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Владимир Петрович Косолапов ◽  
Наталья Николаевна Чайкина ◽  
Галина Владимировна Сыч ◽  
Ольга Николаевна Черных

Вопросы улучшения оказания первичной медико-санитарной помощи детскому населению всегда выступали в качестве приоритетных при оптимизации деятельности службы охраны материнства и детства и вызывали особое внимание организаторов здравоохранения. Одним из значимых решений по повышению качества оказания медико-санитарной помощи, в том числе и детям, является проект по реализации «Новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» в детских структурных подразделениях. Одной из основных задач педиатрической службы Воронежской области является реализация мероприятий региональной программы «Развитие детского здравоохранения Воронежской области, включая создание современной инфраструктуры оказания медицинской помощи детям», которой предусмотрено достижение целевых показателей и выполнение определённых задач. В данной статье рассматриваются вопросы организации деятельности педиатрической службы Воронежской области в плане реализации новой модели медицинской организации, оказывающей первичную медико-санитарную помощь в детских структурных подразделениях. Определяются направления развития детского здравоохранения, включая создание современной инфраструктуры оказания медицинской помощи детям. Приводятся данные по достижению в детских поликлиниках и детских поликлинических отделениях Воронежской области организационно-планировочных решений внутренних пространств, создание условий для внедрения принципов бережливого производства и комфортного пребывания детей и их родителей при оказании первичной медико-санитарной помощи, с акцентом на воплощении идей оптимизации первичной медико-санитарной помощи путем использования принципов и методов бережливого производства в части реализации регионального проекта «Развитие системы оказания первичной медико-санитарной помощи» Нацпроекта «Здравоохранение» в рамках создания и тиражирования «Новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» The issues of improving the provision of primary health care to the children's population have always been a priority in optimizing the activities of the maternal and child health care service and have caused special attention of health care organizers. One of the significant decisions to improve the quality of health care, including for children, is the project to implement the "New model of a medical organization providing primary health care" in children's structural units. One of the main tasks of the pediatric service of the Voronezh region is the implementation of the activities of the regional program "Development of children's health care of the Voronezh region, including the creation of a modern infrastructure for the provision of medical care to children", which provides for the achievement of targets and the implementation of certain tasks. The article deals with the organization of the activities of the pediatric service of the Voronezh region in terms of implementing a new model of a medical organization that provides primary health care in children's structural units. The directions of development of children's health care, including the creation of a modern infrastructure for the provision of medical care to children, are determined. The data on the achievement in children's polyclinics and children's polyclinic departments of the Voronezh region of organizational and planning solutions of internal spaces, the creation of conditions for the introduction of the principles of lean production and a comfortable stay of children and their parents in the provision of primary health care, with an emphasis on the implementation of ideas for optimizing primary health care through the use of principles and methods of lean production in terms of implementation regional project "Development of the system of primary health care" of the National Project "Healthcare" in the framework of the creation and replication of the "New model of a medical organization providing primary health care"

2021 ◽  
Vol 8 ◽  
Cheng Wang ◽  
Peizhen Zhao ◽  
Mingzhou Xiong ◽  
Joseph D. Tucker ◽  
Jason J. Ong ◽  

Background: Sexual health among older adults is a major public health concern globally. The syphilis burden is increasing in older adults in China. This study aimed to describe factors associated with syphilis infection and diagnosis among older adults in China during a 16 year period.Methods: Using 16 years of data (2004–2019) from the syphilis case report system of Guangdong, China, we compared data from older adults (aged ≥50 years) with those from younger people (aged 15–49 years). We compared the two age group with the Chi-square test for difference, and Joinpoint regression models to assess the temporal trends.Results: During the study period, 242,115 new syphilis diagnoses were reported in older adults. The mean notification rate of new diagnoses was 64.1 per 100,000 population across the entire 16-year period, which significantly increased over time (average annual percent change [AAPC] 16.2%, 95% CI 13.7–18.7). Syphilis diagnoses increased significantly over time among less developed cities and older women. In 2019, compared with younger adults, newly diagnosed older adults were more likely to be male, native to reporting city, had unknown transmission routes, and were diagnosed late.Conclusion: Our findings call for an urgent need to deliver more targeted prevention interventions for older adults, such as strengthen awareness among health care providers, and integration of syphilis services and primary health care for older adults.

2021 ◽  
pp. 34-43
T. Yu. Vladimirova ◽  
A. B. Martynova

Introduction. The article is devoted to the special role of the primary care physician - therapist, geriatrician, general practitioner, in assisting the elderly and senile in taking appropriate and timely measures in identifying people with chronic sensorineural hearing loss (SNL), consulting them at the stage of primary health care.Aim of the study. Understand the intended role of general practitioners and therapist in identifying and counseling patients with hearing loss in primary health care.Materials and methods. A survey of general practitioners and therapist was conducted in the form of 88 statements, collected in six concepts, in response to the question “What should be the role of a general practitioner in the treatment of chronic sensorineural hearing loss in persons of an older age group?” in the format of a Google-questionnaire.Results. The results showed a sufficient awareness of general practitioners and therapist about the predisposition of their elderly patients to hearing loss and the significance of the associated consequences on the quality of life. As a result of the data obtained, the highest percentage of statements was noted in Concept 1 “Determine - Diagnose - Discuss” and varied on individual issues from 27.8% to 55.6%, the lowest - in Concept 5 “Educate - Strategise - Encourage” and ranged from 16.7% to 44.4%.Discussion. Strengthening collaboration between therapists and otorhinolaryngologists, otorhinolaryngologists, and audiologists is the most effective strategy for reducing individuals with untreated SNL. The importance of the role of the primary care physician in multidisciplinary care and its coordination is especially emphasized in the concept of “Know - Refer - Coordinate”.Conclusions. The authors conclude that the priority concept of modern health care, which makes it possible to significantly improve the quality of life of patients in the older age group and reduce the psychosocial consequences of hearing loss.

Cureus ◽  
2021 ◽  
Nasser Almulhim ◽  
Fahad Almulhim ◽  
Ali Al Gharash ◽  
Zahra Alghannam ◽  
Rami S Al-ghamdi ◽  

Cureus ◽  
2021 ◽  
Hussain A Al Ghadeer ◽  
Nihad A Al Kishi ◽  
Duaa M Almubarak ◽  
Zainab Almurayhil ◽  
Fatimah Alhafith ◽  

L. Fernández-Arce ◽  
N. Robles-Rodríguez ◽  
A. Fernández-Feito ◽  
A. Llaneza-Folgueras ◽  
A. I. Encinas-Muñiz ◽  

Abstract Purpose To explore the effect of type 2 diabetes mellitus (T2DM) on the risk of death among women with breast cancer (BC). Methods A survival analysis was conducted among a cohort of women diagnosed with BC between 2006 and 2012 in Spain (n = 4,493). Biopsy or surgery confirmed BC cases were identified through the state population-based cancer registry with information on patients’ characteristics and vital status. Physician-diagnosed T2DM was confirmed based on primary health care clinical history. Cox regression analyses were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for all-cause death. Analyses were adjusted for age, hospital size, several clinical characteristics (including BC stage and histology, among others) and treatment modalities. Results Among the 4,493 BC women, 388 (8.6%) had coexisting T2DM. Overall, 1,299 (28.9%) BC women died during the completion of the follow-up and 785 (17.5%) did so during the first five years after BC diagnosis, resulting in a five-year survival rate of 82.5%. The death rate was higher in women with T2DM (43.8% died during whole period and 26.0% during the first five years) when compared with women without T2DM (27.5% and 16.7%, respectively). Accordingly, all-cause mortality was higher in women with T2DM (aHR: 1.22; 95% CI 1.03–1.44), especially if T2DM was diagnosed before BC (aHR:1.24; 95% CI 1.03–1.50) and in women with BC diagnosed before 50 years (aHR: 2.38; 95% CI 1.04–5.48). Conclusions T2DM was associated with higher all-cause mortality among Spanish women with BC, particularly when the T2DM diagnosis was prior to the BC.

2021 ◽  
Vol 10 (23) ◽  
pp. 5656
Krzysztof Studziński ◽  
Tomasz Tomasik ◽  
Adam Windak ◽  
Maciej Banach ◽  
Ewa Wójtowicz ◽  

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.

2021 ◽  
Vol 21 (1) ◽  
Kiarash Tanha ◽  
Noushin Fahimfar ◽  
Shahrzad Nematollahi ◽  
Sayed Mahmoud Sajjadi-Jazi ◽  
Safoora Gharibzadeh ◽  

Abstract Background Osteoporosis (OP) is progressively becoming a global concern with the aging of the world’s populations. Osteoporotic fractures are associated with significantly increased mortality rates and a financial burden to health systems. This Meta-analysis aims to estimate the annual incidence of osteoporotic fractures in Iran. Methods A comprehensive systematic literature search was performed through Medline (PubMed), Embase, Scopus, Web of Science, and Google Scholar to identify studies which contain an investigation of the incidence of osteoporotic fractures in Iran up to December 3rd 2020, with no time and language restriction. For the risk of bias assessments of studies, the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data was used. The pooled estimation of the incidence of osteoporotic fractures in population aged≥50 years was calculated using random-effects meta-analysis, and the heterogeneity of included studies was quantified with the I2 statistic. Results In all, 6708 papers were initially retrieved from the electronic databases, among which seven studies were included in the meta-analysis. The pooled standardized annual cumulative incidence of hip fractures was estimated as 138.26 (95% CI: 98.71–193.65) per 100,000 population and 157.52 (95% CI: 124.29–199.64) per 100,000 population in men and women, respectively. Conclusion This study showed a high incidence rate of osteoporotic hip fractures in Iran. Early detection and treatment of individuals with higher risks of primary fragility fractures at primary health care as well as implementing fracture liaison services to prevent secondary fractures are highly recommended. The results suffer from the following limitations: first, a low number of studies that were eligible for inclusion; second, the lack of population-based studies; and presence of highly heterogeneous studies despite the use of a random effect model.

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