Saratov JOURNAL of Medical and Scientific Research

Health Service Organization

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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Evaluation of influence of social factors on the psycho-emotional state of persons of elderly and senile age

Year: 2019, volume 15 Issue: №3 Pages: 674-677
Heading: Health Service Organization Article type: Original article
Authors: Sazanova G.Yu., Shulpina N.Yu., Ponomarev A.D., Kraynova A.M., Isakova E.A., Tsapikova Yu.S.
Organization: Saratov State Medical University
Summary:

Objective: to identify patterns of influence of social factors on the psycho-emotional state of the elderly and senile age. Material and Methods. A survey of 385 patients (average age-78.5±0.5 years). The following research methods were used: sociological (questionnaires composed of questions relating to the psycho-emotional state from the social block of the WHO quality of life questionnaire), statistical (Chi-square and the coefficient of mutual conjugacy of Chuprov»s qualitative signs using SPSS). Results. In the course of the study it was proved that the psycho-emotional state of the elderly and senile age is influenced by age, marital status, education and the number of children. Life satisfaction among married people was 3.4, widows and widowers 3.3, divorced 2.9 points. The strongest relationship between the level of education and satisfaction of respondents with their ability to make decisions and satisfaction with themselves as a person was revealed in persons with full secondary education (3.6 and 3.2 points, respectively), the lowest — in persons with secondary special (2.9 points) and incomplete secondary education (2.6 points). Respondents with two children and more (1.8 points) who are married (2.0 points) feel less lonely. In general, there is a reassessment of the individual, social status has a huge impact on the well-being and lives of people. They begin to perceive everything that is happening around them more sharply. All this together affects the objective component of life. Conclusion. The regularities of the influence of social factors on the psycho-emotional state of the elderly and senile age. Satisfaction with life in old and old age depends on marital status, education and number of children, which is connected with the opportunity to receive help and help others, and, accordingly, a higher appreciation of oneself as a person.

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The role of doctors in the formation of preventive compliance in patients of cardiological profile

Year: 2019, volume 15 Issue: №3 Pages: 669-674
Heading: Health Service Organization Article type: Original article
Authors: Gruzdeva А.А., Ilyin M.V.
Organization: Kostroma District № 1 Hospital, Yaroslavl State Medical University
Summary:

The purpose of the study is to analyze the compliance of cardiological patients to participate in the prevention of coronary risk and the role of doctors in the compliance formation. Material and Methods. The base of the study was the outpatient medical organizations of the Kostroma region. The study design included a systematic coronary risk assessment using the SCORE European scale; randomization of patients into groups according to the risk degree; assessment of prophylactic patient compliance; analysis of patient compliance; assessment of patient potential; assessment of the relationship between the level of prophylactic compliance of patients with the level of coronary risk; assessment of the quality of compliance prevention by primary care physicians. Scope of the study: 400 patients with cardiac profile, 200 cases of dynamic observation of patients with high and very high levels of coronary risk. Results. We found that 32.4% of patients had a high level of compliance; 64.5% of patients had an average level of prophylactic compliance and 3.1 % of patients had a low level (p<0,05). We discovered the main parameters of reducing of prophylactic compliance of patients, determining factors, as well as the parameters for reducing the quality of compliant prophylaxis in the primary health care system. Conclusion. The obtained data became the theoretical basis for the development of the technology for coronary risk compliance prevention including 7 stages and 3 levels.

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Modern practical-oriented approach to professional selection for medical professions among school graduates

Year: 2019, volume 15 Issue: №2 Pages: 338-341
Heading: Health Service Organization Article type: Original article
Authors: Kasimovskaya N.A.
Organization: I.M. Sechenov First Moscow State Medical University
Summary:

Objective: to study efciency of introduction of new instrument of vocational guidance in the feld of medicine — «Pre-Professional Examination» (Practical part), to estimate the current state of readiness for choice of medical profession among school leavers. Material and Methods. In 2017, for the frst time, an organizational experiment on the technology «Objective Structured Clinical Examination» (OSKE) for students of 11 grades of schools in Moscow (n=2703) was conducted and a comparative analysis with the results of obligatory «Pre-Professional Examination» (Practical part) (n=3100 respectively) to assess the practical skills of frst aid, also applied a sociological method to assess the readiness of graduates of secondary general educational organizations to the choice of the medical profession (n=300). Results. As a result of research it is established that at voluntary choice of participation in the practical-oriented examination (organizational experiment) the results are higher (60 points — 35.1±1.4 %), than at obligatory passage of «Pre-Professional Examination» (Practical part) (60 points — 2.1±0.3 %) which determines its importance as a motivational factor in the choice of professions in the feld of medicine. The sociological survey showed that 49±3.1 % of students-graduates of schools have not yet decided on the choice of profession. Conclusion. The efectiveness and signifcance of introducing the «Pre- professional exam» (practical part) as a promising method of strategic planning in government regulation of the formation of human resources for the health care system from school graduates and challengers for medical specialties has been scientifcally proven.

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Key tendencies in health of citizens of military age

Year: 2019, volume 15 Issue: №1 Pages: 86-90
Heading: Health Service Organization Article type: Original article
Authors: Sogiyaynen А.А.
Organization: The National Research Institute of Public Health n.a. N.A. Semashko
Summary:

Aim: to study key trends in the health status and number of people of military age. Material and Methods. The research materials were official open statistical data and analytical materials of the public health authorities of the Moscow Region, Primorsky Krai and the Russian Federation, statistical data from the Rosstat (www.gks.ru), EIISS (https://fedstat.ru). To solve the tasks in the study, a statistical analysis of the level, dynamics and structure of primary and general morbidity of young men of military age (15—17 years old), as well as dynamic characteristics of the number of people of military age (18- 26 years old) was carried out. Results. The study revealed a negative trend in the number of people of military age (-1,723 thousand people, or-18.5% from 1995 to 2017). The reduction in the number of troops by 2028 will be -43.5% compared with 2010 The overall morbidity among young people aged 15- 17 years from 2006 to 2015 in the Russian Federation increased by 15.2% and amounted to 2247.2. In the structure of general morbidity among young people aged 15-17 years, respiratory diseases dominate in the Russian Federation 33.3%, in the second rank eye disease and accessory apparatus 9.3%, in the third digestive organs (8.8%), on the fourth and fifth musculoskeletal system and connective tissue (7.9%) and injuries, poisoning and other consequences of external factors (7.7%). In the structure of the primary incidence of this category of young people, as in the case of general morbidity, respiratory diseases dominate 47.8%, injuries, poisoning and other consequences of external causes (12.4%) prevail in the second ranking place; on the third diseases of the digestive system (5.7%); in the fourth, diseases of the urogenital system (4.6%); on the fourth and fifth, there are diseases of the eye and its adnexa (4.6%) and diseases of the musculoskeletal system and connective tissue (4.3%), respectively. The incidence of citizens of military age has pronounced regional features. An analysis of the overall incidence in these regions shows that there is a heterogeneous picture in different regions. Thus, the average level of general morbidity in Primorsky Krai among citizens ofmilitary age in 2006-2015 with certain infectious and parasitic diseases exceeds this indicator in the Moscow Region by 49.7%, and in the Russian Federation by 18.1%; neoplasms by 37.8 and 12.9%, respectively, mental disorders and behavioral disorders by 19.1 and 8.6%; diseases of the genitourinary system by 54.7 and 14.5%; other diseases 5.9 and 5.2%. Conclusions. Negative tendencies of primary (+16.0%) and general morbidity (+15.2%) were detected for almost all classes of diseases, significant regional features of the status of recruits, a negative trend in the number of men of military age (by 2028 the decline will be -43.5% compared with 2010). The level of primary incidence of this contingent is currently 1373.8%o and the growth of this indicator over 10 years was 16.0%. When analyzing the incidence of the studied contingent, classes of diseases require the most attention: eye and its adnexa diseases, respiratory diseases, digestive diseases, diseases of ear and mastoid process and nervous system, as well as the genitourinary system diseases.

Epidemiological characteristics of rhegmatogenous retinal detachment in the Central Black Earth region

Summary:

Aim: to estimate the frequency of rhegmatogenous retinal detachment among the population of the Central Black Earth region. Material and Methods. A retrospective study on the study of patients with myopia, who turned to the rhegmatogenous retinal detachment (RRD) in "S. Fedorov Eye Microsurgery Federal State Institution" in the period from 2006 to 2017 The epidemiological characteristics of patients who have applied to the RRF from five regions of the Central Black Earth Region (Belgorod, Voronezh, Kursk, Lipetsk, Tambov) are presented. Results. There is an annual increase in the number of patients with myopia complicated by RRD. The highest number of cases of myopia complicated by RRD was recorded in the age group of 50-59 years and 60 years and older, the smallest — in the age group 0-19 years. The female population suffers from a myopia complicated by the RRD equally with the male, but in the age groups 20-29 years, 30-39 years, men suffer more often, in the age groups 50-59 years, 60 years and older, women suffer more often. Among the patients from the Voronezh region, the largest number of cases of RRD was registered in the age group of 50-59 years, among patients from Tambov, Lipetsk and Kursk regions — in the age category of 60 years and older, from Belgorod region — in the age category of 30-39 years. The majority is represented by pensioners (60.3%), working people — 20.8%, disabled people — 15.8%, others 3.1%. Conclusion. Among the population of the regions of the Central Black Earth region, there is an annual increase in the number of patients with RRD, while the number of such patients will only increase, which indicates the need to improve the organization of eye care to the public.

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Medico-social performance of health centers to identify risk factors for major chronic non-communicable diseases

Year: 2019, volume 15 Issue: №1 Pages: 77-82
Heading: Health Service Organization Article type: Original article
Authors: Krasnikova N.V., Shemetova G.N., Kazban O.G., Кап А.О., Savinov T.Kh.
Organization:
Summary:

Objective: to study the frequency of occurrence of risk factors for cardiovascular disease among the working population of Saratov and to analyze the effectiveness of measures to promote a healthy lifestyle in the district health Center. Material and methods. The study was conducted on the basis of thehealth Center of the Saratov city polyclinic №17. For 2013-2017 surveyed 50301 patient of working age. The plan of the survey included the collection of anamnesis to identify risk factors for cardiovascular disease, physical examination with the implementation of anthropometry (determination of growth, calculation of body mass index), measurement of blood pressure, determination of total cholesterol and glucose in capillary blood. The total risk of fatal cardiovascular complications was assessed on the SCORE scale. Portable peripheral Doppler analyzer Smart Dop 30 EX with automatic measurement of systolic blood pressure and calculation of ankle-brachial index was used for angiological screening. Results: The most common risk factors were poor nutrition and physical activity, hypercholesterolemia, hyperglycemia, overweight and obesity. A decrease in the number of smokers since 2013 by more than 1.5 times: from 12.9 to 7.5%. The incidence of hypertension increased from 29.1 to 41.7%. Conclusion. It was found that more than 70% of patients who applied had risk factors for major chronic noncommunicable diseases. Overweight and obesity, irrational nutrition, low physical activity were detected in more than 50% of cases; hypercholesterolemia was determined in 45% of cases, hyperglycemia in 25%. Over the past 5 years, the incidence of hypertension among patients of working age has increased, primarily due to improved detection. It is important to carry out preventive programs, starting with students and young people, to inform citizens and motivate them to lead a healthy lifestyle.

Keywords: -
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Social and demographic characteristics and health status of women of fertile age in Moscow region

Year: 2019, volume 15 Issue: №1 Pages: 72-77
Heading: Health Service Organization Article type: Original article
Authors: Breusov A.V., Konovalov О.Е., Kharitonov A.K., Kharchenko V.V., Breusov R.A.
Organization: Bauman Moscow State Technical University, Kursk State Medical University, Peoples' Friendship University of Russia
Summary:

 . SObjective: analysis of the state of health, medical activity, social and demographic characteristics of women of child-bearing age to develop a set of medical and organizational measures aimed at reducing the loss of maternal and child health, improving the system of maternal and child health. Material and Methods. The following methods were used in the work: bibliographic, analytical, mathematical- statistical, sociological (questioning). The material of the study was 596 questionnaires of a sociological survey of women — patients of the regional perinatal center. Each questionnaire included 48 questions combined into 6 blocks (social, demographic characteristics, state of health, medical activity), which were processed using the statistical program PASW (Predictive Analytics Software) Statistics 22 Results. It was found that the majority of respondents considered themselves to be in the healthy group, every fifth considered that they had chronic diseases and 11.9% felt sick. In the structure of chronic pathology, the largest proportion was accounted for by respiratory diseases, ENT organs, circulatory system diseases, gynecological diseases. Conclusion. On the basis of the obtained data, the directions for improving the system of maternal and child health have been proposed, such as: strengthening preventive activities, improving the quality of clinical examination of the female population; improvement of continuity in the work of institutions of the maternal and child welfare system; introduction of interactive forms of education for pregnant women.

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Regional problems of organization of medical rehabilitation of children who underwent neuroinfection.

Summary:

The purpose of the study is to demonstrate the main problems of rehabilitation aid to children who underwent neuroinfection. Material and Methods. Statistical evaluation of the results of the survey of doctors, nurses and heads of medical organizations (n=690) of various regions of the Russian Federation involved in the treatment of children with neuroinfections. These results were compared with the opinion of experts of the leading organization that provides assistance to this category of children at the Pediatric Research and Clinical Center for Infectious Diseases of Federal Medical and Biological Agency (n=121). Results. Specialists of all institutions note the growing need for children in rehabilitation activities after neuroinfections. 20,7% of specialists from regional medical organizations and 22,4% of experts from Pediatric Research and Clinical Center for Infectious Diseases of Federal Medical and Biological Agency indicate that continuity between medical organizations of different levels of medical care for children who have undergone neuroinfection is rather ineffective. The survey found that 25,9% of specialists of regional medical organizations pointed to funding problems. 28,3% of regional specialists indicated an insufficient number of medical organizations providing rehabilitation to children, and 59,0% of specialists from regions and 50,2% of Pediatric Research and Clinical Center for Infectious Diseases of Federal Medical and Biological Agency experts indicated the need to improve the legislative base. In addition, the interviewed experts ascertained an insufficient number of doctors and nurses in the organizations of the profile in question. Conclusion. According to the results of the study, the main problems in the organization of children's medical rehabilitation were established. This work can be one of the reasons for making management decisions aimed at improving the quality of this type of care for children who have undergone neuroinfections.

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The role of private medical business in the digital health projects

Year: 2018, volume 14 Issue: №4 Pages: 667-670
Heading: Health Service Organization Article type: Author's opinion
Authors: Muslimov M.l.
Organization: Clinic of Scientific Medicine
Summary:

New medical and information technologies meet a global challenge in the world health system. In developed countries there are legislative and financial arrangements for the transfer of the national health service in digital format. Russia also keeps up with global economic trends: regulatory and legislative acts have been adopted to ensure the transition to digital healthcare, the state program of digital medicine has been approved, and a list of priority tasks proposed for implementation by 2025 has been defined. The author examines the various concepts and directions of the movement to digital health, adopted in some countries and in Russia, analyzes the current state of affairs in the Russian digital health, forming predictive estimates for the future.

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