THE COMPLEX CASE OF PROVIDING MEDICAL CARE TO A PATIENT WITH A PANCREATIC TUMOR IN THE CONTEXT OF COVID-19

2021 ◽  
Author(s):  
Галина Григорьевна Громова ◽  
Ольга Ивановна Шувалова ◽  
Людмила Николаевна Верижникова ◽  
Анна Алексеевна Гаус ◽  
Ольга Витальевна Козловская
Keyword(s):  
Medical Care ◽  
Clinical Case ◽  
Pancreatic Tumor ◽  
Interdisciplinary Approach ◽  
Diagnosis And Treatment ◽  
Complex Case ◽  
Medical Organization ◽  
Specialized Care ◽  
The City

Представлен клинический случай коморбидной патологии у пациента с оказанием специализированной помощи в многопрофильной медицинской организации города Сургута, первично диагностированного как COVID-инфекция. Описанный клинический случай, требовал междисциплинарного подхода в диагностике и лечении пациента и представляет пример эффективности работы многопрофильной больницы. A clinical case of comorbid pathology in a patient with specialized care in a multidisciplinary medical organization of the city of Surgut, initially diagnosed as a COVID infection, is presented. The described clinical case required an interdisciplinary approach in the diagnosis and treatment of the patient and is an example of the effectiveness of a multidisciplinary hospital.

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.

PRODUCTIVITY OF INTERDISCIPLINARY INTERACTION IN TREATMENT OF PATIENTS WITH HEAD AND NECK DISEASES (RESULTS OF AN ORGANIZATIONAL EXPERIMENT OF 2021)

2021 ◽  
pp. 162-167
Author(s):  
Lebedev M.V. ◽  
Zakharova I.Yu. ◽  
Kerimova K.I.
Keyword(s):  
Head And Neck ◽  
Maxillofacial Surgery ◽  
Interdisciplinary Approach ◽  
Integrated Approach ◽  
Work Capacity ◽  
Medical Organization ◽  
Diagnostic Measures ◽  
Head And Neck Pathology ◽  
Specialized Care ◽  
Interdisciplinary Interaction

In 2021, an organizational experiment was conducted to improve the provision of specialized care to patients with head and neck pathology using the example of the Center for Maxillofacial Surgery at the N. N. Burdenko. The chief freelance specialist of the Ministry of Health of the Penza region, the head and doctors of the department, the deputy chief physician for the medical and surgical part, doctors of the quality control department of the N. N. Burdenko evaluated the treatment and diagnostic measures, the feasibility of attracting consultants of related specialties. Taking into account the results obtained, in 2021, on the basis of the Center for Maxillofacial Surgery, an organizational experiment was conducted to optimize the provision of medical care to patients of all ages with head and neck pathology, followed by an assessment of its effectiveness. The organizational experiment consisted of an interdisciplinary approach in the treatment of 15 patients in the conditions of the Center for Maxillofacial Surgery of the N.N. Burdenko. Doctors of related specialties (otorhinolaryngologist, plastic surgeon, oncologist, endoscopist, psychiatrist) participated in the provision of specialized care. The hospitalization of the patient and his treatment are provided at the optimum time by the same specialists. As a result of the experiment, patients saved time, received an integrated approach, reduced risks of postoperative complications, full work capacity or faster recovery and rehabilitation. The experiment showed that for one inpatient treatment, the patient receives an integrated approach to the problem, subject to close interaction of specialists from medical organizations, with the possibility of using specialized equipment without the cost of purchasing it for a medical organization. The conducted organizational experiment improves and improves the quality of care for patients with head and neck pathology. This experiment should be implemented in multidisciplinary medical organizations providing assistance in the field of "maxillofacial surgery".

scholarly journals The organization of a Center for the diagnosis and treatment of breast tumors on the basis of the state regional oncological center

2020 ◽  
Vol 64 (2) ◽  
pp. 61-67
Author(s):  
Nataliya V. Voroshina ◽  
A.V. Vazhenin ◽  
A.S. Domozhirova
Keyword(s):  
Breast Cancer ◽  
Medical Care ◽  
Breast Tumors ◽  
The State ◽  
Diagnosis And Treatment ◽  
Malignant Neoplasms ◽  
Specialized Care ◽  
Personalized Approach ◽  
Chelyabinsk Region

Introduction. In the current environmental situation in Russia, the organization of early detection of cancer in women of fertile age is of particular importance, which has medical, social and demographic consequences. Among malignant neoplasms in women - breast cancer takes the first place in the Russian Federation. 30% of the cases are women of working age. The increase in the incidence of breast cancer in the Chelyabinsk region from 2008 to 2018 was about 30%. In 2018, the proportion of stage I-II breast cancer is 67.5%. To improve the quality of specialized medical care for patients with suspected and/or established breast cancer on the basis of the state medical institution «Chelyabinsk regional clinical center of Oncology and nuclear medicine» in 2018, a center for diagnosis and treatment of breast tumors (hereinafter - the Center) was established. Purpose of work. Analysis of the first results of the Center’s work. Materials and methods. Patients referred for consultation to the Center from 01.11.2018 to 31.08.2019. Results. As a result of the work of the Center for 10 months, there was a reduction in the time of examination of patients with suspected breast cancer from 30 to 14 calendar days. The share of detected breast cancer in the region at localized stages for 10 months of 2019 was higher (69.5%) compared to the same period of 2018 (66.7%), which is based on an increase in active detection of pathology in the established Center. Discussion. The creation of the Center has increased the availability of specialized care for patients with breast pathology. Reduced time for examination and conduct of trepan-biopsy of the tumor to confirm the diagnosis. Patients with breast cancer have a personalized approach to the treatment program. Conclusion. The establishment of the Center allows to improve the quality of specialized medical care for patients with suspected and/or established breast cancer.

scholarly journals PECULIARITIES OF ORGANIZATION OF OUTPATIENT CARE FOR ADULTS AND CHILDREN ON BASE OF MEDICAL CENTER OF YAKUTSK CITY OF THE REPUBLIC OF SAKHA (YAKUTIA)

2020 ◽  
Vol 8 (4) ◽  
pp. 502-510
Author(s):  
E.A. Borisovа ◽  
◽  
I.P. Lutskan ◽  
N.V. Savvina ◽  
L.F. Timofeev ◽  
...  
Keyword(s):  
Medical Care ◽  
Outpatient Care ◽  
Medical Information ◽  
Statistical Data ◽  
Medical Center ◽  
Adult Population ◽  
Age Groups ◽  
Insurance Companies ◽  
Medical Organization ◽  
The City

Aim. To study organization of the outpatient care in Yakutsk, incl. that on the base of Medical Center of Yakutsk in the period from 2012 to 2018. Materials and Methods. For this study, statistical data were used on staffing, attendance, morbidity of the children’s and adult population of the city of Yakutsk by ICD-10 classes (per 100 thousand population) for 2012-2018. Statistical data for the work were obtained from an official source – Yakutsk Republican Medical Information and Analytical Center and medical organizations providing primary health care. The work used the data of official statistical reports (forms 7, 12, 17, 30, 36), demographic parameters of the population of the city of Yakutsk. Statistical data processing was carried out using Statistica10 software (Stat Soft Inc., USA) and Microsoft Excel. SWOT analysis of the organization of outpatient care for the population of the city of Yakutsk was carried out. Results. The health status of the population of Yakutsk was characterized by a high level of morbidity in all age groups. Organization of medical care for the population of Yakutsk was characterized by expansion of the network of medical organizations and strengthening of their material and technical base. Introduction of new management mechanisms into the activities of Medical Center in Yakutsk in 2012-2018 allowed to achieve high results of work among the attached population. Conclusions. Development of quality standards for medical and diagnostic services has reduced the number of acts of insurance companies with defects in the provision of medical care and penalties. Introduction of an «effective contract» made it possible to increase the previous level of salaries of medical workers, to additionally attract new workers, and also to increase the effi-ciency of the organization. Formation in a medical organization of a multilevel performance audit system based on a process approach made it possible to identify the strengths and weaknesses of the organization and develop measures to improve the availability and quality of medical care.

scholarly journals THE ANALYSIS OF THE EFFECTIVENESS OF THE PERINATAL CENTER IN PROVIDING QUALITY MEDICAL CARE

2019 ◽  
Vol 62 (6) ◽  
pp. 304-309
Author(s):  
V. N. Rasskazova ◽  
Pavel F. Kiku ◽  
T. Yu. Kurleeva ◽  
G. N. Bondar ◽  
O. A. Izmaylova ◽  
...  
Keyword(s):  
Medical Care ◽  
Qualitative Evaluation ◽  
Financial Economic ◽  
Management Decision ◽  
Effective Management ◽  
Highly Qualified ◽  
Medical Organization ◽  
Specialized Care ◽  
Management Decision Making ◽  
Perinatal Center

Introduction. Among the problems of health care during the reform period, the problem of quality management of medical care and effective management of the medical organization is particularly highlighted. The purpose of the study is to determine the main priorities of effective management of the medical organization of obstetric and gynecological profile to ensure the proper quality of medical care to the population. Materials and methods. We carried out quantitative and qualitative evaluation of the perinatal center in the period 2015-2017. Studied the efficiency of the administration of the human resources capacity of health organizations quality indicators of the hospital bed Fund and the financial-economic activity of enterprises. Results. The effective activity of the institution in the conditions of the established perinatal center is Shown due to the chosen strategy and tactics of the phased development of new obstetric, neonatal, inpatient-replacement technologies, the provision of highly specialized care with the use of modern equipment and medicines, which allowed to expand the range and volume of Advisory and diagnostic and treatment services, to reduce the level of perinatal and maternal losses. Discussion. The strengths of the organizational activities of the perinatal center management include: the inclusion of women’s consultation in the structure of the perinatal center, ensuring the continuity of care for gynecological and pregnant patients; state social support for motherhood and childhood, changing the conditions and procedure for the provision of free medical care to the population; functioning on the basis of the perinatal center of the Department of pathology of newborns, Department of resuscitation and intensive care of newborns, consultative and diagnostic and gynecological departments. The weak side of the organization can be attributed to the shortage of highly qualified personnel (doctors, nurses and Junior medical staff). Conclusion. In order to effectively use the resources of the institution, it is important to change the approach to the provision of material resources and their rational use in the process of the institution’s activities. The chosen strategy and tactics of management decision-making makes it possible to improve the quality and availability of medical care for pregnant women, mothers, maternity and newborn children.

scholarly journals Analysis of cardiovascular morbidity in the pediatric population of the city of Voronezh

2020 ◽  
Vol 35 (3) ◽  
pp. 134-140
Author(s):  
N. M. Kolyagina ◽  
T. A. Berezhnova ◽  
O. V. Klepikov ◽  
Ya. N. Kulintsova
Keyword(s):  
Cardiovascular Diseases ◽  
Inner City ◽  
Medical Care ◽  
Pediatric Population ◽  
Disease Incidence ◽  
Adult Population ◽  
Historical Background ◽  
Medical Organization ◽  
City District ◽  
The City

Aim: To perform a territorial comparison of the incidence rates of certain cardiovascular diseases (CVD) in the pediatric population of the city ofVoronezh.Material and Methods. The morbidity rates in the pediatric population over certain inner-city zones were assessed using a differentiated approach. This tactic was chosen taking into account historical background as a high percentage of the population (75.8% of the total population in the city district of Voronezh) was registered at particular clinics based on a territorial logic. Of these, 11 pediatric clinics in Voronezh provided care for over 160,000 children under the age of 14 years (about 79% of children residing in the city district of Voronezh) on a territorial basis. The ranking of indicators was performed using a specially designed software developed at the Voronezh State Medical University named after N.N. Burdenko. The territories at risk were identified based on the results of this analysis by the level and dynamics of morbidity in the pediatric population. Results. Cardiovascular diseases were below the top five leading disease classes and were ranked 8–9 in children in the context of overall morbidity structure in the city ofVoronezh. The study showed that the incidence of cardiovascular diseases increased in the adult population of Voronezh relative to the value for the same period analyzed last year: the growth rate in the number of medical care encounters was 14.65% with 14.05% of diagnoses established for the first time in life. The average long-term level of cardiovascular mortality in theVoronezh city district was 24.79 ± 1.40 cases per 1,000 children under 14 years of age.Conclusion. The differences, found in the morbidity rates from the individual intra-city territories provided with pediatric polyclinics, can be explained by the various factors such as the age structure of the population residing in a particular region and human resources of a medical organization including the availability of a pediatric cardiologist. Knowledge of information regarding pediatric disease incidence in certain inner-city territories allowed us to rationally optimize the resources of the urban health system to improve the availability and quality of medical care to the population, particularly the young segments, suffering from cardiovascular diseases at the pre-hospital stage.

scholarly journals Current approaches in providing medical care for patients with corneal diseases in a large city

2021 ◽  
Vol 6 (4) ◽  
pp. 63-67
Author(s):  
Polina I. Konstantinova ◽  
Larisa V. Kochorova ◽  
Konstantin S. Klyukovkin ◽  
Anastasiya V. Antonova ◽  
Ilya S. Kustov
Keyword(s):  
Medical Care ◽  
Statistical Significance ◽  
Corneal Transplantation ◽  
Large City ◽  
Medical Organization ◽  
Statistical Series ◽  
Number Of Patients ◽  
Student’S T ◽  
The City

Objectives to analyze the aspects of the specialized ophthalmological medical care for patients with corneal diseases on the example of St. Petersburg. Material and methods. The data of the patients with corneal diseases treated in hospitals of St. Petersburg were copied onto specially developed cards from the official reporting forms and medical records of inpatients for the period of 5-year follow-up. To analyze the characteristics of patients with a continuous method of observation, we studied data on 2200 patients hospitalized in large ophthalmological hospitals in the city. We also interviewed 840 ophthalmologists in order to identify the main problems. The obtained data were statistically processed with the calculation of statistical series, extensive and intensive indicators. To assess the statistical significance of the differences in indicators in individual years of the observation, we used Student's t-test. Results. The analysis of statistics revealed an increase in the number of patients hospitalized with corneal diseases in the period from 2015 to 2019. The following problems were identified: nonavailability of keratoplasty in the regions (28.6 per 100 respondents), imperfection of the regulatory basis for corneal transplantation (26.2 per 100 respondents), long waiting list for surgery (22.6 per 100 of respondents), lack of modern medical equipment in a medical organization (20.2 per 100 respondents) and an insufficient number of quotas for operations (20.2 per 100 respondents). Conclusion. The availability of a sufficient amount of donor material will reduce the waiting time for specialized ophthalmic medical care for patients with severe corneal diseases, and will help create conditions for their satisfaction with the medical care provided to them.

Interdisciplinary approach to the treatment of bilateral Terson syndrome (clinical case)

2019 ◽  
pp. 162-165
Author(s):  
A.V. Rusanovskaya ◽  
◽  
A.N. Klimova ◽  
M.R. Adelyanov ◽  
◽  
...  
Keyword(s):  
Clinical Case ◽  
Interdisciplinary Approach ◽  
Terson Syndrome

Analysis of Current Practices of Organizing the Export of Medical Services in the United Kingdom, Italy, South Korea and China

2020 ◽  
pp. 30-42
Author(s):  
Arkady Nikolaevich Daykhes ◽  
Vladimir Anatolievich Reshetnikov ◽  
Olga Aleksandrovna Manerova ◽  
Ilya Aleksandrovich Mikhailov
Keyword(s):  
United Kingdom ◽  
South Korea ◽  
Medical Care ◽  
Medical Tourism ◽  
Value Added ◽  
External Factors ◽  
Medical Services ◽  
High Tech ◽  
Medical Organization ◽  
The United Kingdom

Aim of the study. Analysis of medical tourism’s organizational features based on the example of the large medical organizations in the United Kingdom, South Korea, Italy and China. Materials and methods. The data were collected by the authors by interviewing the heads of medical organizations and their deputies in the United Kingdom, South Korea, Italy and China (3–4 respondents per medical organization) using the developed questionnaire to identify the main mechanisms and tools for organizing the export of medical services. SWOT-analysis (Strengths; Weaknesses; Opportunities; Threats) was performed in order to comprehensively evaluate the received information. Results. Along with weaknesses and threats that slow down the development of medical services exports, strengths (internal factors) and opportunities ( external factors) that contribute to the development of medical tourism were also identified: the widespread popularity of the brand of medical organizations abroad which is associated with the provision of premium medical services; versatility and ability to conduct high-tech surgical operations; the presence of a separate premium class building and an international department for working with foreign patients and promoting a medical organization in the world market; well-established business relationships with assistance companies; foreign medical personnel who speak foreign languages and possess necessary skills to treat foreign patients; developed electronic medical care system; developed system of quality control of medical care; the presence of branches in other countries; the presence of a medical visa in the system of legislation; established cooperation with many countries at the embassy level; state licensing and accreditation for the provision of medical services to foreign citzens; the availability of a state website on the provision of medical assistance to foreign citizens; the possibility of the age of value added tax. Conclusion. We identified main patterns in the organization of export of medical services that can be applied to develop this direction in medical organizations of the Russian Federation during the analysis the strengths and weaknesses of four large medical organizations abroad, as well as external factors that affect the work of these medical organizations.

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