Saratov JOURNAL of Medical and Scientific Research

public health

Analysis of medical and social characteristics of day inpatients with gynecological profile

Year: 2020, volume 16 Issue: №4 Pages: 959-962
Heading: public health Article type: Original article
Authors: Fomina A.V., Dzidzariya F.G.
Organization: Peoples' Friendship University of Russia
Summary:

Objective: analysis of the influence of medical and social characteristics of women on the organization of gynecological care in the one day hospital. Material and Methods. The study involved 263 women, undergoing treatment in a gynecological day hospital, organized on the basis of a large multidisciplinary hospital in Moscow. The following research methods were used: sociological (self-developed questionnaire), statistical (descriptive statistics, comparison of mean values, Chi-square). Results. The age and social characteristics of women, their referral fortreatment by primary care or hospital doctors, the possibility of choosing the type of hospitalization are medical and social factors that affect the organization of the activities of the day hospital of the gynecological profile. The largest group (33.1%) included women in the age of 31-40. Most of the patients were referred for one day hospital treatment by doctors of primary care medical organizations (87.5% of cases). The share of women who were treated in a day hospital for the first time was 80.3%. Half of the respondents (51.0%) noted the opportunity to undergo treatment without leaving their family and home. The distribution of the choice between treatment in a 24-hour hospital and in a day hospital is statistically significant for age groups (p <0.05): the choice was given to a greater extent to persons aged 61 and older. Conclusion. The analysis of the obtained medical and social characteristics of the patients of the day hospital of the gynecological profile showed that the organization of specialized medical care in the conditions of hospital-replacing technologies is justified. Factors such as the employment rate of women, their age and social characteristics, and factors related to referral to treatment are taken into account.

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Peculiarities of psychological tests for pregnant women prone to abandoning a newborn

Year: 2020, volume 16 Issue: №4 Pages: 956-959
Heading: public health Article type: Original article
Authors: Manerova О.А., Markina A.Yu.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, South Ural State Medical University
Summary:

The goal is to develop and use psychological tools (test) as an element of the system of primary prevention of early social orphanhood being created in a large industrial region. Material and Methods. The developed psychological test was empirically tested in 2018 on a group of pregnant women, consisting of 113 respondents aged 15-40 years, living in the Chelyabinsk region. The electronic version of the test (questionnaire) was introduced into the work of the regional obstetric and gynecological service in September 2019. Results. The questionnaire showed high sensitivity, identifying in 95% of abandoned mothers in 2019 an increased tendency to abandon a newborn. Most of the pregnant women inclined to abandon the child were identified in urban districts of the region (51 women), and the least — in rural areas (17 women). During the year, a positive effect in the prevention of abandonment was achieved in relation to 54.0% of women initially inclined to abandon a newborn. The best result was shown in the regional center — 60.0%. Conclusion. An effective diagnostic technique has been obtained, which makes it possible to purposefully carry out preventive work to prevent early social orphanhood. The developed test made it possible to exclude as much as possible the subjective moment in the statements of pregnant women about the fate of newborns, which led to a more expeditious start of preventive measures to counter refusals.

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Availability of the specialized oncological health care at federal research centre

Year: 2020, volume 16 Issue: №4 Pages: 950-955
Heading: public health Article type: Original article
Authors: Lomakov S.Y., Chernobrovkina А.Е., Vishnyakov N.I., Kochorova L.V., Smirnova N.Yu.
Organization: Pavlov First Saint Petersburg State Medical University
Summary:

Objective: to assess the availability of specialized medical care for malignant neoplasms of the female genital organs in the Federal research center for residents of various regions of Russia. Material and Methods. A special questionnaire was used to conduct a survey of patients (n=164) at the Federal cancer center on the availability of oncological and gynecological care. The data had a normal distribution, statistically processed with calculation intensive, extensive and mean values (M±m) with the risk of error of 0.05, correlations of Pierson, significance of difference by student f-criterion, scoring (five-point system, where 5 is maximum points). Results. Unsatisfactory availability of oncological and gynecological care for regional patients in the Federal clinic was revealed: 56.3% of patients were not offered to choose a hospital, 41.0% waited 14-30 days for hospitalization, 60.3% were forced to pay for radiation tests before hospitalization due to their low availability at the place of residence. This is reflected in the patients' satisfaction with medical care and its timeliness: when conducting radiation tests before hospitalization, the average waiting time is 15.5±2.7 days, in the absence of it— 18.1±4.2 (f =3.5, p<0.05). Conclusion. Restrictions on the availability of medical care in the Federal clinic for residents of Russian regions are due to the lack of coordination of inter-regional cooperation in the organization of examinations, including radiation, which requires the development of measures to improve it.

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Technology for optimizing medical decision-making

Year: 2020, volume 16 Issue: №4 Pages: 944-949
Heading: public health Article type: Original article
Authors: Korshever N.G., Pomoshnikov S.N.
Organization: Saratov State Medical University
Summary:

The objective of the study is the development of optimization techniques for making management decisions in healthcare institutions. Material and Methods. We combined the research findings obtained earlier and interviewed two groups of healthcare managers (49 set the optimization principles for making management decisions, 79 tested the technology we designed). Methods of analytical, logical, sociological, content-analysis of official and medical documentation, flow charts, organizational experiment, statistical were used. Results. We established the optimization principles for making management decisions in healthcare institutions: goal orientation, system approach (isomorphism and multiparameter interaction), prospectivity, use of adequate criterial and diagnostic apparatus, flexibility, differentiation, competence, democratization. These enabled designing and testing of the optimization technology guided by the authors' automated multicriterial assessment of successfulness for the studied approach; it provided making and implementing the management decisions that were the most appropriate for achieving results of the medical institution (number of institutions) performance. Conclusion. The technology considered in the study enables setting the trend and implementing goal-oriented measures for optimization of the management decisions in healthcare institutions.

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Prevalence of risk factors of chronic non-communicable diseases among medical students with different levels of physical activity

Year: 2020, volume 16 Issue: №4 Pages: 940-943
Heading: public health Article type: Original article
Authors: Apoyan S.A., Guryanov M.S., Pozdeeva A.N.
Organization: "Nizhny Novgorod Regional Center for the Prevention and Control of AIDS and Infectious Diseases", Privolzhskiy Research Medical University
Summary:

The purpose is to identify the prevalence of the leading risk factors for the occurrence of chronic non-infectious diseases among medical students, depending on their physical activity. Material and Methods. Screening-diagnostics of the main risk factors were carried out, taking into account the commitment of students to sports: students (326 people) who do sports regularly, and students (1014 people) who do not have physical activity, except for physical education at a university. Results. Students who are not committed to sports are characterized by a low level of physical activity (76.6%), a high frequency of stress — 34.7% compared to student who do sports regularly 16.2%, (p<0.01) and smoking (15.9 and 5.6%, respectively, p<0.05). Violations of the eating regime and an unbalanced died were recorded in both study groups (with a frequency of 39.2 and 55.5 per 100 respondents, p<0.05), however, low physical activity contributes to the appearance of deviations in body weight in 24.6% of students not committed to sports. The ranking of the most frequently encountered risk factors showed that the leading places among the non-athlete students belong to low physical activity, inadequate diet, low sleep duration and high stress levels. Conclusion. Authors emphasize that a higher prevalence of risk factors for the development of chronic non-communicable diseases was found among medical students who do not have physical activity on the regular basis, which may indicate a possible positive effect of sports on reducing the frequency of discovering risk factors for chronic non-communicable diseases among the soon-to-be doctors.

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Analysis of the provision of specialized medical care to patients with coloproctological diseases at the regional level

Summary:

Objective: analysis of the regional incidence of diseases and needs of medical care on the profile of coloproctology. Material and Methods. A study of the dynamics of regional coloproctological morbidity was monitored over a 15-year period from 2004 to 2018. Results. Diseases related to the coloproctology profile were recorded in 47171 cases in 2018, however, only 30900 outpatient coloproctological procedures were performed in the region, in which 10324 rigid rectoscopes were performed, and 4582 fibrocolonoscopy. The average value of the regional primary coloproctological incidence rate was 21.57±0.54 per thousand people. The total decrease in the incidence rate for the entire study period was 21.0%. The share of cancer in the total coloproctological morbidity is 9.3-21.0%. The total increase in the incidence of colon cancer over the entire study period was 89.0%. The proportion of benign neoplasms in the total coloproctological morbidity slightly varied from 4.4% to 6.1%. The incidence rate of benign diseases of the colon practically did not change + 5.45%. Conclusion. The volume of specialized medical care provided by the regional coloproctological service to patients with diseases of the colon does not correspond to the needs for it. To improve the quality and availability of medical care, it is necessary to reliably predict the need for it and optimize the structure of the specialized service itself.

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The use of hospital resuscitation and intensive care beds in provision of medical care in a city

Year: 2020, volume 16 Issue: №3 Pages: 800-804
Heading: public health Article type: Original article
Authors: Klyukovkin K.S., Kochorova L.V., Kozhin S.A., Okulov M.V.
Organization: Pavlov First Saint Petersburg State Medical University
Summary:

Objective: To identify the shortcomings and reserves of the use of the resuscitation and intensive care bed Fund on the example of the health care system of a city. Material and Methods. The use of resuscitation and intensive care beds in 75 hospitals in Saint Petersburg was analyzed. The data were statistically processed, average values, extensive and intensive indicators were calculated with an assessment of the reliability of their difference, indicators of a dynamic series, and a correlation analysis was performed. Results: The availability of beds in Saint Petersburg in 2015-2019 decreased from 775.7 to 706.9 per 100 thousand population, while the share of intensive care and intensive care beds is stable (4.5-6.1%). This does not correspond to an increase in emergency hospitalization by 14.5%, the number of operations by 14.0%, and high-tech operations by 54.5%). The need for anaesthetic and resuscitation care has increased: from 1387 to 1524 cases per 100 thousand population, while the average number of days of employment of such beds has not changed significantly (in 2015, 245±4.8, in 2019, 241±5.5 (f<2). The availability of intensive care and intensive care beds affects the reduction of hospital mortality (p=-0.7, p<0.05). Conclusion: Intensive care and intensive care beds in Saint Petersburg, despite their intensive use, work effectively, while reserves have been identified that can be used in emergency situations and adverse epidemiological conditions.

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Palliative care: regional aspect

Year: 2020, volume 16 Issue: №2 Pages: 515-520
Heading: public health Article type: Author's opinion
Authors: Ertel L.A.
Organization: Kuban State University
Summary:

The objective of the study is to analyze the activities within the framework of the regional program «Development of the palliative care system», which was developed and approved in the Krasnodar region in order to increase the availability and quality of palliative care for residents of the region. During the analysis, problems were identified that arose during the implementation of the program: lack of a single focal point for monitoring, analysis and forecasting of palliative care in the region, insufficient provision of internists, pediatricians, paramedical staff in hospitals for palliative care. By comparing emerging problems with available research in this area, measures are proposed that will improve the quality of palliative care, which in turn, will bring palliative care closer to international standards. In the region, by 2021, it is planned to put into operation 2 focal points; creation and maintenance of a unified database (registers) of patients suffering from chronic pain syndrome who receive primary medical care by the end of 2020, with the subsequent integration of electronic registries into a unified health information system of the region by 2024. An 80% staffing level is planned for medical organizations providing specialized palliative care, by 2024.

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Tendency in morbidity and primary disability among adult population of the Saratov region due to diseases of endocrine system, eating and metabolic disorders

Year: 2020, volume 16 Issue: №2 Pages: 511-514
Heading: public health Article type: Original article
Authors: Ponomarev A.D., Sazanova G.Yu.
Organization: Saratov State Medical University
Summary:

Objective: To analyze the tendency in morbidity and primary disability of adult population in the Saratov region due to endocrine system diseases, eating disorders and metabolic disorders. Material and Methods: Using analytical and statistical research methods, the official data on morbidity and disability levels of adult population in Saratov region for 2009-2018 was processed. Results: During the study period in the Saratov region there was an increase in primary and general endocrine system morbidity, eating disorders and metabolic disorders by 25.7 and 7.2%, a similar situation was recorded in the Russian Federation and Volga Federal District (by 41.8 and 25.7%); by 41.5 and 31.8%, respectively), the annual increase in the above class of diseases was 5±2.2%; the level of total endocrine system diseases, eating disorders and metabolic disorders among the adult population of the region is 14 and 20% higher than in the Volga Federal District and the Russian Federation, respectively. Conclusion: The data obtained during the study indicate a high level and steady growth of primary and general morbidity of endocrine system diseases, eating disorders and metabolic disorders in the Saratov region, which makes it urgent to conduct a study on the organization of medical care for patients with diseases of endocrine system.

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Epidemiological analysis of incidence of female infertility in the Tambov region

Year: 2020, volume 16 Issue: №1 Pages: 88-93
Heading: public health Article type: Original article
Authors: Prokopov A.Yu.
Organization: Tambov Children Regional Clinical Hospital
Summary:

Aim: assessment of level and structure of incidence of female infertility in the territorial subject of the Russian Federation. Material and Methods. The study of the level and structure of incidence of infertility according to negotiability to the period from 2008 to 2017 among women of fertile age (15-44 years) of the Tambov region was carried out. The study of age of women and duration of infertility was carried out to the moment of the request for medical care for 2017 (n=812). Results. For the research period (2008-2017) there is a growth of incidence of female infertility six times to an indicator 3.5 cases on 1000 women of fertile age. Infertility of secondary genesis prevails over primary (53.1 and 46.9% respectively). In 2008, infertility of the endocrine genesis occupied the 3rd rank in the structure of causes (19.5%), in the second place — absolute tube infertility (31.1%), in the first place — infertility due to endometriosis, uterine fibroids, inflammatory processes (49.4%). In 2017, infertility of the endocrine genesis moved to the 1st place with an indicator of 43.3%, infertility of the absolute tube genesis remained in the 2nd place, but the indicator increased to 40.4%. Infertility due to endometriosis, uterine fibroids, inflammatory processes from the 1st rank place moved to 3rd with an indicator of 16.1%. Average age of the women who addressed in 2017 was 29.9±0.17 years. The average duration of infertility was 5.2±0.1 years. Conclusion. Results of the research demonstrate annual increase in number of women with infertility that shows the necessity of improvement of the organization of delivery of health care of this category of persons.

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