most popular forms of training are distance learning, as well as attending of conferences, seminars and lectures. Reading of medical literature and on-the-job training are somewhat less popular. It was established that 77.5 % of participants are confident that their professional knowledge is sufficient for successful performance of their activity. The others stand in need of additional training. The main difficulty in obtaining professional information for interviewed doctors was lack of time, more rarely - financial restrictions and lack of access to Internet resources. Every second interviewed doctor was a speaker in scientific medical conferences. The reasons for refusal of ultrasonic diagnostic specialists to attend scientific conferences were also analyzed in the article.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):48-53
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COVID-19 AND NEUROPSYCHIC HEALTH: SOME SOCIO-HYGIENIC ASPECTS
Spasennikov B.A.
Abstract
The author presented the results of a medical and sociological study of the neuropsychic health of 400 adult Muscovites and residents of the Moscow Region in the period from April 12-15, 2020. The survey was conducted by phone or email. Of the 400 respondents, 350 people underwent surveys with the author of this article on other socio-hygienic problems, that is, they have experience in such studies. The sample is random, related to the willingness of a person to participate in a medical sociological study. Of the surveyed number of individuals, women accounted for 56%, men - 44%. 15% of people were 18-24 years old; 13% - 25-35 years old; 28% - 36-49 years old; 25% - 50-60 years; 19% are over 60 years old. Non-working pensioners accounted for 14%; housewives - 7%; working in the public sector, government and administration, law enforcement agencies - 24%; employees in various business areas - 30%; self-employed entrepreneurs - 8%; pupils (students, graduate students) - 17%. The examination took place 21 (+/-3) days after the start of the voluntary isolation regime (during the epidemic of COVID-19). At the time of the study, students did not attend universities, did not study at all, or did self-education. Self-employed tried to continue remote work. 67% of small and medium-sized businesses stopped activity. The rest continued to work. 73% of employees stopped working. The rest continue to work as sellers of grocery stores, taxi drivers, couriers or switched to a shorter working day. Public sector employees worked remotely in 83% of cases or periodically visited the workplace. Civil servants continued to work, with the exception of people over 65 and mothers with children under 14. Law enforcement officers continue to serve with increased workload, sometimes in special conditions of service. These factors can be regarded as traumatic, caused by the regime of restriction of social contacts, violations of the usual way of life, lower incomes, the threat of illness and changes in living standards. None of those examined earlier in the psycho-neurological (or narcological) dispensary were registered; they did not actively contact a psychiatrist, psychotherapist, psychologist, or psychologist. 19% of the examined were previously observed by a doctor by reason of arterial hypertension, coronary heart disease, coronary heart disease, vegetovascular dystonia, neurological pathology against the background of osteochondrosis of the cervical spine. 11% of people periodically took psychopharmacological drugs as prescribed by a doctor or on their own to treat the above pathology. No one had known the facts of contact with persons infected with coronavirus. After three weeks of being on voluntary self-isolation at home, 44% of respondents noted a feeling of vague anxiety. Denied a sense of vague anxiety of 18%. 38% could not confirm or deny the feeling of vague anxiety. Annoyance that appeared (or intensified during the period of self-isolation) was noted by 58% of respondents. 17% of individuals denied irritability. The rest did not note increased irritability or could not answer in the affirmative. 29% of people noted the appearance (or increase during the period of self-isolation) of excessive temper, anger, which arose unreasonably or as a result of neutral actions (inaction) of people who underwent self-isolation together with the subjects. 71% of people denied the presence of excessive temper, anger. However, many answers were evasive. 74% of people reported sleep disturbance (or worsening) during the period of self-isolation. The most common violations were falling asleep, less often a superficial sleep with frequent awakenings, or early awakening. 26% of respondents said they increased alcohol consumption. Patients with psychosomatic pathology note an increase in the dose of medications taken to correct blood pressure, reduce heart attacks, and relieve other symptoms. 11% of respondents noted an increase in the number of psychopharmacological drugs taken. From the data obtained it follows that during the period of the coronavirus infection epidemic, the number of borderline mental disorders increased, which require further research in order to optimize measures for the organization of medical and diagnostic assistance to the population.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):54-59
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ASSORTMENT POLICY AS A FACTOR OF AVAILABILITY
Telnova E.A., Zagoruychenko A.A.
Abstract
The main task set by the country's leadership to the health system is to ensure the availability of medical, and therefore medicinal, care. In order to achieve the set goals of preserving and strengthening public health as the main value of the state, an adequate drug policy is necessary, which includes many factors such as accessibility, universality, effectiveness, quality, safety and balance. The basis of the drug supply system is the availability of medicines. "Availability" is a complex concept that includes spatial and temporal availability, physical or product availability, and financial, including price availability. As practice shows, it is not enough to open a sufficient number of pharmacies, it is necessary that pharmacies have the necessary medicines in sufficient quantities at the right time at an affordable price. The article analyzes the formation of assortment policy at various levels. Assortment policy is a set of measures - a system of measures that includes the intentions and capabilities to form the most preferred assortment groups to achieve two goals: on the one hand, to meet the needs of patients, and on the other - to achieve good economic indicators.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):60-67
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THE ANALYSIS OF THE INSTITUTIONAL AND LEGAL FRAMEWORK FOR DISTANCE SELLING OF MEDICINES
Krysanov I.S., Ermakova V.I., Kliueva I.A., Borisova A.V., Shlykov V.S., Malakhova A.R., Shukurlaeva G.E.
Abstract
The Internet-trading has become one of the most popular way of selling due to the socialization community. However, without proper government control over medicine, it is possible to sell low quality products. At present, government body carrying out control and supervision activities cannot control the sphere of drug trade by the Internet, because the regulatory framework and correct privileges of qualified persons and elements exercising control are necessary for monitoring. Research methods: rather-legal analysis, method of systematization, comparison, method of the information gathering, sociological method and concept design method. In the result of the study the futures for development of legislation in the field of the sale of medicines through online-pharmacies have been analyzed, data of the need for online-pharmacies work have been obtained. This research work presents an analysis of organization and legal framework of the medicines sales through the Internet, reveals the opinion of buyers about ordering drugs by the Internet with their home delivery, the main advantages and downsides of this method of retail sales of medicines according of buyers. Analysis of the data from conducted head count showed a generally positive opinion of consumers about ordering products by the Internet. Through a questionnaire, the need for the service for ordering drugs by the Internet and their home delivery and its legalization was identified.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):68-75
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THE QUALITY AND SAFETY CONTROL OF MEDICAL PRACTICE IN PROVIDING PALLIATIVE MEDICAL CARE: LEGISLATIVE FRAMEWORK
Kolomiychenko M.E.
Abstract
An improvement in the public health monitoring is the one of the strategic goals of health-care system in Russian Federation. Palliative medical assistance as a separate part of medical care is characterized by some peculiarities such as the sources of financial support, patients’ source condition etc., so they should be taken into account in estimation of the quality of health care. This publication provides an overview and analysis of legislations’ content regulating implementation of the quality and safety control of medical practice and health-care quality examination. The analysis made it possible to make a conclusion about the formed basis of the quality and safety control system of medical practice and about some changes are needed to lead an increasing efficiency of functioning of this system. Moreover, it is extremely important to separate the quality assessment of medical practice, the quality of medical care and the quality of its organization.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):76-83
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MEDICAL STAFF OF THE KARELIAN FRONT’ HOSPITAL BASE AND ARKHANGELSK CLINICS IN 1941-1944
Bykov V.P., Andreeva A.V., Samburov G.O.
Abstract
In 1941-1942s on the territory of the Arkhangelsk region, 31 evacuation hospitals with 13,700 regular beds were formed. The medical part of hospitals was mainly equipped with mobilized doctors, paramedics and nurses of civilian medical institutions. An severe shortage of doctors and nursing staff in evacuation hospitals and civilian medical institutions in the Arkhangelsk region in the initial period of the war caused a reduction in the duration of training in Arkhangelsk state medical institute from 5 to 3,5 years, and also additional training for nurses, medical examiners at the courses of the Red Cross Society. In 1943 in the hospital base of the Karelian Front, formed of 15 evacuation hospitals, 249 doctors served. In difficult conditions, during the war years the Arkhangelsk state medical institute trained 919 doctors, more than half of them were mobilized and sent to front-line medical institutions. Insufficient training period led to a decrease in the level of professional training. Selfless work of the evacuation hospitals’ medical collectives, professors, associate professors and assistants of the medical institute allowed to achieve good indicators of medical work in 1943-1945s.
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):84-91
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REVIEW FOR THE DISSERTATION ELIZABETA A. SHAROVA “PREVENTABLE HEALTH LOSSES FROM CRANIO-BRAIN INJURY IN CHILDREN: REGIONAL FEATURES AND STRATEGIC APPROACHES TO REDUCE THEM(INTEGRATED SOCIO-HYGIENIC STUDY)” FOR THE ACADEMIC DEGREE DOC. HABIL. IN MEDICINE (SPECIALTY “PUBLIC HEALTH”)
Lindenbraten A.L.
Abstract
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):92-95
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REVIEW FOR THE DISSERTATION PAVEL N. ZOLOTAREV “SCIENTIFIC SUBSTANTIATION OF A MULTIFACTOR APPROACH TO THE ASSESSMENT OF THE LABORATORY SERVICES OF THE SUBJECT OF THE RUSSIAN FEDERATION” FOR THE ACADEMIC DEGREE DOC. HABIL. IN MEDICINE (SPECIALTY "PUBLIC HEALTH")
Lindenbraten A.L.
Abstract
The author presented review for the dissertation Pavel N. Zolotarev “Scientific substantiation of a multifactor approach to the assessment of the laboratory services of the subject of the Russian Federation” for the academic degree Doc. habil. in Medicine (specialty "Public Health").
Bulletin of Semashko National Research Institute of Public Health. 2020;(2):96-99
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