scholarly journals Mortality of Children Born on Early Gestational Age: is it the Impassable Barrier or the Reserve for Reducing the Infants Mortality?

2020 ◽  
Vol 19 (5) ◽  
pp. 340-345
Author(s):  
Anatoly S. Simakhodsky ◽  
Yulia V. Gorelik ◽  
Konstantin D. Gorelik ◽  
Sergey L. Ivanov ◽  
Yulia V. Lukashova
Keyword(s):  
Medical Care ◽  
Premature Infants ◽  
High Mortality ◽  
Medical Insurance ◽  
Human Reproduction ◽  
Federal State ◽  
Premature Delivery ◽  
Insurance Fund ◽  
Saint Petersburg ◽  
Medical Facilities

The problem of premature infants is well recognized in Russia and all over the world. The article discusses the mortality level and structure of extremely premature infant during 2015–2019. The aim of the study was to identify significant cause-effect relations for high mortality of premature infants and infants with extremely low body weight (ELBW) according to reports from obstetric departments, pediatric outpatient clinics, children's hospitals, statistical agencies, queries results from Territorial Compulsory Medical Insurance Fund (TCMIF) in Saint Petersburg and Russian Association of Human Reproduction (RAHR). The main demographic indices are presented by the Petrostat association. Russian Federal State Statistics Service (Rosstat) forms provided by the Center for Analysis and Prediction of Maternal and Child Health of the Saint Petersburg Health care Committee (No. 32 “Information on medical care for pregnant women, women in labour and new mothers” (approved by order of Rosstat No. 591 of 27.11.2015); No. 19 “Information on children with disabilities” registered in children's clinics (approved by order of Rosstat No. 866 of 27.12.2016); No. 14 “Information on the activities of medical facilities units providing inpatient medical care” (approved by order of Rosstat No. 723 of 05.12.2014); No. 30 “Information on the medical facility” (approved by order of Rosstat No. 483 of 03.08.2018 “On the approval of statistical tools for the organization of federal statistical observation in the field of healthcare by the Ministry of Health of the Russian Federation”) presented by Saint Petersburg Medical Informational and Analytical Center (MIAC)), and answers from TCMIF in Saint Petersburg and RARCH have been investigated. The authors have analyzed the fertility and mortality rates of premature infants, the group of children with ELBW has been established. High mortality levels have been revealed in the first weeks of life (22–23), they were mainly associated with infectious processes. The authors associate the premature delivery increase with the widespread implementation of assisted reproductive technology (ART). ART can be performed either via compulsory medical insurance funds, or other non-government sources. The assumption was proposed that there are possible violations of ART indications, contraindications, and the number of procedures. The ART efficacy is difficult to estimate as well due to insufficient information provided by Rosstat report form No. 32. The need of implementation of the new statistical form that will cover the data on the of ART administration, the possibility of efficacy estimation of modern invasive methods for infertility treatment and mandatory submission of reports about the use of these methods by medical facilities is discussed.

ANALYSIS OF THE AVAILABILITY AND EFFICIENCY OF MEDICAL CARE PROVIDED TO PATIENTS IN THE PROFILE "MEDICAL REHABILITATION" IN ASTRAKHAN REGION

2021 ◽  
pp. 23-29
Author(s):  
Ermolaev D.O. ◽  
Ermolaeva Yu.N. ◽  
Mordovсev N.A.
Keyword(s):  
Medical Care ◽  
Medical Insurance ◽  
Medical Rehabilitation ◽  
Federal State ◽  
Insurance Fund ◽  
Rehabilitation Care ◽  
Rehabilitation Potential ◽  
Annual Reporting ◽  
Day Hospitals ◽  
Somatic Diseases

The relevance of the study due to the need to pay more attention to the effective planning of health care volumes under the compulsory health insurance and the creation of an accessible system of medical rehabilitation for adults in the region. The purpose of the study is to analyze the availability and effectiveness of medical care provided to adults in the "medical rehabilitation" profile within the framework of compulsory medical insurance in the Astrakhan region. Materials and methods - on the basis of data from the Federal State Statistics Service, the territorial fund of compulsory medical insurance in the Astrakhan region, annual reporting statistical forms No. 30, 14, 14-DS, the calculation and analysis of indicators of the optimal volume of medical care for the profile of medical rehabilitation was carried out, taking into account the profile of the disease (the number of hospitalizations per one inhabitant per year, funding per unit of the volume of medical care) of adult patients aged 18 years and older. Results and discussion - the article presents the results of assessing the planned and actual indicators of the volume of medical care for medical rehabilitation for adults, taking into account the profile of diseases in the conditions of round-the-clock and day hospitals of medical organizations participating in the territorial program of state guarantees of free provision of medical care to citizens in the region in 2019. It was revealed that at the expense of the compulsory medical insurance fund, the largest proportion of treated patients in rehabilitation beds is noted among those who receive medical services for neuro- and cardiac rehabilitation. However, rehabilitation care for critically ill patients with scores on the rehabilitation routing scale of 5 and 6 points, with a high rehabilitation potential, as well as for other categories of patients with somatic diseases, remains inaccessible. Conclusion. The obtained research data can be used for further organizational and methodological work to increase the availability and efficiency of medical rehabilitation care for adults, the development of available routing schemes, selection procedures, digitalization of the management of patient flows sent to medical rehabilitation within the framework of compulsory medical insurance at the regional level.

scholarly journals problems of organization and financing of high-tech medical care in 2017

2016 ◽  
Vol 1 (5) ◽  
pp. 77-83
Author(s):  
Колесников ◽  
Sergey Kolesnikov ◽  
Перхов ◽  
Vladimir Perkhov
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Medical Insurance ◽  
Federal State ◽  
High Tech ◽  
The Russian Federation ◽  
Federal Laws ◽  
Great Possibility ◽  
High Level

The authors analyzed the essence of new federal laws, which change some implementation aspects of other basic federal laws, such as Law on Compulsory Medical insurance in the Russian Federation, Law on Basics of health protection of citizens in the Russian Federation, Budget Code, Tax Code and other legal acts, determining the peculiarities of financ-ing of high technology medical care since January 1, 2017 onwards. The main challenges and risks of Compulsory Medical Insurance Federal Foundation was identified, it becoming the sole holder of the funds intended for the financing of high-tech medical care. The main risk is that federal and regional authorities are not only being excluded from financing, but are losing the role of health care state customer. And in the conditions of financial crisis in the country it will happen. In this case there is a great possibility of financial deficit for high technological medical care in the federal medical scientific institutions. A number of measures for planning indicators of high-tech medical assistance in the scientific medical organizations was proposed. These measures can prevent corruption and defend federal (state) segment of health care system, providing the complex and high level assistance for the most severe ill patients.

scholarly journals Analysis of female patients' satisfaction of medical care in antenatal clinic working at the system of compulsory medical insurance in Saint Petersburg

2014 ◽  
Vol 21 (4) ◽  
pp. 25-27
Author(s):  
L. V. Kochorooa ◽  
B. L. Tsioyan
Keyword(s):  
Medical Care ◽  
Medical Insurance ◽  
Antenatal Clinic ◽  
Saint Petersburg ◽  
Female Patients ◽  
Patients Satisfaction

2175 of patients were interviewed in 2014 year. The index of female patients' satisfaction of medical care in antenatal clinic is 0.88 but there are differences on some aspects of medical care and in districts of Saint Petersburg. It was recommended to use the obtained data for improving the availability of medical care.

RURAL MEDICINE. CONDITION AND ISSUES

2020 ◽  
pp. 103-110
Author(s):  
Yuliya M. Beglyakova ◽  
◽  
Aleksander S. Shchirskii ◽  
Keyword(s):  
Health Services ◽  
Medical Care ◽  
Rural Areas ◽  
Rural Population ◽  
Rural Medicine ◽  
Self Medication ◽  
Medical Facilities ◽  
Treatment Facilities ◽  
Number Of Treatment ◽  
The Village

The article analyses the accessibility of medical facilities in rural areas of modern Russia and the specifics of their organization and development. The authors reveal causes why rural residents have much less opportunities to seek quality medical care than urban ones, what leads to a disparity between the inhabitants of the city and the village. The thesis is substantiated that state programmes that should make health services accessible to the rural population to a greater extent do not cope with the task at hand. An attempt is made to highlight the public’s response to the existing disparity in the health services of the villagers compared to urban dwellers. Such a reaction can be considered an outflow of people from rural areas, and an increase in self-medication among rural people as a result of the difficulty in obtaining health services. The decrease in the number of treatment facilities in rural areas leads to a deterioration in the medicine situation in rural areas. That, according to the authors of the article, justifies the need to study the issues associated with the provision of medical care to the rural population.

Organization of immunobiological therapy for severe bronchial asthma in the Sverdlovsk region

2021 ◽  
Author(s):  
Evgeny K. Beltyukov ◽  
Valery A. Shelyakin ◽  
Veronika V. Naumova ◽  
Alexander V. Vinogradov ◽  
Olga G. Smolenskaya
Keyword(s):  
Differential Diagnosis ◽  
Targeted Therapy ◽  
Medical Care ◽  
Clinical Guidelines ◽  
Medical Insurance ◽  
Continuation Therapy ◽  
Insurance Program ◽  
Routine Medical Care ◽  
Insurance Funds ◽  
Stay Hospital

Background: Biologicals use in severe asthma (SA) is associated with problem of targeted therapy (TT) availability. Ensuring availability of biologicals can be resolved within the territorial compulsory medical insurance program (TCMIP) in day-stay or round-the-clock hospital. Aims: development and implementation of program for introduction of immunobiological therapy (IBT) for SA in Sverdlovsk Region (SR). Materials and methods: Program for introduction of IBT for SA was developed in SR in 2018 to provide patients with expensive biologicals within the TCMIP. Program includes: SA prevalence study in SR; practitioners training in differential diagnosis of SA; organization of affordable therapy for patients with SA; register of SA patients сreation and maintenance; patients selection and management of patients with SA in accordance with federal clinical guidelines. Results: Atopic phenotype in SA was detected in 5%, eosinophilic - in 2.3% of all analyzed cases of asthma (n=216). Practitioners of SR were trained in differential diagnosis of SA. The orders of the Ministry of Health of SR were issued, regulating the procedure for referring patients with SA to IBT, a list of municipal medical organizations providing IBT in a day-stay or round-the-clock hospital; approved regional register form of SA patients requiring biologicals use; ungrouping of clinical and statistical groups of day-stay hospital was carried out depending on INN and dose of biologicals; patients with SA are selected for TT and included in the regional register. Initiating of TT in round-the-clock hospital and continuation therapy in day-stay hospital provides a significant savings in compulsory medical insurance funds. Conclusions: introduction of IBT for SA in SR is carried out within framework of developed program. Principle of decentralization brings highly specialized types of medical care closer to patients and makes it possible to provide routine medical care in allergology-immunology profile in context of restrictions caused by COVID-19 pandemic.

The first military hospitals in Saint Petersburg

2020 ◽  
Vol 22 (3) ◽  
pp. 258-266
Author(s):  
N. V. Milasheva ◽  
V. O. Samoilov
Keyword(s):  
Medical Care ◽  
Military Medicine ◽  
Senior Physician ◽  
Military Hospitals ◽  
Saint Petersburg ◽  
Peter The Great ◽  
Russian State ◽  
Shortage Of Doctors ◽  
History Of ◽  
Hospital Doctors

Abstract. The documentary materials from the funds of the Russian State Archive of the Navy, other archives, published letters and documents of Peter the Great, his Daily Note and other sources about the history of the first military hospitals (infirmaries) of Saint Petersburg are studied. At the same time, the history of the first military hospitals is reflected against the background of the difficult events of the Northern War of 17001721, with which the establishment of hospitals for the Russian army and the navy and the development of military medicine are inextricably linked. The organization of military medicine became aggravated immediately with the outbreak of hostilities, with the first wounded and sick. The fight against the plague epidemic and other infections during the war, the shortage of doctors, healers, infirmaries, hospitals and their own national staff greatly complicated the provision of medical care. Numerous documents and facts prove that the events before 1715 can be attributed to the first stage in the development of military medicine in Saint Petersburg. It was established that in 1704 the issue of establishing a military land hospital in the northern capital was already discussed (Peter I, A.D. Menshikov, N.L. Bidloo); hospital), and the senior physician of the Navy Yang Govi served in it with zeal In 1713, by the decree of the Great Sovereign Y. Govi, he was appointed head of the Admiralty Hospital, doctors, apprentices and medical students in it. By that time, Dr. R. Erskine actually assumed the office of archiatrist (until 1712). A detailed statement of Lieutenant General R.V. Bruce on the number of sick and wounded who received medical care in hospitals and hospitals in Saint Petersburg from 1713 to 1715. The decree of Peter I on the construction of a complex of General hospitals with anatomical theaters on the Vyborgskaya side (1715) according to Dr. Areskins drawing, and the establishment of a medical school (until 1719) are the next stage in the development of military medicine in Saint Petersburg, prepared by all previous events.

Charter of the Kazan Society of Physicians for the provision of medical care to participants in the sickness funds established by law on June 3, 1912

1913 ◽  
Vol 13 (2) ◽  
pp. 91-110
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Medical Assistance ◽  
Medical Aid ◽  
Insurance Funds ◽  
The Law ◽  
Health Insurance Funds ◽  
The City

The Kazan Society of Physicians for the Provision of Medical Aid to the Participants of the Health Insurance Funds Established on the Basis of the Law of June 23, 1912 "has the goal of providing medical assistance to the participants of the Health Insurance Fund established on the basis of the Law of June 23, 1912 in the city of Kazan and its environs.

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