Suchergebnisse

The article attempts to assess the necessity for a mentoring system in medical institutions in Moscow. It presents the results of a sociological study, conducted in 2019, which include the analysis of expert interviews (among the experts were heads of the medical institutions subordinate to Moscow Department of Health, institutions of secondary vocational education, additional vocational training, and relating higher educational institutions). Starting with consideration of the issues concerning the attitude of experts to the topic of mentoring, the author identified the need to introduce mentoring in medical institutions, as well as the conditions for organization of effective functioning of the mentoring system, such as choosing a mentor, encouraging him, the timing of mentoring, etc.

The author emphasizes that the institution of mentoring is necessary both to help new employees adapt and to help young professionals gain practical skills. According to experts, there is a gap between basic theoretical training and practical experience of young employees, which can be filled with the help of a mentoring system in medical organizations. Analyzing the expert interviews, the author comes to the conclusion that due to the lack of a legal basis for the mentoring system inRussia, it should be said that mentoring is proactive.
This article also provides a review of international experience, recommendations of international organizations concerning the personnel crisis in medicine, and the main problems of the world health systems hampering achievement of the millennium goals and economic growth. Among the main barriers highlighted by WHO are the following: lack of medical personnel, uneven geographical distribution of medical workers, lack of access to medical services among the population, poor quality of medical care, etc.

Background. In 2020 the global community faced a serious unexpected challenge COVID-19. Fighting the aggressive spread of the coronavirus required rapid reconfiguration of the Russian healthcare system, while exposing its weak spots and pressure points. Critical evaluation of the Russian healthcare systems resilience to crises offers new perspectives on the most effective management and organizational solutions for resolving this crisis. Research objective. The main goal of this study is to make a significant long-term contribution to the Russian healthcare system by developing a set of recommendations for increasing the systems sustainability and resilience to crises. Methods. For this study, specialists developed a framework that includes a set of questions in the 1) domains of governance, 2) financing, 3) workforce, 4) medicines and technology and 5) service delivery, which align closely with the well-recognised WHO health system building blocks. In each domain, a series of targeted questions concerned both sustainability and resilience. Findings. The main areas of work for increasing the Russian healthcare systems sustainability and resilience to crises include: adapting the existing legislative framework to the current crisis, and to prepare it for similar crises in the future; increasing healthcare funding; improving the image of the medical profession; promoting healthcare digitalization; reducing the pressure on the inpatient and emergency care services by strengthening preventive and rehabilitative care services. Conclusion. The synthesis and analysis of materials relevant to understanding the impact of the coronavirus pandemic on the Russian healthcare system, supplemented by expert assessments and examples drawn from practice, allowed the authors to compile a list of recommendations for ensuring the healthcare systems sustainability and resilience to future crises. This list offers potential for healthcare industry development. ; Обоснование. В 2020 г. мировое сообщество столкнулось с неожиданным серьезным вызовом со стороны нового инфекционного заболевания коронавирусной инфекции COVID-19. Борьба с агрессивным распространением пандемии запустила процессы масштабной трансформации российской системы здравоохранения, обнажив ее слабые стороны и болевые точки. Критическая оценка устойчивости российской системы здравоохранения и ее сопротивляемости кризисам создает возможности для поиска наиболее эффективных управленческих и организационных решений в целях преодоления кризиса. Цель исследования внесение значительного и долговременно го вклада в российское здравоохранение путем выработки комплекса рекомендаций, нацеленных на усиление устойчивости сферы здравоохранения и сопротивляемости кризисам. Методы. Для целей исследования была разработана рамочная структура, включающая комплекс вопросов по пяти основным разделам: 1) управление системой здравоохранения, 2) финансирование, 3) медицинские кадры, 4) лекарства и технологии, 5) организация и предоставление медицинского обслуживания. Вопросы каждого раздела затрагивали два направления устойчивость системы здравоохранения и ее сопротивляемость кризисам. Результаты. Основными направлениями повышения устойчивости и сопротивляемости кризисам российской системы здравоохранения являются: усиление существующей нормативной правовой базы в части адаптации к нынешнему кризису и подготовки к потенциальным кризисам разного рода в будущем; увеличение финансирования отрасли; повышение престижа профессии врача; максимальное содействие процессу цифровизации сферы здравоохранения; перераспределение нагрузки с сегментов стационарной и скорой помощи на сегменты профилактики и реабилитации. Заключение. Синтез и анализ материалов, актуальных для изучения вопроса влияния пандемии коронавирусной инфекции на российскую систему здравоохранения, дополненные экспертными оценками ситуации и примерами из практики, позволили сформировать перечень рекомендаций по обеспечению устойчивости системы здравоохранения и сопротивляемости будущим потрясениям. Данный перечень несет в себе потенциал развития отрасли здравоохранения и рекомендован к практическому внедрению.

Current processes in the field of public healthcare — optimizing public healthcare institutions, formation of the market of paid medical services, changes in the legislation and in the requirements for qualification of healthcare workers — require new approaches in management. Today is needed not only redistribution of the volumes of medical assistance between different organizations, but also a review of the healthcare infrastructure, which should meet the needs of the population and ensure the quality of medical assistance. Introduction of Professional standards this year and transition to accreditation of all doctors and nurses directly affect the requirements for qualifications of medical workers. All this requires development of targeted training system in higher education and internship, creating a nationwide database of vacancies in healthcare organizations. The formats of work themselves and the requirements for employees are changing. The main task is to eliminate the imbalance in the distribution of medical workers by levels and conditions of medical care. Based on these needs, a new labor behavior of medical workers is being formed, which depends on many factors and needs a high-quality and in-depth study, not only in theory, but also in practice. This article presents the results of studies of the factors affecting labor behavior in the gender aspect. Labor attitudes and values, attitude toward work, labor activity, and job satisfaction are analyzed. There are presented the tools for both quantitative and qualitative analysis of the raised issues and formation of personnel reserve. The purpose of the article is to identify the gender aspects of the labor behavior of doctors at healthcare institutions using the example of Moscow. On the basis of the conducted study were identified qualitative gender differences and developed tools that could be used in healthcare organizations for analysis of personnel's work, internal staff rotation, formation of personnel reserve.

The article is devoted to highlighting the main provisions of the system of remuneration of medical personnel as one of the key functions of personnel management in the healthcare sector. The author highlighted and substantiated that one of the important components of the success of the implementation of an effective system of financing the health sector is the change in the conditions of remuneration of medical workers, with the focus on the volume and quality of performed work.

The research is devoted to the suppliers influence on hospital work on the example of Moscow public procurement in hospitals. An agency model defining the hospital interaction stages with suppliers were constructed. Using the descriptive statistics method and graphical data analysis, procurement was considered with the author's database including 512 681 contracts of 1,2 trillion rubles for 2011-2019. The supplier's work strategies and their fallouts for the services were emphasized. The criteria the suppliers must have to the contract execution were developed. The hypothesis was tested that suppliers selected in a competitive way ensure the effective procurement for hospitals. The empirical analysis showed that drug procurement had a strong competition at auctions and budget savings. The findings concluded that the suppliers play various roles in hospital work. The favourable situation is that the supplier fulfills the contract delivering quality procurement at an affordable price, in full and due time.

By using an example of the Krasnodar dental clinic «Dent-Real», this article describes the features of accounting and tax accounting for the purpose of organizing internal control in healthcare. The authors pay special attention to the main aspects of accounting and control procedures: accounting of provided health-care services, supplies, orthopedic constructions and forms of strict accountability.In this regard, we consider the importance of price list, develop the main areas of cost optimization, rate an accounting of work-inprogress, study cash discipline according to the new requirements of the legislation of the Russian Federation. ; В настоящей статье рассмотрены особенности ведения бухгалтерского и налогового учета с целью организации внутреннего контроля в сфере здравоохранения, на примере стоматологической клиники «Дент-Реал» г. Краснодара. Особое внимание авторы уделяют основным аспектам учетно-контрольных процедур: учет оказанных медицинских услуг, учет запасов, учет ортопедических конструкций и учет бланков строгой отчетности. В связи с этим рассмотрена значимость прейскуранта цен, разработаны основные направления оптимизации расходов, дана оценка учету незавершенного производства, изучена кассовая дисциплина согласно новым требованиям законодательства Российской Федерации.

Introduction. Localization of objects position in closed space plays an important role in many areas of human activity, including medicine. Using indoor-positioning technologies as a part of telemedicine systems allows one to improve the quality of medical care and to reduce mortality of patients. Therefore, indoor-positioning technologies contribute to achieve the goals outlined in the Russian Federation government`s program "Healthcare development". Aim. To study the applicability of modern radiofrequency technologies for localization of patients inside a hospital building. Materials and methods. Scientific sources devoted to indoor-positioning based on radiofrequency technologies were analyzed. The methods used included: - bibliographic retrieval; - selection and verification of sources based on their relevance; - analysis of sources by methods of deconstruction and comparative analysis . Results. The result of the analysis indicated that radiofrequency positioning technologies allow one to locate objects using radio waves properties. The disadvantage of the technology is the penetration of radio signal through walls and floors. Given this, it is necessary to use complex algorithms to detect an object with accuracy to a specific room. Despite this disadvantage, radiofrequency technologies can be used for positioning in medical facilities since they are easy in deployment and service. Also, they are used in ready-made commercial solutions. ZigBee technology is an exception because it does not allow one to track moving objects in real-time. Conclusion. Based on the study it was concluded that BLE technology is the most suitable for indoor-positioning in medical facilities. It is energy-efficient, it has sufficiently fast data transfer rate, good communication radius and a large range of ready-made communication equipment. It is also worth noting that most wireless medical sensors exchange data via the BLE interface. ; Введение. Определение местоположения объектов в закрытом помещении играет большую роль во многих сферах деятельности человека, в том числе и в медицине. Использование технологий локального позиционирования в составе телемедицинских систем позволяет повысить качество оказания медицинской помощи и снизить смертность пациентов, что способствует достижению целей, обозначенных в государственной программе Российской Федерации "Развитие здравоохранения". Цель работы. Анализ применимости современных радиочастотных технологий для определения местоположения пациента в здании стационара. Материалы и методы. В ходе выполнения данной работы анализируются научные источники, посвященные локальному позиционированию на базе радиочастотных технологий. Используемые методы включают в себя: – библиографический поиск; – отбор и проверку источников с учетом их актуальности, соответствия тематике и авторитетности; – анализ источников с использованием методов деконструкции и сравнительного анализа. Результаты. Результат анализа показывает, что радиочастотные технологии позиционирования позволяют определять местоположение объектов, используя свойства радиоволн. Основной недостаток данной технологии заключается в том, что из-за проникновения радиосигналов сквозь стены и перекрытия приходится использовать сложные вычислительные алгоритмы для обнаружения объекта с точностью до конкретного помещения. Несмотря на данный недостаток, радиочастотные технологии могут применяться для позиционирования в медицинских учреждениях, так как они просты в развертывании и обслуживании и используются в готовых коммерческих решениях. Исключением является технология ZigBee, так как она не позволяет отслеживать подвижные объекты в режиме реального времени. Заключение. На основе проведенного исследования сделан вывод о том, что технология BLE является наиболее подходящей для позиционирования в медицинских учреждениях, так как она обладает низким энергопотреблением, достаточно высокой скоростью передачи данных, хорошим радиусом связи и большим выбором готового коммуникационного оборудования. Также стоит отметить, что большинство беспроводных медицинских датчиков осуществляют обмен данными через интерфейс BLE.

This article examines trends in the development of child health care in modern Egypt. The study and systematization of information on the main directions of activities of public authorities in the field of child health protection in Egypt, as well as an analysis of statistical indicators of the birth rate of the child population in this country. ; В данной статье рассматриваются тенденции развития детского здравоохранения в современном Египте. Изучается и систематизируется собранная авторами информация об основных направлениях деятельности органов государственной власти в сфере охраны здоровья детей Египта, а также проводится анализ статистических показателей уровня рождаемости детского населения в данной стране.

The article presents the results of an analysis of data from global monitoring systems and international studies for the period 2000-2017, reflecting the trends in our country's movement towards universal health coverage (UHC) and a reduction in catastrophic medical expenses paid by patients from their own funds within the framework of the tasks for achieving the Sustainable Development Goals by 2030. It is emphasized that for our country it is of great interest to adapt the successful experience of developed and actively developing countries in using targeted integrated strategies for development of UHC programs aimed at giving priority to health in the system of public financing measures. This is confirmed by the data that for the period 2000-2017 against the background of an increase in the share of replacing the missing state funds with cash funds of citizens in the total health budget of our country from 30% to 40%, there was a parallel increase in the number of households, in the structure of the budgets of which the share of health expenditures exceeded 10% of their total financial resources. According to the analysis of monitoring data, the increase in the number of Russian families with this form of catastrophic costs of medical care reached in 2018 the number of 7,532,579 cases with a prevalence rate of 5.23%. These indicators are higher than the data levels for 1997 by more than 2.2 and 2.1 times, respectively. At the same time, the risk of financial catastrophe for families due to the need to seek surgical care in 2018 was noted in 21.3% of cases (WB, 2019). The study emphasizes the importance of scientific assessment of the consequences and prospects for the increased participation of private commercial institutions in implementation of the government program of the State guarantees of free medical assistance to citizens. The significance of such a study is due to the trends of increasing volume of the market for provision of disparate medical services and the need, therefore, to develop optimal intersectoral strategic approaches to development of both the public healthcare system and commercial medicine in the interests of ensuring health and well-being of the population.

Life expectancy to healthcare spending ratio differs significantly among the Russian regions. The differences could be explained with both non-discretionary factors and the regional management efficiency. The main aim of this article is to evaluate the efficiency of the regional healthcare in Russia employing the formal methodological approach. We use three-step data envelopment analysis (DEA) in order to (1) calculate the technical efficiency scores for regional healthcare systems, (2) determine non-discretionary factors affecting the scores and (3) exclude the non-discretionary component from scores to asses the management efficiency. Using data for 76 Russian regions in 2006-2013 we found approx. 27% regional healthcare spending inefficient, which equals to real 269-435 billion rubles of inefficient spending annually. ; Соотношение ожидаемой продолжительности жизни и подушевых расходов на здравоохранение в России существенно различается между субъектами. Такие различия объясняются как действием внешних факторов, так и различиями в эффективности управления здравоохранением. Целью настоящего исследования является разработка и апробация формального подхода к количественной оценке эффективности региональных расходов на здравоохранение в России. Для достижения указанной цели был использован трехступенчатый метод анализа среды функционирования, включающий в себя: 1) оценку соотношений результатов и затрат в здравоохранении; 2) определение влияния внешних факторов; 3) расчет скорректированной оценки эффективности без учета влияния внешних факторов, то есть эффективности, определяемой качеством государственного управления. Для расчетов использовались данные по 76 субъектам РФ за период 2006-2013 гг. В результате было установлено, что в среднем около 27% расходов на здравоохранение в субъектах РФ являются неэффективными. Общая величина неэффективных расходов в 76 субъектах за рассматриваемый период колебалась в реальном выражении от 269 до 435 млрд руб. в год в ценах 2013 г.

The impact on healthcare organization on the territory of Russian Arctic of unique natural and climatic, demographic, ethnic, settlement and professional factors of influencing the health of population, constantly or temporarily living on this territory is studied. The necessity is substantiated of various forms and resource provision with healthcare services such real and potential patients of Arctic medical institutions, as representatives of indigenous small peoples of the North, workers of mining and metallurgical industry, military personnel, sailors and shift workers. In this connection a correction of a number of All-Russian normative acts is proposed.

The article is devoted to the opportunities and key contradictions of the Russian state healthcare system digitalization project implementation. The authors analyze various aspects of the system digitalization algorithms in light of the federal project "Creation of the Single Digital Circuit in Healthcare based on the Unified State Health Information System". The aim of the article was to identify problems within goal-setting, documentation development, and practical implementation of the healthcare system digitalization project, as well as to come up with proposals for eliminating these issues. The analysis showed the inefficiency of the expensive healthcare system digitalization project, which has both objective and subjective reasons for its low effectiveness. The authors come to the conclusion that it is necessary to eliminate a number of contradictions and barriers in the framework of the project implementation in order to increase the efficiency of both the healthcare system itself and the high budget federal project of the economy digitalization as a whole. The practical significance of the article consists in the applicability of proposed approach to making the necessary amendments to the current federal project documentation, which will ensure a focus on real needs within the framework of the initiative implementation. The work may be of interest to civil servants, initiators of projects on the healthcare system digital transformation, governmental bodies, healthcare organizations managers, students, and practitioners. ; Статья посвящена потенциальным возможностям и ключевым противоречиям реализации проекта цифровой трансформации государственного сегмента системы здравоохранения Российской Федерации. Авторы рассматривают различные аспекты алгоритмов цифровизации отрасли в свете федерального проекта «Создание единого цифрового контура в здравоохранении на основе единой государственной информационной системы в сфере здравоохранения». Целью работы было выявление пробелов в области целеполагания, разработки ...

The Declaration on Patient-Oriented Healthcare of theTomsk Region was accepted by the medical and patient communities on August 24, 2018. It was the first document of its kind in Russia. It was created based on several elements: modern international experience in the field of protection of patients' and medical workers' rights, particular qualities of Russian legislation, principles of humanistic medicine, and broad analysis of specific complaints from patients of regional public health institutions in the Tomsk region. The reason to create the Declaration was the necessity to build a healthcare system in which both medical staff and patients comply with such principles as mutual respect, choice and responsibility, involvement, accessibility, and openness. The document explains the need for constant adherence to these principles for the effectiveness of treatment, the protection of the individual, professional dignity, and equality. ; Декларация о пациент-ориентированном здравоохранении в Томской области принята медицинским и пациентским сообществами 24 августа 2018 г. Документ подобного рода стал первым в России. Он создан на основе современного мирового опыта в области защиты прав пациентов и медицинских работников, особенностях российского законодательства, принципах гуманистической медицины, широкого анализа конкретных жалоб пациентов областных государственных учреждений здравоохранения Томской области. Создание декларации обусловлено необходимостью выстраивания системы здравоохранения, в которой и медицинские сотрудники, и пациенты соблюдают такие принципы, как взаимоуважение, выбор и ответственность, вовлеченность, доступность, открытость. В документе объясняется необходимость постоянного следования данным принципам для эффективности лечения, защиты личности, профессионального достоинства и равноправия.

В статье рассматривается взаимодействие государства и частного сектора. Актуальность ГЧП в Республике Казахстан. ГЧП как альтернатива приватизации жизненно важных, имеющих стратегическое значение объектов государственной собственности. ; The article examines the interaction between the state and the private sector. The relevance of public-private partnership in the Republic of Kazakhstan. Public private partnership as an alternative to privatization of vital, strategically important objects of state ownership.