scholarly journals ВИКОРИСТАННЯ ПРИНЦИПІВ Е-МЕДИЦИНИ В УМОВАХ ДЕРЖАВНО-ПРИВАТНОГО ПАРТНЕРСТВА В РЕАБІЛІТОЛОГІЇ. ПОСТАНОВКА ЗАВДАННЯ

2017 ◽  
Author(s):  
O. P. Mintser ◽  
N. O. Sinyenko ◽  
P. P. Haninets ◽  
O. V. Sarkanich ◽  
A. V. Semivolos ◽  
...  
Keyword(s):  
Medical Care ◽  
Rehabilitation Medicine ◽  
Care Quality ◽  
Effective Control ◽  
Advisory Group ◽  
Private Partnership ◽  
Rehabilitation Treatment ◽  
Mobile Medicine ◽  
Quality Of Medical Care

The possibilities and reality of e-medicine problems solving with state-private partnership (SPP) technology in rehabilitation are considered. It is shown that the use of e-medicine is one of the most important levers of improving the quality of medical care during the period of rehabilitation treatment. It is postulated that as the healthcare informatization project are expensive its fast implementation is possible provided the widest use of the principles of SPP. It is believed that mobile medicine is the best example of modern SPP. For effective control of medical care quality the creation of specialized expert and advisory group of specialists is offered. The general principles of e-rehabilitation medicine implementing in the SPP format are defined.

scholarly journals ОСОБЛИВОСТІ ВПРОВАДЖЕННЯ Е-МЕДИЦИНИ В УМОВАХ ДЕРЖАВНО-ПРИВАТНОГО ПАРТНЕРСТВА

2017 ◽  
Author(s):  
N. O. Sinyenko ◽  
G. V. Zagoriy ◽  
S. I. Mokhnachov
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Effective Control ◽  
State Control ◽  
Private Partnership ◽  
Mobile Medicine ◽  
Quality Of Medical Care ◽  
Specialized System ◽  
New System

It was discussed the possibilities and the reality of the e-medicine challenges through technology of public-private partnership (PPP). It is shown that the use of e-medicine is one of the most important levers of improving the quality of medical care in Ukraine. Taking into account that the computerization of health care is extremely expensive project its rapid implementation is possible for the widest possible PPP. It is believed that mobile medicine is the best example of modern PPP. It is postulated that for the effective control of the quality of medical care it should be created specialized expertise and advisory mechanisms in a specialized system of state control of the new system of electronic health systems with strictly defined principles such as objectivity, complimentarily, law and so on.

scholarly journals ALGORITHM FOR MEDICAL EXAMINATION OF ENDODONTIC TREATMENT

2020 ◽  
Vol 5 (4) ◽  
pp. 20-25
Author(s):  
A. К. Iordanishvili ◽  
E. K. Barinov ◽  
I. B. Salmanov
Keyword(s):  
Quality Control ◽  
Medical Care ◽  
Dental Treatment ◽  
Care Quality ◽  
Endodontic Treatment ◽  
Internal Quality ◽  
Dental Clinics ◽  
Quality Of Medical Care ◽  
Te Material

Evaluation (including within the framework of medico-legal examination) of the quality and efectiveness of endodontic dental treatment is a matter of current interest in the clinical dentistry.Obiectives. Te aim of the work was to develop an algorithm of medico-legal examination in case of endodontic treatment, to test this algorithm in the work of the commissions of medical care quality control in the departments of therapeutic dentistry of outpatient dental clinics.Material and methods.Te material of the study was the reports of daily activities of dental clinics of various forms of ownership (municipal, departmental, private) in 3 regions of Russia (Moscow, St. Petersburg, Rostov-on-Don), including periodic reports and reference reports, ofcial statistical reports of the activities of the examined clinics, including registration books of the work of the commissions of the quality of medical care. Tese materials were used as a source of primary statistical information. Afer grouping of the information contained in them, the main data characterizing organization, condition and quality of endodontic care were recovered taking into account nosological entities: pulpitis and periodontitis. Taking into account the medical, statistical and analytical nature of the study, the main conclusions and recommendations were formulated on the basis of a retrospective study of these materials.Results. Based on the studies carried out and recommendations of the European Endodontic Association on provision of the standard of endodontic treatment, an algorithm for medico-legal examination of endodontic treatment was proposed. Tis algorithm allows to assess the quality and efectiveness of endodontic treatment of pulpitis and periodontitis in diferent terms (immediately afer treatment, remote period)Conclusion. Te use of the developed algorithm in clinical practice in internal quality control of endodontic care has shown its efectiveness. A large number of clinical cases of insufcient quality of endodontic treatment and its low efectiveness in the remote period indicate persistence of the potential for claims from patients. 

scholarly journals THE LEGISLATIVE FOUNDATION OF EXPERTISE OF MEDICAL CARE QUALITY ACCORDING CASES OF LETHAL OUTCOMES

2019 ◽  
Vol 62 (2) ◽  
pp. 95-102
Author(s):  
Konstantin V. Polyakov ◽  
N. M. Gayfullin ◽  
Zh. A. Akopyan ◽  
P. G. Mal'kov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Quality Evaluation ◽  
Evaluation Criteria ◽  
Care Quality ◽  
Icd 10 ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
Care Support

The article presents analysis of national and foreign legislative documents concerning issues of expertise of quality of medical care according cases of lethal outcomes (Universal Declaration of Human Rights, the Constitution of the Russian Federation, ICD-10, Federal laws and sectoral orders). It is established that key elements of system of medical care quality control (levels of control, authorized authority, forms of control, sources of development of criteria of quality evaluation, criteria of quality evaluation) are determined legislatively and reflect main requirements of international documents. The criteria of medical care quality evaluation are developed by groups of diseases of conditions on the basis of corresponding of medical care support Procedures, medical care Standards, Rules of implementation of laboratory, instrumental, pathologico-anatomic and other forms diagnostic analysis and Clinical Recommendations (records of treatment) related to issues of medical care support. The shortcoming of the Russian Federation legislation is an inadequate reflection of sources of development of criteria of medical care quality evaluation and relevant incompleteness of the very criteria of medical care quality evaluation. Therefore, their application by experts to issues of evaluation of medical care quality is complicated that effects formation of expert conclusion and negatively affects detection and prevention of possible violations during medical care support. The outdated normative regulation of clinical pathologic anatomic conference is noted as an important form of control of medical care support according cases of lethal outcomes. The necessity of alterations and additions in particular currently in force documents concerning issues of expertise of medical care quality, including according cases of lethal outcomes.

scholarly journals Treatment of patients with acute coronary syndrome in 2019 (data from federal registry of acute coronary syndrome)

2020 ◽  
pp. 37-45
Author(s):  
О.В. Сагайдак ◽  
Е.В. Ощепкова ◽  
Ю.В. Попова ◽  
О.М. Посненкова ◽  
А.Р. Киселев ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Medical Care ◽  
Median Time ◽  
Myocardial Revascularization ◽  
Care Quality ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Quality Of Medical Care

Введение. Проблема качества оказания медицинской помощи больным с острым коронарным синдромом (ОКС) является одной из наиболее актуальных для нашей страны, так как летальность, особенно при ОКС с подъемом сегмента ST (ОКСсST) остается на высоком уровне. Федеральный регистр больных с ОКС (далее – Регистр) дает возможность выявлять недостатки и разрабатывать подходы к улучшению оказания медицинской помощи больным в реальной клинической практике. Цель исследования: анализ качества оказания медицинской помощи больным с ОКС, прошедших лечение в 2019 году. Материалы и методы. За период с 01.01.2019 по 31.12.2019 в Регистр были внесены данные 27929 больных с ОКС из 138 медицинских организаций 32 субъектов Российской Федерации (средний возраст 65,3±11,7 лет, 62,7% мужчин). Результаты: Из 20757 у 65,9% (n= 13399) диагноз при выписке – острый и повторный инфаркт миокарда, у 32,6% – нестабильная стенокардия. 44,7% (n=9287) составили больные с ОКС с подъемом сегмента ST (ОКСсST), 55,3% (n=11470) – c ОКС без подъема сегмента ST(ОКСбST). Из 9287 больных с ОКСсST75,8% (n=7044) была выполнена реваскуляризация миокарда. Из них у 21,7% (n=1532) использовался фармакоинвазивный подход, у 61,1% (n=4304) больных выполнено только ЧКВ, у 17,0% больных проводили только тромболитичсекую терапию без ЧКВ. Остальным больным реваскуляризация не была проведена и выбрана консервативная тактика лечения. Из 11470 больных с ОКСбST реваскуляризация выполнена лишь у 31,5% (n=3621). У больных с ОКСсSTмедиана времени от момента госпитализации до начала ЧКВ составило 55 [34;106] мин. Медиана времени от начала симптомов заболевания до начала ЧКВ составила 320 [180;807] мин. Среди больных с ОКСбST медиана времени от момента госпитализации до начала ЧКВ составила 195 [75;1025] мин. От начала симптомов заболевания до начала ЧКВ составила 945 [370;2620] мин. Заключение При анализе соответствия клиническим рекомендациям, отмечается, что оказание медицинской помощи больным с ОКС оказывается не в полном объеме, что наиболее выраженно в подгруппе больных с ОКС без подъема сегмента ST. Introduction. The problem of the quality of medical care for patients with acute coronary syndrome (ACS) is one of the most relevant for our country, since mortality, especially for patients with ACS with ST segment elevation (ACSwST) remains high. The Federal Registry of Patients with ACS (hereinafter referred to as the Register) makes it possible to identify gaps in medical care quality and develop approaches for its improvement. Objective: to analyze the quality of medical care for patients with ACS who underwent treatment in 2019. Materials and methods. For the period from January 1, 2019 to December 31, 2019, data from 27029 patients with ACS from 138 medical organizations in 32 regions of the Russian Federation was included in the Registry (average age 65.3 ± 11.7 years, 62.7% of men). Results: Out of 20757, 65.9% (n = 13399) had an acute and repeated myocardial infarction diagnosis at discharge, and 32.6% had unstable angina pectoris. 44.7% (n = 9287) were patients with ACS with ST segment elevation (ACSwST), 55.3% (n = 11470) - with ACS without ST segment elevation (ACSnST). Of 9287 patients with ACSwST, 75.8% (n = 7044) underwent myocardial revascularization. Of these, in 21.7% (n = 1532) the pharmacoinvasive approach was used, in 61.1% (n = 4304) of patients only PCI was performed, in 17.0% of patients only thrombolytic therapy without PCI was performed. The remaining patients did not undergo revascularization and conservative treatment was chosen. Of 11470 patients with ACSnST, revascularization was performed only in 31.5% (n = 3621). In patients with ACSwST, the median time from hospitalization to the onset of PCI was 55 [34; 106] min. The median time from the onset of symptoms to the onset of PCI was 320 [180; 807] min. Among patients with ACSnST, the median time from the time of hospitalization to the onset of PCI was 195 [75; 1025] min. From the onset of symptoms to the onset of PCI, it was 945 [370; 2620] min. Conclusion Analyzing the quality of ACS patients medical care we concluded that ssufficient part of patients with ACS are provided with non-optimal treatment due to clinical guidelines, and the medical care is the it was noted that the provision of medical care to patients with ACS is not in full, which is most pronounced in the subgroup of patients with ACS without raising the ST segment.

Mobile medicine (m-health) a potential reserve of the health care system in crisis situations as exemplified by the coronavirus epidemic COVID-19

2021 ◽  
pp. 58-69
Author(s):  
Liliya G. Ivanova ◽  
Raisa Y. Tatarintseva ◽  
Dmitry V. Migachev
Keyword(s):  
Medical Care ◽  
Meta Analysis ◽  
Dynamic Monitoring ◽  
Mobile Medicine ◽  
Patients At Risk ◽  
Quality Of Medical Care ◽  
Potential Reserve ◽  
Older Citizens ◽  
And Control

The article discusses new opportunities to improve the quality of medical care, including for older citizens, when organizing a system of remote dynamic monitoring using methods of preventive, predictive and personalized medicine, including during the epidemic and quarantine events. Objective: to study the benefits of using mobile medicine technologies (m-health) during the fight against coronavirus infection COVID-19. The research method is the analysis and meta-analysis of publications on this topic. The results of the study show the importance of using mobile medicine technologies (m-health) in the structure of medical care for patients at risk and the particular relevance of using these technologies in the development of organizational measures to prevent and control the epidemic, caused, inter alia, by unknown infectious agents.

scholarly journals RESULTS OF MEDICAL-SOCIAL RESEARCH ON MEDICAL CARE QUALITY FOR PATIENTS WITH COVID-19 OF INPATIENT HOSPITAL DEPARTMENTS IN SUMY REGION

2021 ◽  
Vol 74 (5) ◽  
pp. 1057-1060
Author(s):  
Natalia O. Dryha ◽  
Alla V. Stepanenko ◽  
Lesia A. Rudenko ◽  
Daria O. Zhaldak ◽  
Svitlana M. Piven ◽  
...  
Keyword(s):  
Medical Care ◽  
Social Research ◽  
Care Quality ◽  
Viral Infectious Disease ◽  
Working Age ◽  
Quality Of Medical Care ◽  
Bed Days ◽  
Health Institutions ◽  
The Relationship

The aim: The aim of the study is to assess the quality of medical care and determine the relationship between treatment outcomes of patients and acute respiratory viral infectious disease caused by SARS-CoV-2,depending on patients` age, the time from onset of symptoms to hospitalization, and the presence of comorbidity. Materials and methods: According to the specially designed form, a retrospective analysis of primary accounting documents was carried out (f. No. 103/o) in 158 patients with COVID-19. The research was carried out in specialized inpatient infectious diseases wards of health institutions of the Sumy region during the period from April to September 2020. The study used a systemic approach, bibliosemantic, comparative and statistical analyses, logical generalization methods. Results: Among the study group of patients, namely 158 people, a bigger number of women (56.33±3.95%) than men (43.67±3.95%) were recorded. Patients of working age (from 18 to 64 years old) took 70.89±3.61% of all patients, and people aged 65 years and older – 29.11±3.61%. The time from the beginning of symptoms to hospitalization in each second patient (49.37±3.98%) lasted 5-7 days. In most cases, the patient’s stay in the hospital equaled 13-15 bed-days – 32.28±3.72%. The index of patients with severe and critical state was 20.89±3.23% (33 patients). In 8.23±2.19% (13 people) of treated cases of hospital stay ended in death. A large index of patients with a severe course of the disease, the treatment of which ended in discharge, were in hospital for more than 13 bed days – 12.03±2.59% (19 people). All of these patients were older, had CNCDs (chronic non-communicable diseases), half of them were hospitalized on day 7 and later from the onset of symptoms. Conclusions: In older people, the disease progresses faster and complications are developing more often. Also, the severity of the SARS-CoV-2 pattern and the length of staying in the hospital are affected by the time starting the onset of symptoms till hospitalization and the presence of CNCDs. The hereinafter data allows to increase knowledge about spreading of COVID-19, to improve the quality of organizational and preventive events in the provision of medical care, and reducing mortality.

A critical view of the healthcare control system

2021 ◽  
pp. 33-49
Author(s):  
Natalya Konstantinovna Guseva Guseva ◽  
Vitaliy Anatolievich Berdutin
Keyword(s):  
Quality Control ◽  
Medical Care ◽  
Healthcare Sector ◽  
Effective Control ◽  
Results Of Treatment ◽  
Russian State ◽  
Quality Of Medical Care ◽  
Modern Era ◽  
New Phase

The Russian state acts not only as the governing regulator, but also as the owner of an immense medical system called the healthcare industry. With bitterness, we have to admit that from year to year the administrative legislation is only growing. Just a few years ago, it was difficult to imagine that the state would want to go so far and thoroughly in tightening quality control of medical care. Nevertheless, in the existing regulatory framework there are many defects, contradictions and collisions regarding the quality of medical care. In the modern era of artificial intelligence and «digital Russia», there is an urgent need to create a new management system in the healthcare sector, which could provide a true, and not declared by officials’ reports, economic interest in the results of treatment, the possibility of using advanced technologies that guarantee the most effective methods of healing the sick. The purpose of our article was to define the place of the system of quality control and safety of medical activities in the management of healthcare institutions and the main shortcomings of its organization now. The authors believe that the core approaches to the organization of effective control should be borrowed from management theory. The control regulations should reflect its main characteristics: overall, comprehensive, timely, easy to realize, ensuring the continuous repetition of the management process in a new phase, with scientifically sound methods of implementation from both negative and positive perspectives.

scholarly journals WORK EXPERIENCE OF THE MULTI-PROFILE HOSPITAL ON AUTOMATION OF EXPERT ACTIVITIES IN THE HEALTH CARE QUALITY MANAGEMENT SYSTEM

2018 ◽  
Vol 25 (3) ◽  
pp. 88-96
Author(s):  
O. T. ODNOVOLOV ◽  
N. A. ARSHINOVA ◽  
V. V. PONOMAREV ◽  
YA. O. TRUSOVA
Keyword(s):  
Quality Management ◽  
Medical Care ◽  
Management System ◽  
Health Care Quality ◽  
Quality Management System ◽  
Care Quality ◽  
Internal Quality ◽  
Regulatory Documents ◽  
Quality Of Medical Care

Aim. Improvement of the quality of medical services provided due to a precise organization of the health care quality management system, based on the implementation of the requirements of existing regulatory documents determining expert work and its subsequent automation.Materials and methods. The quality management system in the institution is based on an active multifunctional organizational structure able to respond quickly to the detection of defects in providing medical care through the use of computerization of all areas of its activities. The automated control system of the diagnostic and treatment process proposed by us allows moving from the formal compliance with requirements established by the current regulatory documents to full management of the quality of medical care in the institution through comprehensive automation of the structure of internal quality control of medical care that ensures monitoring of all directions of the institution with the formation of automated accounting and reporting forms.Results. The introduction into the practical work of an automated quality management system for providing medical care made it possible to reduce by 5 times the time for obtaining of operative medical information, to reduce defects caused by poor registration of medical documentation by 46%, to reduce the unjustified delay of patients in the hospital by 10%, to reduce the number of cases of repeated hospitalization , due to inadequate inpatient medical care by 11%, to minimize delays at medical sub-commission for the extension of sick leave almost to zero cases.Conclusion. The automated control system of the diagnostic and treatment process proposed by us, in contrast to the existing ones at the present time, allows us to move from formal compliance with requirements established by the current normative documents to full-fledged management of the quality of medical care in the institution through comprehensive automation of the internal quality control structure of medical care providing monitoring of all activities of the institution and achievement of the recommended regulatory documents criteria of quality of medical care.

scholarly journals Assessment of the quality of medical care provided to patients in a psychiatric hospital

2020 ◽  
Vol 15 (4) ◽  
pp. 274-282
Author(s):  
Irina Shikina ◽  
◽  
David Davidov ◽  
Keyword(s):  
Quality Control ◽  
Medical Care ◽  
Psychiatric Hospital ◽  
Care Quality ◽  
Internal Quality ◽  
Diagnostic Process ◽  
Medical Diagnostic ◽  
Quality Coefficient ◽  
Quality Of Medical Care

Monitoring and evaluation of the quality of medical care provided to patients is essential in any medical specialty, but especially in relation to specialized care in mental health hospitals. The aim of our work is to assess the quality of specialized medical care provided to patients in the psychiatric hospital. We have examined 270 medical records and internal quality control cards of patients hospitalized from 2015 to 2019 in the Psychiatric Clinical Hospital No. 4 of the Moscow Healthcare Department (hereinafter referred to as “PCH No. 4” of MHD). The quality control of the provided medical care was carried out twice with the assessment of each studied section in the range from 0 to 1 point. Thus, it was possible to calculate the overall medical care quality coefficient with a description of the defects found in the provision of medical services. After the first control, quality coefficient appeared to be 0.86 (0.79; 0.91), and after the second one 0.95 (0.92; 0.96). During the second control, which was conducted in 2019, the medical care quality was significantly higher (p = 0.011) compared to the results of 2015–2018. The total share of detected defects in the medical-diagnostic process in a psychiatric hospital was 40.7 % (and was captured in 110 out of 270 cases). The results of our study demonstrate the necessity of medical care internal quality monitoring in a psychiatric hospital, since it contributes not only to the improvement of overall quality of medical treatment, but also to timely detection and reduction of the number of defects in the medical-diagnostic process.

scholarly journals THE MEDICAL AND LEGAL ASPECTS OF EFFECTIVENESS EVALUATIONOF THE EXAMINATION AND TREATMENT OF COMPLICATED FORMS OF DIABETICFOOT IN PATIENTS DISSATISFIED WITH THE QUALITY OF MEDICAL CARE PROVIDED

2017 ◽  
Vol 9 (3) ◽  
pp. 121-126
Author(s):  
K N Movchan ◽  
R B Iskhakov ◽  
A V Kovalenko ◽  
K I Rusakevich
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Quality Assessment ◽  
Diabetic Foot ◽  
Healthcare Providers ◽  
Legal Aspects ◽  
Care Quality ◽  
Patient Cooperation ◽  
Quality Of Medical Care

Medical care quality assessment in patients suffering from ulcerous-necrotic forms of diabetic foot is a rather problematic question, especially in cases of negative disease outcome. Patients fighting against diabetes mellitus and its complications for saving their lives occasionally not only criticize the healthcare organization without a good cause but use civil law procedures, bringing in an indictment accusing healthcare practitioners of unsuitable medical care. The article discusses deonto- logical aspects of providing medical care to patients with diabetic foot dissatisfied with the quality of examination and treatment in healthcare providing institutions. It also demonstrates the medical and legal conflict which arose due to medical care quality assessment in a patient with complicated form of diabetic foot who regularly was consulted and was under the care of different health care practitioners as an in-patient so as an out-patient. The article illustrates that important factors in successful treat- ment of patient with diabetes mellitus are professional engagement and interaction between healthcare providers of specialized centres and healthcare practitioners at the out-patient stage as well as case follow-up with suitable and well-timed correction of glucemia. Special attention should be given to doctor-patient cooperation. Only a multidisciplinatory approach offers the possibility to improve the quality of medical care provided to patients with complicated forms of diabetic foot and to reduce the frequency of complaints to different medical, social and politico-administrative authoritative bodies.

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