Saratov JOURNAL of Medical and Scientific Research

Health Service Organization

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.

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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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Health care supervisors' opinion on prophylactic work in medical organizations

Year: 2018, volume 14 Issue: №3 Pages: 438-444
Heading: Health Service Organization Article type: Original article
Authors: Korshever N.G., Sidelnikov S.A., Yakhina R.R.
Organization: Saratov Regional Centre of Medical Prophylaxis, Saratov State Medical University
Summary:

 The aim: to investigate the condition of prophylactic work in medical organizations and to determine the directions for optimization of this process. Material and Methods. There has been carried out an anonymous questioning 92 of health care supervisors of the Saratov region, as well the analysis of data obtained from Saratov Regional Centre of medical prophylaxis. It was found that there were significant shortcomings in the individual items in the preventive work of medical organizations. Results. There has been determined the awareness of health care supervisors about normative-legal acts regulating prophylactic work; use of corresponding informational-methodical materials; management of registration documents and submission of reporting documents; performance of primary, secondary and tertiary prophylactic measures; realization of means and methods of hygienic upbringing and education of patients; activities of offices (departments) of medical prophylaxis. It has been established that the condition of prophylactic work in medical organizations of the Saratov region is at the satisfactory level but needs to be optimized. The directions of optimization are determined by the necessity to raise the levels of a number of characteristics analyzed. None of the considered measures of the first prophylaxis has been evaluated with the mark "good", (> 4,0 points); some measures of the secondary prophylaxis (purposeful sanitary-hygienic education of patients and members of their families in skills of care associated with a certain disease or with a group of diseases, etc.) (2 points) have been evaluated with the mark "unsatisfactory"; the state of the tertiary prophylaxis has been evaluated on the whole with the mark "satisfactory", i.e. 3,4 points. Conclusion. The obtained materials may be useful in daily practice of medical organizations.

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Methodology of advanced medical information registries design

Year: 2018, volume 14 Issue: №3 Pages: 434-437
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Kolesnikova A.S., Rozhkova Yu.Yu., Kirillova I.V., Bessonov L.V., Ulyanov V.Yu., Kossovich L.Yu.
Organization: Saratov State Medical University
Summary:

Aim: development of information exchange methodology between the main participants of health branch in providing of medical care for traumatology and orthopedic patients at the base of specialized registers design. Material and Methods. Analysis and systematization of 31 registers of medical information in the field of traumatology and orthopedics functionality placed in Federal Institute of Industrial Property, European Patent databases, developers' web-sites were made. Search depth was designated from 1979 and was defined by the date of the earlier found information source. Results. Analysis of specialized registries has shown that most of it (70.9%) are mono-nosological and contain information about diagnostic and treatment measures provided at the level of a medical institution. It was developed a methodology of specialized registry of medical information functionality including the information of applied medical devices, pharmaceutical preparations, medical technologies, rehabilitation programs, medical care evaluation results methodology which let operate with the data forming in information systems of the main health branch participants. Conclusion. Proposed information exchange methodology determines the necessity of integrated target-oriented registry development. Its practical use let increase management decisions quality influencing the achievement of health branch participants objectives.

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Analysis of resources of therapeutic institutions providing medical care to patients with diseases of the circulatory system

Year: 2018, volume 14 Issue: №2 Pages: 293-290
Heading: Health Service Organization Article type: Original article
Authors: Sazanova G.Yu., Shulpina N.Yu., Dolgova E.M., Tupikin D.V.
Organization: Saratov State Medical University
Summary:

Objective: to conduct an analysis of the provision of beds and medical personnel of medical institutions in the region that render medical care to patients with circulatory disorders. Material and Methods. Calculation of the optimal volume of inpatient medical care, the required number of beds and staff units of cardiologists in the region was carried out in accordance with regulatory legal acts. Results. In medical organizations, an excessive number of round-the-clock beds on the "cardiology" profile (more for 186 beds) and insufficient number of cardiac beds in day hospitals (less than 40 beds) were deployed; the number of cardiologists working in cardiological rooms of polyclinic medical organizations, dispensaries for cardiology and daily hospitals has been identified. Conclusions: Redistribution in the region's medical organizations of the bed fund, material, and financial resources leads to the optimization of patients' referrals and promotes rational use of resources of health care, increasing the availability and improvement of quality of medical care to adult population of the region.

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Motivation of medical staff of dental organizations of various property types: data of sociological research

Year: 2018, volume 14 Issue: №2 Pages: 287-293
Heading: Health Service Organization Article type: Original article
Authors: Kaneva D.A., Breusov A.V.
Organization: Peoples' Friendship University of Russia
Summary:

The searching of effective methods of staff management is the most important task for healthcare managers. The purpose of the study: to assess the degree of work satisfaction of doctors and nursing staff of dental organizations of various forms of ownership and to analyze the factors that determine it. Material and Methods. The survey was conducted using a specially developed questionnaire, which included blocks describing the following parameters: satisfaction with various aspects of the work; factors affecting labor activity; rating characteristics of work; motives that determine professional interest; conditions that stimulate activity. Results. As a result of the study, differences were found in the satisfaction with the professional activity and working conditions of medical and nursing staff of dental organizations of various forms of ownership. Factors determining the motivation of the work of the personnel of the modern medical organization are revealed. This allowed for a differentiated approach to the development of measures to improve the diverse motivation of the staff. Conclusion. It was established that the main directions in improving the staff motivation system may be: material and non-material promotion; optimization of work organization; involving staff in the management of organization and making management decisions; improvement of professional skills of employees, fair distribution of remuneration and social services.

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