scholarly journals REFORM OF DENTAL CARE TO THE POPULATION OF UKRAINE: PROBLEMS OF THE PRESENT

2020 ◽  
pp. 109-114
Author(s):  
L.A. Lytvynova ◽  
E.N. Donik ◽  
L.I. Artemchuk
Keyword(s):  
Medical Care ◽  
Dental Care ◽  
Rural Areas ◽  
Standards Of Care ◽  
Specific Method ◽  
Dental Services ◽  
Medical Specialties ◽  
Non Profit ◽  
The Status ◽  
Dental Diseases

The article discusses the current problems of dental care reform. Key issues identified features of the need to determine the minimum amount of free dental care services; development of standards and protocols for the provision of all types of dental care; creation of a register of dental morbidity in the country's population; determination of the model of reorganization of state and municipal dental institutions by changing the form of management with the status of non-profit institutions; development of pricing methods for dental services; introduction of a maxillofacial surgeon and a dentist to a dentist; the need for approval of state postgraduate dental education. Dental care is one of the most popular types of medical care. By the number of dentists (18857, which is 11% of the total number of doctors in Ukraine) and patient visits (32.5 million per year), dentistry takes the second place among all medical specialties. Provision with dentists is 6.1 per 10 thousand people and corresponds to the European level. Also in Ukraine there are approximately 5500 state and friendly dental institutions and offices. However, with such significant amounts of care and powerful staffing, the problem of access to dental care is exacerbating. This situation can be explained by many reasons related to the reform of medical care in general in the country. Now all dentists are referred to the secondary level of medical care, although the real majority of them provide primary dental care, that is, this issue is not legally regulated. In the most European countries, 80-85% of dentists are general practitioners. Recently, there has been significant progress in the diagnosis and treatment of dental diseases, dental prosthetics, but dental care is gradually losing its mass availability. The situation is even worse in rural areas, where the position of dentist has been eliminated at the primary level. The decrease in the availability of dental care and the reduction of the preventive dentistry sector is causing an increase in dental morbidity, which in Ukraine is one of the highest in Europe. Many dental diseases at the initial stage are asymptomatic and patients seek medical help too late. Therefore, preventive examinations are an important component of the prevention system not only of dental diseases, but also of the mucous membrane of the oral cavity, that is, there must be oncological alertness. Reforming is not only the order of medical care, but also the dental institutions themselves. Optimization consists of providing territorial communities with medical care without making a profit by creating communal non-profit enterprises, that is, transferring them to self-sufficiency (with partial support from local budgets). Dentistry actually remains without financial support from the state, with the exception of planned dentistry for children under 16 years of age and urgent dental care for adults and children. Paid dentistry will reduce the number of visits to insolvent citizens, which will entail, accordingly, costlier services. The second stage of reforming medical institutions involves not only their partial reduction (optimization by enlargement), but also the reduction of medical posts. One of the possible ways out of this situation was the proposal to introduce medical self-government (administration of the dental industry by representatives of the profession). The study of the needs of the population in dental care is based on the results of a study of the incidence rate for circulation and data from examinations. But in fact, it is not so much the incidence that is studied as the volumes of dental care, which is associated with outdated registration forms that are filled out in dental institutions. A specific method for studying the incidence in dentistry is the method of stratification cluster samples, which, unfortunately, is complex in design and is carried out exclusively by scientists. Dentistry is an expensive worldwide, so dental care pricing is an important. The economic rationale for the cost of treatment is directly related to the standards of care and clinical protocols, which also require revision according to the principles of evidence-based medicine.

scholarly journals Forecasting assessment of dental care availability for the population of Ukraine in the conditions of healthcare reform (discussion)

2021 ◽  
Vol 105 (1) ◽  
pp. 96-101
Author(s):  
I. Mochalov ◽  
◽  
R. Stupnytsky ◽  
I. Shupyatsky ◽  
I. Molozhanov ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Dental Care ◽  
Dental Treatment ◽  
Dental Health ◽  
Dental Services ◽  
State Budget ◽  
Dental Health Care ◽  
Dental Diseases ◽  
Care Availability

Abstract. In modern conditions dental treatment is one of the most common types of medical care in Ukraine, only 7.00 % of the young population are dentally healthy. During 2015–2019 the general practice of using 3.91 % of the consolidated state budget for health care for dental care was determined, mainly such funds were used for the maintenance of dental health care establishments. Resolution of the Cabinet of Ministers of Ukraine «Some issues of implementation of the program of state guarantees of medical care in 2020» from February 5, 2020 for № 65 provides the calculation of the tariff for dental services in the amount of UAH 9.19 per unit. Preliminary calculations indicate that comparing to 2019 during 2020 the state financial support of dental care will be reduced by 3444.20 million UAH (68.60 %). There are reasonable doubts about the rationality of the design of the Medical Guarantee Program in terms of treatment of dental diseases which carries the risk of further increase in dental morbidity and reduced availability of dental care for population. Key words: dentistry, treatment, financing, reform, accessibility, discussion.

scholarly journals Theoretical Foundations of Marketing in the Healthcare System

2021 ◽  
Vol 7 (5) ◽  
pp. 248-256
Keyword(s):  
Medical Care ◽  
Dental Care ◽  
Marketing Research ◽  
Medical Personnel ◽  
Medical Services ◽  
Highly Qualified ◽  
Health Organizations ◽  
Dental Services ◽  
Contact Points ◽  
High Level

Marketing in the health system contributes to increasing public satisfaction in the demand for medical care, providing the population with high-quality medical care and improving their standard of living. The method of identifying and analyzing contact points, based on the results of studying and taking into account the opinion of patients, for the implementation of patient-oriented and participative approaches to marketing medical services, provides for the active participation of the patient himself in discussing issues of his own health, which can be used to evaluate and qualitatively improve the activities of health organizations. In modern conditions, there are problems in the dental services market due to the lack of modern equipment and the provision of highly qualified quality dental care. The client orientation of medical personnel is a significant indicator of the quality of medical services, the patient's perception of the value of the service and is associated, both with a high level of medical service delivery and the qualification of medical personnel. The lack of managerial and financial autonomy of health-care organizations limits their ability to improve the use of financial resources. Marketing research is mainly used to optimize the activities of non-state health organizations and allows the development of a dental clinic by introducing economically justified forms of medical care and the possibility of improving the provision of medical services, which will contribute to improving dental care for the population.

scholarly journals The impact of out-of pocket payments of households for dental healthcare services on catastrophic healthcare expenditure in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abraha Woldemichael ◽  
Satar Rezaei ◽  
Ali Kazemi Karyani ◽  
Mohammad Ebrahimi ◽  
Shahin Soltani ◽  
...  
Keyword(s):  
Dental Care ◽  
Rural Areas ◽  
Healthcare Expenditure ◽  
Financial Burden ◽  
Healthcare Services ◽  
Dental Services ◽  
Cross Sectional ◽  
Care Services ◽  
Out Of Pocket Payments ◽  
The Impact

Abstract Background Dental healthcare is the costliest and single most source of the financial barrier to seeking and use of needed healthcare. Hence, this study aims to analyses impact of out-of-pocket (OOP) payments for dental services on prevalence catastrophic healthcare expenditure (CHE) among Iranian households during 2018. Methods We performed a cross-sectional analysis to determine the prevalence rate of CHE due to use of dental healthcare services among 38,858 Iranian households using the 2018 Household Income and Expenditure Survey (HIES) survey data of Iran. The WHO approach was used to determine the CHE due to use of dental care services at the 40% of household capacity to pay (CTP). Multiple logistic regression models were used to obtain the odds of facing with CHE among households that paid for any dental healthcare services over the last month while adjusting for covariates included in the model. These findings were reported for urban, rural areas and also for low, middle and high human development index HDI across provinces. Results The study indicated that the prevalence of CHE among households that used and did not used dental services over the last month was 16.5% (95% CI: 14.9 to 18.3) and 4.3% (95% CI: 4.1 to 4.6), respectively. The adjusted odds ratio (AOR) for the covariates revealed that the prevalence of CHE for the overall households that used dental healthcare service was 6.2 times (95% CI: 5.4 to 7.1) than those that did not use dental healthcare services. The urban households that used dental healthcare had 7.8 times (95%CI: 6.4–9.4) while the rural ones had 4.7 times (95% CI: 3.7–5.7) higher odds of facing CHE than the corresponding households that did not use dental healthcare services. Conclusions The study indicates that out-of-pocket costs for dental care services impose a substantial financial burden on household’s budgets at the national and subnational levels. Alternative health care financing strategies and policies targeted to the reduction in CHE in general and CHE due to dental services in particular are urgently required in low and middle income countries such as Iran.

scholarly journals Healthcare Service In The "Dentistry" Profle To The Population Of Moscow Under Restrictive Measures Of Covid-19

2021 ◽  
Vol 19 (2) ◽  
pp. 121-125
Author(s):  
A. Mitronin ◽  
A. Eremin ◽  
D. Ostanina
Keyword(s):  
Medical Care ◽  
Dental Care ◽  
Healthcare Service ◽  
Medical Insurance ◽  
Emergency Medical Care ◽  
Dental Services ◽  
Dental Equipment ◽  
Coronavirus Infection ◽  
In The Beginning ◽  
Restrictive Measures

In the beginning of the COVID-19 pandemic in March 2020, by the decree of the Mayor of Moscow, the provision of dental services to the population was temporarily suspended, with the exception of diseases and conditions requiring emergency or urgent dental care. A Headquarters was established to coordinate the provision of emergency and urgent dental care for COVID-19 patients and for those who was in isolation during lockdown. The Moscow Healthcare Department has been organized an activity of mobile medical and nursing teams (MNT) to provide emergency medical care in the "dentistry" profle. All MNTs were equipped with portable dental equipment. The MNTs has been working for free within the framework of compulsory medical insurance. For the period from March 26 to June 16 – 2020, medical care was provided to 1501 patients, of which 294 with a confrmed diagnosis of COVID-19, including 57 children. The measures taken were of a temporary nature and were aimed at preserving the health of Moscow residents and preventing the further spread of the new coronavirus infection COVID-19 in Moscow.

scholarly journals REVIEW OF SCIENTIFIC LITERATURE AND NORMATIVE LEGAL DOCUMENTATION FOR ORGANIZATION OF AND PAYMENT FOR DENTAL CARE

2021 ◽  
Vol 9 (1) ◽  
pp. 107-120
Author(s):  
I.V. Uspenskaya ◽  
◽  
S.V. Yurina ◽  
E.V. Manukhina ◽  
M.V. Peshkov ◽  
...  
Keyword(s):  
Medical Care ◽  
Dental Care ◽  
Outpatient Basis ◽  
Dental Services ◽  
Dental Procedures ◽  
Medical Documents ◽  
Labor Inputs ◽  
Quality Of Medical Care ◽  
Low Coverage

The article presents a review of scientific domestic and foreign literature and regulatory legal documentation, which allowed to identify problems in the organization of and payment for dental care and to determine possible directions of scientific research on the stated topic. Dependence of availability of specialized dental care on the income level, limited availability and late medical assistance in the rural regions, measures to increase availability through use of the programs of preferential prosthetics are shown. The problems of low coverage of dental services by mandatory medical insurance programs are considered. The levels of provision of population of RF with medical care, methods and difficulties of payments to specialists, of use of conventional units of labor inputs, of correction factors for children and adults, the issues of standardization of primary dental care, ambiguous attitude to the classifier of basic medical dental procedures and technologies that changed the established principle of remuneration in dental practice, are described. The method of payment for primary dental care provided on an outpatient basis for a completed case of treatment in terms of cost of clinic-statistical groups, as well as the per capita principle of payment for outpatient dental care and the difficulties with its implementation within compulsory health insurance in most regions are considered. An important role of automation of the working place for filling the medical documents, of improvement of organizational and medical technologies with use of new materials and equipment, is indicated. Analysis of the scope of medical care demanded by the population within the programs of the state guarantees is given. An emphasis is placed on the priority of the development of the modern dentistry as governmental-private partnership in terms of high adaptation to the market conditions. A complex character of issues of prophylaxis, screening, improvement of organization of and payment for dental care is emphasized, salvation of which will permit to considerably improve the quality of medical care and to guarantee its availability.

scholarly journals Urban-Rural Disparities in Dental Services Utilization Among Adults in China's Megacities

2021 ◽  
Vol 2 ◽  
Author(s):  
Xiang Qi ◽  
Xiaomin Qu ◽  
Bei Wu
Keyword(s):  
Dental Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Living Arrangement ◽  
Place Of Residence ◽  
Dental Services ◽  
Services Utilization ◽  
Urban Rural ◽  
Dental Services Utilization ◽  
Urban And Rural Areas

Objective: China's dental care system is bifurcated between urban and rural areas. However, very few studies have examined the dental services utilization inequities in China's megacities, particularly in these urban and rural areas. This study aims to examine the urban-rural disparities in dental services utilization among adults living in China's megacities based on the Andersen dental services utilization model.Methods: This study used data from 4,049 residents aged 18–65 who participated in the “2019 New Era and Living Conditions in Megacities Survey.” Multivariate logistic regressions were employed to examine the associations between place of residence and dental services utilization for individuals from ten megacities in China. Predisposing variables (age, gender, marital status, living arrangement, and education), enabling variables (socioeconomic status, occupational status, income, insurance coverage, health attitude, and health behavior), and need variables (self-rated health, oral health status, gum bleeding) were controlled for.Results: The mean age of the 4,049 adults was 45.2 (standard deviation = 13.0), and 30.4% (n = 1,232) had no dental visits at all. Adults who resided in urban areas were more likely to use dental services [odds ratio (OR) = 1.57, 95% confidence interval (CI) = 1.30 to 1.91] than those residing in rural areas after controlling for key covariates. Factors associated with higher odds of visiting dentists include having a higher income (OR = 1.44, P < 0.001), higher education level (OR = 1.53, P = 0.042), being covered by insurance for urban residents/employees (OR = 1.49, P = 0.031), having a positive attitude toward healthy diets (OR = 1.43, P < 0.001), attending regular physical examination (OR = 1.66, P < 0.001), having more tooth loss (OR = 1.05, P < 0.001), and having frequent gum bleeding (OR = 2.29, P < 0.001).Conclusion: The findings confirm that place of residence is associated with dental services utilization while adjusting for key covariates. Despite rapid economic development in China, many adults had never visited dentists at all. More efforts should be taken to encourage widespread dental care, such as providing more dental coverage and better access to dental care services.

scholarly journals DIGITALIZATION AS A RESOURCE FOR IMPROVING THE AVAILABILITY AND QUALITY OF MEDICAL CARE ON THE EXAMPLE OF UIA "SP NO. 12"

2020 ◽  
Vol 16 (3) ◽  
pp. 159-166
Author(s):  
Tat'yana Elovicova ◽  
Arkady Fomin ◽  
Michael Chernavsky ◽  
Aleksandr Chernavskiy
Keyword(s):  
Patient Satisfaction ◽  
Medical Care ◽  
Dental Care ◽  
Digital Technologies ◽  
Psychological Resources ◽  
Dental Services ◽  
Digital Dentistry ◽  
Dental Procedures ◽  
Remote Patient ◽  
The Impact

Subject. Modern medical care is not complete without the use of modern digital technologies — from remote patient registration and appointment, to remote diagnostics and laboratory tests, monitoring the condition of the patient. In most foreign countries and Russian medical institutions, telemedicine and digital technologies are actively used in the provision of dental care. The impact of digitalization of medical organizations as part of the transformation of the technological environment on the effectiveness of the organization of dental care services and patient satisfaction. The goal is to study the parameters of psychological resources of subjects of the treatment process that affect the development of digitalization. Develop an initiative to increase the benefits of digitalization in dental care. Methodology. Individual, tutored training in digitalization skills. Group forms of training (seminars, round tables, trainings). Results. Our research has shown that digitalization should start with the registry. This also implies improving the personal qualities and skills of both health professionals and patients. In addition, digitalization should also contribute to the development of comfort in the provision of dental services and improve the quality and safety of medical services provided. Conclusions. A resource-based approach in digital dentistry can be a conscious choice that can improve the efficiency of dental procedures and optimize workflows. In dental practice, saving time for performing auxiliary procedures means reducing the duration of appointments, increasing throughput, and increasing patient satisfaction in General and specific cases.

RURAL MEDICINE. CONDITION AND ISSUES

2020 ◽  
pp. 103-110
Author(s):  
Yuliya M. Beglyakova ◽  
◽  
Aleksander S. Shchirskii ◽  
Keyword(s):  
Health Services ◽  
Medical Care ◽  
Rural Areas ◽  
Rural Population ◽  
Rural Medicine ◽  
Self Medication ◽  
Medical Facilities ◽  
Treatment Facilities ◽  
Number Of Treatment ◽  
The Village

The article analyses the accessibility of medical facilities in rural areas of modern Russia and the specifics of their organization and development. The authors reveal causes why rural residents have much less opportunities to seek quality medical care than urban ones, what leads to a disparity between the inhabitants of the city and the village. The thesis is substantiated that state programmes that should make health services accessible to the rural population to a greater extent do not cope with the task at hand. An attempt is made to highlight the public’s response to the existing disparity in the health services of the villagers compared to urban dwellers. Such a reaction can be considered an outflow of people from rural areas, and an increase in self-medication among rural people as a result of the difficulty in obtaining health services. The decrease in the number of treatment facilities in rural areas leads to a deterioration in the medicine situation in rural areas. That, according to the authors of the article, justifies the need to study the issues associated with the provision of medical care to the rural population.

scholarly journals Decreased Medical Care During the COVID-19 Pandemic – A Comprehensive Analysis of Radiological Examinations

2021 ◽  
Author(s):  
Annette Aigner ◽  
Bernd Hamm ◽  
Florian Nima Fleckenstein ◽  
Tazio Maleitzke ◽  
Georg Böning ◽  
...  
Keyword(s):  
Medical Care ◽  
Control Period ◽  
Surrogate Marker ◽  
Medical Specialty ◽  
Case Volume ◽  
Medical Specialties ◽  
Key Points ◽  
Depth Analysis ◽  
The Impact ◽  
Radiological Examinations

Objectives As a cross-section discipline within the hospital infrastructure, radiological departments might be able to provide important information regarding the impact of the COVID-19 pandemic on healthcare. The goal of this study was to quantify changes in medical care during the first wave of the pandemic using radiological examinations as a comprehensive surrogate marker and to determine potential future workload. Methods A retrospective analysis of all radiological examinations during the first wave of the pandemic was performed. The number of examinations was compared to time-matched control periods. Furthermore, an in-depth analysis of radiological examinations attributed to various medical specialties was conducted and postponed examinations were extrapolated to calculate additional workload in the near future. Results A total of 596,760 examinations were analyzed. Overall case volumes decreased by an average of 41 % during the shutdown compared to the control period. The most affected radiological modalities were sonography (–54 %), X-ray (–47 %) followed by MRI (–42 %). The most affected medical specialty was trauma and orthopedics (–60 % case volume) followed by general surgery (–49 %). Examination numbers increased during the post-shutdown period leading to a predicted additional workload of up to 22 %. Conclusion This study shows a marked decrease in radiological examinations in total and among several core medical specialties, indicating a significant reduction in medical care during the first COVID-19 shutdown. Key Points: Citation Format

scholarly journals Deferred Action for Childhood Arrivals (DACA) medical students – an examination of their journey and experiences as medical students in limbo

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christina Gillezeau ◽  
Wil Lieberman-Cribbin ◽  
Kristin Bevilacqua ◽  
Julio Ramos ◽  
Naomi Alpert ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
First Year ◽  
Convenience Sample ◽  
Student Sample ◽  
Medical Specialties ◽  
Residency Programs ◽  
Deferred Action ◽  
The Status ◽  
Depth Interviews

Abstract Background Although the value of DACA medical students has been hypothesized, no data are available on their contribution to US healthcare. While the exact number of DACA recipients in medical school is unknown, DACA medical students are projected to represent an increasing proportion of physicians in the future. The current literature on DACA students has not analyzed the experiences of these students. Methods A mixed-methods study on the career intentions and experiences of DACA medical students was performed utilizing survey data and in-depth interviews. The academic performance of a convenience sample of DACA medical students was compared to that of matriculated medical students from corresponding medical schools, national averages, and first-year residents according to specialty. Results Thirty-three DACA medical students completed the survey and five participated in a qualitative interview. The average undergraduate GPA (SD) of the DACA medical student sample was 3.7 (0.3), the same as the national GPA of 2017–2018 matriculated medical students. The most common intended residency programs were Internal Medicine (27.2%), Emergency Medicine (15.2%), and Family Medicine (9.1%). In interviews, DACA students discussed their motivation for pursuing medicine, barriers and facilitators that they faced in attending medical school, their experiences as medical students, and their future plans. Conclusions The intent of this sample to pursue medical specialties in which there is a growing need further exemplifies the unique value of these students. It is vital to protect the status of DACA recipients and realize the contributions that DACA physicians provide to US healthcare.

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