Problems of Iatrogenic Crimes Qualification

2021 ◽  
Author(s):  
K.V. Pitulko ◽  
Keyword(s):  
Causes Of Death ◽  
Statistical Data ◽  
Criminal Responsibility ◽  
Patient Treatment ◽  
Criminal Prosecution ◽  
Medical Assistance ◽  
Judicial Practice ◽  
Quality Of Medical Care ◽  
The Difference

The article reveals the features of the distinction between criminal and non-criminal circumstances, leading to a patient treatment unfavorable outcome. The aim of the research undertaken is to identify the nature and degree of social danger of professional negligence in the diagnosis and treatment of diseases. The article analyzes statistical data characterizing the dynamics of bringing doctors and other medical workers to criminal responsibility for committing crimes that caused harm to the life and health of patients. The organic connection of iatrogenic crimes with defects in the quality of medical care and improper performance of professional duties by medical workers is argued. The author reveals the difference between the causes of death and deterioration in the health of persons seeking medical assistance, and analyzes the practice of termination of medical workers criminal prosecution on rehabilitating grounds. On the basis of materials of modern judicial practice, it is proved that there is no need to separate the category «iatrogenic crimes» in the criminal law. A differentiated approach to qualification of adverse treatment outcomes seems promising. The author proposes detailing the legal liability of medical workers and medical organizations, depending on the criminal or non-criminal nature of the circumstances of causing harm to the life and health of the patient.

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.

scholarly journals Consequences of failure to pay a court fine

2020 ◽  
Vol 11 (3) ◽  
pp. 639-650
Author(s):  
Nina Yu. Skripchenko ◽  
Keyword(s):  
Supreme Court ◽  
Criminal Law ◽  
Criminal Responsibility ◽  
Criminal Liability ◽  
Criminal Code ◽  
Criminal Prosecution ◽  
Judicial Practice ◽  
The Supreme Court ◽  
Legislative Regulation

The article discusses issues that arose during enforcement of the new grounds for exemption from criminal responsibility, enshrined in 2016, in connection with a court fine (Article 76.2 of the Criminal Code). Despite the criticism of its legislative regulation, demand for a new way of ceasing criminal prosecution began to appear in connection with the non-payment of a fine. Having determined the voluntary execution of a court fine, the legislator did not settle the issue of the further execution of the fine in cases where there are valid reasons for non-payment. After analyzing the existing proposals to solve this problem, the author confirms that the elimination of the gap would be facilitated by the legislative obligation of the bailiff to establish the circumstances by which the judicial penalty is not paid, as well as the addition of the list of decisions made by the bailiff to suspend enforcement proceeding. Analysis of judicial practice showed that Art. 76.2 of the Criminal Code began to be applied in cases where the court has justification for implementing less onerous grounds for the defendant to be exempt from criminal liability. Legislative duplication of the conditions under which criminal prosecution can be terminated for various reasons calls into question the wide alternative of the latter, as well as the embodiment of the idea of humanizing criminal law, which is the basis for securing a new ground for exemption from criminal liability. The article substantiates the proposal to supplement the Resolution of the Plenum of the Supreme Court dated June 27, 2013 with a provision allowing the release of a person from criminal responsibility with a judicial fine in cases where the court has no basis for suspending criminal prosecution for unconditional types of exemption from criminal liability. The author draws attention to the gap in the legislation, part 3 of Article 78 of the Criminal Code, which is related to the renewal of the statute of limitations for criminal liability when an individual avoids paying a court fine.

CRIMINAL PROSECUTION OF HOLOCAUST DENIAL IN GERMANY

2020 ◽  
Vol 10 (3) ◽  
pp. 115-120
Author(s):  
ANNA SEREBRENNIKOVA
Keyword(s):  
Criminal Law ◽  
Criminal Responsibility ◽  
Freedom Of Expression ◽  
Criminal Liability ◽  
Criminal Prosecution ◽  
World War ◽  
Public Attention ◽  
Holocaust Denial ◽  
Judicial Practice

Currently, they are attracting public attention and causing public resonance problems associated with the reassessment of the feat of the Soviet people in World War II. Various kinds of insinuations arise related to the denial of the persecution and mass extermination of Jews living in Germany, in the territory of its allies and in the territories occupied by them during the Second World War; the systematic persecution and extermination of European Jews by Nazi Germany and collaborators during 1933-1945. Practice shows that those guilty of Holocaust denial try to avoid criminal liability and influence judicial practice, referring to freedom of speech enshrined in Art. 5 Abs. 1 of the Basic Law of Germany. The purpose of the article. Investigate the institution of criminal responsibility for Holocaust denial in Germany. Based on an analysis of the norms of criminal law and judicial practice in Germany in specific criminal cases, investigate the difficulty of delimiting criminal liability for denying the Holocaust freedom of expression. Methodology and methods. For the purposes of this article, the author uses the methods of analysis, synthesis, induction, diduction, as well as comparative legal, historical legal and historical comparative methods. Conclusions. After conducting a study, the author concludes that in Germany the issue of criminal liability for Holocaust denial is complex. The article points out the fact of heterogeneity of court decisions, analysis of judicial practice shows that this issue is resolved extremely ambiguously. Despite this, the author points out the high role of the legislator and the practice of law enforcement in shaping the right attitude to historical events, the high role of peoples in certain significant facts that are part of the foundation of historical and cultural heritage. Scope of the results. This work may be of interest to students of higher educational institutions, as well as graduate students interested in criminal law of foreign countries. The article can be used by teachers of law schools as an addition to the educational material.

Health problems of the region with low population density according to data of the Amur oblast

2014 ◽  
Vol 95 (2) ◽  
pp. 254-257
Author(s):  
O A Agarkova ◽  
L N Voyt
Keyword(s):  
Mortality Rate ◽  
Statistical Data ◽  
Malignant Tumors ◽  
Disease Prevalence ◽  
External Factors ◽  
Amur Oblast ◽  
Statistical Parameters ◽  
Quality Of Medical Care ◽  
Tuberculosis Prevalence

Aim. To estimate the present health status of the population of Amur Oblast. Methods. The evaluation was based on analysis of statistical data on mortality, morbidity, disability in population. Intensive and extensive statistical parameters were calculated and compared. Results. The top three reasons for death in Amur Oblast were: cardiovascular conditions, external factors and malignancies (in Russia overall, malignancies rated the 2nd and external factors the 3rd). Mean survival rate has increased significantly both in Russia and Amur Oblast over the last 5 years (by 4.5 and 1.5 years accordingly). Overall disease prevalence has increased by 1.1 times over the last 5 years, with disease prevalence among children and adolescents increasing the most. Tuberculosis prevalence and mortality rate in Amur Oblast have dropped, although still higher compared with the whole Russia (prevalence - by 1.5 times, mortality rate - by more than 2 times). Syphilis prevalence rate has also dropped, although still exceeding the prevalence in Russia by 2.9 times. The prevalence of malignancies in Amur Oblast increased by 1.1 times, but it is by 1.1 times lower compared to Russian. Malignant tumors of lungs, skin, breast and stomach are the most prevalent types. Conclusion. Positive changes of public health characteristics can be expected at improving the life conditions and quality of life, the active promotion of healthy lifestyles and the high quality of medical care.

SANATION OF PATIENTS MOUTH IN DENTAL ORGANIZATIONS OF PRIVATE HEALTH CARE SYSTEM

2019 ◽  
Vol 25 (4) ◽  
pp. 194-198
Author(s):  
Lyudmila E. Smirnova ◽  
V. D Vagner
Keyword(s):  
Health Care ◽  
Statistical Data ◽  
Well Being ◽  
Whole Body ◽  
Orthopedic Treatment ◽  
Dental Patient ◽  
Carious Lesions ◽  
Depth Analysis ◽  
Quality Of Medical Care

Oral sanitation - a set of measures aimed at curing diseases of the organs and tissues of the mouth, including the treatment of dental caries, its complications, non-carious lesions and professional hygiene or preparation of the mouth for further orthodontic and orthopedic treatment. Sanation of the mouth can be considered as an indicator of the quality of medical care, as it is a planned result of the treatment of the whole body. However, this indicator is not subject to accounting and analysis in private medical organizations, as a result of which statistical data on the true situation of dental disease and the effectiveness of treatment are unreliable. We conducted a study on the activities of four private dental organizations to achieve the effectiveness of treatment of patients. Evaluation of the scope and cost of work performed, complete rehabilitation of the mouth, carried out the certificate of completion. The collection of data on the structure of dental morbidity by turnover was studied by the medical records of the dental patient. The reason for the refusal to continue treatment before the rehabilitation of the mouth was studied by interviewing (telephone survey) of patients carried out by employees of private dental organizations (medical registrars). The activities of medical organizations, regardless of ownership, should include an in-depth analysis of statistical information, which is part of the management process in health care, ensuring the strengthening of public health and the effectiveness of the health system. Statistics reveal problems, priorities and challenges for the rational use of human, financial and logistical resources. In this regard, all offices of the organization must provide statistical data on their activities to the appropriate authorities and a range of socio-economic measures aimed at the final result of the dental Wellness of the population, strengthen the health and well-being of the person through the reorganization of the mouth.

scholarly journals Indicators Of Morbidity And Mortality From Diseases of the Digestive System in the Krasnodar Krai and the Quality of Medical Care for Gastroenterological Patients

2019 ◽  
Vol 29 (4) ◽  
pp. 30-37 ◽  
Author(s):  
N. V. Korochanskaya ◽  
V. M. Durleshter ◽  
O. V. Kovalevskaya ◽  
S. N. Serikova ◽  
K. I. Popandopulo
Keyword(s):  
Medical Care ◽  
Digestive System ◽  
Causes Of Death ◽  
Age Groups ◽  
Antiplatelet Agents ◽  
Krasnodar Krai ◽  
Digestive Diseases ◽  
Quality Of Medical Care ◽  
Inflammatory Drugs

Aim. To analyse the dynamics of morbidity and mortality from diseases of the digestive system, as well as the quality of medical care for gastroenterological patients in the Krasnodar Krai.Materials and methods. The analysis was carried out according to C 51 “Distribution of deaths by gender, age groups and causes of death” form of the Territorial Authority of the Federal State Statistics Service for the Krasnodar Krai for the period from 2006 to 2018, as well as on the basis of the “Demography” block database of the Parus software of the healthcare management system of the Krasnodar Krai for 6 months of 2019. 1341 medical records of patients receiving outpatient medical care and the medical records of people who had died from digestive diseases in 2017-2019 were reviewed.Results. Digestive diseases (DD) occupy the fourth place (7.1 %) in the structure of the general morbidity of the population in the Krasnodar Krai. Over the study period (13 years), the structure of mortality from DD has not changed significantly among the region’s population. About 70% of the causes of death from DD among people of working age account for liver diseases. The pathology of the pancreas takes the second place (13.5 %). The peptic ulcer of the stomach, duodenum and “other diseases of the digestive system” (8.8 % and 7.7 %, respectively) are represented in almost equal shares. In the etiological structure of liver cirrhosis, viral (39 %) and alcoholic (36 %) liver diseases are leading. The frequency of viral liver lesions tends to decrease, while the proportion of liver cirrhosis in the outcome of non-alcoholic fatty liver disease (NAFLD) progressively increase, having reached 7 % in 2017–2018. In the group of patients with inflammatory diseases of the pancreas, men prevail (66.9 %), often those abusing alcohol. The third leading cause of mortality from DD in the Krasnodar Territory is pathological conditions that occurred in the upper gastrointestinal tract (acute stomach ulcer, duodenal ulcer with bleeding, perforation) in older age groups taking antiplatelet agents and non-steroidal anti-inflammatory drugs (71.8 %). Conclusions. The main causes of death among the population of the Krasnodar Krai from diseases of the digestive system at a young age are alcohol consumption with unhealthy consequences. At the same time, people of older age groups die from a lack of prevention of ulceration and inadequate eradication of Helicobacter pylori in patients taking non-steroidal anti-inflammatory drugs and antiplatelet agents.

A STUDY OF SATISFACTION OF PATIENTS AND THEIR RELATIVES WITH THE QUALITY CONDITIONS OF STAY IN DEPARTMENT OF NURSING CARE

2019 ◽  
Vol 25 (2) ◽  
pp. 70-75
Author(s):  
N. V Polunina ◽  
V. S Polunin ◽  
Stepan E. Teptin
Keyword(s):  
Growth Rate ◽  
Medical Care ◽  
Nursing Care ◽  
Elderly Population ◽  
The Elderly ◽  
Active Ageing ◽  
Medical Assistance ◽  
Degree Of Satisfaction ◽  
Quality Of Medical Care

Currently active ageing of the population of the planet, the growth rate of the elderly population accounted for 2.6 per cent per annum. The purpose of the study is identify the satisfaction of patients of nursing care (ESG) and their relatives the terms stay in Office, as an indicator of the quality of medical care. Material and methods. Questioning 100 patients representative by sex and age had been treated in the overall composition of the OSU and 100 relatives of patients. Results. Of those surveyed 71.0% of patients were treated with three or more months, including 42% - more than six months. 15% of the relatives visited patients weekly, 25% - 2-3 once a month, 35.0% monthly, others once a month 2-3. Conclusion. The degree of satisfaction of patients and their relatives the terms stay in nursing Office high poll allows you to identify some of the defects in the Organization of medical assistance, which is not easy to identify when you use other forms of quality control of medical care.

USING THE PRINCIPLES AND TOOLS OF LEAN PRODUCTION IN ORGANIZING WORK IN THE CONTEXT OF PROVIDING MEDICAL CARE TO PATIENTS WITH COVID-19 INFECTION

2021 ◽  
Author(s):  
I.V. Kisel ◽  
◽  
T.M. Sharshakova ◽  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Business Processes ◽  
Lean Production ◽  
Pilot Project ◽  
Healthcare Management ◽  
Patient Treatment ◽  
Quality Of Medical Care ◽  
The Republic

Abstract. Introduction. Improving the efficiency of the use of public resources and the quality of medical care provided in modern conditions is becoming one of the priority tasks of science and healthcare management. In industry and the service sector, different management methods are successfully applied. Lean production is considered one such example in healthcare. Lean production is a management concept based on an unswerving commitment to eliminating all types of waste, continuous improvement of processes, improvement of organization and working conditions. One of the central provisions of Lean production is the concept of value for a patient and a medical worker in the performance of a medical service [1]. In the Republic of Belarus in 2019 the implementation of the pilot project of the Ministry of Health of the Republic of Belarus "Caring Polyclinic" was started, which was based on the principles and tools of lean production. The goal of the pilot project is to increase the satisfaction of consumers of medical services with the quality and availability of medical care by optimizing business processes and eliminating losses. Research methods: the study presents a process of providing health care to the population, which can be improved based on the principles of lean production. Possible directions of using the accumulated material on the application of the principles of lean production in the healthcare system in the context of COVID-19 are considered [2]. Studied and analyzed the original publications containing information on the features of the organization of medical care in a lean production [3]. Results. The concept of lean production is able to solve the main problems of organizing the work of primary health care and demonstrates the effectiveness of this approach for optimizing the business processes of providing medical care. The use of leanproduction technologies in a polyclinic allows not only to increase the throughput of the institution, increase labor productivity, but also to ensure the quality of medical care, to increase the satisfaction of patients and employees. Conclusion. The use of the principles and tools of lean production in healthcare provides an increase in the productivity and efficiency of medical workers, optimization of work processes, which leads to a reduction in the waiting time for patient services and a reduction in the duration of patient treatment, respectively, to improve the quality of medical care, reduce costs, and increase patient and employee satisfaction.

scholarly journals REGIONS WITH HIGH CONCENTRATION OF SINGLE-INDUSTRY TOWNS: PROBLEMS OF DATA QUALITY IMPROVEMENT

2018 ◽  
Vol 2018 (3) ◽  
pp. 62-68 ◽  
Author(s):  
И. Антонова ◽  
I. Antonova
Keyword(s):  
Statistical Data ◽  
Quality Of Data ◽  
High Concentration ◽  
Mathematical Methods ◽  
Single Industry ◽  
The Difference ◽  
Territorial Division ◽  
Zipf Law ◽  
Selective Character

With all the diversity of studies of single-industry towns’ development problems, little attention has been given to the quality of statistical data: neither the selective character of official statistics nor the difference between a single-industry town and a municipality are taken into account. The latter makes it impossible to use mathematical methods to simulate the spatial development of towns. The purpose of the current research is to identify the problems of assessment for regions with high concentration of monotowns and to introduce some ways of improving the quality of data by using the case of the Kemerovo region. Research methods include collection and grouping of data on the single-industry towns of the Kemerovo region taking into account the administrative-territorial division of the region, the construction of the logarithmic model of distribution of cities and towns according to the «rank-size» rule and evaluation compliance of the received distribution with the Zipf rule. As a result of research, the author proposes directions of improvement of data on towns and obtained results. In particular, the study specifies the conformity of Kuzbass towns to the Zipf law. The results can be applied in the field of forecasting and management of single-industry towns’ development at the regional level.

scholarly journals Avoidable mortality in the Russian regions

Stanovnistvo ◽  
2011 ◽  
Vol 49 (2) ◽  
pp. 1-23
Author(s):  
T.P. Sabgajda ◽  
A.E. Ivanova ◽  
V.G. Semenova ◽  
G.N. Evdokuskina
Keyword(s):  
Public Health ◽  
Medical Care ◽  
Malignant Tumors ◽  
Avoidable Mortality ◽  
Death Rates ◽  
Regional Health Care ◽  
Quality Of Medical Care ◽  
The Difference ◽  
Death Cases

The current trends of avoidable mortality, which is an integral indicator of health system performance, were analyzed. The paper discusses the regional heterogeneity of levels and trends in avoidable mortality in the Russian Federation. Also, it contains the analysis of impact of the financial costs of public health on avoidable mortality in regions with different levels of economic development. The last 20-years period was studied, which includes a stage of crisis as well as a social recovery phase. The official data of the State Statistics Committee were analyzed. In Russia, all death cases are registered in accordance to the international classification ICD-10. Special computer program summarizes death cases from preventable causes, and calculates the standardized rates for the population aged from 5 to 64 years. The old European standard of population age structure is used. Estimates of avoidable mortality were made in accordance with the European approach, under which avoidable mortality accumulates deaths of persons aged from 5 to 64 years due to 34 causes and 4 classes of causes. These 38 causes are divided into 3 groups according to three levels of diseases prevention. The level of avoidable mortality in the different regions varies up to 8 times. That is comparable to the difference between Russia and the countries of European Union in 1994. This gap is due to the coexistence of different stages of epidemiological development among the regions in Russia. When death rates increased, it is shown that mortality from causes which are preventable by measures of primary and tertiary prevention increased to a greater extent than mortality from the causes which depend from measures of secondary prevention. Therein, the largest growth of observed mortality was due to low quality of medical care in case of males (group 3), and due to causes which are preventable by measures of primary prevention in case of females (group 1). When mortality was reduced, the rates of change for causes in groups 1 and 3 were approximately the same for both sexes. Avoidable mortality due to late detection of malignant tumors (group 2) has been changed the least. Preventable component defines over 80% of the regional differences in death rates. In 2009, the level of avoidable mortality differed more than fourfold among different regions of the Russia. Similarly, the difference in the level of unavoidable mortality was 1.3-fold and 1.7-fold, for males and females respectively. Proportion of deaths from preventable causes in the total sum of death cases varies from 40% till 75%. Funding for comprehensive programs of public health to a greater extent stimulates the reduction in mortality from preventable causes of the first group. Mortality connected with quality of medical care is more determined by socio-political situation in the country than by regional health care expenses. Based on these results, it is concluded that the action plans to reduce mortality in Russia must have a strong regional specificity, different targets and indicators. Using the proportion of preventable causes, it is possible to separate the regions into groups with different ratios of death determinants, which, therefore, require different approaches to reduce mortality.

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