Saratov JOURNAL of Medical and Scientific Research

public health

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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Legal aspects of medical services in the professional activity of a doctor

Year: 2020, volume 16 Issue: №1 Pages: 83-87
Heading: public health Article type: Author's opinion
Authors: Kovalenko Yu.V., Fomicheva R.V., Tolstokorov A.S., Kravchenya A.R., Titova D.A.
Organization: Saratov State Law Academy, Saratov State Medical University
Summary:

The substantiation of the need to improve the legal model of ensuring the safety of interaction between the patient and medical personnel in the provision of medical services is given. The study conducted a comparative legal analysis of the sources of legal regulation of individual components of the quality of medical services. The material for the assessment were articles of the Federal law "On the basis of health protection of citizens in the Russian Federation", as well as orders approved by the Ministry of Health of the Russian Federation. Proposals have been developed to improve the current legislation aimed at ensuring legal protection of medical personnel. On the basis of the conducted research it is established that there is no legal definition of quality of medical services. Existing laws protect the rights of patients, but the professional activities of medical personnel do not have a system of insurance of risks that create increased danger in the provision of medical care to the population.

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Internal quality control of medical care in scientific publications and regulatory legal acts of the Russian Federation (review)

Year: 2019, volume 15 Issue: №4 Pages: 925-930
Heading: public health Article type: Review
Authors: Chubirko M.I., Chubirko Yu.M., Antonenkov Yu.E.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

The review is devoted to the current state of the problem of activity, which is assigned to each medical organization without taking into account the forms of ownership: the organization of internal quality control and safety of medical activity in medical organizations in Russia. The authors analyzed scientific publications, regulatory legal acts and laws on internal quality control and safety of medical activities at present and made recommendations on the issue under consideration.

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Medical rehabilitation after total hip and knee arthroplasty: logistics and resource provision

Year: 2019, volume 15 Issue: №4 Pages: 920-924
Heading: public health Article type: Original article
Authors: Fedonnikov A.S.
Organization: Saratov State Medical University
Summary:

Aim: analysis of problems of logistics and resource provision of medical rehabilitation of patients after total hip and knee arthroplasty. Material and Methods. In the period of 2013-2018 for 24 Russian regions studied: statistic materials of Federal Ministry of Health (form № 14); territorial government guarantee programs. Results. It was developed an author's scheme of logistics and resource provision of medical rehabilitation, describing 4 of its possible trajectories, guaranteed governmental funding sources, and infrastructure capabilities. It was revealed the regional differentiation and the lack of stable dynamics in tariffs growth for in-patient stage of medical rehabilitation — an increase in the tariff was revealed only in 8% of the regions, in a day hospital — in 29% of the regions. Conclusion. The insufficient amount of financial resources within the framework of budgetary allocations and the basic program of compulsory medical insurance leads to limited access for patients to the trajectory of the completed cycle of medical rehabilitation after these surgical interventions. The current practice reduces the medical and social effectiveness of concerned high-tech medical care programs that in the long run creates a risk of socio-economic devaluation of the medical result achieved at the stage of resource demanding surgical treatment.

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Comparative analysis of the attitude of doctors and representatives of social groups without medical education to the problems of organ transplantation

Year: 2019, volume 15 Issue: №4 Pages: 916-920
Heading: public health Article type: Original article
Authors: Romanov S.V.
Organization: Volga District Medical Center of FMBA
Summary:

Purpose: on the basis of the comparative analysis to reveal features of the relation to problems of transplantation and organ donation among doctors and persons without medical education. Material and Methods. The study was conducted on the basis of questionnaires from 266 doctors of donor bases, 420 students and 250 patients of the hospital. The author's questionnaire contained two groups of questions: the awareness of participants about the possibilities of transplantology and the legal component of organ donation. Results. The only difference between doctors and respondents without a medical education was a higher awareness of donor base employees in legal issues related to post-mortem organ donation in Russia (p <0.05). There were no differences between the examined groups in their readiness to support organ transplantation to relatives and to consent to the posthumous organ donation (pva|ue>0.05). Conclusion. Thus, the results of the comparative analysis of the attitude to the problems of transplantation and organ donation among doctors and persons without medical education with a naturally higher level of awareness of doctors did not reveal statistically significant features in the aspect of personal support for these programs. This indicates the need forthe medical community to develop an understanding of the importance of their professional participation in the development of organ transplantation programs to save the lives of the patients.

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. Actual problems of provision of Russian healthcare with specialists with secondary medical education (analytical review)

Year: 2019, volume 15 Issue: №4 Pages: 909-916
Heading: public health Article type: Review
Authors: Novokreshchenova I.G., Chunakova V.V., Semikina N.A., Aranovich L.M.
Organization: Saratov State Medical University
Summary:

According to the literary sources and official statistics it was revealed that high needs in the paramedical personnel preserve in medical organizations of different levels and profile and in the whole industry. The mechanisms of forming of deficit of paramedics in the healthcare system of our country were considered. Within the framework of authorial approach the article presents basic directions of solving the problems of staffing of local healthcare system with specialists with secondary medical education.

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Features of the level and dynamics of early social orphanhood as a medical and social phenomenon in various administrative-territorial formations of the Chelyabinsk region

Year: 2019, volume 15 Issue: №4 Pages: 904-909
Heading: public health Article type: Original article
Authors: Markina A.Yu.
Organization: South Ural State Medical University
Summary:

The aim is study the features of the level and dynamics of early social orphanhood as a medical and social phenomenon in various administrative and territorial entities of the Chelyabinsk region. Material and Methods. The method of copying data from the accounting documentation of the maternity hospital was applied (Form No. 32 "Information on medical care for pregnant women, puerperals and parturient women" for 2009-2017, Form No. 96 "Birth history"). A total of 1438 observation units were investigated. Results. During the period from 2009 to 2017 in the Chelyabinsk region there is almost two-fold reduction in the number of early social orphans: from 175 to 84 newborns. The highest prevalence of newborns abandonment was in urban districts:4.5±0.9 cases per 1000 newborns. Among women from rural areas and from megalopolis those indices did not differ significantly: 3.5±0.2 and 3.3±0.4 cases per 1000 newborns respectively (p>0.05). Conclusion. In the Chelyabinsk region the number of early social orphan hood decreased by almost half by the period of 2009-2017. The number of these children in megalopolis, urban and rural districts was subjected to serious fluctuations in the particular years of the study. Considering the differences in the level of birth rate and female population of reproductive age in urban and rural areas it is necessary to use index "prevalence of newborns abandonment per 1000 newborns" proposed by us. After a sharp decrease in absolute and relative values reflecting the number of early social orphans at the turn of 2013-2014, the indicators stabilized in subsequent years. This may be a consequence of both the reduction of preventive measures and the formation in the population of mothers of refusers of a certain contingent, which is insensitive to traditional methods of socio-psychological impact.

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Academic performance, motivation and quality of life associated with the health of senior students of medical and humanitarian specialties

Year: 2019, volume 15 Issue: №4 Pages: 897-904
Heading: public health Article type: Original article
Authors: Kuznetsov V.V., Bayramov R.A., Smirnov E.A., Kosilova E.K., Kosilov K.V., Karashchuk E.M., Zayko A.A.
Organization: Pacific State Medical University, Far Eastern Federal University
Summary:

Objective: a comparative analysis of the relationship of quality of life associated with health with academic performance and motivation to learn from students of humanities and medical specialties of senior courses. Material and Methods. The study was conducted at the School of Biomedicine of the Far Eastern Federal University and Pacific State University. The sample size is 516 students (51% girls). 272 (52.7%) students studied medical specialties; 244 (47.3%) — humanities. For questioning students used a comprehensive questionnaire self-assessment of socio-economic and medical status of a student of the University (Pozdeyeva, 2008), the questionnaire MOS SF-36. Academic motivation was assessed on the scale of Т. О Gordeeva and O. A. Sychev (2014); academic performance — according to the semester statistical reports of the relevant departments and faculties. Results. The total indicators of physical and mental health in the assessment of quality of life associated with health among students of medical and humanitarian specialties did not differ significantly, although the assessment of their quality of life by humanitarians was slightly higher (67.1/64.1; p>0.05). It was found that strong relationships are characteristic of variables: learning conditions (r=0.89, p<0.05); academic performance and motivation to study (r=0.75, p<0.05; r=0.79, p<0.05); the presence of bad habits (r=0.77, p<0.05); self-assessment of physical health (r=0.67, p<0.05). Conclusion. The quality of life associated with health at students of medical and humanitarian specialties is interconnected by motivation to study and progress, and also a number of variables of the social and economic status and morbidity.

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Optimization of medical organization activities by implementation of lean-production

Year: 2019, volume 15 Issue: №4 Pages: 893-897
Heading: public health Article type: Author's opinion
Authors: Breusov A.V., Fenyutina V.A., Orudzhev A.A.
Organization: Peoples' Friendship University of Russia, Bauman Moscow State Technical University
Summary:

The existing health care system in the Russian Federation requires significant changes related to the reorganization of the current processes of medical care in medical institutions, therefore, the topic of introducing the principles of lean production in the healthcare sector is extremely relevant today. Lean healthcare is aimed at increasing the availability and quality of medical care to the population by streamlining processes and eliminating losses. The main objectives of the medical institution as part of the implementation of the concept of lean manufacturing are to increase the satisfaction of consumers of medical services, increase the quality and productivity of medical personnel. The need to implement these tasks is caused by the unreasonably long time spent of patients in the clinic during research, the uneven workload of medical institution specialists, queues at the reception desk, filling in a large number of different paper forms and processing of unnecessary information. The study allowed us to comprehensively analyze the basic principles of the concept of lean manufacturing, to substantiate the relevance and the possibility of extrapolating its principles to the healthcare sector, as well as to study the organization of the activities of the best "lean" clinics abroad, which could become role models when introducing the principles of lean manufacturing in domestic medical organizations.

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Information systems perspectives in the improvement of dental care quality (review)

Year: 2019, volume 15 Issue: №4 Pages: 888-893
Heading: public health Article type: Review
Authors: Bragina М.G., Fomina A.V.
Organization: Peoples' Friendship University of Russia
Summary:

The analysis of literature data on the possibilities and prospects for the use of information technologies (IT) to improve the efficiency and quality of dental medical care (QDMC) to the population has been performed. The need for the introduction of IT systems as part of pilot projects in dental facilities was noted. According to a number of researchers, the prospects for introducing medical information systems (IS) are associated with increasing the supporting business processes. The results of a number of studies are presented in which it is demonstrated that the use of the software systems proposed by different authors allows for the operative control of the QDMC with the evaluation of medical personnel, as well as for improving the effectiveness of treatment and optimizing the patient flow. It is indicated that the electronic method of collecting, storing and processing data makes it possible to combine the efforts of specialists who are participants in the process of providing dental care to the population in a single information field, which undoubtedly should make a significant contribution to improving the efficiency of their treatment.

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