To the question of the role of consultation liaison psychiatry in diagnostics of psychosomatic disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S315-S316
Author(s):  
V. Lebedeva ◽  
O. Pavlova ◽  
E. Yurovskaya
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
General Medicine ◽  
Gastrointestinal Diseases ◽  
Psychosomatic Disorders ◽  
Liaison Psychiatry ◽  
Psychosomatic Disorder ◽  
Primary Health ◽  
Consultation Liaison Psychiatry

BackgroundRelevance of consultation liaison psychiatry is conditioned by trend of steady rise of psychosomatic disorders and insufficient development of supplied forms and methods of medical care to patients with this pathology.AimTo study incidence rate of psychosomatic disorders in primary health care, to develop algorithm of medical care.Material and methodsA total of 2010 patients of the primary health care unit were examined. Methods used: clinical-psychopathological, clinical-dynamic, questionnaire screening, statistical (factor analysis).ResultsMental disorders, co-morbid with physical pathology, constituted 3.9% of the contingent with predominance of psychosomatic disorders–15.6 per 10,000 of the population. Respective from clinical-dynamic structure of psychosomatic disorders three groups of patients were distinguished: in need for consultation by a psychiatrist (22.9%); for course treatment by psychiatrist and subsequent observation by physicians (28%); and for systematic therapy and observation by psychiatrist (49.1%). Patients with psychosomatic disorders addressed general medicine network 1–2 years after onset of mental disorder and 6.4 ± 1.2 years after diagnostics of somatic pathology. Patients had predominantly cardiovascular (37.7%; P < 0.05), respiratory (20.5%), and gastrointestinal diseases (20.9%). Exacerbation of psychosomatic disorder was reliably interrelated with psychotraumatic situation and exacerbation of physical pathology. Introduced algorithm of psychiatric consultation consisted of:– evaluation of mental and physical status;– distinguishing the nosological groups;– choice of therapy;– formation of groups of observation (risk groups in need for course therapy, systematic therapy).ConclusionConsultation liaison psychiatry in general medical institution allows widening accessibility of psychiatric care and makes its provision more cost-effective.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Primary Health Care and the ICD-11

2013 ◽  
Vol 10 (01) ◽  
pp. 33-37 ◽  
Author(s):  
M. Klinkman ◽  
D. Goldberg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Medical Care ◽  
Special Needs ◽  
Field Trials ◽  
Primary Medical Care ◽  
Dsm 5 ◽  
Primary Health ◽  
Icd 10

SummaryThis paper describes the necessity of adapting the major classifications of mental disorders exemplified by the ICD-11 and the DSM-5 for the special needs of primary medical care. An earlier version of the classification – the ICD-10-PHC – is described, and the process of adapting it is described in detail. The new 28 item version of the classification is described, and the procedures to be adopted in the Field Trials to be held during 2013 are set out, together with the specific problems these field trials will address.

scholarly journals The value of an integrated approach to assessing the availability of primary health care, taking into account public opinion and EMIAS data

2021 ◽  
Vol 65 (5) ◽  
pp. 411-417
Author(s):  
Sergei S. Budarin ◽  
Andrei V. Starshinin ◽  
Andrei A. Tyazhelnikov ◽  
Elena V. Kostenko ◽  
Yulia V. Elbek
Keyword(s):  
Health Care ◽  
Public Opinion ◽  
Primary Health Care ◽  
Medical Care ◽  
Medical Information ◽  
Integrated Approach ◽  
Sociological Study ◽  
Primary Health ◽  
Level 1 ◽  
Index Value

Introduction. The study of public opinion as the basis for strategic planning of the activities of medical institutions is more relevant than ever, as it allows finding ways to solve the problems of ensuring the availability and satisfaction of citizens with medical care. Purpose. Comparative assessment of the availability of primary health care based on the results of a sociological study of public opinion and data from the Unified Medical Information and Analytical System of the City of Moscow (UMIAS). Material and methods. To study public opinion, the practice of population survey was used, which was conducted through direct interviewing with filling out questionnaires of visitors to Moscow polyclinics and the method of questioning doctors based on a questionnaire developed by researchers. To analyze the data, the authors used general scientific methods of cognition, including the dialectical method, a systematic approach, logical correspondence and harmonization, detailing and generalization. As part of the study, the index value of the patient loyalty to the medical institution (MI) was calculated according to Net Promoter Score (NPS) method as the difference between the share of the “Promoters” group and the share of the “Critics” group in the total number of responses. Results and discussion. The established correlations indicate the opinions of doctors and citizens to coincide and the UMIAS data on the issue of assessing the accessibility of admission of level 1 doctors for citizens. Based on the results of a sociological survey, the number of dissatisfied patients is mainly affected by managing medical care and its availability. The study confirmed that the higher the availability of an appointment with a level 1 doctor, the lower the number of visits the doctor on duty. Conclusion. The conducted research has shown the practicality of an integrated approach to evaluating the activities of medical organizations based on the results of public opinion research and UMIAS data.

scholarly journals International and Russian Experience in Primary Health Care Organization

2018 ◽  
pp. 146-148
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Health Care Organization ◽  
The United States ◽  
Evidence Base ◽  
Care Organization ◽  
Care Provision ◽  
Primary Health ◽  
Effective Instrument

In this study, they presented the analysis of current views on the important link in medical care provision to the population, namely, primary health care. According to the Alma-Ata Declaration on the organization of primary health care this type of medical assistance has made it possible to carry out reforms within this area in many countries, which has led to effective results (the reduction of infant mortality, the increase of life expectancy and a number of other indicators). In this paper, they performed the analysis of Russian and foreign sources of literature on the topic under study between 1978 and 2018. It has been established that primary health care is regarded as the most effective instrument of health protection than specialized medical care according to the experience of Russian Federation, a number of countries in Europe, Asia and the African continent, Australia and the United States. The performed analysis clearly shows that the experience of some countries demonstrates the correlation between the general coverage of primary health care and the achievement of public health indicative indicators. At the same time, the question is raised about the expediency of certain aspect replacement concerning the provision of specialized medical care by the doctors of general practice, i.e. primary health care. The obtained results can be interpreted as an evidence base for the necessity and an undeniable effectiveness of primary health care as a central link in the health care system.

scholarly journals Scientific substantiation of the assessment of the territorial availability of primary medical health care to the rural population

2020 ◽  
Vol 101 (6) ◽  
pp. 890-896
Author(s):  
A A Kalininskaya ◽  
N A Bayanovа
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Rural Population ◽  
Primary Medical Care ◽  
Orenburg Region ◽  
Primary Health ◽  
Medical Health Care ◽  
Medical Health ◽  
Selection Of

Aim. To assess the territorial accessibility of primary health care (PHC) to the rural population in the Orenburg region. Methods. Statistical, monographic, organizational experiment research methods were applied. Statistical processing was carried out by using the Statistica 10.0 software. Basic statistics were calculated (arithmetic mean, weighted arithmetic mean). All parameters were checked by using ShapiroWilk, KolmogorovSmirnov and Lilliefors tests for normal distribution. The parametric method of statistics (Student's t-test) was used. Results. The assessment of the territorial accessibility of primary medical health care to the population of the Orenburg region was carried out using the methodology developed by us for calculating the criteria for the accessibility of primary medical health care to the rural population Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population. The use the methodology allows making management decisions regarding the territorial planning of primary health care for the rural population in the selection of problem areas with low accessibility of primary medical care. In the Orenburg region, there are the following problems: different levels of accessibility of primary health care with a variety of distance up to 30 km and different population sizes in settlements create difficulties in organizing the provision of primary health care; remoteness from the regional center up to 300 km forms a personnel deficit. Conclusion. Application of the methodology Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population in the Orenburg region has allowed the development of the following recommendations for making management decisions at the regional level: (1) prioritization of territories for priority measures to ensure the availability help; (2) selection of the form of primary health care organization for the timely medical care provision to the population; (3) the formation of competition among medical organizations in the ranking of the availability of primary health care.

Organization of primary health care and specialized medical care for patients with prostate cancer in the Nizhny Novgorod Region

2021 ◽  
pp. 20-31
Author(s):  
Egor Aleksandrovich Perevezentsev ◽  
Maya Andreevna Kuzmina ◽  
Dariya Dmitrievna Vasina ◽  
Denis Igorevich Volodin
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Medical Personnel ◽  
Malignant Neoplasms ◽  
Medical Organization ◽  
Primary Health ◽  
High Level ◽  
Nizhny Novgorod Region

At present, the quality and availability of medical care are the aspects to which close attention is paid in the system of organizing medical care. One of the ways to achieve a high level of quality and accessibility of medical care is building up human resources, i.e. the presence of highly qualified general practitioners, sub-specialties and middle medical personnel in sufficient numbers in a medical organization. Currently, the oncological service of Russia has been assigned tasks to fulfill the instructions from the State Program for the Development of Health Care. The results of the work should lead to a decrease in mortality and an increase in the quality of life of the population. To address the issue of reducing mortality from malignant neoplasms, in particular from prostate cancer, a three-level system of oncological care has been created on the territory of the Nizhny Novgorod Region, including 1 regional center, 2 interdistrict cancer centers, 88 primary oncology rooms and 96 examination rooms. The tasks set to reduce morbidity and mortality from oncological diseases can be realized only with close interaction of the oncological service with the primary health care sector, in which the prevention should be the priority direction of work.

ANALYSIS OF THE IMPLEMENTATION OF A NEW MODEL OF A MEDICAL ORGANIZATION PROVIDING PRIMARY HEALTH CARE IN CHILDREN'S STRUCTURAL UNITS

2021 ◽  
pp. 117-127
Author(s):  
Владимир Петрович Косолапов ◽  
Наталья Николаевна Чайкина ◽  
Галина Владимировна Сыч ◽  
Ольга Николаевна Черных
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Medical Organization ◽  
Structural Units ◽  
New Model ◽  
Primary Health ◽  
Voronezh Region ◽  
Pediatric Service ◽  
The Creation

Вопросы улучшения оказания первичной медико-санитарной помощи детскому населению всегда выступали в качестве приоритетных при оптимизации деятельности службы охраны материнства и детства и вызывали особое внимание организаторов здравоохранения. Одним из значимых решений по повышению качества оказания медико-санитарной помощи, в том числе и детям, является проект по реализации «Новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» в детских структурных подразделениях. Одной из основных задач педиатрической службы Воронежской области является реализация мероприятий региональной программы «Развитие детского здравоохранения Воронежской области, включая создание современной инфраструктуры оказания медицинской помощи детям», которой предусмотрено достижение целевых показателей и выполнение определённых задач. В данной статье рассматриваются вопросы организации деятельности педиатрической службы Воронежской области в плане реализации новой модели медицинской организации, оказывающей первичную медико-санитарную помощь в детских структурных подразделениях. Определяются направления развития детского здравоохранения, включая создание современной инфраструктуры оказания медицинской помощи детям. Приводятся данные по достижению в детских поликлиниках и детских поликлинических отделениях Воронежской области организационно-планировочных решений внутренних пространств, создание условий для внедрения принципов бережливого производства и комфортного пребывания детей и их родителей при оказании первичной медико-санитарной помощи, с акцентом на воплощении идей оптимизации первичной медико-санитарной помощи путем использования принципов и методов бережливого производства в части реализации регионального проекта «Развитие системы оказания первичной медико-санитарной помощи» Нацпроекта «Здравоохранение» в рамках создания и тиражирования «Новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» The issues of improving the provision of primary health care to the children's population have always been a priority in optimizing the activities of the maternal and child health care service and have caused special attention of health care organizers. One of the significant decisions to improve the quality of health care, including for children, is the project to implement the "New model of a medical organization providing primary health care" in children's structural units. One of the main tasks of the pediatric service of the Voronezh region is the implementation of the activities of the regional program "Development of children's health care of the Voronezh region, including the creation of a modern infrastructure for the provision of medical care to children", which provides for the achievement of targets and the implementation of certain tasks. The article deals with the organization of the activities of the pediatric service of the Voronezh region in terms of implementing a new model of a medical organization that provides primary health care in children's structural units. The directions of development of children's health care, including the creation of a modern infrastructure for the provision of medical care to children, are determined. The data on the achievement in children's polyclinics and children's polyclinic departments of the Voronezh region of organizational and planning solutions of internal spaces, the creation of conditions for the introduction of the principles of lean production and a comfortable stay of children and their parents in the provision of primary health care, with an emphasis on the implementation of ideas for optimizing primary health care through the use of principles and methods of lean production in terms of implementation regional project "Development of the system of primary health care" of the National Project "Healthcare" in the framework of the creation and replication of the "New model of a medical organization providing primary health care"

Primary Health Care or Primary Medical Care: In Reality

2007 ◽  
Vol 13 (2) ◽  
pp. 18 ◽  
Author(s):  
John Macdonald
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Vertical Integration ◽  
Social Determinants ◽  
Primary Medical Care ◽  
Primary Health ◽  
Comprehensive Primary Health Care ◽  
The Social ◽  
And Training

Despite considerable rhetoric, comprehensive primary health care remains largely a matter of a paper exercise. The theory promotes horizontal and vertical integration and the active participation of people in planning. Experience in Australia and elsewhere indicates that what is in place in health services is often primary medical care: the management of the needs of presenting individuals. The arguments for upstream interventions remain valid, bolstered by research on the social determinants of health. Two examples are given of primary health care that attempt to work upstream, before clinical interventions become necessary and illustrate the need for both horizontal and vertical integration. Consequences for policy and training are drawn.

scholarly journals Investigation and Analysis of Standardized Training for Residents of General Practitioners of Gansu Province in China

2020 ◽  
Author(s):  
Hui Cai ◽  
Hongjing Wang ◽  
Jin He ◽  
Dongzhi Zhang ◽  
Yue Wu ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
General Medicine ◽  
Gansu Province ◽  
Common Disease ◽  
Family Doctors ◽  
Primary Health ◽  
Health Care Institutions ◽  
Primary Health Care Institutions

Abstract Background: China’s standardized training for residents of General Practitioners (GPs) is aimed at providing the postgraduate training for family doctors who will serve the primary health care institutions. The aim of this paper is to investigate the standardized training situation, satisfaction with standardized training, work situation, intention, satisfaction and attitude of GPs who have finished standardized training. Methods: This study was undertaken in 6 training hospitals in Gansu province using a questionnaire with 45 questions. Results: Approximately 275 residents of GPs were enrolled. Finally, 263 residents completed the questionnaire (95.64% response rate), including 133 females (50.57%) and 130 males (49.43%) with an average age of 28 years (standard deviation, 1.93 years; range, 25-36 years). Additionally, 56.65% were single and 43.35% were married. Of all subjects, 92.40% residents had obtained certification of standardized training for residents of GPs and only 39.54% residents were satisfied with monthly income during training. There were 171 oriented rural medical graduates, of whom, only 42.69% expressed the willing to continue working in the primary health care institutions after the serve time (6 years) expired. Around 86.31% of residents of GPs who had finished standardized training got jobs with more than half serving in the primary health care institutions. For medical institutions and sanitary bureau were clear about general medicine policies, only 29.96% subjects registered as GPs. Among the residents in general practice department, 68.42% were engaged in the diagnosis and treatment of common disease and frequently-occurring diseases as well as referral of patients. The percentage of residents who were satisfied with the job and income were 30.40% and 14.98%, respectively. Conclusion: Standardized training for residents of GPs in China is gradually improving. In order to cultivate more GPs and increase their willing to serve in the primary health care institutions, it is necessary to formulate and execute better policy of GPs, publize general medicine and improve the training quality.

scholarly journals Combined antibacterial drug in ambulatory surgical practice with a position of clinical efficiency and drug safety

2019 ◽  
pp. 74-82
Author(s):  
E. N. Degovtsov ◽  
D. I. Trukhan ◽  
A. F. Sulimov
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Clinical Efficacy ◽  
Drug Safety ◽  
Antibacterial Drug ◽  
Antibacterial Drugs ◽  
Surgical Practice ◽  
Clinical Efficiency ◽  
Primary Health

The diverse amount of therapeutic and diagnostic manipulations and the expansion of the volume of medical care provided by the surgeon at the stage of providing primary health care to patients suggests the availability of effective, safe and affordable antibacterial drugs in the arsenal of drugs used. The review considers the possibility of using the combined antibacterial drug ciprofloxacin + tinidazole in outpatient surgical practice from the standpoint of clinical efficacy and drug safety.

Sign in / Sign up

Export Citation Format

Share Document