Review of clinical guidelines “Cystic fibrosis”, 2020

2021 ◽  
Vol 31 (2) ◽  
pp. 135-146
Author(s):  
E. I. Kondratyeva ◽  
E. L. Amelina ◽  
M. Yu. Chernukha ◽  
V. D. Sherman ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
Health Care Services ◽  
Diagnostic Tools ◽  
Federal State ◽  
Diagnostic Strategy ◽  
The Russian Federation

The aim of the experts who provide health care for patients with cystic fibrosis (CF) has been to develop clinical guidelines on cystic fibrosis for children and adults.Methods. The 2020 Clinical Guidelines were based on the European consensus documents on cystic fibrosis and the national consensus “Cystic fibrosis: definition, diagnostic criteria, therapy” (2016, 2019). When creating clinical guidelines, the experts were guided by Article 2 of the Federal Law No.323-FL “On the basics of health care in the Russian Federation” as of November 21st, 2011, and the regulatory legal documents governing the development and approval of clinical guidelines (https://rosmedex.ru/kr/).Results. The clinical guidelines were approved by the Federal State Budgetary Institution “Centre for Expertise and Quality Control of Medical Care” of the Russian Ministry of Health in August 2020. Standards of medical care for children and adults with cystic fibrosis were prepared based on these guidelines. The diagnostic algorithms have been expanded with a three-stage DNA diagnostic strategy, functional assays of CFTR channel, laboratory and instrumental diagnostic tools for assessing disorders of respiratory and other systems, diagnosis of the microbial inflammatory process, microbiological monitoring, and therapeutic approaches. The antibiotic therapy with dosages and courses is described in detail. The updated document should describe a unified tactic for the management of Russian CF patients.Conclusion. Unified clinical guidelines for children and adults should develop unified tactics for the diagnosis, therapy, and follow-up of CF patients in the Russian Federation and ensure continuity between health care services for children and adults.

scholarly journals Oncology calculator as a tool for optimizing drug provision for patients with malignant neoplasms in the subjects of the Russian Federation

2021 ◽  
Vol 65 (5) ◽  
pp. 418-424
Author(s):  
Sergey A. Linnik ◽  
Elena E. Tumenko
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
Federal Budget ◽  
Federal State ◽  
Malignant Neoplasms ◽  
Constituent Entity ◽  
Patients With Cancer ◽  
Number Of Patients ◽  
The Russian Federation

Introduction. The increase in financial resources on the part of the state for the procurement of medicines for treating patients with malignant neoplasms makes the issue of calculation the need in medicinal preparations (MP) actual. The aim of the work is to develop a special tool (oncology calculator) that standardizes the method for determining the need for drugs and can calculate the need for medications for the treatment of malignant neoplasms in a particular constituent entity of the Russian Federation. Material and methods. To develop an oncology calculator, we analyzed the need for the drugs for the treatment of patients with the most common malignant neoplasms was analyzed based on current clinical guidelines approved and published on the Ministry of the Russian Federation website. The number of patients at each stage of a specific cancer was calculated. The frequency of application of a particular treatment regimen was calculated based on the approved standards of medical care for patients with cancer or from a project. The number of patients was calculated on the official statistics presented in the P.A. Hertsen Moscow Oncological Research Institute - branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” by the Ministry of Health of Russia. Results. We have developed a tool called the “Oncology calculator” that standardizes the methodology for determining the need of a constituent entity of the Russian Federation or a medical institution for drugs based on clinical guidelines, as well as facilitating the planning of the volume of medical care in the conditions of round-the-clock and day hospitals, and in the provision of medical care to patients with malignant neoplasms in outpatient settings. Conclusion. The existing approaches to calculating the need for drugs for the treatment of patients with cancer in the constituent entities of the Russian Federation are scattered, which leads to the ineffective use of funds from the federal budget, compulsory medical insurance funds, budgets of the constituent entities of the Russian Federation. A uniform approach to calculating the need for drugs to treat malignant neoplasms should be based on clinical guidelines containing drug regimens for treating patients.

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.

About the results of the inspections of medical organizations which provide a medical care in the area of “plastic surgery”

2019 ◽  
Vol 2019 (5) ◽  
pp. 45-50
Author(s):  
Анатолий Шаронов ◽  
Anatoliy Sharonov ◽  
Алексей Прыкин ◽  
Aleksey Prykin
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Plastic Surgery ◽  
Russian Federation ◽  
Delivery Of Health Care ◽  
Health Care Services ◽  
Ministry Of Health ◽  
Care Services ◽  
The Russian Federation ◽  
The Government

In the second half of 2018, Federal Service for Surveillance in Healthcare, in accordance to the instruction of the government of the Russian Federation, conducted the unscheduled inspections of legal entities and individual entrepreneurs performing medical activities in the area of plastic surgery. The article presents the data on a number of medical organizations specialized in plastic surgery, as well as an analysis of reveled in the course of inspections improprieties of the Order of delivery of health care services in the area of “plastic surgery” approved by the order № 298n from 31.05.2018 of Ministry of Health of the Russian Federation.

scholarly journals Assessment of the prospects for introducing drug insurance into military healthcare as part of project activities

2020 ◽  
Vol 22 (2) ◽  
pp. 125-133
Author(s):  
A. Y. Fisun ◽  
Y. V. Miroshnichenko ◽  
M. P. Shcherba ◽  
R. A. Golubenko
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Subsequent Development ◽  
Outpatient Basis ◽  
Drug Supply ◽  
Military Health ◽  
Drug Insurance ◽  
Insurance System ◽  
The Russian Federation

It is shown that one of the priority areas of the social policy of the Russian Federation is the consideration of improving the drug supply, the rationale for the national drug policy, as well as the introduction of the drug reimbursement (insurance) system, as one of the key mechanisms to increase the affordability of drugs by partially or fully reimbursing their cost citizens when providing medical care on an outpatient basis. It was revealed that in the context of reforming the healthcare system, the specifics of the work of power ministries and departments are not sufficiently taken into account. In this regard, the features have been studied and an assessment has been given of the prospects for introducing drug insurance into military health care as part of project activities, as one of the mechanisms for implementing interagency cooperation in modern socio- economic conditions when reforming drug supply. It is reflected that the introduction of drug insurance mechanisms can increase the availability of drugs, have a positive effect on the health of the assigned contingents, and reduce the frequency and duration of hospitalizations. At the same time, the following were identified as the main prospects and systemic prerequisites for implementation: the need to create a reliable legal basis for the formation and subsequent development of a unified state system of drug supply, taking into account the specifics of military health; transition to a rational system of financing drug supply for the provision of medical care on an outpatient and inpatient basis as part of a project to develop a new model for the provision of primary health care and specialized medical care based on a unified medical and technological hospital base; prospective reduction of expenses for the supply of medical care in stationary conditions; optimal distribution of rights and responsibilities, ensuring coherence between health authorities; prevention of duplication, ensuring equal and guaranteed drug supply for citizens as part of the project to ensure the quality and accessibility of medical care to privileged contingents of the Ministry of Defense of the Russian Federation. A possible model of drug supply for contingents attached to military medical organizations is substantiated when providing medical care on an outpatient basis when introducing a drug insurance system at the state level. The following key elements of a grounded model are described: adjustment of drug supply management; clarification of the categories of assigned contingents; optimization of the order of dispensing of drugs; the formation of restrictive lists of drugs; optimization of financing.

scholarly journals Legal regulation of telemedicine in the health care system of the Russian Federation: state and prospects for improvement.

2019 ◽  
Vol 21 (3) ◽  
pp. 15-22
Author(s):  
N V Allamyarova ◽  
E G Sanakoeva
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Russian Federation ◽  
Legal Framework ◽  
Legal Regulation ◽  
Legal Documents ◽  
Current State ◽  
The Russian Federation ◽  
Care System

The legislation in the field of e-health, adopted in 2017, opens fundamentally new opportunities in the development of medical care using telemedicine technologies. The article provides an analysis of regulatory legal documents that establish the legal framework for the provision of medical care using telemedicine technologies. An assessment is made of the current state of telemedicine legal regulation in Russia. The law on telemedicine requires adjustment and refinement of existing regulations, procedures, standards of medical care with a detailed regulation of tools and situations of their application.

scholarly journals Analysis of personnel resources of doctors according to «dentistry» profile in units providing medical care in outpatient and inpatient conditions

2020 ◽  
Vol 24 (1) ◽  
pp. 55-60
Author(s):  
L. E. Smirnova ◽  
V. G. Butova
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Russian Federation ◽  
Dental Care ◽  
Health Workers ◽  
Dental Hygienists ◽  
The Russian Federation ◽  
Care System

In the health-care system in the Russian Federation, the units providing medical care in outpatient and inpatient conditions employ more than 55,000 individuals of dental doctors of various specialties, dental doctors and dental hygienists every year from 2014 to 2018. The availability of dentistry by doctors tends to decline from 4.20 (2014) to 3.75 (2018). By 2018, 99.45% of dentistry doctors and 99.3% of dental doctors have a specialist certificate and accreditation certificate. 38.16% of dentistry doctors and 54.88% of dental doctors confirmed their qualification category. In dynamics there is a tendency to decrease the passing of certification for obtaining qualification category by these specialists. These facts show a decrease in the availability and quality of dental care, as it is ensured by the availability of the necessary number of health workers and their level of qualification.

scholarly journals Development of voluntary medical insurance in the Russian Federation

2019 ◽  
Vol 100 (5) ◽  
pp. 796-801
Author(s):  
E V Arsentyev
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Russian Federation ◽  
Medical Insurance ◽  
Insurance Policy ◽  
Labor Migrants ◽  
Voluntary Health Insurance ◽  
Legislative Framework ◽  
The Russian Federation

Aim. To analyze the dynamics of the development of voluntary medical insurance in the Russian Federation. To identify the factors hindering the development of this insurance sector in modern conditions. Methods. In the course of the study, analysis was conducted of the legislative framework for organizing medical care for the population of the Russian Federation in the system of voluntary medical insurance. The problem-chronological, systematic, and analytical research methods were used. Results. It has been established that, despite the development of voluntary medical insurance system over the past 25 years, the availability of this type of insurance for citizens of the Russian Federation still remains very low. The policy of voluntary medical insurance is mainly available only to working citizens, and only in those large enterprises where the employer is interested in preserving and protecting the health of its employees. For most citizens of the Russian Federation, the voluntary health insurance policy remains inaccessible due to the high cost of the policy, as well as due to relatively low incomes. At the same time, a voluntary health insurance policy is required by law for labor migrants to obtain a patent for employment in the Russian Federation. However due to the absence of legislative framework for voluntary health insurance, organization of medical care for labor migrants is not always standardized. Conclusion. For the further development of voluntary medical insurance, it is necessary to develop the measures for decreasing the cost and increasing the availability of a voluntary medical insurance policy for citizens of the Russian Federation; to optimize organization of health care for labor migrants it is necessary to primarily develop regulatory framework of emergency health care.

scholarly journals Citizens' Rights to Health Protection and Medical Assistance, Guaranteed by Article 41 of the Constitution: Problems of Enforcement

2019 ◽  
Vol 3 (1) ◽  
pp. 97-103
Author(s):  
Ольга Фадеева ◽  
Olga Fadeeva
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Medical Personnel ◽  
Right To Health ◽  
Health Protection ◽  
Medical Specialists ◽  
Medical Graduates ◽  
The Russian Federation ◽  
The Right

The paper reflects the state of the modern healthcare system and various enforcements of the right to medical care guaranteed by the Constitution of the Russian Federation. The right to health, as well as the provision of qualified, free, and timely health care, are among the most important and fundamental human rights. The paper also features some key enforcement problems concerning the right to health protection and medical care, guaranteed by Article 41 of the Constitution of the Russian Federation, e.g. a lack of medical personnel, untimely provision of the first aid, and insufficient financing in the health care system. The article also considers the causes and consequences of "staff shortages" in Russian hospitals, employment of medical graduates, and financial support of young medical specialists. The author analyzes the equipment status of medical organizations in 2018 and 2016, voices the problem of optimization in healthcare institutions by reducing the inpatient level and expanding outpatient clinics, and offers statistics of complaints to the Department of Public Health on quality and timeliness of medical care. The author believes that the enforcement of the right of citizens guaranteed by Article 41 of the Constitution of the Russian Federation can be characterized as very low, which indicates the pretentiousness of the law.

Amendments to the Constitution of the Russian Federation: Dictated Necessity and Consequences in the Conditions of the Modern World

2021 ◽  
Author(s):  
V.V. Chuksina ◽  
◽  
K.A. Mirvoda ◽  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Local Governments ◽  
Health Care Systems ◽  
Modern World ◽  
Depth Analysis ◽  
Care Systems ◽  
The Russian Federation ◽  
The Impact

The subject of this article is Law of the Russian Federation on Amendments to the Constitution of the Russian Federation (14.03.2020 No. 1-Federal Constitutional Law) «On improving the regulation of certain issues of the public power organization and functioning», namely, aspects of «coordination of health care» and «protection of the family, motherhood and childhood». The authors analyzed the issues of the medical care provision centralization, the impact of these amendments on the legal capacity of citizens. For a more in-depth analysis, the experience of foreign countries (Canada and Germany) was used. Despite the fact that the health care systems of the countries cited as an example differ in their essence and organization, nevertheless, they influence the formation of the availability of medicine for the population. As a result of the study of this experience, it was concluded that the delegation of freedom in the provision of medical care to lower levels of government allows to provide to the population affordable and high-quality medical care. It is noted that at present it is necessary to review the degree of participation of local governments in ensuring the availability of medical care in accordance with the federal law.

The evaluation of epidemiology and the availability of medical care for patients with retina diseases in the Russian Federation

2020 ◽  
pp. 26-36
Author(s):  
I. V. Laricheva ◽  
◽  
I. M. Son ◽  
E. S. Yastrebova ◽  
V. V. Neroev ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Macular Degeneration ◽  
Russian Federation ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Complete Evaluation ◽  
Age Related ◽  
Number Of Patients ◽  
The Russian Federation

Retinal diseases are significant causes of blindness and vision loss and they take the second place in the structure of disabilities due to blindness in Russia. Objective: analysis of the official statistical data on the disease and availability of health care to patients with age-related macular degeneration (AMD) and diabetic retinopathy (DR) that are prescribed intravitreal injection of drugs (IVD) as the first-line therapy for wet age-related macular degeneration and diabetic macular edema, respectively. Materials and methods: Epidemiological parameters were assessed by the data obtained from the form of statistical records № 12 for 2018–2019 years. The availability of IVD was analyzed by the information registered in the form of statistical records № 14 for 2016–2019 with a recalculation per 1000 population. Results: In 2019 in the Russian Federation 330 thousand patients with AMD were registered (0.45% among the population older than 40 years old). The incidence rate was significantly lower than in other countries (8.69%). The data on the number of patients with DR was unavailable for statistical recording because of the absence of the code Н36.0 IDC‑10 in form № 12. However, according to the federal register of diabetes mellitus, the total rate of DR can reach 760 thousand people all over Russia. The availability of IVD for all-day inpatient health care was 0.39 injections per 1000 population. In 26 subjects of the Russian Federation, the availability was higher than the average in Russia, while in the rest 59 subjects, the availability was lower than the average. Presently, there are no data on the number of IVD performed in day-time inpatient facilities. Conclusions: The current rate of application of IVD in Russia can be estimated as low considering the revealed problems with the registration and accounting of patients with AMD and DR. It is impossible to perform a complete evaluation of the availability of IVD for the Russian population within obligatory medical health insurance because of the lack of data on the provision of IVD in day-time inpatient facilities. For the rational planning of the volumes of medical care provision to patients with AMD and DR, the form of statistical records should include the data on the indication of IVD in the day-time inpatient facilities in the subjects of the Russian Federation.

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