Analysis of Some Indicators Characterizing the Quality of Medical Care for Children with Cancer in the South Federal District of the Russian Federation: An Ecological Study

2018 ◽  
Vol 5 (4) ◽  
pp. 238-247
Author(s):  
M. Yu. Rykov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Malignant Tumors ◽  
Federal District ◽  
The South ◽  
Children With Cancer ◽  
Number Of Children ◽  
Quality Of Medical Care ◽  
The Russian Federation

Background. Improving the quality of medical care is based on a coordinated policy at the federal, regional and municipal levels in the field of health. The implementation of this goal is based on a regular assessment of the current state of the healthcare system in the Russian Federation.Objective. Our aim was to analyse of the main indicators characterizing medical care for children with cancer in the South Federal District.Methods. The operative reports for 2017 of the executive authorities in the sphere of health protection of 8 subjects of the Russian Federation that are part of the South Federal District of the Russian Federation have been analyzed.Results. The number of children were 3 216 797 people (aged 0–17 years), the number of children’s oncological beds is 272 (0.8 per 10 thousand children aged 0–17 years), the average number of days of berth employment in the year is 289.9 bed days. In 4 (50%) subjects of the department of pediatric oncology are absent, in 1 (12.5%) — there are no children’s oncological beds. The number of doctors providing medical care to children with cancer is 50, of them 42 (84%, 0.1 per 10 thousand children aged 0–17 years) have a certificate of a pediatric oncologist. In 2 (25%) subjects, there are no pediatric oncologists. Incidence of malignant tumors was 13.9 (per 100,000 children aged 0–17 years), prevalence was 86.5 (per 100,000 children aged 0–17 years), mortality was 2.5 (per 100,000 children aged 0–17 years), a one-year mortality rate of 4.7%. 8% of patients were actively detected. 104 (23.2%) of primary patients were sent to medical organizations of federal subordination, 4 (0.9%) of primary patients left the territory of the Russian Federation.Conclusion. The analysis revealed a number of defects: incorrect information contained in the reports, low incidence (detectability) of patients, including during planned preventive examinations, staff shortages and non-rational use of bed facilities.

Medical Care for Children with Cancer in the Russian Federation: Current Situation and Development Prospects

2019 ◽  
Vol 6 (1) ◽  
pp. 5-15
Author(s):  
Maxim Yu. Rykov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Pediatric Oncology ◽  
Malignant Tumors ◽  
Social Significance ◽  
Children With Cancer ◽  
Number Of Children ◽  
The Social ◽  
The Russian Federation ◽  
One Year

Background. The social significance of pediatric oncology and attention to the problems of treating children, both representatives of the authorities and the community, a small number of primary patients detected annually, a shortage of pediatric oncologists and pediatric oncological beds explain problems in organizing medical care for this category of patients. This requires a search for new approaches to the organization of medical care, based on scientific calculations. Objective. Our aim was to improve the organization of medical care for children with cancer in the Russian Federation. Methods: The operative reports for 2017 of executive bodies in the sphere of health care 81/85 (95.3%) of the subjects of the Russian Federation were analyzed. Results. The number of children was 28 132 685 people. (0–17 years), the number of child oncology departments — 47, children›s oncological beds — 1925 (0.7 for 10,000), the average number of days of berth employment in the year — 315.3 days. In 30 (35.3%) subjects of the department of pediatric oncology are absent, in 12 (14.1%) — there are no children›s oncological beds. The number of physicians that provide medical care to children with cancer — 392, of which 259 (66%, 0.09 for 10 thousand) have a certificate, a pediatrician oncologist. In 12 (14.1%) subjects, there are no doctors-children oncologists, 6 (7%) did not provide these data. In 6 (7%) subjects there are no children›s oncological beds and doctors-children›s oncologists. The incidence of malignant tumors was 13.2 (100,000 thousand) prevalence — 91.3, death rate — 2.5, a one-year lethality — 6.5%. Actually revealed 8.3% of patients. 1385 (37.4%) of primary patients were sent to medical organizations of federal subordination, 61 (1.6%) primary patients left the territory of the Russian Federation. Conclusion. It is necessary to take measures aimed at modernizing the system of rendering medical care to children with cancer, namely: to increase the reliability of statistical data, to analyze the needs of subjects in the number of children’s oncological beds and pediatric oncologists, to introduce criteria for selecting patients for children’s oncological beds as part of medical organizations of various levels, to minimize the deficit of doctors and children’s oncologists, to systematically increase the number of children’s cancer beds simultaneously dividing existing in accordance with the needs of the population and the level of congestion, as well as ensure the routing of patients in accordance with a three-tier model.

scholarly journals Monitoring in obstetric critical care (“maternal near miss”) in the Northwestern Federal District of the Russian Federation in 2018-2019

2021 ◽  
Vol 70 (1) ◽  
pp. 5-18
Author(s):  
Vitaly F. Bezhenar ◽  
Oleg S. Filippov ◽  
Leila V. Adamyan ◽  
Igor M. Nesterov
Keyword(s):  
Maternal Mortality ◽  
Medical Care ◽  
Russian Federation ◽  
Federal District ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Integral Model ◽  
Internal Quality ◽  
Quality Of Medical Care ◽  
The Russian Federation

This article presents data of monitoring critical obstetric conditions (maternal near miss) for the purpose of auditing the quality of medical care and prevention of maternal mortality, obtained on the basis of an analysis of statistical data from eleven federal subjects of the Northwestern Federal District of the Russian Federation for 2018-2019. We characterized the critical obstetric conditions that allow avoiding maternal mortality cases, which, in modern legal practice, most often require forensic examinations on the fact of providing obstetric and gynecological medical care of inadequate quality. We determined that the main causes of maternal mortality cases (83.1% in 2018 and 84.0% in 2019) were massive obstetric bleeding and complications of severe preeclampsia, which more often occurred during childbirth and the first days of the postpartum period. All patients who survived a near death condition belonged to the group of high obstetric and perinatal risk, but most of them were delivered in obstetric hospitals of the second level, with more than half of the women by caesarean section. We discussed the main ways of preventing and reducing the incidence of critical obstetric conditions and maternal mortality based on the improved modern integral model of internal quality control of medical care in obstetric institutions. We also discussed the findings based on the introduction into practice of medical, organizational and methodological (including telecommunication and other) technologies aimed at increasing professional competencies in the regions of the country. Special attention is drawn in this article to the need to systematize and develop uniform and clear criteria for assessing critical obstetric conditions.

REVISITING THE QUESTION OF COMPLIANCE WITH DEPARTMENTAL REGULATORY LEGAL ACTS OF THE PENAL SYSTEM OF RUSSIA, REGULATING THE PROCEDURE OF RENDERING AND QUALITY OF MEDICAL ASSISTANCE TO PENAL STAFF AND THE REQUIREMENTS OF FEDERAL LEGISLATION

2020 ◽  
pp. 77-84
Author(s):  
Олег Алексеевич Свидерский
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Medical Service ◽  
Legal Regulation ◽  
High Tech ◽  
Medical Assistance ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
Correction System

В статье поднимаются отдельные вопросы правового характера оказания медицинской помощи сотрудникам УИС в лечебно-профилактических учреждениях ФСИН России, МВД России, Минобороны России, а также в учреждениях государственной или муниципальной систем здравоохранения. Проведен анализ нормативных баз Минздрава России и Минюста России, в которых осуществляется регламентирование вопросов оказания медицинской помощи. Показано, что в федеральных и ведомственных нормативно-правовых актах Минюста России законодательно не закреплен порядок оказания высокотехнологичной медицинской помощи по перечню видов, которые не включены в базовую программу ОМС. В целях устранения пробела в законодательстве предлагается медицинской службе ФСИН России разработать соответствующий регламент, в котором прописать перечень необходимых документов и порядок направления на лечение нуждающихся сотрудников. Проведенный опрос сотрудников УИС показал, что более 2/3 респондентов недовольны не только условиями, в которых оказываются медицинские услуги, но и качеством оказанной им медицинской помощи. Рассмотрены права и возможности сотрудников УИС по предъявлению претензий к лечебному учреждению в случае неудовлетворенности качеством оказанной медицинской услуги (помощи). Анализируются проблемы правового регулирования и практического решения вопроса, оценки качества оказанной медицинской услуги (помощи). Предлагается сформировать в системе ФСИН России институт экспертов по оценке качества медицинской помощи. The article raises certain issues of the legal nature of the provision of medical assistance to the penal correction system in medical institutions of the Federal Penitentiary Service of Russia, the Ministry of Internal Affairs of the Russian Federation, the Ministry of Defense of the Russian Federation, as well as institutions of the state or municipal health systems. The analysis of the regulatory framework of the Ministry of Health and the Ministry of Justice, which regulates the provision of medical care. It is shown that the federal and departmental regulatory legal acts of the Ministry of Justice do not legislatively regulate the procedure for providing high-tech medical care according to the list of species that are not included in the basic program of compulsory medical insurance. In order to fill the gap in the legislation, it is proposed that the medical service of the Federal Penitentiary Service of Russia develop an appropriate regulation in which a list of necessary documents and the procedure for referring treatment to needy employees are prescribed. A survey of employees of the penal correction system showed that more than 2/3 of respondents are dissatisfied not only with the conditions in which medical services are provided, but also with the quality of medical care provided to them. The rights and possibilities of the penitentiary system staff to make claims to a medical institution in case of dissatisfaction with the quality of the medical service (assistance) provided are examined. The problems of legal regulation and practical solution of the issue, assessing the quality of the medical service (assistance) provided are analyzed. It is proposed to form an institute of experts in the FSIN system for assessing the quality of medical care.

Medical Care for Children with Cancer in the North-West Federal District of the Russian Federation: An Ecological Study

2018 ◽  
Vol 5 (3) ◽  
pp. 155-163 ◽  
Author(s):  
M. Yu. Rykov ◽  
I. A. Turabov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Care Delivery ◽  
Pediatric Population ◽  
Federal District ◽  
Children With Cancer ◽  
North West ◽  
The North ◽  
Bed Capacity ◽  
The Russian Federation

Background.Analysis of statistical data in the federal districts of the Russian Federation provides opportunities to assess the quality of medical care delivery in children with cancer and plan further development with consideration for the point elimination of existing defects. Objective. Our aim was to analyze the main indicators characterizing medical care for children with cancer in the North-West Federal District.Methods.The study analyzed operative reports for 2017 provided by the executive public health authorities of 11 subjects of the Russian Federation affiliated to the North-West Federal District.Results.The pediatric population was 2 537 133 children (0–17 years), the pediatric oncological bed capacity — 174 (0.7 per 10 000 aged 0–17 years), the annual berth average occupancy — 290.7 days. 6 (54.5%) subjects did not provide pediatric population with departments of pediatric oncology, 4 (36.4%) subjects did not have bed capacity. The number of practitioners providing medical care to children with cancer was 38, 27 among them (71%; 0.1 per 10 thousand 0–17 years) had a certificate of pediatric oncologist. 2 (18.2%) subjects did not have pediatric oncologists in the medical stuff. The incidence of malignant tumors in children aged 0–17 was 15.6 (per 100,000), the prevalence was 92.6 (per 100,000), the mortality rate was 2.6 (per 100,000), one-year mortality rate — 4.5% (18/397). The number of patients identified actively was 11 (2.8%). 160 (40.3%) primary patients were sent to Federal medical facilities, 6 (1.5%) — left the territory of the Russian Federation for the further treatment.Conclusion.The incidence and mortality rates are rather low which indicates the defects in patient detection and lack of reliable follow-up data. The percentage of patients referred for treatment to Federal medical facilities is not very high; however, to interpret this indicator according to patient routing, we have to analyze the medical history of all the patients. We can assert that health care delivery service for children with oncological diseases is at an acceptable standard level but needs to be improved. 

scholarly journals Medical care for children with cancer in the Siberian Federal District

2019 ◽  
Vol 18 (1) ◽  
pp. 5-12
Author(s):  
M. Yu. Rykov
Keyword(s):  
Mortality Rate ◽  
Medical Care ◽  
Russian Federation ◽  
Federal District ◽  
Siberian Federal District ◽  
Children With Cancer ◽  
Aim Analysis ◽  
Incidence And Mortality ◽  
Hospital Beds ◽  
The Russian Federation

background. The analysis of the quality of medical care for children with cancer is based on statistical data. Evaluation of the results obtained is also the basis of the strategy for the development of medical care for this category of patients. aim: analysis of the main parameters characterizing medical care for children with cancer in the Siberian Federal District. material and methods. The reports for 2017 on the health protection of 11/12 (91.6 %) constituent entities of the Russian Federation belonging to the Siberian Federal District were analyzed (Irkutsk Region did not provide data). results. In 2017 the number of children aged 0–17 years was 3 722 470, the number of pediatric hospital beds for children with cancer (ages 0–17 years) was 260 (0,7 per 10,000), and the average number of bed-days per year was 342.2. In 3 (25 %) constituent entities of the Russian Federation, there were no departments of pediatric oncology and in 1 (8,3 %) there were no hospital beds for children with cancer. The number of physicians, who specialized in children’s cancer was 49, of them 32 (65,3 %, 0,08 per 10,000, ages 0–17 years) had a certificate of a pediatric oncologist. In 1 (8,3 %) constituent entity of the Russian Federation, there were no pediatric oncologists. For children aged 0–17 years, the cancer incidence rate was 11.7 per 100,000 children, the cancer mortality rate was 2,2 per 100,000, and one-year mortality rate was 7,4 %. 188 (43,2 %) primary cancer patients were referred to medical institutions of the Federal District, and 17 (3,9 %) primary patients left the territory of the Russian Federation. conclusion. The low incidence and mortality rates can be explained by the lost of reliable follow-up data. It is advisable to introduce electronic health record systems. For reliable estimation of hospital bed supply for children with cancer and percent of patients referred to medical centers for treatment, it is necessary to carry out a clinical audit. Deficiency of pediatric oncologists should be eliminated by reforming the training of medical personnel.

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 JUSTIFICATION FOR ESTABLISHING THE PRIMARY AND CLINICAL DIAGNOSIS IN THE GROUP OF DISEASES – ACUTE PSYCHOTROPIC DRUG POISONING

2020 ◽  
Vol 26 (4) ◽  
pp. 10-15
Author(s):  
Pavel Pavlovich Gavrikov ◽  
◽  
Boris Borisovich Yatsinyuk ◽  
Vyacheslav Aleksandrovich Zhidkov ◽  
Ekaterina Alekseevna Barats ◽  
...  
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Psychotropic Drugs ◽  
Clinical Symptoms ◽  
Acute Poisoning ◽  
Clinical Observations ◽  
Clinical Diagnoses ◽  
Quality Of Medical Care ◽  
The Russian Federation

The study, based on clinical observations of a group of specialists (toxicologists, anesthesiologists, resuscitators), reflects the course of clinical symptoms that occur in acute poisoning with new psychotropic drugs (alpha-pyrrolidinopentiophenone). The article provides a rationale for establishing primary and clinical diagnoses that reflect the quality of medical care in patients in this nosological group of diseases, evaluated on the basis of Federal clinical recommendations and orders of the Ministry of health of the Russian Federation.

scholarly journals Assessment of organization of medical care and drug provision for patients with rheumatic diseases, and the socioeconomic burden of these diseases in the Russian Federation

2018 ◽  
Vol 12 (3) ◽  
pp. 112-119 ◽  
Author(s):  
A. M. Lila ◽  
R. О. Dreval ◽  
V. V. Shipitsyn
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Legal Regulation ◽  
Drug Supply ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
Socioeconomic Burden ◽  
Drug Provision ◽  
Local Levels

This article reviews data on the assessment of the incidence of rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA, arthropathic psoriasis), as well as related disability and the economic burden of these nosological entities, including their therapy with biological agents. It considers the issues of organization and quality of medical care, drug supply, normative and legal regulation. The paper also shows the important epidemiological and socioeconomic importance of RA, AS, and PsA in Russia, points out the regional peculiarities of medical care and drug provision, and proposes solutions for their optimization at the federal and local levels. In preparing this investigation, the authors have taken into account the opinions of many specialists and experts in this field from different subjects of the Russian Federation.

The achievements of pulmonology and the main directions of further improvement of medical care in the Russian Federation

2021 ◽  
Vol 31 (6) ◽  
pp. 782-791
Author(s):  
Tatiana N. Bilichenko ◽  
Alexey A. Shutov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Primary Care Physicians ◽  
Scientific Research ◽  
Scientific School ◽  
Treatment And Prevention ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
Research Institute

The development of pulmonology in Russia is linked with the creative activity of the Scientific Research Institute of Pulmonology of the Federal Medico-Biological Agency (Research Institute of Pulmonology of the FMBA) and its scientific school.The aim of the analytical review was to assess the role and contribution of the research team of the Research Institute of Pulmonology in improving the quality of medical care to the population of Russia.Methods. The data of medical statistics of the Ministry of Health of the Russian Federation on morbidity and mortality of the population due to respiratory diseases (RD) from 2004 - 2018 are analyzed. The publications on scientific research conducted with the participation of employees of the Research Institute of Pulmonology for the period from 2005 to 2020 were studied.Results. Over the past 30 years in Russia, with the participation of the staff of the Research Institute of Pulmonology, the state task of creating a system for organizing medical care for the population with RD has been successfully solved. The study and implementation of modern innovative approaches in the diagnosis, treatment and prevention of RD, the training of primary care physicians allowed to improve the quality of medical care to patients to the level of world standards. For the period from 2004 - 2018 the mortality of the population from RD 35.6% decrease was registered. During the pandemic of a new coronavirus infection, the use of pulmonology achievements in clinical practice contributed to a decrease in the frequency of deaths in people with COVID-19.Conclusion. Currently, the Research Institute of Pulmonology of the FMBA of Russia retains a leading position in the country in the field of fundamental scientific research, innovative methods of diagnosis and treatment of RD, educational activities and training of specialists in the field of pulmonology.

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