Evaluation of the Quality of Medical Care to the Population at the Level of Day Stations and Emergency Stations

Insufficient availability of emergency medical services to the rural population is noted. The dynamics of the growth of calls to emergency medical services testifies to the fact that emergency medical institutions have taken over part of inpatient services for the provision of emergency care to patients with chronic diseases and acute colds.

Problems in the Social Life of the Resettled Population in Uzbekistan (1925-1941)

This article highlights the policy of resettlement of households and problems in the social life of the population in Uzbekistan and its southern regions. Along with this, from a scientific point of view, the state of the farms of the resettled population and the problems of providing them with housing, medical care and in the field of education are analyzed.

Human health care against COVID-19 via environmental management

Although vaccines are successfully developed against Severe Acute Respiratory Syndrome Coronavirus-19 (COVID-19), and many anticancer, anti-malarial, antibiotic drugs have been repurposed against the disease, it has been just impossible to save valuable human lives in specific conditions. Therefore, medical care has been developed against COVID-19 but not fully able to save human life from the disease. As a result, the third wave is noticed in many countries. Preventive methods such as social distancing, wearing masks, and hand salinization have been accepted as the main strategies to break the chain of the disease. Due to the reduction in pollution under less or no industrial and vehicular operations, water and air ecosystems have been restored in an unseen manner. Especially, NO₂, SO₂ and particulate matters etc. modulated higher expression of angiotensin-converting enzyme 2, the receptor of Severe Acute Respiratory Syndrome Coronavirus -2 in humans have also been emphatically documented. Therefore, along with medical care, environmental protection (especially to regulate NO₂ emissions) along with practicing COVID-19 guidelines is to be maintained fully to combat COVID-19 the disease. Human beings must use this knowledge and experience as a spotlight to save nature in current and future times.

How to avoid medical errors, how to respond and relate to them: a review of the scientific monograph «Defects in the provision of medical care»

Currently, the number of judicial proceedings on real and alleged offenses and disputes in area of provision of medical care has been exponentially increased. Some of such proceedings become publicly disclosed, but many more of them remain unnoted in mass media and civilian society as a whole. Increasing number of medical doctors has been accused of criminal offenses, being more often sentenced to real terms of imprisonment, showing a clear tendency to increase gravity of responsibility applied to medical doctors. This publication represents a peer-reviewed response of paramount importance to the book by A.A. Ponkina and I.V. Ponkin «Defects in the provision of medical care» raising ontological, value and technical issues for negative outcome of medical care – by the fault or in the absence of the fault of the doctor. The book puts the scientific basis beneath changes so much awaited by the Russian public health in relation to medical doctors, their social importance, objective limitlessness of their opportunities and capabilities in curing sick people and saving their lives.

Mental Health and Access to Medical Care in Patients with Chronic Cardiovascular Conditions: An Analysis of the Behavior Risk Factor Surveillance System

Introduction. Poor mental health is associated with worse outcomes for chronic diseases. It is unclear whether mental illness predisposes to difficulties with healthcare access. Methods. Using a combined dataset of the 2016-2019 behavioral risk factor surveillance system, we included individuals who reported a chronic cardiovascular condition. Weighted multivariable logistic regression analyses were used to explore the association between domains of mental health and measures of healthcare access including delaying medical care, > 1 year since last routine checkup, lack of a primary care physician (PCP), and cost-related medication nonadherence (CRMNA). Results. Among 1,747, 397 participants, 27% had a chronic cardiovascular condition, 12% had clinical depression, and 12% had poor mental health. Those with poor mental health (OR 3.20 [3.08 – 3.33]) and clinical depression (OR 2.43 [2.35 – 2.52]) were more likely to report delays in medical care. Those with greater stress frequency (OR 8.47 [6.84 -10.49] stressed all of the time), lower levels of emotional support received (OR 3.07 [2.21 – 4.26] rarely get needed emotional support), and greater life dissatisfaction (6.66 [4.14 – 10.70] very dissatisfied) reported greater delays in medical care. Conclusions. Individuals with poor mental health have greater difficulty accessing medical care independent of socioeconomic variables.

Transitional and Long-Term Care System in Japan and Current Challenges for Stroke Patient Rehabilitation

In Japan, the national medical insurance system and long-term care insurance (LTCI) system cover rehabilitation therapy for patients with acute, convalescent, and chronic stroke. Medical insurance covers early and multidisciplinary rehabilitation therapy during acute phase hospitalizations. Patients requiring assistance in their activities of daily living (ADL) after hospitalization are transferred to kaifukuki (convalescent) rehabilitation wards (KRW), which the medical insurance system has also covered. In these wards, patients can receive intensive and multidisciplinary rehabilitation therapy to improve their ADL and transition to a smooth home discharge. After discharge from these hospitals, elderly patients with stroke can receive outpatient (day-care) rehabilitation and home-based rehabilitation using the LTCI system. The Japanese government has proposed building a community-based integrated care system by 2025 to provide comprehensive medical services, long-term care, preventive care, housing, and livelihood support for patients. This policy aims to promote smooth coordination between medical insurance services and LTCI providers. Accordingly, the medical insurance system allows hospitals to receive additional fees by providing patient information to rehabilitation service providers in the LTCI system. A comprehensive database on acute, convalescent, and chronic phase stroke patients and seamless cooperation between the medical care system and LTCI system is expected to be established in the future. There are only 2,613 board-certified physiatrists in Japan, and many medical schools lack a department for rehabilitation medicine; establishing such a department at each school is encouraged to teach students efficient medical care procedures, to conduct research, and to facilitate the training of personnel in comprehensive stroke rehabilitation.