scholarly journals ОСНОВНІ ХАРАКТЕРИСТИКИ СИСТЕМИ ВЗАЄМОДІЇ МЕДИЧНИХ ЗАКЛАДІВ В МЕЖАХ ОДНОГО ГОСПІТАЛЬНОГО ОКРУГУ

2020 ◽  
pp. 11-18
Author(s):  
Стовбан Микола Петрович ◽  
Стовбан Ірина Василівна
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Medical Care ◽  
Strategic Decisions ◽  
Local Authorities ◽  
Prospective Development ◽  
Hospital District ◽  
Functional Association ◽  
Development Plans ◽  
Area Health

The article examines the concept of "hospital district". Broad participation of hospital districts requires the implementation of effective forms of partnership in planning and taking strategic decisions on their development. The hospital districts are created to organize a network of health care institutions in the region, in a way that will provide systematic interaction between members of the hospital district, as well as with providers of other types of care (primary, tertiary (highly specialized) medical care, palliative care and rehabilitation), pharmaceutical services. Boundaries and composition of each district are formed on the basis of criteria of the district, they are established by the Procedure for the creation of hospital districts. The hospital districts are created as "a functional Association of hospitals located in a particular area". Health establishments, which belong to the hospital district, remain in the ownership and subordination of local authorities who are members of the hospital district. To improve secondary healthcare, Hospital Council are created with the aim of coordinating actions, devising ideas the on organization and operation of medical care within a separate hospital district, preparation and confirmation of the prospective development plans of hospital districts for 5 years (taking into account the needs of modernization and resources).

Rendering Pediatric Palliative Medical Care on Outpatient Basis

2016 ◽  
Vol 7 (2) ◽  
pp. 154-157
Author(s):  
Alexander E Tkachenko ◽  
Irina V Kushnareva
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Comparative Analysis ◽  
Medical Care ◽  
Pediatric Palliative Care ◽  
Outpatient Basis ◽  
Current Health ◽  
Health Care Legislation ◽  
Palliative Medical Care

The article discusses the complexity of interpretation of the current health care legislation in relation to the provision of pediatric palliative care on outpatient basis. It also introduces a comparative analysis of the current legislation and represents amendment proposals.

THE INTER-DISCIPLINARY CONCEPTUALIZATION OF PALLIATIVE CARE AS A SOCIAL SUB-INSTITUTION

2017 ◽  
Vol 16 (2) ◽  
pp. 68-71
Author(s):  
I. L Krom ◽  
M. V Erugina ◽  
E. A Andriyanova ◽  
A. B Shmerkevitch
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Medical Care ◽  
Social Institution ◽  
Structural Functions ◽  
Social Structural ◽  
Palliative Medical Care

The health care is considered as a social institution since XX century. The main purpose of health care is in amelioration, rehabilitation and promotion of health. This social institution, according to its implementing functions, comprises four sub-institutions. The analysis of trends of institutionalization of the sub-institution «Palliative medical care» is presented in methodological plane of system of social structural functions (AGIL). From the perspective of dysfunctional practices of sub-institution of palliative medical care developing in Russia, a medicalization of palliative care is discussed.

scholarly journals Ethical and Social Issues for Health Care Providers in the Intensive Care Unit during the Early Stages of the COVID-19 Pandemic in Japan: a Questionnaire Survey

2021 ◽  
Author(s):  
Yusuke Seino ◽  
Yayoi Aizawa ◽  
Atsushi Kogetsu ◽  
Kazuto Kato
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Intensive Care ◽  
Medical Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
Social Issues ◽  
Free Text ◽  
Care Providers

AbstractThis questionnaire-based observational study was conducted in July 2020 with the aim of understanding the ethical and social issues faced by health care providers (HCPs) registered with the Japanese Society of Intensive Care Medicine in intensive care units (ICUs) during the coronavirus disease (COVID-19) pandemic. There were 200 questionnaire respondents, and we analyzed the responses of 189 members who had been involved in COVID-19 treatment in ICUs. The ethical and social issues that HCPs recognized during the pandemic were difficulties in the decision-making process with patients’ families, limitations of life-sustaining treatment, lack of palliative care, and inadequate mental support for patients’ families and HCPs. Regarding decision-making on issues of clinical ethics during the pandemic, more than half of the respondents thought they had failed to provide sufficient palliative care to patients and responded that they experienced moral distress. The free-text responses on moral distress revealed issues such as unusual treatment and care, restricted visits, challenging situations for HCPs, and psychological burden. Additionally, 38.1% of respondents experienced episodes of social prejudice or discrimination and 4.7% experienced a shortage of medical resources. Our study result shows that the moral distress of HCPs was caused by difficulties in patient-centered decision-making and insufficient medical care to patients and their families. These were caused mainly by a lack of communication due to the stronger implementation of infection control measures. We believe that it is important to address ethical and social issues during a pandemic in order to provide appropriate medical care and prevent burnout among HCPs.

scholarly journals The tendencies in institutionalization of palliative care of adult population in the present-day Russia

2016 ◽  
Vol 15 (1) ◽  
pp. 14-18
Author(s):  
I. L Krom ◽  
M. V Erugina ◽  
A. B Shmerkevitch
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Medical Care ◽  
Chronic Diseases ◽  
Adult Population ◽  
Social Institution ◽  
Legal Documents ◽  
Well Development ◽  
Palliative Medical Care

The analysis of actual interpretations of palliative care from perspective of multi-professional and multi-disciplinary approach is presented. The main trajectories of chronic diseases determining modern strategies of palliative care are considered. The main tasks and directions of palliative care are indicated. According the authors, the normative legal support of provision of palliative medical care of population permits planning and developing of the mentioned type of care in Russia. To provide availability of palliative medical care scientific methodical substantiation is required and as well development of unified classification of conditions requiring indication and organization of palliative care. The standards of provision of palliative care are to be adjusted to the mentioned classification. The article mentions that the legal documents adopted in Russia determine palliative care as palliative medical care. The medicalization of palliative care in Russia is considered from perspective of dysfunctional practices of social institution of health care.

scholarly journals The topicality of regulatory of general practitioners-family doctors activity regarding of palliative care patients the quality of life the determination and assessment

2021 ◽  
Vol 10 (4) ◽  
pp. 107-111
Author(s):  
O.P. Bratsyun ◽  
O.G. Shekera ◽  
L.F. Matyukha ◽  
A.V. Tsarenko
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Palliative Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Ministry Of Health ◽  
Primary Health ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

Background. Access to palliative care and symptom relief for patients with incurable and serious illnesses remains a pressing issue for the health systems of many countries around the world. It is estimated that more than 40 million patients with serious illnesses and life-threatening and limiting conditions require palliative care (PC) each year. Most of the patients requiring PC are at home, so PC that can alleviate most of the suffering of the patient and his family is provided by general practitioners. Settling the regulatory framework is an important factor in providing quality palliative care. The purpose of the study: to propose amendments to the regulatory documents governing the provision of palliative care to determine and assess the quality of life of patients. Materials and methods. Scientific literature, WHO documents, EORTC QLQ-C30 questionnaire and patient survey results (n = 219). We used the method of system analysis, synthesis, sociological and medical-statistical. Results. We analyzed literature sources regarding a patient-family-centered approach in the health care system. We studied the WHO recommendations for determining the quality of life (QOL) of patients. We identified a gap in the current documents regulating the provision of PC in assessing the QOL of patients. As a result of involving patients (n = 219) in self-assessment of the QOL using the EORTC QLQ-C30 questionnaire and further ensuring the subjective needs of patients, an improvement in their QOL was established. It was proposed to amend the orders of the Ministry of Health of Ukraine, regulating the provision of primary medical care and PС, in order to achieve the main goal of this type of medical care - to ensure the maximum achievable QOL. Conclusions. 1. It has been shown that the regulatory framework for the provision of PС regulates the provision of the most attainable QOL of the patient as the main goal of this type of medical care. However, the use of funds for determining the level of QOL and its components by doctors when providing PС on an outpatient basis, including at home, is not not regulated by law. 2. It has been proven that the use of the EORTC QLQ-C30 questionnaire to determine the QOL of patients receiving PС allows assessing their general and psycho-emotional state, as well as the level of the patient's functioning from his subjective point of view. This ensures the patient's partnership in a multidisciplinary team, his responsibility and participation in the treatment. At the same time, the key need of the patient to be involved in decision-making on diagnostics and the choice of treatment methods in accordance with personal beliefs and expectations is satisfied. 3. It is necessary to amend the order of the Ministry of Health of Ukraine dated 04.06.2020 No. 1308 "On improving the organization of the provision of palliative care in Ukraine" on the procedure for providing PC and the order of the Ministry of Health of Ukraine dated 03.19.2018 No. 504 "On approval of the Procedure for the provision of primary health care" according to the list medical services for the provision of primary health care in terms of using questionnaires to determine QOL and achieve the main goals of PC.

Primary Health Care and the ICD-11

2013 ◽  
Vol 10 (01) ◽  
pp. 33-37 ◽  
Author(s):  
M. Klinkman ◽  
D. Goldberg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Medical Care ◽  
Special Needs ◽  
Field Trials ◽  
Primary Medical Care ◽  
Dsm 5 ◽  
Primary Health ◽  
Icd 10

SummaryThis paper describes the necessity of adapting the major classifications of mental disorders exemplified by the ICD-11 and the DSM-5 for the special needs of primary medical care. An earlier version of the classification – the ICD-10-PHC – is described, and the process of adapting it is described in detail. The new 28 item version of the classification is described, and the procedures to be adopted in the Field Trials to be held during 2013 are set out, together with the specific problems these field trials will address.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

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