scholarly journals Order of medicines rationing with the provision of qualified surgical help to military servicing

2019 ◽  
pp. 20-30
Author(s):  
O. V. Bielyozorova ◽  
O. P. Shmatenko
Keyword(s):  
Nervous System ◽  
Comparative Analysis ◽  
Medical Care ◽  
Medical Service ◽  
Blood System ◽  
Military Hospital ◽  
Medicinal Products ◽  
Surgical Assistance ◽  
Care And Treatment ◽  
The Military

The standardization of medicines, taking into account the considerable experience of the military medical service, is a promising direction for improving the medical supply of the health facilities of the Ministry of Defense of Ukraine and provides medical provision in accordance with established norms in order to fully and timely meet the needs of the medical service in the Ministry of Health for the provision of quality and effective medical care and treatment of wounded and sick. The purpose of the study was the rationale of the method of valuation and a comparative analysis of the proposed norms for supplying medicines to a military hospital and a military mobile hospital offered in the treatment of surgical personnel. A comprehensive analysis of the medical treatment of soldiers in the surgical section of the military hospital and the military mobile hospital was conducted (345 and 202 persons, respectively), the normative method of the proposed nomenclature and the number of drugs for the provision of qualified surgical care in the conditions of the military hospital and the military mobile hospital. The nomenclature of medicines under the international non-proprietary names included in the proposed list of norms for the supply of medicinal products and is intended for servicemen of a surgical profile for the needs of military hospitals and military mobile hospitals is 147 and 130 titles of medicines, respectively. In the conditions of the military hospital in the species diversity, the most represented groups are medicinal products that affect the blood system and hemopoiesis (19%), drugs that affect the nervous system (16%), antimicrobials for systemic use (15%); in the conditions of a military mobile hospital ‒ medicines affecting the blood system and hemopoiesis (23 titles), in the second place drugs affecting the nervous system (21 titles), the third means affecting the digestive system and path (19 titles). Thus, a comparative analysis of the proposed fragment of the delivery of medicines for the needs of the military hospital and the military mobile hospital with approved Temporary Settlement of Medical Assets for the provision of medical care and treatment of wounded and patients for a special period demonstrated the conformity of the nomenclature of drugs to 41% (68 INN medicines for provision of qualified surgical assistance from 167 INN medicines for providing qualified medical aid).

scholarly journals Approaches to the justification of targeted subsidies for drugs in providing medical care in ambulatory conditions in military medical organizations

2021 ◽  
Vol 23 (3) ◽  
pp. 177-188
Author(s):  
Yuri V. Miroshnichenko ◽  
Maria P. Shcherba ◽  
Andrey V. Merkulov
Keyword(s):  
Medical Care ◽  
Wide Spectrum ◽  
Essential Medicines ◽  
Drug Supply ◽  
Medicinal Products ◽  
Medical Organization ◽  
Military Health ◽  
Military Health Care ◽  
Funding Mechanisms ◽  
The Military

This study presents the results of the analysis of the funding mechanisms for drug supply of assigned contingents in the provision of outpatient medical care in military medical organizations. Existing approaches to determining methods for optimizing the need for drugs are considered. In addition, this paper presented approaches to the formation of a formulary list of medicinal products of a military medical organization. This study also showed the possibility of using pharmacoeconomic assessment in justifying targeted subsidies for drug supply. The relevance of the analysis of the assortment structure for entry into the approved list of vital and essential medicines is emphasized. A possible algorithm for substantiating a targeted subsidy for drug supply in the provision of outpatient medical care within the framework of military health care involved eight stages. First, the incidence of attached contingents entitled to drug supply at the expense of the Russian Ministry of Defense for outpatient treatment was analyzed. Second, the nomenclature of medicines was determined by comparing the incidence pattern of attached contingents with the list of medicines presented in the standards of medical care and clinical recommendations. Third, groups of drugs (with specific and wide spectrum of action) normally used are distinguished, considering the uniqueness of consumption when predicting (planning) demand. Fourth, the need for medicines were formulated using the normative method, modeling method, and logicoeconomic and other methods for determining the need, taking into account the peculiarities of their application in medical, social, and economic conditions of the military medical organization. Fifth, the created drug list was optimized based on the combined ABC-VEN analysis. Sixth, the formal list of the military medical organization was optimized by taking into account the results of pharmacoeconomic research on the treatment of specific diseases. Seventh, an analysis of the assortment structure in relation to the list of vital and essential drugs was performed to further substantiate their economic, clinical, and pharmacoeconomic effectiveness. Eighth, a targeted subsidy for drug supply was calculated, and application was filed, which contained calculations of planned costs with the appendix of the list of planned drugs for purchase, as well as commercial proposals justifying its cost.

scholarly journals Organization of rendered surgical assistance in extreme conditions of autonomous navigation

2018 ◽  
Vol 20 (2) ◽  
pp. 254-258
Author(s):  
A K Soroka ◽  
V N Kotelnikov ◽  
V E Nazarov ◽  
B I Geltser ◽  
V A Dergunov
Keyword(s):  
Medical Care ◽  
Autonomous Navigation ◽  
Medical Service ◽  
Surgical Care ◽  
Extreme Conditions ◽  
Surgical Assistance ◽  
Active Implementation ◽  
High Level ◽  
Laparoscopic Techniques

The problem related to the need to improve the effectiveness of providing emergency surgical care in extreme conditions of autonomous navigation is discussed. The principle of organization of medical support cannot be effectively implemented in the realities of the present time, due to the lack of sufficient naval bases. Modern medical technologies seem to be a strategic reserve that can solve the emerging problems before the medical service of the Navy. The most priority and promising technique with a high level of quality of urgent surgical care is the use of laparoscopic techniques by the personnel of the medical service directly at the ship’s medical station. Presented data on the results of the application of this technique indicate its prospects. In addition, in order to optimize the provision of emergency medical care to seamen in conditions of autonomous navigation, it is expedient to actively use telemedicine. The historical and systematic review of modern literature confirms the high potential of these methods provided that the surgeons’ competence and scientific and practical solution of technical aspects are sufficient. Important is the development of professional standards for specialized medical care in emergency conditions in the sea and active implementation in clinical practice.

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

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. 

The development of health care in Siberia in the 18th — first half of the 19th century

2019 ◽  
Vol 5 (2) ◽  
pp. 121-132
Author(s):  
Ekaterina V. Shulyak
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Political Development ◽  
Medical Personnel ◽  
Military Hospital ◽  
Genetic Method ◽  
Industrial Enterprises ◽  
Medical Institutions ◽  
Russian State ◽  
Folk Remedies

Development of health care of Siberia in the 18<sup>th</sup>&nbsp;— first half of the 19<sup>th</sup> century was closely connected with economic and political development of the Russian state. Before the medical personnel emergence in Siberia its population received medication only in the form of folk remedies. Development of its territory, insanitary conditions of life of Siberians, constant contingent of exiled to the indigenous people, and severe climate contributed to the spread of such diseases as smallpox, syphilis, and others.<br> The first medical institutions of Siberia were military hospital and infirmaries. In the days of reign of the Empress Anna Ioannovna, the city medical care started developing, and thanks to an initiative of the industrial enterprises owners&nbsp;— medical care for miners. After the establishment of the Public Charity Orders in Siberia, hospitals under their jurisdiction began to function in Tobolsk, Irkutsk, and Tomsk. A worthy contribution to the development of local medical institutions was made by donators Tolstopyatov, Bednyagin, Chupalov, and others. However, deficiency of financing, hospitals, and the medical personnel couldn’t adequately satisfy the needs of Siberian inhabitants in medical care.<br> The purpose of the article is to analyse the condition of public health, causes of morbidity and mortality of the population, as well as the process of medical care development in Siberia the turn of the 18<sup>th</sup> century by means of a historical and genetic method.

Erosion of Civilian Control in Democracies: A Comprehensive Framework for Comparative Analysis

2021 ◽  
pp. 001041402198975
Author(s):  
Polina Beliakova
Keyword(s):  
Comparative Analysis ◽  
Civilian Control ◽  
Intrastate Conflict ◽  
Civil Military Relations ◽  
Large N ◽  
Military Relations ◽  
Comprehensive Framework ◽  
The Military ◽  
New Framework

Civilian control of the military is a fundamental attribute of democracy. While democracies are less coup-prone, studies treating civilian control as a dependent variable mostly focus on coups. In this paper, I argue that the factors predicting coups in autocracies, weaken civilian control of the military in democracies in different ways. To capture this difference, I advance a new comprehensive framework that includes the erosion of civilian control by competition, insubordination, and deference. I test the argument under conditions of an intrastate conflict—a conducive environment for the erosion of civilian control. A large-N analysis confirms that while intrastate conflict does not lead to coups in democracies, it increases the military’s involvement in government, pointing to alternative forms of erosion taking place. Further case study—Russia’s First Chechen War—demonstrates the causal logic behind the new framework, contributing to the nuanced comparative analysis of civil-military relations across regimes.

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