Vol 63, No 6 (2019)
- Year: 2019
- Published: 16.12.2019
- Articles: 8
- URL: https://rjonco.com/0044-197X/issue/view/9551
Full Issue
HEALTH CARE ORGANIZATION
ASSESSMENT OF WORKING CONDITIONS BY PHYSICIANS OF STATE, OCCUPATIONAL AND PRIVATE MEDICAL ORGANIZATIONS
Abstract
Introduction. Strengthening of human resources, developing sustainable solutions related to their retention and improving professional skills is currently a paramount task in health policy. The causes of the real problems of health workers are varied and complex. Personnel problems depend on many factors, some of which are difficult to assess at the government level. Material and methods. The study is based on sociological data. The survey involved 2836 physicians of medical organizations of various ownership forms in the Far Eastern Federal District of the Russian Federation in 2017-2018. Sociological data are collected using a specially designed questionnaire consisting of 24 questions. Analysis of statistical data was performed by calculating relative and average values, using one-way analysis of variance. Results. Statistical analysis showed significant differences in satisfaction with working conditions among physicians of state, occupational and private clinics. According to the selected criteria, physicians of private organizations on a five-point scale have a good level of satisfaction with working conditions, physicians of occupational and state organizations are medium, low and very low. In the study there was revealed statistical differences among groups in the main factors of motivation. Discussion. The study revealed statistically significant differences in satisfaction with the working conditions of physicians of state, occupational and private clinics. Conclusion. The results of the study made it possible to determine the problems of satisfaction with the working conditions of physicians in the three health sectors and can be used to develop a health development strategy.
Health Сare of the Russian Federation. 2019;63(6):284-291
284-291
PROBLEMS OF SOCIALLY SIGNIFICANT DISEASES
THE INCIDENCE OF CHRONIC VIRAL HEPATITIS C IN CHILDREN IN THE RUSSIAN FEDERATION - LONG-TERM STUDY
Abstract
The article presents the results of analysis of reported incidence of chronic viral hepatitis С (CVHC) in children of Russian Federation in 1999-2018. Material and methods. The study was conducted according to official statistics of CVHC in children in 1999-2018. The authors used descriptive statistics, correlation analysis and regression analysis. Results. The incidence of CVHC in children in the Russian Federation have an uncertain forecast (y = -0,03t + 2,79; R2 = 0,12; p > 0,05). There are regions with low and high incidence of CVHC in children. The increase period (1999-2006) and recession period (2007-2018) of children’s CVHC-incidence were determined. The rate of CVHC-incidence growth in 1999-2006 was 1,4 times lower than the rate of it was reduction in 2007-2018. During the increase period of changes in the CVHC-incidence in children were correlated with the dynamics of the CVHC-incidence in the adult population (0,40 ≤ rS ≤ 0,91; p<0,05; 0,26≤ R2≤ 0,88; 10,53 ≤ F ≤ 43,90; p < 0,05) in all federal district of the Russian Federation. No dependencies were identified during the recession period. Discussion. The authors showed changes in the mechanisms of the CVHC-epidemic process in children. Conclusion. The increase period and recession period of children’s CVHC-incidence are widespread. The rate of increase in the incidence of CVHC in children in 1999-2006 is lower than the rate of its decline in 2007-2018. The mechanisms of the CVHC-epidemic process in children have changed. It is necessary to develop the pediatric approaches in CVHC prevention.
Health Сare of the Russian Federation. 2019;63(6):292-299
292-299
CHILDREN AND ADOLESCENTS’ HEALTH
CHILD MORTALITY FROM CONGENITAL HEART DISEASES AS A REFLEX OF SURGICAL TREATMENT AVAILABILITY
Abstract
Introduction. High efficiency of providing medical care to patients with congenital heart defects is based on a balanced assessment of the need for its volumes as well as on a dynamic assessment of the spent resources. Mortality reflects the productivity of the cardiovascular surgery. Objective: to compare mortality trends in children with congenital heart disease with the increase in the volume of surgical care. Material snd methods. Based on official data from 1989 to 2017, standardized mortality rates from congenital heart disease were calculated for age groups of children of both sexes (0-14, 0-1, 1-4, 5-14 years). For selected age groups, mortality dynamics were modelled. For Russian regions the average death rates were calculated for periods 1996-1998 and 2015-2017. Surgical activity was evaluated on the base of statistics which was collected by the A.N. Bakulev Center of Cardiovascular Surgery during 1995-2017. Results. Analysis of child mortality from congenital heart disease for the period from 1989 to 2017 showed that the uneven rate of the mortality decrease across different regions of the Russian Federation was rather due to insufficient disease detection because of low access to specialized health services and possible errors in death cause coding than geographical accessibility of health care facilities alone. Discussion. The beginning of the reduction in mortality from congenital heart disease coincided with the commissioning of the building of the V.I. Burakovsky Research Institute of Cardiosurgery. Conclusions. The identified reserves for reducing mortality substantiate the need to maintain (or increase in some cases) the level of financing of the Government Contract on “Cardiovascular Surgery”/“Congenital heart disease” section. Сrucial impact on reducing congenital heart disease mortality in Russia was made by increasing the availability of high-tech surgical care to the population.
Health Сare of the Russian Federation. 2019;63(6):300-307
300-307
TOPICAL ISSUES OF HYGIENE
MICROBIOTA OF THE AIR ENVIRONMENT OF THE MEDICAL ORGANIZATION
Abstract
The hospital environment is one of the most favorable environments for the colonization of air and environmental objects by various microorganisms. In the hospital environment of medical organizations (MO) from patients fall pathogens of infectious diseases. The purpose of the work is to study the features of the air microflora in the premises of a MO, where air samples should meet sanitary and hygienic standards for microbiological indicators. Material and methods. All types of isolated microorganisms were identified by mass spectrometry and sequencing in air samples (n=22) taken in the premises of the MO. Results. A wide species diversity of fungi and bacteria belonging to opportunistic pathogens and causing infections associated with the provision of medical care has been established. In most rooms of the MO there were Micrococcus spp. (75.0% of cases) including Kocuria kristinae (12.5%), Acinetobacter spp. (12.5%) and Stenotrophomonas maltophilia (25.0%), Neisseria flava (12.5%), Penicillium spp. (12.5%), Alternaria spp. (43.8%), Cladosporium spp. (31.3%), Aspergillus spp. (18.8%), Acremonium spp. (25.0%), Stemphylium spp., Neurospora spp., Trichoderma spp. (6.3%). Discussion. The results obtained in the study are consistent with the literature data and indicate the presence of pathogens of hospital infections and allergic diseases in the air of MO, that causes some caution and requires quality control of disinfection measures in MO. Conclusion. In the air of the MO, pathogens of infections associated with the provision of medical care, belonging to the 3-4 group of pathogenicity, were found. This dictates the need to improve measures to monitor infections associated with the provision of medical care caused by pathogens of bacterial and fungal nature.
Health Сare of the Russian Federation. 2019;63(6):308-312
308-312
OCCUPATIONAL MEDICINE
IDENTIFICATION OF LIFE EXPECTED FACTORS: ANALYSIS OF PANEL DATA
Abstract
The aim of the study was to assess the factors affecting the expected life expectancy (life expectancy) of the population of the Republic of Bashkortostan (RB). Material and methods. The study was conducted by regression analysis using panel data. The study used official statistical materials of the Territorial Authority of the Federal State Statistics Service for the Republic of Bashkortostan: Table C 51; collections of «Demographic processes in the Republic of Bashkortostan», «Socio-economic situation of municipal districts and urban districts of the Republic of Bashkortostan»; Rosstat data: collections «Regions of Russia. Socioeconomic indicators» (2002-2018). We considered the data consisting of observations on rural municipalities of 54 municipal districts and 21 cities (urban districts and urban settlements) of the Republic of Belarus traced in 16 years (2002-2017). Results. Life expectancy, both in general and among men and women in the republic, tends to increase, but the life expectancy of women is significantly higher than that for men. The effect on the dynamics of life expectancy of the population is provided by territorial differences. The regression models we constructed with fixed effects according to panel data confirmed the existence of a link between the life expectancy of the population and health care resources (medical services), population density, which is explained by a higher standard of living, the provision of social infrastructure, and medical care, which leads to an increase in life expectancy. The relationship between life expectancy and primary adult disability, the level of crime is negative. Discussion. The level of life expectancy of the population for both men and women is affected by the level of infrastructure development and health care system, as well as crime rate. Conclusion. The results of the analysis show that the regression model according to panel data with fixed effects allows you to get a significant and reasonable version of the simulation, which can be used to assess life expectancy depending on indicators of socioeconomic development, development of the health care system.
Health Сare of the Russian Federation. 2019;63(6):313-321
313-321
RISK FACTORS OF YOUTH MORTALITY GROWTH AND PECULIARITIES OF THEIR ACCOUNTING IN MOSCOW
Abstract
Introduction. Over the past quarter of a century, life expectancy in Moscow has increased by 17.3 years for men and 10.1 years for women, significantly outpacing the pace of positive trends in Russia, where rates have increased by 10.2 and 6.7 years, respectively. But since 2010, Moscow, despite its obvious socio-economic advantages, significantly loses to Russia in terms of growth in life expectancy (1.9 and 0.9 against 2.5 and 1.3 years, respectively, and in 2016-2018 in the capital there was a stagnation of indicators. In this regard, the aim of the work is to find out what specific reasons and age groups are responsible for the emerging negative changes in the capital. Material and methods. The data of Rosstat on mortality of the population of Russia calculated in the FAISS-Potential environment, data of the RFU-EMIAS of Moscow (data analysis period July-December 2018 - January-June 2019) were used. Standardized mortality rates for causes of death in selected age groups were calculated. The direct method of standardization, the European standard of age structure, is used. The deceased persons of unknown age are previously distributed in proportion to the number of deaths by age groups over the age of 1 year. Results. A multiple decrease in the mortality of the working-age population of Moscow in 2014-2017 from symptoms, signs and inaccurately marked conditions occurred against the background of an increase in losses from accidental poisoning by alcohol and drugs, injuries with uncertain intentions and unspecified cardiomyopathy. At the present time in Moscow the maximum observed rate of death from cardiomyopathy among young people. Discussion. It is hypothesized that, with a high degree of probability, the abnormal increase in cardiac mortality is a statistical artifact - a consequence of the transfer of deaths of narcotic genesis in the latent form. Conclusion. Judging by the stagnation of life expectancy observed in Moscow in 2017-2018, and especially by the increase in youth mortality during this period, the capital has exhausted the reserves of extensive growth in life expectancy due to its socio-economic resources, and the resumption of positive trends is possible only with the implementation of specific targeted measures developed taking into account the specifics of the capital, which, in turn, implies a full and detailed account of its losses.
Health Сare of the Russian Federation. 2019;63(6):322-330
322-330
LITERATURE REVIEW
THE INCIDENCE OF BRONCHIAL ASTHMA IN CHILDREN AS A RELEVANT MEDICAL AND SOCIAL PROBLEM
Abstract
Bronchial asthma (BA) in children is an urgent medical and social problem, as it causes serious complications. A scientific review of modern domestic and foreign publications reveals the inconsistency of the results on the prevalence of BA among children in some cases. However, most of the studies show a steady upward trend and only in some countries there is an obvious stabilization of the incidence of BA in the child population. The data presented in the review are of scientific and practical importance for specialists in the field of pediatrics and healthcare organization. The results of studies based on standardized questionnaires in various territories of the Russian Federation and in other countries show that it is difficult to conduct a comparative research of the prevalence of BA and diseases accompanied by symptoms of difficulty breathing in children. However, the findings indicate a continuing increase in primary and overall incidence of BA in different age groups. These trends in the dynamics of the incidence of BA among the children are established both according to the data of access to medical institutions and special questionnaires, including international ones. The analysis of the incidence of children with BA will allow specialists at the regional level to ensure the formation of treatment and prevention programs, taking into account the identified trends.
Health Сare of the Russian Federation. 2019;63(6):331-338
331-338
LETTERS TO EDITOR
ERRORS AND ADVERSE EVENTS IN MEDICAL PRACTICE
Abstract
The article presents a concise overview of international publications covering issues of patient safety, adverse events in medical practice, role of medical errors and negligence in their occurrence. The overview is based on the analysis of Harvard Medical Practice Study results, World Health Organization (WHO) recommendations on patient safety. The study has shown that different adverse events took place in 3-16% of all hospitalized patients, 13% of these events were fatal. More than a half of those events were shown to be potentially preventable. WHO specialists had developed and brought into everyday hospital practice special patient safety toolkit, which has proved to be effective in reducing amount of harm brought to patients, making medical aid safe and attractive. Considered are problems associated with medical errors in Russian Federation.
Health Сare of the Russian Federation. 2019;63(6):339-342
339-342
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: ПИ № ФС77-50668 от 13.07.2012 г.
Регистрационный номер и дата принятия решения о регистрации СМИ: ПИ № ФС77-50668 от 13.07.2012 г.