Vol 28, No 4 (2020)

Full Issue

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Articles
The patterns of seasonal outbreaks of acute respiratory diseases
Gundarov I.A.
Abstract
The COVID-19 epidemic cause is considered to be “patient zero” contaminated by coronavirus infection in December 2019 in China. However, accumulated facts dispute this version of events. The first infected patient appeared in September in the United States, in December - in France. in November-December pneumonia of similar severity raged in Russia. It is difficult to explain numerous outbreaks of simultaneous contagions in isolated staffs, including military garrisons. In most of healthy adults’ antibodies to coronavirus are found. The most of infected patients have no symptoms of disease. To explain these paradoxes ecological hypothesis is proposed - humanity and coronaviruses have been interacting evolutionarily for thousands years in system of biogeocenosis, periodically confronting under influence of cyclical ecological processes.The purpose of study is to investigate relationship between mortality of acute out-of-hospital pneumonia, coronavirus ones included, and cyclical fluctuations of environmental conditions.The primary material was obtained from data of Rosstat, international information bases, results of scientific studies. The classic methods of medical statistics were applied. The summer solstice (June) was used as reference point for estimating dynamics of monthly mortality in 2015-2020. The analysis of dynamics of mortality of pneumonia averaged for 2015-2020 revealed three epidemic waves with peaks in October, January, and March. Such cyclical pattern was consistently reproduced for particular years in 2015-2020. The first wave always was the lowest one. When the second wave exceeds the third one, increase in mortality in February and March was the smallest one. The greatest epidemic losses were established at the plateau. In 2020, the rate of coronavirus infection in the world coincides with the established cyclicity. The stable reproducibility of three peaks of mortality in same months testifies their regular character. The cause of all this may be the cyclicity of ecological interactions between coronaviruses and human population.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):507-511
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The analysis of indices of population morbidity at the level of region
Khabriev R.U., Mingazova E.N., Jelezova P.V., Gureyev S.A.
Abstract
The article presents the results of the analysis of indices of morbidity of children and adults in the Kostroma Oblast in 2000-2017. The main trends and changes during analyzed period are established. The high morbidity in such classes of diseases as respiratory diseases, injuries and poisoning, complications of pregnancy, childbirth and postpartum period are determined. The morbidity population in the Kostroma Oblast in the main classes of diseases increased by 14.3% in 2000-2017. The children morbidity in age group 0-14 years remains high.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):512-517
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The dynamics of primary and common morbidity of population older than able-bodied age
Alexandrova O.Y., Linnichenko Y.V., Vasilieva T.P., Smbatian S.M., Palevskaia S.A.
Abstract
The purpose of the study is to analyze dynamic of primary and general morbidity of population older than able-bodied age in Moscow Oblast, including data comparing in the Central Federal Okrug and the Russian Federation. The data of statistical reports of City of Moscow, the Central Federal Okrug and the Russian Federation in 2013-2018 was included in analysis. The common analytical and mathematical statistical methods were applied. It was established that in Moscow Oblast in 2013-2018, against the background of stagnation of primary morbidity of population older than able-bodied age, indices of mental and behavioral disorders, neoplasms and diseases of circulatory system. At the same time, the level of primary morbidity of the region’s population older than able-bodied age exceeds that one of the Russian Federation or the Central Federal Okrug in almost all classes of diseases. The structure of primary morbidity has not changed and respiratory diseases, injures and poisoning and diseases of circulatory system continue to rank first places. The level of general morbidity also remained unchanged. However, morbidity of neoplasms, diseases of endocrine system and mental and behavior disorders continues to increase. The structure of general morbidity of population of this age group differs the structure of primary morbidity and diseases of circulatory, respiratory and musculoskeletal systems ranked first places. Monitoring and analysis of primary and general morbidity of population older than able-bodied age is necessary for developing measures of its decreasing on the basis of development of medical social and geriatric care in the regions.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):518-522
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The characteristics of mortality of population older that able-bodied age in the Russian Federation in 2012-2018
Madyanova V.V., Kakorina E.P., Klokova T.A.
Abstract
The positive trend of decreasing mortality of elderly population in all countries of the European Region in 2000-2015 was observed. In the Russian Federation the mortality of elderly population decreased up to 3,798.3 per 100 000 population in the 2018, i.e. on 14% lower as compared with 2012 (4424.6), and on 45% lower as compared with corresponding indices in 1998 (6877.0 per 100 000 population). The purpose of the study is to identify characteristics of mortality and to compare with foreign data of mortality of population older than able-bodied age in the Russian Federation. The standardized indices of mortality in 2012-2018 were analyzed. The gender characteristics of mortality levels were established. The main causes and the structure of main causes of death were presented. The comparison of mortality rates. The contribution of particular age groups into total mortality of population of the Russian Federation over the years was described.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):523-528
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The development of morbidity and mortality encoding in the system of the Ministry of Internal Affairs of Russia
Berseneva E.A., Mikhailov D.Y., Agamov Z.K.
Abstract
Despite attempts of improving actual system of morbidity and mortality accounting, the study research established significant real data distortion. These differences do not allow to assess in fullness complete picture of actual morbidity and mortality. Hence, improvement of approaches to increasing efficiency of indices data registration. The study was carried out in 2017-2019 on the bases of medical organizations of the Ministry of Internal Affairs of Russia. The study assessed quality of encoding of morbidity of 28 061 case histories/out-patient records. The size needed to obtain reliable results was determined using the Lopez-Jimenez formula. The statistical data was processed by MS Excel and Statistica-6 software.The most common errors were associated with non-rubricated and incorrectly rubricated diagnoses (53.2%, n = 2860). The second most common error in the structure of incorrectly formulated diagnosis was associated with using non-informative terms (14.6%, n = 785). The errors regarding non-observance of the ICD 10 revision requirements followed resulting in using and wordings not corresponding to modern classification (10.6%, n = 568). A number of errors was associated with unspecified localization of process (3.6%, n = 195) and other rarely occurring causes (2.6%, n = 139).The results of study permitted to conclude that one of the most promising directions of modernization of the encoding system is the automated encoding system.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):529-534
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On the issue of morbidity and mortality encoding
Kolomiychenko M.E., Vaysman D.S.
Abstract
The encoding of cases of disease and death is the translation of clinical diagnoses into alphanumeric code with observance of certain rules. Properly selected ICD-10 codes ensure reliability of statistical data that undoubtedly affects quality of managerial decisions. The article considers results of analysis of information from primary medical documentation (in-patient medical record, discharged patient statistical record) and its comparing with the ICD-10 codes. The detailed analysis of encoding errors is presented. The structure of hospital morbidity and mortality of patients of palliative care department of multidisciplinary hospital is analyzed.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):535-540
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The risk groups of infection with hepatitis С virus in conditionally healthy population of the Belgorod oblast
Mikhailov M.I., Jherebtzova N.Y., Schibrik E.V., Piven V.I., Fetter V.V., Berdinskikh L.V., Belousova O.N., Zlobina A.G., Rudenok O.P.
Abstract
The purpose of study was to establish risk group on hepatitis C in conditionally healthy population of the Belgorod oblast. Total 2025 conditionally healthy inhabitants aged between 1 and 99 were surveyed and serum samples from them were tested. There were eight age groups: 1-14 years (12.3%), 15-19 years (13.1%), 20-29 years (12.7%), 30-39 years (12.8%), 40-49 years (12.8%), 50-59 years (11.8%), 60-69 years (8.6%) and over 70 years of age (15.7%). Overall, 44.6% of the examined persons were male. 41.3% (ranging from 6.5 to 72.1%) of respondents reported surgery in their anamnesis, 5.1% (ranging from 0.8 to 12.6%) had blood/blood products transfusion, 10.3% (ranging from 1.7 to 57.9%) ear/nose piercing and 2.96% (ranging from 0.8 to 6.6%) tattoos. There were no people who injected drugs. The piercing was significantly higher in age groups 15-19 years and 20-29 years than other age groups (p-value<0.05). The tattoos were significantly higher in group of 70 years and older than in age groups 15-19 years, 30-39 years and 40-49 years (p-value<0.05). Anti-HCV antibodies were detected using third-generation enzyme-linked immunosorbent assay (“IFA-ANTI-HCV”, Nizhny Novgorod). The HCV RNA was tested with RT-PCR. The Anti-HCV was detected in 22 persons (1.1%), 77.3% out of them were older than 53 year and they were born prior to 1965. The Anti-HCV were significantly higher for the people over 70 years of age than in the age groups of 1-14 years, 15-19 years, 30-39 years and 40-49 years (p-value<0.05). The 2.65% of the examined persons were older 53 years had anti-HCV. Only 0.36% of anti-HCV were found in the young age groups of the examined persons who were born after 1965, the percentage was significantly lower than in older age groups (p-value<0.05). The 16 people had RNA-HCV and 87.5% persons were born in or before 1965. There was one person with genotype 3a (age group 30-39 years), 15 persons with genotype 1b (fourteen out of them were older 53 years and one person was in the age group 20-29 years. The study established that risk age group are inhabitants born before 1965 in Belgorod region. It can be taken into account in regional hepatitis С screening programs.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):541-547
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The methodological approaches to prognostication of morbidity summary coefficient on the basis of studying patterns of natality order
Zaytzeva N.V., Kiryanov D.A., Babina S.V., Sichikhina L.A.
Abstract
The methodological approaches to total birth rate prognostication based on the study of births order-predicted patterns. The article considers issues of forecasting total birth rate as key indicator characterizing intensity of demographic processes. This problem is also relevant to the Russian Federation, since birth rates are evaluation criteria of social economic situation governing in regions. The lacking of available data in scientific methodological publications describing forecasting methods complicates understanding of demographic processes and reduces management efficiency. The methodology of predicting total birth rate states construction of causal relationships for birth rates differentiated by mother's age and birth order. The forecasting technique involves construction of multiple regression models for dependencies between the births’ distributions for different birth order with the time lag parameters. To determine the delay values, iterative procedure using correlation analysis with data offset in 1-year increments was applied. To determine the time lag, offset corresponding to the maximum reliable correlations between the total birth rates depending on the children’s birth of the current and subsequent order was implemented.The results obtained via correlation and regression analysis as system of equations allowed to predict total birth rate for given sequence of births from previous ones. At the same time, frequency of first births must be set following statistical series of this data. The proposed methodological approach used extrapolation of previous period trend as exponential function. Methodical approaches were tested using actual data on birth rates in a large region of the Russian Federation with a population close to 3 million people. State statistical observation form was used to perform the forecast.The results of forecasting total birth rate revealed period of temporary increase and subsequent decrease of indicator. The forecast of temporary increasing of total fertility rate is based on time lag observed between birth of the first child and subsequent children. The decreasing of studied indicator is based on negative dynamics of first births, but if the process is managed it is likely to stabilize indicator that results in its subsequent increasing.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):548-554
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The persistent disability of population in the Russian Federation: analysis and assessment of regional characteristics
Proklova T.N., Schepin V.O., Chicherin L.P., Telnova E.A., Karpova O.B., Mirgorodskaya O.V.
Abstract
The disability is one of the main indices of public health, along with medical and demographic characteristics, morbidity and physical development that characterizes level of social economic development and is a major problem of health and social care authorities. The availability of statistical data and analysis of problem of population disability will allow to properly plan activities of various administrative bodies.The article presents trends of persistent disability in the Russian Federation during the studied period. In recent years, total number of disabled people has been gradually decreasing. In Russia, most of disabled people have disability group II. At the same time, the percentage of persons with group III increases and proportion of disabled persons with the groups I and II gradually decreases. The children disability in Russia tends to increase. In the Russian Federation, the analysis of regional differences in disability is presented. The analysis and assessment of regional characteristics of disability are necessary for planning and forecasting measures of medical and social support of persons with disability. The analysis of available statistical data permitted to established interdepartmental dissociation on this issue. The results of the study permitted to conclude that the need of increasing attention to the problem of disability results in strengthening interdepartmental interactions and developing of unified register of disabled people.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):555-559
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The condition and trends of morbidity of diseases of urogenital system in adult population of Moscow
Breusov A.V., Orudzhev A.A.
Abstract
The article presents the results of studying state and trends of incidence of adult urban population in the city of Moscow by the classes of diseases of the genitourinary system. The purpose of study was to analyze urogenital morbidity of population of metropolis as compared with similar indices of the Central Federal Okrug and the Russian Federation in 2014-2018. The corresponding official statistical data of the Minzdrav of Russia and research publications were studied. It was established that permanent monitoring of dynamics of urological morbidity can be considered as important methodological and informational and analytical base for planning medical care of population, that makes it possible to develop in practice the basis of development and implementation of integrated system of measures of development of community-based and hospital care, which must be taken into account by the administration of medical organizations and health care management at various levels.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):560-563
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The impact of habitation environment on population alcohol consumption in Russia
Mulik A.B., Ulesikova I.V., Nazarov N.O., Sroslova G.A., Shatyr Y.A.
Abstract
The article presents the results of analysis of complex of potential environmental factors for alcohol consumption by population of the Russian Federation. It was revealed that the level of alcoholization of residents of certain territories of the Russian Federation is positively associated with systemic severity of indices of social and criminal tension in society. The potential physical and geographical risk factors of alcohol abuse of population are severity of Northern latitude of residence and low level of average annual air temperature and longitude of day in winter season. The content of boron, calcium and magnesium in human body are negatively and copper, manganese and nickel positively associated with alcoholization of residents of Russian regions. It should be noted that systematic accounting of environmental characteristics can predict risk of alcoholization among residents of certain territories of the Russian Federation.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):564-567
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The social economic indices of regions and population morbidity of myocardium infarction
Masiuk N.N., Usacheva E.V., Kulikova O.M.
Abstract
In Russia, in recent decades, there were regional gapping in terms of social inequality and high level of morbidity and mortality in comparison with European countries. The high morbidity and mortality of population in the Russian Federation from diseases of circulatory system on one hand, and regional differences in terms of social economic status on the other hand, determined the purpose of the study.In order to evaluate relationship between social economic status of regions of the Russian Federation and incidence rate of myocardial infarction, the analysis was applied to standardized data of adult morbidity in classes of acute myocardial infarction and repeated myocardial infarction. Also was evaluated a number of social economic indices that reflect state and conditions of life of population. The statistical analysis was applied using MS Excel and Statistica 6 software. The critical significance level of null statistical hypothesis was established as p=0.05.When analyzing morbidity of adult population of Russia with acute and repeated myocardial infarction, significant regional differences were established. The seven factors were identified that statistically significantly affect morbidity rate of the adult population with myocardial infarction, which made it possible to divide the regions into four clusters, between which differences in morbidity rate of acute myocardial infarction were revealed. The analysis of morbidity of acute and repeated myocardial infarction established significant regional differences such as in 2017 7.7 times for acute myocardium infarction and 61 times for repeated myocardium infarction. The allocation of regional clusters depending on their social economic status allows to supplement regional and federal projects with risk-oriented technologies with purpose of decreasing morbidity of diseases of circulatory system.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):568-575
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The social hygienic risk factors to be applied in acute endometritis prognostication
Agarkov N.M., Kicha D.I., Gontarev S.N., Lutsenko V.D., Makkonen M.F., Budnik I.V.
Abstract
The article presents the results of investigation of prevalence and prognostic significance of socio-hygienic risk factors of acute endometritis in 187 patients with this disease and 150 patients with non-complicated postnatal period. It is established that development of acute endometritis is associated more with quality of life indices, early (up to 14 years of age) onset of sexual activity, presence in anamnesis of medical and spontaneous abortion. These risk factors should be considered in the process of prognosticating development of acute endometritis.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):576-580
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The dynamics of demographic indices in the Republic of Bashkortostan
Victorov V.V., Sharafutdinov M.A., Mukhamadeeva O.R., Pavlova M.Y., Sharafutdinova N.K., Galikeeva A.S., Borisova M.V.
Abstract
The article presents results of analysis of demographic indices in the Republic of Bashkortostan. The primary data for analysis was acquired from official public statistics. The dynamics of fertility and mortality indices in 1985-2018 is described. The prognostication of indices dynamics up to 2025 was made. The distribution of mortality indices by gender, age, causes of death, place of residence is proposed for 2012, 2015 and 2018. Four periods with increasing or decreasing of fertility and mortality was allocated. The linear correlation made up to r = -0.492, p <0.01, i.e., with decreasing of birth rate increasing in mortality occurred. The assessment of dynamics of mortality in 2015-2018 established that young age groups (15-29 years old) are characterized by significant increasing of mortality in every subsequent age group as compared with previous age group. Between 2012 and 2018, total mortality decreased from 13.2 ‰ to 12.4 ‰. Males and females aged 40-44 and females aged 45-49 and 50-54 had such negative trend as increasing of mortality as compared with 2012 and 2015. The decreasing of indices of overall mortality occurred only among males. In males, mortality rate exceeded mortality rate in females up to 1.33 times in 2012, up to 1.29 times in 2015 and up to 1.23 times in 2018. The mortality rate of rural population is 1.3 times higher than mortality rate of urban population. While mortality rate of able-bodied population is 1.4 times higher. The increasing of mortality occurred due to malignant neoplasms, while the growth rate was more pronounced among rural population as compared with urban population. The mortality of respiratory diseases is more than 2 times higher in rural areas and of diseases of the digestive system is 1.5 times higher among rural population. The established growth trends in mortality among rural population due to respiratory and digestive diseases and decreasing of mortality of diseases of the circulatory system and significant decreasing of such cases as “elder age” can be explained by probability of defects in encoding of causes of death.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):581-586
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The medical social characteristic of patients of private stomatological clinics
Suleymanova K.A., Piven E.A., Marusova A.S., Konovalov O.E., Piven N.P.
Abstract
The article deals with results of anonymous questionnaire survey of patient in private dental clinics “LiderDent” (241 respondents of able-bodied age) and “GelioDent” (419 respondents of able-bodied age). The purpose of the study was to investigate peculiarities of medical and social characteristics. The questionnaire included questions concerning social status of respondents, their financial condition, self-assessment of dental health and its maintenance at the proper level for a number of parameters, as well as evaluation of work of private dental organizations. The assessment of dental health of elderly patients established that 58.1% of respondents rated their dental health as good, 27.8% as satisfactory; and 4.1% of respondents estimated their dental health as bad. The analysis included also evaluation of negative health habits of respondents resulting in dental diseases and afflict damage to teeth and oral cavity. It was found that more than half of respondents had higher education. They consider themselves as financially secure, they did not smoke and had good condition of oral cavity. They choose dentists according recommendation of friends and seek dental care only in case of obvious signs of disease. The analysis of possible reasons for seeking dental professional revealed that 75.5% of respondents seek dental care when there are “obvious signs of disease and deterioration of health”, 21.2% “when first signs of disease occurred” and 3.3% “only in critical situation”. It is concluded that dental professional of private medical centers should be more widely carried out sanitary and educational work with population in order to increase the medical activity of patient, as well as to increase their awareness of ways and means of maintaining the dental health.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):587-591
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The analysis of factors effecting professional self-assessment of physicians
Bakirov A.B., Nazarova L.S., Bakirova B.A., Abdrakhmanova E.R., Kalimullina D.K., Akhmetzianova E.K., Gimaeva Z.F.
Abstract
To explore the factors potentially related to professional self-assessment of physicians, sociological survey on the basis of sampling of 223 respondents who underwent professional training in 2017 was organized. The physicians with the first qualification category more often assessed themselves as “good” than other respondents (p=0.049). On the contrary, physicians with no qualification category rated their work as “good” less often and as “satisfactory” more often than other respondents (p=0.041 and p=0.010, respectively). The rate of professional self-assessment as “excellent” significantly increased among physicians identifying themselves with highest stratum of society (p=0.00034). Statistically significant differences in age, total duration of service in profession between physicians assessing their work for “excellent”, “good” and “satisfactory” were not detected (p>0.05). The most frequent problems complicating life of physicians and their families were “Fatigue, overwork” (69.06%), “lack of free time” (60.09%), “low income” (44.39%). The reliable relationship between these factors and professional self-assessment was not detected (p>0.05). The relationship between professional self-assessment and availability of qualification category, as well as stratum of society to which they relate themselves, was established.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):592-595
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Clinical and organizational assessment of endovascular care accessibility at the regional level
Abramov A.U., Goloshchapov-Aksenov R.S., Semenov V.Y., Kicha D.I., Rukodaynyy O.V.
Abstract
The world health care system´s concern of inequalities in treatment of receiving the necessary medical care. The purpose of article to evaluate the availability of endovascular care (EVC) for patients at regional level in Russia and to develop a system for its improvement. As a result the low availability of EVC for the population at the regional level in Russia with coronary heart disease, atherosclerosis of the brachiocephalic arteries and critical lower limb ischemia (CLLI) was funded. The main reasons for the difficulties in obtaining EVC in the regions of Russia are the low frequency of diagnosing a critical stage of cardiovascular disease (CVD) requiring surgical treatment, the absence of cardiovascular surgeons and cardiologists in the medical care organizations, the failure in information to patients attending a regular doctor´s appointment about effectiveness and safety of endovascular treatment technology. More old-school traditional methods remain in place like bypass or endarterectomy surgery. Further obstacles are prolonged waiting list at the regional level for the provision of high-tech care in cardiovascular surgery, choice of conservative treatment methods or amputation of lower limbs for patients with CLLI 3 and 4 st. (p <0.05).In Conclusion the Clinical and organizational assessment of the endovascular care accessibility in CVD for the population in regions of Russia elaborated. One way to improve the situation is the introduction of the cardiovascular care clinical management. A dual-circuit clinical and organizational system was developed and proposed to increase endovascular care accessibility in regions.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):596-599
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The assessment of successfulness of management decision-making in medical organizations
Korshever N.G., Pomoshchnikov S.N., Dorovskaia A.I.
Abstract
The decision-making management in health care organizations is one of the basic components of their efficiency. However, there is imbalance between requirements of everyday practice and scientific rationale of process under consideration, in particular lacking of appropriate criteria-diagnostic apparatus causing certain difficulties in decision-making. The purpose of the study was to design automated multi-criteria method of evaluating success of decision-making management in health care organizations. The survey of 62 experts, health care managers, was carried out. 23 criteria for evaluating success of decision-making management in health care organizations have been defined as well as their gradation and significance, integral model options, i.e. the multi-criteria evaluation method has been designed. The automation of method on “1C: Enterprise” software greatly facilitates assessment of not one but a number of health care organizations enabling their ranking. The machine processing results in integral evaluation and informative criteria determining it thus making possible search of case causes and ways of correction. The obtained results can be applied in daily procedures and training of executives of health care organizations.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):600-604
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The particular aspects of development of medical and health promoting tourism
Ananchenkova P.I., Kamynina N.N.
Abstract
The expansion of types of medical care and the development of tourism activities in medical services market in Russia actively gains momentum. The certain successes were achieved in this sector of economy. Medical and health tourism is more than complex and complicated category as compared to classical types of tourism and requires additional investigation related to improving efficiency of market business activities of related services and implementation of optimal state policy related to regulation and support of development of this segment of tourism industry. The article analyzes current state of market of medical services provided to foreign citizens and considers trends of further development of market of medical and health tourism. The topic of development of medical and health tourism in context of need is to ensure sustainable development of national economy and integration cooperation in the field of recreation and tourism.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):605-609
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The evaluation of efficiency of the program “The automated working place of the senior medical nurse”
Demina E.A., Karaseva L.A., Dvoynikov S.I., Sirotko M.L.
Abstract
The qualitative functioning of any medical institution depends on both professional competence of its staff and document management. The contemporary society is moving towards e-document management. The topicality of investigation stems from necessity to give scientific rationale and put into practice modern information systems and electronic technologies in the activities of head nurses. The article considers realization issues of the Decree of the President of the Russian Federation of May 7, 2018 No. 204 “On national goals and strategic objectives of the development of the Russian Federation for the period until 2024”. Among other “national development goals of the Russian Federation for the period until 2024, the Decree sets the goal to ensure the accelerated digital enabling in the economy and social sphere”. Therefore, it is no coincidence that the Federal project “Creating a single digital circuit in health care based on unified state health information system” takes central position in the National Health Care Project.The study used content analysis, expert judgment, sociological and statistical methods. The introduction of the AWP SMS program into professional activities of senior medical nurses allows optimizing documents processing. Its effectiveness was evaluated using mathematical modeling methodology.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):610-615
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The organization of registration of rate, capacity and effectiveness of first aid measures
Zhuravlev S.V., Kolodkin A.A., Maksimov D.A., Trofimenko A.V., Dezhurny L.I., Boyarintsev V.V.
Abstract
The organization of accounting frequency, scope and effectiveness of first medical aid measures could significantly affect improvement of the first aid system in the Russian Federation. According to the score of severity of injury - Abbreviated Injury Scale (AIS-90) and the Injury Severity Scale (ISS) and experts review 23.4% of road accident victims who died before the arrival of emergency medical care had survival probability of more than 50%. The total number of first aid cases before the arrival of the ambulance is only 4.4% of all victims of road traffic crashes. More than 60% of victims needed first aid care and treatment. All reporting statistical forms in force in the Russian Federation at the moment do not provide data for accounting cases of first aid. The developed and tested new registration form “First Aid Registration Card”, containing necessary indicators of first aid effectiveness, permits quickly to fill out main indicators data of the victim condition and to complete first aid measures. Also it allows to assess the impact of first aid on mortality, disability and timing of temporary disability loss.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):616-620
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The particular aspects of improvement of laboratory service of region
Zolotarev P.N., Cherkasov S.N., Baeva E.S.
Abstract
The analysis of various needs in medical laboratory services among physicians of the Samara oblast is targeted to further improvement of laboratory service at oblast level. It is established that effectiveness of laboratory service depends on the needs of customer of service sector which are both physicians and patients. Ignoring their needs results in an increasing both of number of unsatisfied customers and level of mistrust individual operators and laboratory service itself. On the contrary, client-centric approach facilitates dialog of all participants of process of providing laboratory services.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):621-626
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The regional experience of implementation of program of prevention of abortions with non-medical indications
Chuchalina T.V., Casparova A.E., Mescheriakov V.V., Kovalenko L.V.
Abstract
The unfavorable demographic situation in the Russian Federation determines need of developing medical, organizational and social technologies for preventing abortions because of non-medical reasons. The purpose of the study was to analyze consensus opinion of physicians about reasons women refusing to continue pregnancy, to establish directions of preventing abortions and to evaluate efficiency of the Municipal Competition “Life is sacred gift”, the initiative of the All-Russian Program “Sanctity of Motherhood”. The study applied such sociological technique as questionnaire survey of 20 obstetricians gynecologists about causes of miscarriage and main directions of prevention of abortion. The analysis was implemented of dynamics of rate of abortions during last 5 years before the introduction of innovative program of prevention of abortion with participation of physicians, psychologists, representatives of public and religious organizations in the form of the competition “Life is sacred gift” (2006-2010) and in program implementation (2012 -2016 GG.) Also were applied the concordance technique, the Fisher's angular transform and rank correlation. The consistency of opinions of physicians about place of lacking of knowledge about risks of abortion and reproductive health in woman decision making about abortion (W = 0.32; χ² = 44.8; p <0.001), about motivation of preserving pregnancy as the main focus on non-medical abortion prevention (W = 0.33; χ² = 33.3; p <0.001). The implementation of innovation program permitted to increase percentage of women who refused abortion from 3.3% to 17.5% (p <0.01), to reduce number of non-medical abortions from 37.9 to 16.9 per 100 births, and from 17,5 to 10.5 per 1000 women of fertile age (p <0.01). The implementation of innovative program increases effectiveness of standard interventions to prevent abortions.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):627-631
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The disproportions of personnel support of medical sphere
Zudin A.B.
Abstract
The article discusses such issues of current state of staffing in medical sector as availability of health care system specialists, training programs for applicants to medical educational organizations and post-graduate programs for specialists, professional motivation and job prospects for graduates, prospects for development of medical education and training. In addition to professional sphere, modern health care system is also a market for medical services, which, according to expert estimates, is about 10 trillion US dollars per year. The participants in the field of medical services are not only organizations that provide medical care, but also manufacturers of medical equipment and medications. The medical sphere can't to effectively develop isolated from social structure. The staffing in medical field requires, along with professional motivation and job prospects in order to attract specialists in the field of medicine, and provide social support for their retention. The students entering medical university need decent salary after graduation and favorable conditions for further progression in professional field.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):632-637
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The problems of physicians-paramedical personnel interaction
Vasilenok A.V., Buyanova N.M., Matzneva I.A., Golubenko E.O.
Abstract
The problem of physicians-paramedical personnel interaction has long history. There are such reasons for misunderstanding as: actual stereotypes and arrogant attitude on the part of physicians, low assessment of medical nurse professional activities, gender inequality. The system of medical care becomes more complicated depending on advanced technologies, sophisticated specialization and disregard to human personality relations that complicates adaptation of specialists and team relationships. Therefore, it is important that all participants in patient medical care understand their individual roles and responsibilities, and realize their functions and actions affect all team members. The increasing tension within team results in decreasing in medical care quality and undermines confidence of patients to medical and paramedical personnel. These misunderstandings contribute to current shortage of nursing staff in Russia. The ways of resolving the “eternal conflict” based on national and international researchers experience are proposed.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):638-644
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The role on medical education in implementation of program “Zemstvo doctor”
Kopytov A.A., Zudin A.B., Aksenova E.I., Nadutkina I.E., Volkova O.A.
Abstract
The article presents the results of study concerning improving medical care quality in rural areas. The purpose was to investigate the characteristics of medical personnel training in the framework of the “Zemstvo Doctor” program. The activities of the University were analyzed concerning implementation of professional training of medical personnel and including continuing medical education. To achieve this goal, efficiency of educational programs development considering contribution of the “Zemstvo doctor” program implementation was evaluated. The study was carried out in 2013-2019 on the basis of the Medical Institute of Belgorod State National Research University. The structured interview was applied as methodology of collecting primary data. The fact of decreasing of medical profession prestige that occurs against the background of implementation of the state program “Zemstvo Doctor” was established. The overcoming of this situation is necessary to improve medical care quality in rural areas. The focusing on existing regional features of medical care support and taking into account characteristics of health of population are required. In this respect the key factor is the training of rural physicians to employ high-tech technologies, including digital simulation and telecommunications equipment. The relevance of the state program “Zemstvo Doctor” is obvious, but the medical education system has no official instructions concerning the need of correcting educational programs. The efficiency of changes applied to educational programs was determined by subjective assessment of the need and the clinical experience of physicians-lecturers who are involved in resolving scientific and practical problems of health care in rural areas.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):645-650
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The academician N. N. Burdenko - the participant of four wars (to the seventy fifth Anniversary of victory in the Great Patriotic War)
Stochik A.A.
Abstract
On the eve of the 75th anniversary of the Victory in the Great Patriotic War, one should recall the great neurosurgeon, scientist, organizer of military medical science, founder of prominent scientific school, academician N. N. Burdenko. His first experience as direct participant in warfare occurred in 1904 when he was medical student. He went through four wars being permanently at the front line. He carried out extremely complicated surgery operations, improved medical care and organized evacuation of the wounded. During the Great Patriotic War 1941 -1945, he, being the chief surgeon of the Red Army, headed all activities of organization of surgical care, came out to the troops, trained military surgeons to emergency interventions, developed teaching of wound, developed methods of surgical treatment of blood vessels, traumatic shock, introduced application of antibiotics (penicillin and gramicidin), developed methods of surgical treatment of oncologic diseases of central and vegetative nervous system, improved technique of surgical interventions on spinal cord roots as well as on cerebellum, bulbectomy operations, etc. The academician N. N. Burdenko as Stalin Prize laureate, became one of founders and the first President of the USSR Academy of Medical Sciences. The contribution of academician N. N. Burdenko in the cause of victory in The Great Patriotic War is priceless.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):651-656
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The state regulation of penicillin price in the USSR in the second half of 1940s
Sherstneva E.V.
Abstract
The article considers, on the basis of analysis of declassified archival documents, issue of the Soviet government regulating price of penicillin in the second half of the 1940s in conditions of continuing drug shortage. The factors that affected formation of selling and retail prices of antibiotic are considered. Based on the calculation of cost of treatment of a number of nosologies in different age groups and comparing it with the level of income of the population, the conclusion is derived that real availability of antibiotics for population in the USSR was achieved by early 1950s.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(4):657-662
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