scholarly journals Epileptic status: reality 2021

2021 ◽  
Vol 40 (4) ◽  
pp. 59-68
Author(s):  
Sergey N. Bazilevich ◽  
Mikhail Yu. Prokudin ◽  
Dmitriy A. Averyanov ◽  
Dmitriy E. Dyskin
Keyword(s):  
Medical Care ◽  
Antiepileptic Drugs ◽  
Early Stage ◽  
Treatment Protocol ◽  
Case Series ◽  
Medical Personnel ◽  
General Anesthetics ◽  
Quality Of Medical Care ◽  
The Russian Federation

Epileptic status is one of the urgent conditions in neurology that requires clear and urgent measures at any stage of medical care. It ranks second among all urgent neurological conditions. The therapeutic principle time-brain is applicable not only for urgent measures in acute cerebrovascular accident, but also for the relief of epileptic status, since the worst prognosis is associated with an increase in the duration of seizure activity. According to the standards proposed in the world for the treatment of epileptic status, benzodiazepines, intravenous forms of antiepileptic drugs, and general anesthetics are used. In the Russian Federation, the use of many drugs is limited due to the lack of registration, their lack in standards, and unavailability in hospitals. Due to the lack of studies on the treatment of epileptic status that go beyond the early stage of status, most of the recommendations presented worldwide remain based on case series or expert judgment. The efficacy benefits of anti-status drugs used in the second and third stages of epileptic status therapy remain unclear. Therefore, if there is a choice of anti-status drugs, the decision of which drug, in what dose and in what sequence will be used, should be made by the senior and most trained doctor in this matter, taking into account the characteristics of each patient. Based on modern international and personal experience, the paper presents a step-by-step protocol for the treatment of generalized convulsive epileptic status, discusses the successes and problems of providing care to patients with this pathology in Russia. The quality of medical care in epileptic status can be significantly improved provided that medical personnel at all stages of the treatment protocol are required to evacuate patients with epileptic status to specialized centers of multidisciplinary hospitals with the possibility of examination and therapy, including the availability of EEG monitors, neuroimaging and laboratory capabilities, and also access to modern antiepileptic drugs (1 table, bibliography: 30 refs)

Assessment of the Quality of Medical Care Among Patients with Early Stage Prostate Cancer Undergoing Expectant Management in the United States

2012 ◽  
Vol 188 (3) ◽  
pp. 769-774 ◽  
Author(s):  
Jamie Ritchey ◽  
E. Greer Gay ◽  
Benjamin A. Spencer ◽  
David C. Miller ◽  
Lauren P. Wallner ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Medical Care ◽  
Early Stage ◽  
Expectant Management ◽  
The United States ◽  
Quality Of Medical Care

scholarly journals Accessibility and quality of medical care in public out-patient clinics and private medical centers of the Amur oblast as reported by patients with back pain

2014 ◽  
Vol 95 (2) ◽  
pp. 257-261
Author(s):  
K Yu Dobrovinskaya ◽  
L N Voyt
Keyword(s):  
Back Pain ◽  
Medical Care ◽  
Working Hours ◽  
Medical Personnel ◽  
Medical Aid ◽  
Medical Centers ◽  
Private And Public ◽  
Quality Of Medical Care ◽  
Pain Patients

Aim. To study the opinion of patients with low back pain of judgement of assessibility and quality of medical care in public and private medical centers. Methods. Back pain patients to assess the quality of medical care filled in specially designed questionnaires for each type of medical facilities (two types of questionnaires for each patient who underwent treatment in both outpatient public clinics and private medical centers, total of 600 questionnaires). The poll was anonymous and was performed at one of the private medical centers in august 2013. Patients were randomly picked out from all patients who seek for medical aid in private center being unsatisfied with the quality of medical aid offered at public medical centers or who were on the waiting list for a doctor visit, or with disease worsening not within the working hours of public medical centers (600 questionnaires). The poll included patients of active working age: men aged 20 to 60 years (118 patients, 39.3%) and females aged 20 to 55 years (182 patients, 60.7%). Results. The majority of patients were more satisfied with the quality of the treatment, examination and attitude of medical personnel in private medical centers compared to public institutions. The following issues of providing medical aid to back pain patients were discovered both in private and public settings: untimely referral to specialist, or consultation only by general practitioner without subsequent consultation of neurologist, long waiting lists, incomplete neurologic examination, and low qualification of doctors in choosing appropriate examinations, treatment approach and further prophylaxis. Abovementioned issues were more significant in public settings. Conclusion. The research showed that there is a need in developing uniform standards of medical care in case of a back pain in outpatients that do not yet exist.

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.

POTENTIAL FOR IMPROVING THE QUALITY OF CANCER CARE

2021 ◽  
pp. 91-97
Author(s):  
Mushnikov D.L. ◽  
Kozlov V.A ◽  
Polacov B.A.
Keyword(s):  
Medical Care ◽  
Healthy Lifestyle ◽  
Medical Personnel ◽  
Original Method ◽  
Expert Assessment ◽  
Oncological Care ◽  
Care Outcomes ◽  
Quality Of Medical Care ◽  
Integral Assessment

The quality of medical care is one of the leading problems of both foreign and domestic healthcare. The purpose of the study: to assess the potential of the quality of medical care of the oncological profile and to give recommendations for its improvement. Materials and methods. A study was conducted on the basis of the oncological service of the Ivanovo region. The research program included the use of expert, sociological and statistical methods. A survey of 120 doctors and an expert assessment of 410 cases of oncological care were conducted. A feature of the study was the use of an original method of integral assessment of the quality potential of oncological care. The potential for improving the quality of medical care was assessed in three components: infrastructure (personnel, logistics and drug support), procedural (compliance of the technology of assistance with standards and clinical recommendations), expert (quality of examination of the quality of medical care). Outcomes. It is established that the infrastructure component of the quality of medical care is of priority importance from the point of position of improvement (reserve 11,0%), in second place – the procedural component (9,0%), on the third – expert (5,0%). The survey showed that among medical personnel there is a high prevalence of adverse socio-hygienic factors: unsatisfactory housing conditions; a high percentage of unmarried personnel; a significant number of people suffering from chronic diseases; not observing the principles of a healthy lifestyle. Findings. The developed approach to improving the quality of medical care of the oncological profile, tested in the conditions of medical organizations of the Ivanovo region, will ensure targeted correction of factors associated with quality and a steady trend towards improving the quality of medical care. The set of proposals developed during the study was tested in an organizational experiment conducted on the basis of medical organizations that provide assistance to patients of the oncological profile of the Ivanovo region in 2019. According to the results of the implementation, a positive dynamic of the potential for the quality of medical care was obtained - from 91,7% to 98,5%.

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.

THE QUALITY OF MEDICAL CARE IN MEDICAL ORGANIZATIONS OF MOSCOW PUBLIC HEALTH CARE SYSTEM IN APPRAISALS OF PATIENTS AND PHYSICIANS

2017 ◽  
Vol 16 (2) ◽  
pp. 100-106 ◽  
Author(s):  
I. Ya Tadjiev ◽  
A. V Belostotsky ◽  
S. S Budarin
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Medical Personnel ◽  
Public Health Care ◽  
Fee For Service ◽  
Emergency Medical Care ◽  
Emergency Medical ◽  
Quality Of Medical Care ◽  
High Level

The article presents the analysis of results of complex medical sociological survey of effectiveness and efficiency of medical care as main criteria of its quality and accessibility. The survey comprised 1,737 patients of various social groups of population of Moscow and 203 physicians of polyclinics. At self-rating of health, 13.2% of respondents determined it as unsatisfactory, 45.1% as satisfactory and 31.3% as good. In all population groups, the most called-for proved to be polyclinic institutions. The high level of satisfaction of patients with quality of emergency medical care was established in all groups. The quality of medical care in polyclinics and hospitals was assessed significantly lower. The most negatively assessed criteria turned out transition to fee-for-service forms of medical support and time limits of waiting for all modes of medical care, except emergency medical care and district therapist. The evaluation by physicians of their own activity and present problems is characterized by their unanimity in need of increasing of salary (100%) and increasing of typical sectoral standards of time of reception of a patient (96.5%), decreasing of intensity of work of medical personal (92.3%) and reduction of some forms of record cards with the purpose of releasing of time and attention of physician for a patient (88.4%). The disrespectful attitude of patients to medical personnel was mentioned by 77.3% of physicians which is a new phenomenon testifying loss of confidence in patient-physician relationship. The quality of implemented work was assessed equally and rather high by both young and experienced physicians. The positive and negative aspects of reorganization of health care were analyzed. Two alternatives of problems were established to focus plans of development of system of Moscow health care to support accessible and qualitative medical care of population.

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