Digestive Disease Mortality Dynamics During New Coronavirus Infection Pandemic in Different Subjects of Russian Federation

Aim. An analysis of digestive disease mortality dynamics in different subjects of the Russian Federation in course of the new coronavirus infection pandemic.Key points. In most subjects of the Russian Federation, the first half of 2021 enduring the COVID-19 pandemic has witnessed a higher overall mortality from digestive diseases and from peptic ulcer, liver and pancreatic illnesses compared to the same period in 2020. This situation may have roots in both the adverse impact of coronavirus infection on pre-existing digestive diseases and shortages in providing specialty medical aid to gastroenterological patients during the pandemic. Improved outpatient care and remote counselling, as well as successful educational measures, may reduce gastroenterological disease-associated mortality.Conclusion. Most regions of Russia have registered a growing mortality from digestive diseases at the new coronavirus infection pandemic due to the SARS-CoV-2 adverse impact on illness progression, as well as imposed difficulties in providing specialty medical aid.

DEFINING THE ONTOLOGICAL STATUS OF LABOUR PRODUCTIVITY IN HEALTH CARE

he present research touches upon the problem of comprehension of the concept «labor productivity» as applied to the field of healthcare in comparison with other categories and the corresponding indicators, used in the assessment of the medical organization personnel activity. As methodological basis the ideas in the field of labor economics, conceptual apparatus and theoretical bases of which have proved their efficiency in the solution of the tasks of development of the organizations of different branch affiliation act. The statement that labor productivity in public health services is connected with the transfer of knowledge and technologies from industrial sphere to medicine, requiring the interpretation of concepts and conceptual apparatus in relation to the considered branch is taken as the basis. In modern conditions of high intensity of work of medical organizations at simultaneous necessity of observance of obligatory requirements to quality and safety of medical aid, rational use of resources, the demand for formation of scientifically grounded approaches to labor productivity estimation in healthcare is realized by authors by means of development of an integrated index of labor productivity estimation. The present research can be considered in the development of the theory of labor productivity as applied to the branch of health care taking into account its orientation on rendering qualitative and safe medical aid. The offered by the author approach to the estimation of the given indicator allows to reflect not only quantitative (output, labor input) or cost estimation of labor productivity, but also takes into account complexity, intensity of work of the employees, and also an estimation of a degree of achievement of productivity (quality) of their activity. Its novelty is seen in the mutual conditionality of medical, social and economic evaluation of the effectiveness of the use of labor resources of the employees of medical organizations.

A policy mapping analysis of the U.S. Congressional approach to medical aid-in-dying

Oregon was the first state to legalize medical aid-in-dying (MAID), in 1994. Since then eight states and Washington, DC have legalized MAID through legislation. Despite literature exploring the legal and ethical aspects of MAID, very little research examines MAID policy at the federal level. This study aimed to 1) examine the objectives of MAID legislation introduced to the US Congress, and 2) investigate whether these bills increase or decrease access to MAID. This study used the congress.gov website to search for bills related to MAID introduced by the US Congress between 1994 and 2020. From the 98 bills identified, we excluded bills that were not directly related to MAID or were introduced in subsequent congresses. In total, 23 bills were retained and analyzed. The greatest number of bills aimed to restrict funds for MAID, followed by bills that sought to regulate the drugs used for MAID. Other bills prohibited the development of policies supporting MAID, regulated penalties for practitioners related to the drugs used for MAID, and restricted legal assistance for accessing MAID. These bills intended to block or limit patient access to MAID by restricting drugs, funds, health care services, legal assistance, policy, and research. These findings suggest that the federal approach is incongruous with the growing numbers of states that have legalized MAID. Federal policymakers must develop policies to 1) prevent discrimination against vulnerable groups, 2) support funds to study MAID, and 3) build a system to allows eligible individuals to access MAID equally.

The scope of childhood cancer in South Africa: A response to ‘Childhood cancers in a section of the South African private health sector – Analysis of medicines claims data’

Childhood cancer is an under resourced medical field that is emerging as a great healthcare concern in low- and middle-income countries such as South Africa. Therefore, reporting data in this field that may inform policymakers should be representative of the subject matter. This article aims to discuss why medicines claims as an indicator for incidence, as per an article published in 2020, is not representative of childhood malignancies in the South African setting. Literature to support the commentary were sourced using Pubmed, Google scholar, and data presented by members of the South African Children’s Cancer Study Group (SACCSG). Private medical aid coverage in South Africa between 2002 and 2018 varied between 15.5% and 18.2%. Of these, 9.5% were children under 18 years and 3.5% were under the age of six. Only 13.5% of children were treated in private paediatric oncology units during 2015. The limitations in the study were the variable medical aid coverage, the disproportionate age representation, and lack of reliable indicators for measurement and calculation of incidence. Utilising one medicines claims database to evaluate the incidence of childhood cancer in South Africa is not representative and cannot inform policy.Contribution: This article highlights the importance of accurate registration of childhood cancer diagnoses, especially when data and conclusions based on these results inform policy. The study highlights the limitations of extrapolating general conclusions based on data representing only a small sector of the childhood cancer landscape in South Africa.

Medical and Social Component of Medical Management: Improving the Model of Providing Medical Aid for Children with Infectious-Inflammatory Diseases of the Urinary System

The purpose of the study was to substantiate and develop the improved model of the specialized nephrology care for the children with infectious inflammatory diseases of the urinary system at the regional level. Materials and methods. The official statistical data have been studied (reports on the state of medical care for children in the Chernivtsi region and data from the Center of medical statistics of the Ministry of Healthcare from 2006 to 2017), information-analytical and statistical methods have been used. The modern etiological structure of uropathogens – urinary tract infection pathogens among the children of the Chernivtsi region (2009-2016) was studied. Clinical and laboratory examination of 3,089 children (0-17 years old) was conducted in the region; the regional spectrum of sensitivity to antibacterial drugs was determined among the main groups of urinary tract infection pathogens; their age, gender and administrative-territorial differences among the children's population of the region are analyzed. Results and discussion. During 2012-2017 there was a significant increase (by 23.0%) in the incidence of infectious and inflammatory groups of the urinary system diseases among children of 0-14 years old, while among adolescents there was simultaneously an intensive decrease in indicators (by 40.0%) compared to 8.7% in 2006-2011. The ratio of indicators and their dynamics suggests that the growth of sick adolescents is largely due to the insufficient effectiveness of medical care, while children of 0-14 years old is due to their low and insufficient prevention. The data formed the foundation for substantiation and development of an improved functional-organizational model of the system. In addition to the existing and functionally changed elements the model contains new elements: regional/inter-regional center of specialized medical aid for children with infectious-inflammatory diseases of the urinary system. Conclusion. Implementation of the elements of the suggested improved model in a part of a rational approach in distribution of functions concerning medical observation of patients at the stages of providing medical aid enabled to make the period of hospitalization of nephrological patients by 11.40% shorter and an average period of treatment of patients with infectious-inflammatory diseases of the urinary system by 2.93% shorter. Efficiency of implementation of certain elements of the suggested model with its positive evaluation by independent experts and its compliance with the strategy of branch reforms enables to recommend the improved functional-organization model of providing medical aid for children with infectious-inflammatory diseases of the urinary system at the regional level to be introduced into the health care system of Ukraine