Study of Citizens of CIS Countries Receiving Medical Services on the Territory of the Russian Federation: Insights for Development of the Export of Medical Services (Based on Material of Focus Group Interviews)

Background. The export of medical services is one of the most dynamically developing areas both in the structure of the world economy and in the structure of world health care. By decree of V.V. Putin of May 7, 2018 On national goals and strategic objectives of the development of the Russian Federation the need to increase the volume of exports of medical services was outlined. The real experience of receiving medical care by foreign citizens living in the territory of the Russian Federation has a serious impact on the broadcasted image of Russian medicine. Sociological research aimed at studying the opinion of foreign citizens about domestic medicine is a promising tool for ensuring a targeted approach in the export of medical services. Aims to study the opinion on the Russian medicine among foreign citizens of the CIS countries living in the territory of the Russian Federation in order to form an effective strategy for promoting medical services provided for foreigners in the territory of the Russian Federation. Methods. The focus group interviews with citizens of the CIS countries who received medical services and residing in Russia were held. For the analysis, the text data encoding procedure was carried out. At the same time, the study was not aimed at revealing the prevalence of opinions, statistical criteria were not used. An adapted COM-B model was used as a theoretical basis for the analysis, and the BCW (Behavior change wheel) method was used to develop recommendations. Results. The study examined some important details of the image of Russian medicine in the opinion of group participants (good equipment, reliable ambulance, feeling of conveyor belt, bureaucracy, etc.). The results are structured using the adapted COM-B model. The study identified the main strategies used by foreign citizens when seeking medical care. Insufficient awareness of foreign citizens about their rights in the field of medical provision in the territory of the Russian Federation was revealed. The main channels of communication used by citizens of the CIS to select a medical organization / specialist for seeking help have been studied, it is primarily word of mouth. It has been established that in order to be attractive, for Russian medicine its not enough to have advantages, they should be perceived as sufficient to overcome the convenience of conservative respondents to refer to native, familiar, as well as the fear of the stranger. Based on the results obtained using the BCW model, the recommendations have been developed and interventions have been proposed to promote medical services provided in the Russian Federation among foreigners.

Download Full-text

The problem of unreliability of information in the system of compulsory medical insurance in the context of the implementation of the constitutional right to free medical care

Izvestiya of Saratov University New Series Series Economics Management Law ◽

10.18500/1994-2540-2021-21-2-206-214 ◽

2021 ◽

Vol 21 (2) ◽

pp. 206-214

Author(s):

Veronika A. Fadeeva ◽

Keyword(s):

Medical Care ◽

Russian Federation ◽

Medical Insurance ◽

Relevant Information ◽

Medical Services ◽

Legal Analysis ◽

The Russian Federation ◽

Constitutional Right ◽

The Right ◽

The Cost

Introduction. The addition of the section “Information on the cost of medical services rendered” to “Public Services”, the state information system, allowed the citizens of the Russian Federation to receive relevant information promptly. This possibility soon exacerbated the problem of unreliability of information about the medical services provided to the insured persons under compulsory medical insurance. The article defends a position based on the legal analysis of the legislation of the Russian Federation in the sphere of compulsory medical insurance. According to this position, the problem can be overcome by appropriate changes in the regulatory documents governing the control powers of the territorial funds of compulsory medical insurance, health insurance organizations. Theoretical analysis. The right to reliable information is enshrined in a number of regulatory legal acts of the Russian Federation, the analysis of which allows us to investigate the problem of unreliability of information in the system of compulsory medical insurance (“medical prescriptions”). Empirical analysis. Identification of unreliability of information about the provided medical services can be carried out both by the insured persons under compulsory medical insurance and through the control of the competent authorities. In this regard, the article analyzes the control powers of the territorial funds of compulsory medical insurance, medical insurance organizations. Results. The result of the author’s analysis of the problem of unreliability of information in the system of compulsory medical insurance (“medical attributions”) is a proposal to improve the procedure for organizing and monitoring the volume, timing, quality and conditions of providing medical care for compulsory medical insurance.

Download Full-text

Implementation of a Complex Health Services Intervention in Long-term Care Homes: A Process Evaluation Using Focus Groups

10.21203/rs.3.rs-46877/v1 ◽

2020 ◽

Author(s):

Rieka von der Warth ◽

Vanessa Kaiser ◽

Christina Reese ◽

Boris A. Brühmann ◽

Erik Farin-Glattacker

Keyword(s):

Primary Care ◽

Nursing Homes ◽

Focus Group ◽

Focus Groups ◽

Medical Care ◽

Process Evaluation ◽

The Elderly ◽

Focus Group Interviews ◽

Total N ◽

Group Interviews

Abstract BackgroundWith increasing numbers of the elderly living in nursing homes in Germany, the need for on-site primary care increases. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. Therefore, project CoCare (“coordinated medical care”) implements a complex health intervention in nursing homes, using among others regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports the results of a process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.MethodsFocus group interviews were held between the fall of 2018 and the fall of 2019 with nursing staff, general practitioners and medical assistants working in or consulting a participating nursing home. A half-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis. ResultsIn total, N=11 focus group interviews with N= 74 participants were conducted. Ten main themes with seven subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to talk most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding CoCare had prevented unnecessary hospitalizations. Main barriers were understaffing and complexity of the program.ConclusionImplementation of CoCare in nursing homes is complex and holds some barriers. However, the overall acceptance was good and first positive results were reported by participants. Furthermore, the project provides a good structure to overcome potential barriers.Trial Registration: German Clinical Trial Register (DRKS00012703)

Download Full-text

New Sub-Sector of Criminal Law?

Russian Journal of Legal Studies ◽

10.17816/rjls18296 ◽

2017 ◽

Vol 4 (3) ◽

pp. 124-133

Author(s):

A I Rarog

Keyword(s):

Medical Care ◽

Russian Federation ◽

Social Relations ◽

Criminal Law ◽

Native Speaker ◽

Criminal Code ◽

Medical Services ◽

The Russian Federation ◽

Fundamental Values ◽

Protection Of Life

The damage to life and health of people, as well as a threat to these fundamental values represent a serious danger to the totality of social relations because a person is a native speaker and participant. Criminal law protection of life and health is the goal of many of the norms dispersed in various chapters of the Criminal code of the Russian Federation. Among them are the following rules, which establishes liability for causing or creating threat of harm to the life or health of people when they receive medical services. The danger of such acts is determined not only by the value protected by criminal law, personal benefits, but also the emergency of their prevalence, because of the provision of medical care throughout life is forced to turn almost everyone.

Download Full-text

Implementation of a complex health services intervention in long-term care homes: a process evaluation using focus groups

10.21203/rs.3.rs-46877/v2 ◽

2020 ◽

Author(s):

Rieka von der Warth ◽

Vanessa Kaiser ◽

Christina Reese ◽

Boris A. Brühmann ◽

Erik Farin-Glattacker

Keyword(s):

Primary Care ◽

Nursing Homes ◽

Focus Group ◽

Focus Groups ◽

Medical Care ◽

Process Evaluation ◽

The Elderly ◽

Focus Group Interviews ◽

Total N ◽

Group Interviews

Abstract BackgroundWith rising numbers of the elderly living in nursing homes in Germany, the need for on-site primary care is on the increase. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. The CoCare (“coordinated medical care”) project has therefore implemented a complex health intervention in nursing homes, using inter alia, regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports upon the results of the process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.MethodsFocus group interviews were held between the fall of 2018 and the fall of 2019 with nurses, general practitioners and GP´s assistants working in or consulting a participating nursing home. A semi-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis. ResultsIn total, N=11 focus group interviews with N=74 participants were conducted. Eleven main themes with four subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to speak most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding that CoCare had prevented unnecessary hospitalizations. The main barriers were understaffing and complexity of the program.ConclusionImplementation of CoCare in nursing homes is complex and presents some barriers. However, the overall acceptance was good and participants reported the first positive results. Furthermore, the project provides a good structure to overcome potential barriers. However, some adaptions to the implementation process should be made.

Download Full-text

ANALYSIS OF THE RESULTS OF SOCIOLOGICAL STUDIES OF THE QUALITY AND AVAILABILITY OF HEALTH CARE

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-6-225-231 ◽

2021 ◽

pp. 225-231

Author(s):

Lindenbraten A.L. ◽

Kolomiychenko M.E.

Keyword(s):

Medical Care ◽

Health Center ◽

Social Services ◽

Russian Federation ◽

Complex Analysis ◽

Sociological Research ◽

Outpatient Basis ◽

Complex Procedure ◽

The Russian Federation

Sociological research is an important tool for assessing the social effectiveness of medical care, it allows you to analyze the quality of the organization of medical care and social satisfaction of consumers. This study is an analysis of the results of "Selective observation of the quality and availability of services in education, health and social services, employment promotion." This statistical observation has several advantages: complex procedure for forming a sample, coverage of the population in all constituent entities of the Russian Federation, including urban and rural population, ensure that the data is representative, and allow for complex analysis in the dynamics. As a result of sociological surveys of the population of the Russian Federation in 2015, 2017, 2019, it was determined that the share of respondents satisfied with the work of health center and diagnostic services remains low (less than half of the respondents). When interviewing respondents, the reasons for dissatisfaction with the work of the health center were highlighted, the “leader” among which is “the length of waiting in queues”. Moreover, the share of respondents who choose “the work of medical specialist” and “the lack of necessary equipment and drugs” as negative aspects in the provision of medical care on an outpatient basis is increasing. About half of the respondents are satisfied with the comfort of their stay, the availability of drugs and modern equipment in the hospital. Analysis of the main negative phenomena observed in the provision of medical care to the population made it possible to determine the leading trends, which remain the high cost of drugs and an increase in the volume of paid medical care. More than half of respondents noted a decline in the quality of medical services, insufficient equipment of health center and hospitals.

Download Full-text

Сomparative epidemiological and demographic characteristics of TB and HIV infections among military personnel of the Russian Federation and USA armed forces and armed forces of National liberation army of people’s Republic of Сhina

HIV Infection and Immunosuppressive Disorders ◽

10.22328/2077-9828-2021-13-2-33-43 ◽

2021 ◽

Vol 13 (2) ◽

pp. 33-43

Author(s):

I. T. Rusev ◽

A. A. Kuzin ◽

E. A. Malikova ◽

K. V. Kozlov ◽

K. V. Zhdanov ◽

...

Keyword(s):

United Nations ◽

Hiv Infection ◽

Medical Care ◽

Russian Federation ◽

Military Personnel ◽

Current System ◽

Armed Forces ◽

World Health ◽

People Living With Hiv ◽

The Russian Federation

More than 1,7 million people, 770 thousand people from HIV infection, died from tuberculosis worldwide in 2018. In accordance with the United Nations Sustainable Development Goals and the World Health Organization’s strategy to fight tuberculosis, all countries need to reduce the incidence of tuberculosis by 80% and reduce the death rate from tuberculosis by 90% by 2030. According to the Joint United Nations programme on HIV/AIDS (UNAIDS) goals of «90–90–90», countries should achieve the following indicators by 2020: «90% of people living with HIV infection should know their HIV status; 90% of those who know about their HIV infection should receive treatment, and 90% of those who are being treated should not have their viral load determined». Socially significant diseases are a serious problem for the Russian Federation (RF). The RF is one of 30 countries with a high incidence of tuberculosis and ranks 3rd place in multidrug-resistant tuberculosis and 6th place in the prevalence of HIV infection. Socially significant diseases present a serious problem for the Armed Forces of the RF. 150 new cases of tuberculosis, over 50 cases of HIV infection are diagnosed every year among military personnel of the RF Armed Forces.The purpose of the study is to analyze the current epidemiological situation of tuberculosis and HIV infection in the armed forces of the Russian Federation and foreign armies, to generalize domestic and foreign experience in the organization of medical care for military personnel with these diseases.Data from reports of the medical service and a review of domestic Russian and foreign medical literature allowed us to assess TB and HIV sickness rate among military personnel in the RF and foreign states, as well as to characterize the current system of medical care for this category of patients.

Download Full-text

The World Health Organisation’s Caregiver Skills Training Programme for Autism and Developmental Disorders: Adapting and Pretesting in Hong Kong

10.21203/rs.3.rs-408342/v1 ◽

2021 ◽

Author(s):

Paul W.C. Wong ◽

Yan Yin Lam ◽

Janet Siu Lau ◽

Hung Kit Fok

Keyword(s):

Hong Kong ◽

Focus Group ◽

Skills Training ◽

Training Programme ◽

Autism Spectrum ◽

World Health ◽

Skills Development ◽

Focus Group Interviews ◽

The World ◽

Group Interviews

Abstract Background The World Health Organisation Caregiver Skills Training programme (WHO-CST) was developed to strengthen a caregiver’s skills in supporting their child’s development and the caregiver’s well-being. The WHO-CST Hong Kong (HK) was adapted to support families with children suspected of having autism spectrum disorder (ASD) while the families were waiting for a confirmed diagnosis.Aim This sequential mixed methods study aimed to explore the adaptation process, using a formative qualitative method. It assessed the acceptability, feasibility, and perceived benefits of the WHO-CST, using caregivers’ qualitative and quantitative prepost feedback.Methods Data examined included (1) two consultation meetings with stakeholders; (2) a detailed review of translated and adapted WHO-CST HK materials by Master Trainees (MTs) (n = 10) trained by WHO representatives; (3) need assessment focus group interviews with caregivers (n = 15) of children with ASD; and (4) prepost CST programme qualitative focus group interviews and quantitative evaluation (n = 11).Results Consultation with stakeholders suggested that the programme is acceptable for the local community, but the home visit and fidelity components were initially considered to be challenges for the feasibility and sustainability of the programme. Thematic analyses of the focus group interview with caregivers generated six subthemes from preprogramme focus group interviews and five subthemes from postprogramme focus group interviews. The programme was reported to be helpful for caregivers’ skills development and for aiding children’s verbal and social skills development. There was also improvement in caregivers’ mental health after completing the programme.Conclusion The prepilot evaluation findings of WHO-CST HK indicate that it is feasible and acceptable to implement the programme in a metropolitan area where families have busy working schedules. The findings indicate potential programme developments for supporting families in communities in high income countries.

Download Full-text

ВОПРОСЫ ОКАЗАНИЯ МЕДИЦИНСКОЙ ПОМОЩИ ОСУЖДЕННЫМ К ЛИШЕНИЮ СВОБОДЫ В УСЛОВИЯХ МЕДИЦИНСКОЙ ЧАСТИ ИСПРАВИТЕЛЬНОГО УЧРЕЖДЕНИЯ

Vestnik Samarskogo iuridicheskogo instituta ◽

10.37523/sui.2019.36.5.013 ◽

2020 ◽

Author(s):

Oleg Sviderskiy

Keyword(s):

Medical Care ◽

Russian Federation ◽

Legal Regulation ◽

Medical Services ◽

Correctional Institution ◽

Federal Law ◽

Ministry Of Health ◽

Private Practitioners ◽

Medical Institutions ◽

The Russian Federation

В статье проведен анализ соответствия ведомственных нормативно-правовых актов, регулирующих вопросы оказания медицинской помощи лицам, находящимся в учреждениях уголовно-исполнительной системы, требованиям федерального закона «Об основах оказания медицинской помощи гражданам Российской Федерации» и приказам Минздрава России. Рассматриваются организационные и правовые вопросы оказания скорой и первичной медико-санитарной медицинской помощи осужденным в условиях медицинской части (здравпункта) исправительного учреждения. Показано, что в требованиях приказов Минюста России, отражающих вопросы оказания медицинской помощи, имеются несоответствия требованиям, изложенным в федеральном законе «Об основах оказания медицинской помощи гражданам Российской Федерации» и приказах Минздрава России. Анализируются проблемы правового регулирования и практического решения вопроса проведения экспертизы качества оказанной медицинской услуги (помощи) заключенным. Затронуты вопросы практического оказания дополнительных услуг медицинского характера, финансируемых лицами, находящимися в местах лишения свободы. Автором предлагаются варианты реализации существующей проблемы посредством более широкого использования негосударственных лечебных учреждений и частнопрактикующих врачей.The article analyzes the compliance of departmental regulatory legal acts governing the provision of medical care to persons in penitentiary institutions with the requirements of the federal law “On the Basics of Medical Care for Citizens of the Russian Federation” and orders of the Russian Ministry of Health. Organizational and legal issues of providing emergency and primary health care to convicts in the medical unit (health center) of a correctional institution are considered. It is shown that in the requirements of the orders of the Ministry of Justice, reflecting the issues of providing medical care, there are inconsistencies with the requirements set forth in the federal law «On the basics of providing medical care to citizens of the Russian Federation» and the orders of the Ministry of Health of Russia. The problems of legal regulation and the practical solution to the issue of conducting an examination of the quality of the medical services (assistance) provided to prisoners are analyzed. The issues of the practical provision of additional medical services funded by persons in prison are raised. The author proposes options for implementing the existing problem through the wider use of non-state medical institutions and private practitioners.

Download Full-text

Progress and Problems of Practical Cardiology in Russia at the Present Stage

Kardiologiia ◽

10.18087/cardio.2019.3.10242 ◽

2019 ◽

Vol 59 (3) ◽

pp. 53-59 ◽

Cited By ~ 4

Author(s):

S. A. Boytsov ◽

A. E. Demkina ◽

E. V. Oshchepkova ◽

Yu. A. Dolgusheva

Keyword(s):

Cardiovascular Diseases ◽

Medical Care ◽

Russian Federation ◽

Statistical Data ◽

World Health ◽

Present Stage ◽

The World ◽

The Russian Federation ◽

Delivery Of Medical Care ◽

Health Organization

Mortality of the population due to diseases of the cardiovascular system is the most acute problem in Russia. According to the World Health Organization, the standardized death rate from cardiovascular diseases in the Russian Federation remains one of the highest in Europe. This review presents statistical data on morbidity and mortality from cardiovascular diseases in the Russian Federation and analyzes the delivery of medical care to patients with these diseases in 2017. Information about activity of primary vascular departments and regional vascular centers is given. The article suggests a set of measures aimed at improvement of the provision of medical care to patients with cardiovascular diseases.

Download Full-text

International Cooperation of the Russian Federation in Health Care Amid the Pandemic

Legal Concept ◽

10.15688/lc.jvolsu.2021.3.16 ◽

2021 ◽

pp. 100-107

Author(s):

Natalia Platonova ◽

◽

Valeria Vargina ◽

Keyword(s):

Health Care ◽

International Cooperation ◽

Russian Federation ◽

Research Process ◽

World Health ◽

Sociological Research ◽

Scientific Methods ◽

Legal Method ◽

The World ◽

The Russian Federation

Introduction: the current epidemiological situation in the world, characterized as a pandemic since March 11, 2020, has proved the importance of developing national health systems, and also emphasized the need to develop the channels of international cooperation in health care for joint operational measures to combat the spread of the virus. In this regard, the purpose of the study was to determine the prospects for the development of this area and the opportunities for improving the existing systems. Methods: the general scientific methods were used in the research process: logical, system-structural, complex, and functional, as well as the specific scientific methods in the form of the method of concrete-sociological research, the method of modeling, and the formal-legal method. Results: the paper considers the basics of the implementation of international cooperation of the Russian Federation in healthcare amid the pandemic: the differentiation of international cooperation formats is carried out, the legal bases of cooperation are analyzed, and the organization of interaction with the World Health Organization is studied. Justified in the work the trajectories of the development of international cooperation in healthcare are predicted. Conclusions: as a result of the study, it is established that the post-coronavirus era will be characterized by new priorities for cooperation. On the basis of the conducted research, a proposal was made to amend the Federal Law “On the Basics of Public Health Protection in the Russian Federation”, as well as the main recommendations for further implementation of international cooperation in healthcare.

Download Full-text