Organization of high-tech cardiac surgical medical care in the Ural Federal District.

Purpose. Carrying out medical and statistical analysis of morbidity and mortality of the population with malignant neoplasms, development of proposals for greater accessibility and areas of improvement of specialized including high-tech medical care (HTMC) for patients with cancer in the Moscow region.Materials and methods. The analysis of morbidity and mortality of the population of the Moscow region from malignant neoplasms and the organization of specialized, including high-tech, medical care to cancer patients on the basis of forms of Federal state statistical observations in relation to the three-level system of the organization of medical care to the population of the region with identification of organizational and financial problems.Results. The incidence of malignant neoplasms in the Moscow region in 2017 amounted to 364.9 per 100 thousand population, which is 1.0% below the level of 2016-365.9 per 100 thousand population and below the average for the Central Federal district and the Russian Federation. The mortality rate from neoplasms in the Moscow region decreased in 2017 to 174.7 cases per 100 thousand population, which is less than the average for the Central Federal district — 207.1 and the Russian Federation — 196.9 per 100 thousand population. At the same time, the volume of specialized medical care (including high — tech medical care) for malignant tumors, in a 24-hour hospital is more than twice the average Russian standard — 13% for SMC and 50% for HTMC. Exceeding the standard of medical care is mainly due to the HTMC 2, which is not planned in the subject of the Russian Federation and is usually in Federal clinics. The share of oncological medical care received outside the medical organizations of the MR is 16%, which exceeds the share of medical care in all other profiles received outside the Moscow region (12%). This situation contributes to the availability of cancer care to the population of the Moscow region.Conclusion. The performed work allowed to draw conclusions that in normative legal acts of Federal level it is necessary to define separately the standard of volumes of specialized, including hi-tech medical care, on the profile of Oncology. Large volumes of HTMC cannot be an unambiguous characteristic of the availability of medical care in General, since HTMC is medical care with the use of complex methods of diagnosis and treatment in clinically complex cases. Large volumes of HTMC can be a consequence of the complexity of clinical cases, but also a consequence of neglect of the disease due to the lack of diagnosis and treatment in the provision of primary health care (PHC) at the 1st level. In the Moscow region, there is a need to redistribute the volume of this medical care not only to cancer dispensaries, but also to other medical organizations. After that, there is a need for the distribution of patients, taking into account the morbidity in the territories, the place of residence of citizens, and taking into account the capabilities of medical organizations for the treatment of cancer patients (surgical treatment, chemotherapy, radiotherapy). Medical organizations of the subject of the Federation shall be ranked taking into account the applied technologies and opportunities of drug therapy. As a result, a clear routing of patients with cancer should be developed in the subject of the Russian Federation.

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The rationale for dislocation of interregional specialized surgical care centers for children in the Russian Federation

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic694 ◽

2020 ◽

Vol 10 (3) ◽

pp. 263-274

Author(s):

Vladimir M. Rozinov ◽

Dmitriy A. Morozov ◽

Sergey A. Rumyantsev ◽

Nikolay N. Vaganov ◽

Vladimir I. Petlakh ◽

...

Keyword(s):

Thoracic Surgery ◽

Medical Care ◽

Russian Federation ◽

Current System ◽

Surgical Care ◽

Federal District ◽

Urgent Care ◽

High Tech ◽

Universal Method ◽

The Russian Federation

Introduction. In Russia, there is a need to reorganize the system of providing specialized surgical care to children, primarily in emergency and urgent care and in remote, sparsely populated, and hard-to-reach areas. This need is evidenced by the significant persisting disparities in the mortality rate in the countrys various regions. Purpose of the study. This study aims to provide multifactorial substantiation of the expediency, profile, and location of specialized (surgical) interregional centers (MRC), including high-tech, medical care for children, by the priority profiles of activity, about medical organizations of the federal districts (FD) of Russia. Materials and methods. The study design included a two-level (regional and federal) system of professional expertise and justification in terms of the profile, location, and area of responsibility of the MRC in the federal district of the country. At the regional level, Delphi technology was implemented with a mathematical and statistical analysis of 103 expert opinions from 85 constituent entities of Russia, the result of which activities priority profiles were substantiated (newborn surgery, neurosurgery, thoracic surgery, oncology, combustiology) and patient routing preferences. At the second stage of the work, with the involvement of federal experts, the SWOT analysis technology was implemented as a universal method of strategic planning, with the justification of the location and number of MRCs in individual FD of the country, about specific medical organizations where they are based. For an objective (quantitative) assessment of the provision of the Federal District of Russia with the MRC of specialized medical care for children according to the established profiles of activity, we have proposed a calculated indicator the regional contingency coefficient (CRC), representing the ratio of two uniformly calculated values the number of MRCs and regions in a particular Federal District, or the country as a whole. Results. The consolidated position of federal experts regarding the location of the MRC was formulated according to the established profiles of activity about FD and specific medical organizations in the Russian Federation constituent entities. The cattle in the profile of the activity of neonatal surgery was 0.14, and about neurosurgery, thoracic surgery, and oncology, respectively, 0.12, 0.11, and 0.11 for Russia as a whole. The lowest (0.09) cattle in the country characterized the situation with the combustiology profile. In the overwhelming majority (76.0%), the location of the MRC is tied to the administrative centers of the Federal District or cities of federal significance. Among the 50 MRCs of all priority profiles, 43 (86%) were potentially designated by experts based on multidisciplinary pediatric medical organizations. Discussion. The effectiveness of the MRC functioning is due to the organization of medical and evacuation support for children with diseases and injuries. The development of consultative and resuscitation centers in the primary hospital structure is promising. Its functionality, along with remote counseling, treatment, and evacuation activities, includes monitoring the condition of sick and affected children at the place of primary hospitalization. An alternative is a presence on the clinical base of the MRC of a structural unit or a branch of the regional center for emergency medical care and disaster medicine. Conclusion. Overcoming the inequality in the availability and quality of medical care for children in certain FD and regions of Russia is necessary to reorganize the current system of staged medical care. Optimal logistics of medical and evacuation support for specialized patients and injured people include the MRC as a collector for children in need of specialized care, including high-tech medical care, with the implementation of the predominant principle of evacuation of oneself.

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Results of medical work in 2020 of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-1-18-24 ◽

2021 ◽

pp. 18-24

Author(s):

O.V. Kolenko ◽

◽

V.V. Egorov ◽

M.V. Pshenichnov ◽

O.A. Pryadko ◽

...

Keyword(s):

Medical Care ◽

Far East ◽

Federal District ◽

State Institution ◽

Federal State ◽

High Tech ◽

The Novel ◽

Medical Work ◽

Novel Coronavirus ◽

Far Eastern

Purpose. Analysis of organization and results of medical work in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (Khabarovsk Branch) in the context of a pandemic of the novel coronavirus disease (COVID-19) in 2020. Material and methods. The analysis of regulatory documents adopted in the Russian Federation, Khabarovsk Krai, and orders of the Director of the Khabarovsk Branch to ensure epidemiological wellbeing in organization of treatment process was carried out. Results. The developed complex of anti-epidemic measures to ensure epidemiological wellbeing at provision of emergency and planned ophthalmological care to residents of the Far Eastern Federal District of Russia made it possible in 100% of cases to fulfill the state task for the provision of high-tech medical care. The total volume of medical care for ophthalmological diseases in the Khabarovsk Branch as a whole decreased by 18,9%. It should be noted that the same trend was observed in all branches of the S. Fyodorov Eye Microsurgery Federal State Institution. Conclusion. Despite the problems that COVID-19 brought to work of the Khabarovsk Branch, it still fulfilled its mission, as defined by S. Fyodorov - to bring light and goodness to people living in the Far East of Russia. Key words: ophthalmology, medical work, hightech medical care, COVID 19, SARS-CoV-2, pandemic, organization of medical care, ocular emergency.

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Some indices characterizing medical care to children with cancer in the Russian Federation

Russian Journal of Oncology ◽

10.18821/1028-99842016-21-3-146-150 ◽

2016 ◽

Vol 21 (3) ◽

pp. 146-150

Author(s):

Maksim Yu. Rykov ◽

N. A Susuleva ◽

V. G Polyakov

Keyword(s):

Medical Care ◽

Russian Federation ◽

Pediatric Oncology ◽

Federal District ◽

Controlled Study ◽

High Tech ◽

North Caucasus ◽

Children With Cancer ◽

The North ◽

The Russian Federation

Introduction. The large size of the Russian Federation, different size and density of the child population in the regions of the country require for careful planning organization of care for children with cancer and the rational use of available resources, since in spite of the significant progress made in pediatric oncology, malignant neoplasms (External testing) are the second most common cause of the death in children. Purpose of the study. Perfection of the organizational-methodological approaches to care for children with cancer in Russia in order to improve the quality and effectiveness of treatment. Material and methods. In a non-randomized non-controlled study there were included reports of regional ministries and departments of health from 83 subjects of the Russian Federation for 2013. Results. The highest incidence rate of malignant tumors (per 100,000 ofpopulation agedfrom 0 to 17 years) was registered in the Lipetsk region - 21.7, the lowest - in the Republic of Tyva - 5.5. The number of patients newly diagnosed in 2013 was the highest in the Central and Volga Federal Districts - 775 and 653, respectively. The smallest - in the Far Eastern Federal District - 138. The number of primary patients referred to the federal clinic, was the largest in the North Caucasus Federal District (North Caucasus Federal District) - 80%, the lowest - in the South - 32.5%, the largest number of doctors who do not have primary specialization in “Children’s oncology”, was registered in the North Caucasus Federal District and the Volga Federal District - 50%, the lowest - Urals - 14.2%. Total in Russia 51 children’s oncological department operate, while the number of beds in which we treat these patients, including beds in non-core branches is 2021. 390 doctors treat children with cancer, out of which 252 (64, 6%) did not have a certificate in pediatric oncology. In 2013, 33 78 children were registered with the External testing, 1705 (50.5%) of them were directed for the management in federal clinics. Conclusion. It is necessary to improve further the existing vertical provision of high-tech medical care for children with cancer, the creation of regional cancer registers, certification of specialists and the quality control of medical care through the implementation of internal and external audit.

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Meaning of innovative technologies for improvement of results in treating burned patients

Medical alphabet ◽

10.33667/2078-5631-2020-13-44-47 ◽

2020 ◽

pp. 44-47

Author(s):

A. A. Alekseev ◽

A. E. Bobrovnikov ◽

V. V. Bogdanov

Keyword(s):

Clinical Practice ◽

Medical Care ◽

Clinical Effectiveness ◽

High Tech ◽

Comprehensive Treatment ◽

Case Histories ◽

Innovative Technologies ◽

Treatment Technologies ◽

Burn Disease ◽

Complications And Mortality

In order to include innovative technologies in clinical recommendations, confirmation of their clinical effectiveness in comprehensive treatment of burned patients is necessary. 1,696 case histories of patients with burns were audited, which are divided into two groups depending on peculiarities of treatment. The use of innovative treatment technologies for burned patients has reduced the incidence of burn disease complications and mortality. Introduction of innovative technologies in treating burned patients into broad clinical practice improves results of provision of specialized, high-tech medical care for victims of burns.

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MANAGEMENT OF MEDICAL CARE FOR CHILDREN WITH CANCER IN THE REGION № 2, THE VOLGA FEDERAL DISTRICT

Oncopediatrics ◽

10.15690/onco.v4i1.1680 ◽

2017 ◽

Vol 4 (1) ◽

pp. 17-24

Author(s):

M. Yu. Rykov ◽

E. N. Baibarina ◽

O. V. Chumakova ◽

V. G. Polyakov

Keyword(s):

Medical Care ◽

Federal District ◽

Children With Cancer

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Medical Care for Children with Cancer in the Donetsk People’s Republic: Results of an Ecological Study in 2014–2017

Oncopediatrics ◽

10.15690/onco.v5i3.1932 ◽

2018 ◽

Vol 5 (3) ◽

pp. 145-154

Author(s):

M. Yu. Rykov ◽

I. N. Inozemtsev ◽

S. A. Kolomenskaya

Keyword(s):

Medical Care ◽

Pediatric Patient ◽

Ecological Study ◽

Medical Service ◽

Care Delivery ◽

Benign Tumors ◽

High Tech ◽

Malignant Neoplasms ◽

Children With Cancer ◽

Patient Capacity

Background.Analysis of medical care delivery for children with cancer in armed conflict is highly important because the high-tech treatment in this context is extraordinary difficult and challenging task. Objective. Our aim was to analyze the morbidity and mortality rates in children with malignant tumors, to assess the pediatric patient capacity and medical service density in the Donetsk People’s Republic.Methods.The ecological study was conducted where the units of analysis were represented by the aggregated data of the Republican Cancer Registry on the number of primary and secondary patients with malignant and benign tumors, the deceased patients in the DNR in 2014–2017, pediatric patient capacity, and medical service density.Results.The number of pediatric patient capacity for children with cancer was 10 (0.27 per 10,000 children aged 0–17), pediatric patient capacity for children with hematological disorders — 40 (1.37 per 10,000 children aged 0–17). The treatment of children with cancer was performed by 5 healthcare providers: 1 pediatric oncologist (0.02 per 10,000 children aged 0–17), 3 hematologists (0.08 per 10,000 pediatric population aged 0–17), and 1 practitioner who did not have a specialist certificate in oncology. Morbidity rate for malignant neoplasms from 2014 to 2017 decreased by 25% (in 2014 — 9.6 per 10,000 children aged 0–17; in 2017 — 7.2). In the morbidity structure, the incidence proportion of hemoblastoses was 68.4%, brain tumors — 2.6%, other solid tumors — 29%. The death rate due to malignant neoplasms decreased by 37% (in 2014 — 2.7; in 2017 — 1.7).Conclusion.Low levels of the incidence rate and pattern of morbidity indicate defects in the identification and recording of patients. This explains the performance of the bed: low average bed occupancy per year and low turnover. For a reliable analysis of mortality statistical data is not available: in 2014–2015 only the number of in-hospital deceased patients is presented. Limited data is due to the lack of reliable patient catamnesis which is explained by the high rate of population migration.

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