DISADVANTAGES IN THE ORGANIZATION OF OUTPATIENT AND POLYCLINIC SERVICES IN THE FIELD OF MAXILLOFACIAL SURGERY FOR ADULTS AND CHILDREN IN THE GBUZ PENZA REGIONAL CLINICAL HOSPITAL NAMED AFTER V.I. N.N. BURDENKO FOR THE PERIOD 2018 -2020

2021 ◽  
pp. 6-12
Author(s):  
Lebedev M.V. ◽  
Zakharova I.Yu.
Keyword(s):  
Medical Care ◽  
Outpatient Care ◽  
Single Case ◽  
Care Service ◽  
Maxillofacial Surgery ◽  
Outpatient Service ◽  
The State ◽  
Medical Documentation ◽  
Clinical Hospital

The availability and quality of medical care is determined by the state of primary health care. Optimization and development of outpatient care is the primary task of healthcare. For the Penza region, according to the resolution of the Government of the Penza region of 02.10.2013 N 743-PP, improving the quality of outpatient care in the field of maxillofacial surgery and increasing its availability is one of the primary tasks for our region. In this regard, the assessment of the work of the outpatient office of the Department of Maxillofacial Surgery of the Consultative Polyclinic of the State Budgetary Healthcare Institution of the Penza Regional Clinical Hospital named after V.I. N.N. Burdenko. Aim: to analyze the work and effectiveness of a dentist - surgeon in the outpatient office of the consultative polyclinic GBUZ Penza Regional Clinical Hospital named after V.I. N.N. Burdenko. Materials and methods. To achieve this goal, a retrospective analysis of the primary accounting and reporting medical documentation for 2018–2020 was carried out, a questionnaire survey of patients hospitalized through an outpatient office in the Department of Maxillofacial Surgery of the N.I. N.N. Burdenko. Statistical data analysis procedures were carried out using MS Office Excel 2010 spreadsheets and PASW Statistics 18 statistical software package. Results. The analyzed accounting and reporting medical documentation for 2018–2020, the results of the questionnaire indicate the ineffective work of the doctor surgeon - dentist in the outpatient office of the consultative polyclinic GBUZ POKB im. NN Burdenko, the workload of the department with non-core hospitalizations, the increased workload on doctors - the department of maxillofacial surgery. The ways of solving the problem of replacing a dentist-surgeon with a doctor-maxillofacial surgeon are proposed; on the organization of a rehabilitation room for patients of the adult and pediatric population with pathology of the maxillofacial region; to create a single case history. Conclusion. Carrying out the above changes will reduce the burden on doctors - maxillofacial surgeons of the Department of Maxillofacial Surgery, transfer some of the manipulations from the inpatient to the outpatient service (inpatient replacement technology), thereby improving the medical care service in the field of maxillofacial surgery in the Penza region.

ANALYSIS OF THE STRUCTURAL AND ORGANIZATIONAL RESTRUCTURING OF MEDICAL CARE FOR PEDIATRIC MAXILLOFACIAL SURGERY IN THE PENZA REGION IN 2021

2021 ◽  
pp. 76-82
Author(s):  
Lebedev M.V. ◽  
Zakharova I.Yu. ◽  
Kerimova K.I.
Keyword(s):  
Medical Care ◽  
Economic Effect ◽  
Maxillofacial Surgery ◽  
Maximum Efficiency ◽  
Technical Equipment ◽  
Organizational Restructuring ◽  
Clinical Hospital ◽  
Medical University ◽  
Surgery Center

The annual increase in patients and increased requirements for the quality of medical care lead to the reorganization of the work of various departments of medical hospitals. In order to improve the quality and accessibility of specialized medical care in the profile "maxillofacial surgery" in the territory of the Penza Region, in 2020, the structure of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko will be reorganized, which allows solving a number of existing problems. An important direction in the modernization of the Center was the structural and organizational restructuring. The purpose of the study: to analyze the quality and effectiveness of providing care to children with pathology of the maxillofacial region by doctors of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko. Materials and methods. A comprehensive assessment of the quality of care for children with maxillofacial pathology from 2018-2020 in the Penza region and in the period from November 2020 to July 2021 was carried out. Center of Maxillofacial Surgery of the N. N. Burdenko State Medical University. Results and discussion. Having analyzed the existing shortcomings and problems, established connections, the growth of patients in need of treatment by a maxillofacial surgeon contributed to the opening of the Maxillofacial Surgery Center in the N. N. Burdenko State Medical University, which included 10 specialized children's beds; 2 ultra-short stay beds; an outpatient office; a rehabilitation room; material and technical equipment, tools, medicines for children; maxillofacial surgeon, pediatrician, pediatric dentist, general dentist, clinical nurses, speech therapist. Conclusion. The opening of the Maxillofacial Surgery Center in the Penza region has shown high efficiency. The economic effect in obtaining specialized treatment due to the work of an outpatient office and a rehabilitation office based on a patient-oriented model is noted. In order to achieve maximum efficiency and fully meet the need for providing medical care to the children's population of the Penza region in the profile "maxillofacial surgery", it is necessary to open a department of pediatric maxillofacial surgery due to the projected workload of open beds.

Frequency and structure of purulent inflammatory diseases of the maxillofacial region

2020 ◽  
pp. 73-84
Author(s):  
B. K. Normurodov ◽  
J. A. Djuraev ◽  
A. Z. Shaumarov ◽  
J. M. Akhmedov
Keyword(s):  
Medical Care ◽  
Inflammatory Diseases ◽  
Maxillofacial Surgery ◽  
Medical Documentation ◽  
Oral And Maxillofacial Surgery ◽  
Maxillofacial Region ◽  
Factors Affecting ◽  
Medical Academy ◽  
Multidisciplinary Clinic

The frequency and structure of purulent-inflammatory diseases of maxillofacial region are analyzed. Medical documentation of patients with purulent-inflammatory diseases of maxillofacial region was studied. According to the Department of Oral and Maxillofacial Surgery, multidisciplinary clinic of Tashkent medical academy (TMA) from period 2017–2018yy. specialized medical care for purulent-inflammatory diseases was provided to 593 patients. Some causes of the development of purulent-inflammatory diseases are determined taking into account the spectrum of identified microorganisms. Factors affecting of timing and quality of treatment of purulent inflammatory diseases have been established.

IRRATIONAL USE OF MEDICINES IN MEDICAL ORGANIZATIONS OF THE VOLGA FEDERAL DISTRICT. (ON THE EXAMPLE OF THE PENZA REGIONAL CLINICAL HOSPITAL NAMED AFTER N. N. BURDENKO, WHEN PROVIDING SPECIALIZED CARE TO CHILDREN IN THE CONDITIONS OF THE ADULT DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY)

2021 ◽  
pp. 168-175
Author(s):  
Lebedev M.V. ◽  
Abdullina Y.A. ◽  
Zakharova I.Y.
Keyword(s):  
Medical Care ◽  
Maxillofacial Surgery ◽  
Federal District ◽  
Oral And Maxillofacial Surgery ◽  
Medical Organization ◽  
Maxillofacial Region ◽  
Clinical Hospital ◽  
Specialized Care ◽  
Rational Therapy ◽  
Medical Histories

The issues of financing in a medical organization are one of the most relevant areas of healthcare in the Russian Federation. Providing departments with the necessary financial resources to provide effective and accessible medical care to the population is important for both the administration and doctors and nurses. In some regions of the Volga Federal District, the departments are combined (Penza, Saransk), that is, all types of medical care are provided to both adults and children in one place, which leads to a number of problems associated with the irrational use of medicines. One of these is the department of Maxillofacial Surgery of the N.N. Burdenko National Clinical Hospital, on the basis of which the disadvantages of using drugs for parenteral use are considered. The purpose of this work is an economic analysis of the effectiveness of the use of solutions for parenteral use in children on the basis of an adult medical organization. The materials of the study were data from patients ' medical histories, prescribing lists, invoices from the pharmacy organization, and data on the cost of medicines. The results of the work are an analysis of the existing problems of combined type departments related to drug provision, a number of medicines for parenteral use that are not available to order, but are included in the standards of treatment of children with injuries of the maxillofacial region. The ABC - analysis of expenses under the item "medicines" is calculated, the data of the VEN – analysis is presented, which includes vital, necessary and secondary medicines for the treatment of children with injuries of the maxillofacial region. An algorithm for the selection of effective and rational therapy has been developed, using the example of antibacterial agents for parenteral administration.

scholarly journals PATHOLOGY OF WISDOM TEETH AS THE REASON OF APPEALABILITY OF THE MILITARY PERSONNEL BEHIND THE MEDICAL CARE

2017 ◽  
Vol 13 (4) ◽  
pp. 44-49 ◽  
Author(s):  
Андрей ИОРДАНИШВИЛИ ◽  
Andrey IORDANIShVILI ◽  
Никита Коровин ◽  
Nikita Korovin ◽  
Евгения Веретенко ◽  
...  
Keyword(s):  
Medical Care ◽  
Military Personnel ◽  
Maxillofacial Surgery ◽  
Medical Documentation ◽  
Case Histories ◽  
Medical Organization ◽  
Wisdom Teeth ◽  
The Military ◽  
Military Units ◽  
Patient Department

In work, on the basis of the analysis of primary medical documentation and the analysis of 8180 addresses of the military personnel at the call of and to the contract at the age of 18 – 55 years in stomatologic offices of military units and a dental out-patient department, and also 4498 case histories of unit of maxillofacial surgery and an odontology of the military-medical organization the frequency and structure of diseases of wisdom teeth at planned or urgent appealability is studied. It is established that diseases of wisdom teeth and pathology of their eruption are one of the main reasons for appealability of the military personnel to the dentist as in an army link (2,5-8,5% of cases), and in a dental out-patient department (4,4-5,25% of cases). In the conditions of unit of maxillofacial surgery and an odontology of a versatile hospital at the military personnel diseases of wisdom teeth make from 2,2% and 5,3%, at the same time at them pathology of the lower wisdom teeth meets more often (from 17,6% to 16,2% of cases), at the same time the vast majority of the servicemen are hospitalized according to urgent indications in connection with pathology of a teething of wisdom or an exacerbation chronic periapical or the parodontal of the centers of a dontogenous infection.

scholarly journals ON THE QUESTION ORTHODONTIC MEDICAL RECORDS COMPLETION WHEN DENTOALVEOLAR ANOMALIES AND DEFORMATIONS DIAGNOSING

2017 ◽  
Vol 25 (2) ◽  
pp. 279-288
Author(s):  
A. K. Lapina ◽  
O. N. Arharova ◽  
T. S. Rodina ◽  
V. D. Vagner
Keyword(s):  
Medical Care ◽  
Medical Records ◽  
Treatment Plan ◽  
Medical Documentation ◽  
Conflict Situations ◽  
Quality Of Medical Care ◽  
Main Instrument ◽  
The Moment ◽  
Medical University

Correct registration of primary medical documentation is very important for storage of diagnostic information, the treatment plan, information about the carrying out of medical manipulations for the elimination of dentofacial anomalies, for examination of quality of medical care in conflict situations. Medical card of the orthodontic patient (form 043- 1/у), approved by order of Ministry of Health of the Russian Federation On approval of unified forms of medical records used in medical organizations providing medical care in outpatient conditions and procedures for their filling from 15.12.2014, №834 is the main document of the orthodontist. At the moment, two years after the release of the order, you need to find out whether approved new medical report form in hospitals with orthodontic care, to determine the property of filling as the main instrument used for examination of quality of medical care provided. The article presents the results of the retrospective analysis of medical cards of the patients receiving orthodontic treatment in the dental clinic at Ryazan State Medical University. Found that detailed and properly designed, only 16,0% of medical cards. Orthodontists don't pay enough attention to the medical history, examination of patients, the conduct of clinical trials and the use of special additional methods of examination of patients, such as cephalometry and functional diagnostics.

scholarly journals FORENSIC MEDICAL AND LEGAL ASPECTS OF THE PROVISION OF MEDICAL CARE IN OBSTETRICS AND GYNECOLOGY

2020 ◽  
Vol 16 (2) ◽  
pp. 40-44
Author(s):  
A.O. Pletenetska
Keyword(s):  
Infant Mortality ◽  
Medical Care ◽  
Causal Relationship ◽  
Postpartum Period ◽  
The State ◽  
Unfavorable Outcome ◽  
Medical Examination ◽  
Medical Documentation ◽  
Court Decisions ◽  
Causal Connection

Relevance. Sometimes statistics on medical errors are hushed up, and information about individual incidents becomes known thanks to the media. Objective: to identify the most common obstetric-gynecological profile defects and their causes by analyzing the data of the State Statistics Service on maternal and infant mortality during pregnancy, childbirth, and the postpartum period and compare it with the forensic analysis of obstetric-gynecological profile medical care. Materials and methods. 625 cases were analyzed according to the State Statistics Service on maternal and infant mortality during pregnancy, childbirth and the postpartum period, court sentences in criminal cases under Articles 139 and 140 of the Criminal Code of Ukraine, according to the Unified State Register of Court Decisions of Ukraine since 2009 in 2019, as well as data from forensic medical examination commissions on “medicinal matters” for 2013-2019 performed by the State Institution “Main Bureau of Forensic Medical Examination of the Ministry of Health of Ukraine”, including cases of previous departmental audits by the commissions of the Health Administration. The data obtained were subjected to statistical processing by standard methods of descriptive statistics. Results. In these 255 examinations, defects in the provision of medical care were found by expert commissions in 186 cases, which amounted to 72.9%. Moreover, of these "defective cases", 62.9% (117 cases) were in a direct causal relationship with an unfavorable outcome; 35.5% (6 cases) - in some deficiencies that did not have a causal relationship with the onset of fetal death. In 3 cases of examinations in gynecology, there were contradictions in the entries in the medical documentation, they did not allow assessing the quality of medical care and the relationship with the consequences. At the pre-hospital stage (in the clinic), defects were allowed in 65.5%, and at the hospital - in 72.8%. In the presence of departmental inspections in 23%, there was a complete coincidence of the results of the conclusions of the commissions of the bureau of forensic medical examination and medical examination, and only in cases of significant defects in direct causal connection with the consequences. At the same time, when analyzing 53 court sentences according to the register of court decisions, it turned out that 13 of them related to the obstetric and gynecological profile, and 12 of them were indictment. In all cases, the source of evidence in cases was exclusively the “Expert Conclusions”. Conclusions. It was found that forensic medical examinations for the provision of obstetric and gynecological medical care occupy a leading place in the overall structure of commission examinations in “medical matters”, in the vast majority of examinations, defects in the provision of medical care were found that were in direct causal connection with an unfavorable outcome.

scholarly journals The justice as key principle of humanitarian model of quality management of health care system from position of sociology of medicine

2016 ◽  
Vol 15 (1) ◽  
pp. 41-47
Author(s):  
N. G Kaleva ◽  
O. F Kalev
Keyword(s):  
Health Care ◽  
Quality Management ◽  
Medical Care ◽  
Medical Documentation ◽  
Rural Regions ◽  
Large Cities ◽  
Rural Districts ◽  
Sociology Of Medicine ◽  
Quality Of Medical Care

The problem of detection, measurement, evaluation and elimination of inequity and injustice related to health continues to be unresolved in all countries. The study was carried out to evaluate situation related to quality of medical care in primary health care at the regional level and to determine means of its amelioration on the basis of humanitarian model of system of quality management from positions of sociology of medicine. The materials of territorial foundation of mandatory medical insurance of the Chelyabinskaia oblast were taken as basis for analysis. The sampling consisted of 54 383 acts of expertise of quality of medical care, including 42 998 expertises of medical care provided by pediatricians and 61 860 by therapists. The design related to type of clinical audit of medical documentation of completed case in polyclinic practice. The significant differences were established concerning rate of defects of quality of medical care in oblast centers, large cities, towns ans rural regions. The phenomenon of sub-optimization of quality of medical care in towns, and rural districts during period of financing increase of health care is established. The results of study testify availability of injustice in issues of health care of population residing in unfavorable social economic conditions. To support justice related to health the concept of humanitarian model of system of management of quality from positions of sociology of medicine was developed.

THE PEDIATRICIAN AND THE PUBLIC

PEDIATRICS ◽  
1948 ◽  
Vol 1 (3) ◽  
pp. 416-425
Keyword(s):  
Medical Care ◽  
Low Income ◽  
Common Ground ◽  
Medical Profession ◽  
Health Department ◽  
The State ◽  
Professional Groups ◽  
Income Groups ◽  
Low Income Groups

Maryland has developed a highly effective instrument for analyzing and developing plans to meet health and medical needs through the standing Committee on Medical Care of the State Planning Commission. One of the recommendations of this committee has resulted in development of a Medical Care Program for low income groups in the counties. Administration of this program has been worked out jointly by the Health Department, which is the administrative agency, and the professional groups which are called upon to provide the services. The program assures persons in low income groups of access to a type and quantity of medical care which is about on a par with the care which is generally available in the community for patients who can afford to pay. Physicians are assured of reasonable payment for their services to this group, and are thus relieved of a heavy burden of charity practice. Through development of new diagnostic laboratory facilities in branch laboratories of the Health Department, development of consultation clinics, and through extension of bedside nursing care, the program promises to have a favorable influence on the quality of care provided. The program offers numerous other opportunities for experimentation in methods of improving the quality of medical care. The endorsement of the program by the medical profession represents an important landmark in Maryland. It represents the finding of a common ground of agreement as regards medical care between the State government and the medical profession. The responsibility of government to provide care for the medically indigent is clearly recognized, and a framework is established for a developing partnership between government and the profession, with the goal of bringing high quality care to a group of the population who in the past have received grossly inadequate medical care. The importance of this common ground of agreement between government and the medical profession cannot be overemphasized. The discussion of public medical care has frequently been so inflamed by proposals totally unacceptable to professional groups that many have gained the impression that cooperation toward a common goal is impossible. Professional groups resist sweeping proposals placing government in a dominant position in medicine because they are afraid of what it will do to them as individuals and as professional groups. This seeming impasse can be resolved if agreement can be achieved on limited programs and if government can administer these limited programs in such a way as to provide improved services through administrative methods acceptable to physicians, dentists, and hospitals. Mutual confidence of professional groups and government will be gained, not by angry debate, but by cooperative exploration of areas of agreement.

RESULTS OF OPTIMIZATION OF THE MEDICAL CARE SERVICE FOR THE ADULT POPULATION OF THE PENZA REGION IN THE PROFILE "MAXILLOFACIAL SURGERY" IN 2021

2021 ◽  
pp. 131-137
Author(s):  
Lebedev M.V. ◽  
Kerimova K.I. ◽  
Zakharova I.Yu.
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Maxillofacial Surgery ◽  
Technical Equipment ◽  
Medical Organization ◽  
High Quality ◽  
Maxillofacial Region ◽  
Care System

The increase in the number of patients with pathology of the maxillofacial region necessitates improving the quality of medical care provided to the population in the field of "Maxillofacial surgery". Anatomical and physiological features of the maxillofacial region, the prevalence of pathology determine the implementation of organizational measures, the involvement of narrow specialists, the need for medical organizations in modern material and technical equipment. The indicators of medical care mainly depend on a full-fledged diagnosis, and are also determined by the availability, quality and speed of specialized medical care. In modern conditions of the development of the health care system, an integrated approach to the organization, the introduction of new methods of providing medical care and rehabilitation of patients is required. Optimization of the maxillofacial surgery service within a multidisciplinary medical organization, the introduction and development of an outpatient polyclinic link, the training of highly qualified personnel contribute to improving the quality of diagnosis, treatment and timely detection of pathology. This article presents the results of optimizing the service for providing medical care to patients with pathology of the maxillofacial region. In the Penza region, the full-fledged, high-quality functioning of the service is realized through the organization of the Center for Maxillofacial Surgery on the basis of the State Budgetary Healthcare Institution «Penza Regional Clinical Hospital named after N.N. Burdenko». The structure of the Center for Maxillofacial Surgery ensures the continuity and complementarity of specialists of a medical organization in the treatment and diagnostic process. Optimal conditions have been created for the diagnosis, treatment and rehabilitation of patients with pathology of the maxillofacial region, in order to provide the population with affordable and high-quality medical care, regardless of the category of citizens. The creation of the Center for Oral and Maxillofacial Surgery contributes to an increase in the structural efficiency and medical efficiency of the health care system of the Penza region. The results of the measures and innovations carried out can be used to eliminate the existing shortcomings in the organization of medical care for patients with pathology of the maxillofacial region in other regions.

scholarly journals The evaluation of quality of medical care and labor process according results of survey of physicians

2019 ◽  
Vol 60 (6) ◽  
pp. 293-297
Author(s):  
S. V. Evstigneev ◽  
Valery V. Vasilyev
Keyword(s):  
Medical Care ◽  
Labor Process ◽  
Working Process ◽  
Clinical Hospital ◽  
Survey Results ◽  
Quality Of Medical Care

The article presents results of sociological survey of opinions of physicians concerning quality of medical care and working process in the N.N. Burdenko Penza regional clinical hospital. The factors mainly impacting these appraisals. The survey results testify alteration in positive way the opinions of physicians concerning this problem as following increasing of level of organization of medical care in hospital.

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