The regional model of palliative medical care support of patients with malignant neoplasms

Author(s):  
Akhmetzianov F. Sh. ◽  
◽  
Hairullin I. I. ◽  
Shaimardanov I. V. ◽  
Shaihutdinov N. G. ◽  
...  
2018 ◽  
Vol 5 (3) ◽  
pp. 145-154
Author(s):  
M. Yu. Rykov ◽  
I. N. Inozemtsev ◽  
S. A. Kolomenskaya

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. 


2019 ◽  
Vol 61 (1) ◽  
pp. 17-22
Author(s):  
I. P. Artyukhov ◽  
F. V. Kapitonov ◽  
Vladimir F. Kapitonov

The shortcomings offunctioning of ambulatory polyclinic service and overrated volume ofprovided emergency medical care became actual propblemin primary medical care support of population in small towns due to age structure of population. Purpose of study. To investigate dynamics of age structure of out-patient visits and calls of emergency care by population of small town in 2011-2015. The analysis of out-patient visits and calls emergency care in 2011-2015 demonstrated that during five years number of visits to polyclinic decreased up to 5.3% mainly (14%) at the expense of residents of able-bodied age while number ofpatients of junior and senior able-bodied age increased on 1.5% and 5.1% correspondingly. The analysis of calls of emergency medical care revealed shortcomings in organization of ambulatory polyclinic care: more than a half (70.4%) of all calls because of instant diseases and conditions falls on the period of working hours of polyclinic (from 8 to 20 h.) The occasion of call by population of junior able-bodied age in 68.7% became acute diseases of respiratory organs (acute respiratory viral infection - in 93.6%) and by patients of senior ablebodied age in 72.6% - exacerbation of chronic pathology (ischemic heart disease, hypertension disease). The correction of these calls could be implemented by ambulatory polyclinic service itself. The acquired data corresponds to publication data and indicates to existing problems of primary medical care support of rural population in various regions of the Russian Federation. The investigation of age structure of out-patient visits, calls of emergency medical care of data of sociological survey of respondents revealed shortcomings in organization of functioning of municipal polyclinic related to population of senior able-bodied age that result in increasing of volume of work implemented by teams of emergency care.


2019 ◽  
Vol 61 (3) ◽  
pp. 133-137
Author(s):  
V. B. Ziatdinov ◽  
G. M. Trukhina ◽  
Gulnara G. Badamshina ◽  
L. V. Krestnikova

The retrospective epidemiological study was carried out concerning infections related to medical care support registered in population on the territory of the Republic of Tatarstan in 2002-2015. The reason of such a study was because of late identification and registration of infections related to medical care support, significant damage to population health, development of complications in significant percentage of hospitalized patients and necessity of investigation of patterns of development and outspread of nosocomial infections. The epidemiological analysis was implemented using report form of the Federal statistical observation № 2 of the Federal service of control of sector of defense of rights of consumers and human well-being “The data of infectious and parasitic infections”. The dynamics, structure of many years morbidity and main parameters of manifestation of epidemic process were investigated. The derived data was used as a basis to provide epidemiological characteristic of many years' dynamics of various classes of infections related to medical care support. The indices of morbidity are calculated with consideration for average annual population size. The priority nosologic forms of infections related to medical care support were established concerning newborns (pyodermatitis, conjunctivitis, pneumonia, omphalitis, sepsis, etc.), puerpera (pyo-septic infections, mastitis, sepsis), adult population (postoperative and post-injection complications, infections of urinary tracts, nosocomial pneumonia, viral hepatitis, etc.) which dynamics was characterized by positive and negative rate of increment of indicator. The obtained data was compared with indices represented in national and foreign publications. The implemented study testifies the necessity of development of measures epidemiological monitoring of decreasing of morbidity because of infections related to medical care support in medical organizations.


Author(s):  
Egor Aleksandrovich Perevezentsev ◽  
Maya Andreevna Kuzmina ◽  
Dariya Dmitrievna Vasina ◽  
Denis Igorevich Volodin

At present, the quality and availability of medical care are the aspects to which close attention is paid in the system of organizing medical care. One of the ways to achieve a high level of quality and accessibility of medical care is building up human resources, i.e. the presence of highly qualified general practitioners, sub-specialties and middle medical personnel in sufficient numbers in a medical organization. Currently, the oncological service of Russia has been assigned tasks to fulfill the instructions from the State Program for the Development of Health Care. The results of the work should lead to a decrease in mortality and an increase in the quality of life of the population. To address the issue of reducing mortality from malignant neoplasms, in particular from prostate cancer, a three-level system of oncological care has been created on the territory of the Nizhny Novgorod Region, including 1 regional center, 2 interdistrict cancer centers, 88 primary oncology rooms and 96 examination rooms. The tasks set to reduce morbidity and mortality from oncological diseases can be realized only with close interaction of the oncological service with the primary health care sector, in which the prevention should be the priority direction of work.


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