Saratov JOURNAL of Medical and Scientific Research

Fedonnikov A.S.

Saratov State Medical University n.a. V.I. Razumovsky, Vice Rector for Research Work, Head of Department of Innovative Technologies in Medical Care and Rehabilitation of Research Institute of Traumatology Orthopedics and Neurosurgery Candidate of Medical Sciences

Risks of trust in the institute of medicine in conditions of digital health: theoretical analysis and management practice

Year: 2020, volume 16 Issue: №1 Pages: 94-98
Heading: Sociology of Medicine Article type: Original article
Authors: Fedonnikov A.S., Andriyanova Е.А.
Organization: Saratov State Medical University
Summary:

Aim: to analyze the trust risks structure in medicine and healthcare and to study of the possibilities of online communication in healthcare for managing these risks. Material and Methods. The methodological basis of risk analysis of trust in the institute of medicine was the theory of social trust (Luhmann N., 1988). The study used methods of a systematic approach, structural and functional analysis and typologization. An empirical analysis of the problem of trust in the dyad «patient-medical specialist» carried out in 2018-2019 at the Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n. a. V. I. Razumovsky using the developed and introduced into practice System of interactive monitoring and feedback (SIMF), which allows to improve the quality of management of patient' preparation for the upcoming high-tech operation and the subsequent process of medical rehabilitation of patients (N=381). Result. It has been developed a theoretic model for the treatment of trust risks in healthcare in relation to medical rehabilitation, which is the basis for development practical tools for the prevention of medical, social and socio-psychological risks based on SIMR Conclusion. The use of online communication services increases the effectiveness of medical and rehabilitation measures based on a personalized approach; expands the ability to manage the interaction of patients and medical professionals through the prevention of trust risks in the institute of medicine.

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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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Decision making support system in spine-and-pel-vic surgery as an instrument of branch control automation

Year: 2019, volume 15 Issue: №3 Pages: 677-682
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Kolesnikova A.S., Rozhkova Yu.Yu., Kossovich L.Yu.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University
Summary:

Aim: to prove the use of decision making support system (DMSS) in spine-and-pelvic surgery as an instrument of control automation in health branch. Material and Methods. Development of DMSS presented in current work made at the base of methodology «planning-modeling-forecasting». For graphical analysis and description of DMSS performance applied the logic diagram method. Materials of DMSS performance evaluation were the data extracted from 22 protocols of its beta-testing processing. Results. Description of the development and beta-testing of organization tech- nology allowed to implement DMSS in healthcare at the base of Regional center (fulfilling medical and expert activity) and Technological center (fulfilling computational functions) interaction. Conclusion. Development and implementation of DMSS as an instrument of branch control automation allow influence the heath quality increasing by means of raising accuracy, specificity and personalizing of diagnostics, decreasing of complications and terms of rehabilitation. Besides this kind of systems allow reduce workload for medical personnel with rising of its labor efficiency that meets the needs of innovative development of medicine and healthcare.

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Medical and organizational issues of patients' preoperative fears management (analytical review)

Year: 2018, volume 14 Issue: №4 Pages: 686-690
Heading: Sociology of Medicine Article type: Review
Authors: Fedonnikov A.S., Katkova A.V., Andriyanova E.A.
Organization: Saratov State Medical University
Summary:

 The article deals with the problem of preoperative patient fears. Specific characteristics of preoperative fears and the mechanisms of their occurrence were described. According to the scientific literature analysis the typology of preoperative fears was performed. Within the framework of the author's approach the directions of the following theoretic understanding and practical solutions of indicated problem were presented. They included health managers focusing on interpersonal communication of patient and medical specialist; further analysis of factor influencing interpersonal communication of patient and medical specialist under disease condition requiring surgery; development of psychologically based medical care and postoperative rehabilitation quality indicators.

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The history of the development of national traumatology on the example of medical and scientific activities of Saratov Research Institute of Traumatology and Orthopedics (SarNIITO) (1950-1980)

Year: 2018, volume 14 Issue: №3 Pages: 596-602
Heading: Traumatology and Orthopedics Article type: Short message
Authors: Ulyanov V.Yu., Grishin S.E., Puchinyan D.M., Fedonnikov A.S., Chibrikov G.l., Norkin I.A., Ilyina E.S., Skobelkina A.V.
Organization: Saratov Socio-Economic Institute of G. V. Plekhanov Russian University of Economics
Summary:

We outlined and described basic directions of national traumatology development at the period of 1950-1980 illustrated by the example of Saratov traumatological school, estimated the contribution of SarNIITO traumatologists into this development at the abovementioned period, depicted syna — one of the founders of acute trauma clinics.

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The epidemiology of spine and spinal cord injuries

Year: 2018, volume 14 Issue: №3 Pages: 592-595
Heading: Traumatology and Orthopedics Article type: Review
Authors: Tolkachev V.S., Bazhanov S.P., Ulyanov V.Yu., Fedonnikov A.S., Ninel V.G., Salikhu Kh., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The article contains domestic and foreign data reflecting epidemiological peculiarities of traumatic injuries of spine and spinal cord, their character and incidence among various population groups with respect to gender and age parameters. The study outlines spine and spinal cord injury structure with regard to modern classification schemes, introduces injury incidence data, specifies indexes of lethality in spine and spinal cord injuries.

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Professor I.Ya. Livshits and his contribution to the development of national neurosurgery

Summary:

The article traces the professional path of Professor Lev Yakovlevich Livshits, assesses his scientific contribution to the development of national neurosurgery. The concept of minimally invasive surgical treatment of trigeminal nerve neuralgia, developed by L. Ya. Livshits, allowed developing an original method of puncture surgical treatment of pain syndrome by directed hydrothermal destruction of the sensitive trigeminal root. The concept of "growing radicalism" created by Professor L. Ya. Livshits allowed his students elaborating algorithms for treating severe chronic pain syndromes of any localization and etiology.

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Rehabilitation after hip and knee joints replacement: several results of medical and sociological monitoring

Year: 2017, volume 13 Issue: №4 Pages: 796-799
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Andriyanova Е.А., Erugina M.V, Norkin I.A.
Organization: Saratov State Medical University
Summary:

Aim: research of rehabilitation process problem areas after hip and knee joints replacement. Material and Methods. Program of monitoring and evaluation of medical, organizational, social and psychological components of rehabilitation was developed. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. It was revealed an absence of real interaction between key parties of rehabilitation processes based on significant disproportion between high level (more than 80%) of patients' satisfaction of rehabilitation organizing and low activity of health managers (9.4%). Despite of declared patients' high rehabilitation quality permanent pain noted by 45% of respondents, move freely without additional support is available only for about 50% of patients. Conclusion. Rehabilitation management and its' quality are the key values for locomotor system functional recovery. Provided study has designated main problems of rehabilitation quality evaluation after hip and knee joints replacement.

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The dynamics of patients' life quality indices under the conditions of two-stage knee joint replacement

Year: 2017, volume 13 Issue: №3 Pages: 768-772
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shpinyak S.P., Fedonnikov A.S., Barabash А.Р., Barabash Ju.A.
Organization:
Summary:

 The aim: to analyze the changes in the life quality indices of the patients with deep periprosthetic joint infection of the knee under the two-stage surgical treatment. Material and Methods. 57 patients who underwent two-stage revision-ary treatment in Research Institute of Traumatology, Orthopedics and Neurosurgery were interviewed with life quality questionnaire Short Form Medical Outcomes Study (SF 36 v.1). Interview results were compared with standardized population indices of SF-36 scales for males and females. Results. In all groups regardless of sex there was a general tendency for an increase in physical and psychological health component up to mean population values after the first stage of surgery and further growth after the second stage. Rehabilitation potential of psychomotor health was higher in women than in men. The ability to handle stress was lower in direct ratio with the patients' age. Conclusion. Two-stage reendoprosthetic treatment with articulating antimicrobial spacer implantation having high grade of fixation is an effective treatment method for deep periprosthetic infection which increases physical health and improves social functioning of patients.

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Medical and sociological issues of rehabilitation of patients after hip and knee joints replacement

Year: 2017, volume 13 Issue: №3 Pages: 761-764
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Fedonnikov A.S., Erugina M.V., Andriyanova E.A., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The aim: research of medical and social issues of rehabilitation after hip and knee joints replacement. Material and Methods. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. Within the scope of medical surveillance after the surgery 69.8% of patients made regular visits to orthopedic specialists after joint replacement, but only 9.4% of surveyed patients confirm the practice of active monitoring of rehabilitation on the part of health services. There had been determined a high level of declared patients satisfaction (more than 80%) with weak health managers activities argue considerable informational gap between the key parties of rehabilitation. Conclusion. Provided study has designated problem areas of patient and health system communication in rehabilitation after hip and knee joints replacement.

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