Activities Of Medical Institutions Research Articles

Medical and social aspects of the activities of local self-government and the medical community of Yekaterinodar in the late XIX – early XX century

The purpose of the study: to study the medical and social aspects of the activities of public institutions of the city of Yekaterinodar in the early twentieth century, as a reflection of global trends shaping the public health system. Materials and methods: historical-descriptive, comparative-historical, problem-chronological, biographical methods were used in the work. The article is based on published sources and archival materials available to the authors. Results. Currently, there is no doubt that the level of public health depends not only on the activities of medical institutions, the qualifications of doctors, medical staff, but also on the timely comprehensive solution of many social issues with the participation of public and state institutions. The article presents some examples of the formation of such interaction and original solutions to urgent medical and social problems in Yekaterinodar (now Krasnodar) at the end of the XIX – beginning of the XX century. The issues of financing medical institutions, medical salaries and pensions, the organization of measures to combat epidemics, the formation of sanitary services, the opening of new specialized hospital departments, and services for the poorest segments of the population were touched upon. The elements of educational work, ways to solve the problem of high infant mortality and the organization of the first Consultation for infants are shown. Many doctors actively participated in the work of local city government, being “public” of the City Duma and the City Council, thereby contributing to the solution of many social and medical issues, including problems of payment for treatment, different categories of the population and “hospital arrears”. Conclusion . Thus, without having a clear state concept and program for the development of healthcare, the city administration, together with the medical community, demonstrated the desire and possibility of jointly solving many medical and social problems of the city of Yekaterinodar. That is, during this period, the potential properties and understanding of the need for the development of the public health system and sphere were formed in the regional society.

Digitalization in healthcare: open opportunities and hidden risks

The issues of digitalization in the field of healthcare in the activities of medical institutions are considered. The increase and complication of the IT equipment of medical institutions should be accompanied not only by increased attention of the employer to the accounting of IT facilities, but also by compliance with legal norms to ensure the safety of these technical means, including the rights of employees entrusted with these facilities. The analysis of the mechanism of financial responsibility of employees of medical institutions, restrictions and risks of the employer is carried out; the assessment of the counter obligations of the parties to the employment contract is given, including the employee to take care of the employer’s property, and the employer to provide appropriate conditions for the employee to perform his work duties.

Values-based healthcare (systematic review)

The current demographic situation is characterized by an increase in life expectancy and gain in the number of chronic non-communicable diseases. Healthcare is faced with the task of preserving the population health in these additional years of life, which, in turn, will lead to an increase in the shortage of resources in healthcare and, in general, negatively affect the economies of states. One of the modern concepts of optimal use of resources, evaluation of the effectiveness of health systems is value-based healthcare. In the described model, the value for the patient is the result of medical care in relation to health, which is important for the patient, the criteria for achieving which are determined by the patient himself. According to the concept of the Center, measuring the results and costs for each patient is part of the strategic program for the transition to a highly efficient healthcare system. 
 The purpose of the study is to investigate the features of value-based healthcare in different countries of the world.
 A systematic review was conducted according to the PRISMA guidelines.
 The literature search was performed in the electronic databases PubMed/MEDLINE, Scopus, eLibrary, CyberLeninka, and Yandex and Google systems among English and Russian-language reports. In the healthcare systems of countries that have implemented a value-based approach, the activities of medical institutions are evaluated according to indicators that reflect the value to the patient. To combine the available resources and coordinate the provision of medical care, multidisciplinary teams of specialists are being created and the patient is provided with a full range of services without delay at all stages. In such models, all processes in medical institutions are standardized, which makes it possible to reduce losses and costs at all stages of medical care and increase the results that are valuable for patients.

The role of marketing strategy in the activities of medical institutions under the conditions of COVID-19

The article is devoted to the topical issues of analyzing the impact of COVID-19 on the marketing activities of medical institutions. Attention is paid to the analysis of the main innovations in the field of medical marketing that arose in response to the challenges caused by the coronavirus pandemic. Changes in society's priorities were analyzed, as well as ways of adapting the marketing activities of business entities in the health care sector were investigated. Determinants of the micro- and macro-environment of medical institutions, which significantly affect the functioning of such institutions in the conditions of challenges of a different nature, in particular in the conditions of epidemics, are determined. An analysis of the competitiveness of a separate medical institution in the region of Ukraine was carried out. The authors proposed an innovative version of Maslow's matrix, which in its essence is more about safe behavior and physiological needs of the consumer. The authors paid attention to the peculiarities of maintaining pages in social networks, setting up targeted advertising, development of health care sites, partnership between medical institutions, virtual assistance of doctors and other important parameters of marketing activity. Three main interrelated topics were chosen for social media posts: COVID-19, hospital, laboratory. Based on the results of the research, recommendations were developed for improving the marketing activities of a private medical center in the context of a pandemic. The authors developed a media plan for the popularization of a comprehensive examination of the human body after suffering from the coronavirus disease. Using the example of a medical center, the implementation of new marketing trends in the work of a medical institution is described (digitalization, updating pages in social networks, implementation of online patient records, maintenance of expert accounts). Outcomes were assessed by monitoring the number of patient records. The effectiveness of the implementation of marketing innovations in the activities of these business entities in the conditions of pandemic challenges has been proven. The advantages of introducing such innovations into the activities of medical institutions and the prospects for their improvement have been studied

Assessment of efficiency of the organic production development in Western Polissia regions

Purpose. The purpose of the article is to assess the socio-ecological and economic efficiency of the organic land-use through the economic substantiation of the organic production development in the Western Polissia regions and its impact on the population health. Methodology / approach. We used general scientific and special research methods for the study. With methods of comparisons, extrapolations, correlations and the regression analysis, we could give an ecological and economical estimate for costs using for the organic land-use engineering and for the feasibility evaluation of the organic production development. The synthesis method was useful in determining the socio-economic efficiency of growing organic products. The State Statistics Service data, collections of health indicators and the activities of medical institutions in the Rivne region became the initial basis for the present study. Results. We made the scientific rationale for the organic production development in the Western Polissia, namely, in Volyn, Rivne, Zhytomyr and Kyiv regions, determined the stabilizing costs for the quality condition of 1 hectare of agricultural land. Moreover, the absence of a direct and close relationship between the agro-ecological indicators of soils and the rate of land certification was proved. It was proposed to use the economic criteria for the agricultural land suitability relative to the organic production, as they are defined as informational rather than restrictive. Mathematical modeling helped to evidence the existence of a relationship between the volume of mineral fertilizers applied per hectare of sown area and the level of the population oncological morbidity exemplified by Rivne region, resulting in mathematical models obtained and applied for the predictive estimates of health problems among the population in Rivne region for the coming years. Originality / scientific novelty. For the first time, the assessment of the socio-economic efficiency of the organic land use was carried out with the involvement of economic justification for the development of organic production in Western Polissia regions and its impact on the population health. Practical value / implications. Key results of the study are primarily actionable for determining the ecological and economic substantiation of the development advisability of the organic production through the implementation of the ecological and economic appraisal of costs using for the organic land-use engineering. In addition to it, another key result is to set the level of reduction in the population morbidity due to a decrease in mineral fertilizers applicable per hectare of sown area.

Environmental Safety and Legal Regulation of Medical Waste Management: International Experience

The article deals with the issues of protecting the population and the environment from the harmful effects of medical waste. Medical waste is dangerous, as the biomaterial carrying the virus accumulates. The list of medicines used in the activities of medical institutions, along with the risk of waste, is also extensive. In the world practice, the issues of neutralization and processing of medical waste are considered. In addition, the analysis of sanitary requirements and legal regulations for the disposal of medical waste was carried out. The hazard class of medical waste is considered depending on the degree of their epidemiological, toxicological and radiation hazard, as well as negative impact on the habitat.

Using Foresight Technology to Limit the Spread of Sexually Transmitted Infections in the Population

Introduction. Over the past decade there has been a steady increase in the incidence of sexually transmitted infections (STIs), which are one of the main causes of reproductive health problems in the world. In the Russian Federation, as in the rest of the world, this problem is relevant, especially among pregnant women. In addition, the problem of detecting, registering, and recording the prevalence of STIs, as well as involving contact persons in the examination remains a problem in Russia. The purpose of this work was to analyze the possibility of using foresight technology to reduce morbidity and monitor the prevalence of sexually transmitted infections in the population, including by evaluating the available literature. Materials and methods. A retrospective study of medical records of syphilis and gonorrhea morbidity in the Sverdlovsk region over a ten-year period was carried out. Intensity rates of gonorrhea, syphilis and other infections per 100 thousand people were calculated. Student's test was used to compare incidence rates. Results. In order to implement foresight-technology we determined the basic indicators of morbidity indicator: gender, age and social data, belonging to "risk groups", motivational and behavioral features of different groups in the population. The incidence of syphilis and gonorrhea in the Sverdlovsk region over a 10-year period decreased by more than 50% (p < 0.05), the incidence rate of syphilis in the group of pregnant women in 2019 is five times higher than in the entire population of the Sverdlovsk region (p < 0.05). The actual discrepancy between the trend for 2019 and the registered actual incidence in the same year was 1.7-3 times. Discussion. Based on the discrepancy between the actually registered incidence of syphilis and gonococcal infection with the calculated trend for them, the main groups of problems in the organization of the activities of medical institutions were identified. Conclusions. The use of elements of foresight technology to limit the spread of STIs by organizing medical and preventive measures to minimize and prevent infection with these infections, both in specific populations and in the general population, allows for the effectiveness of this work in the practice of the dermatovenerologist.

Midwifery as the first official profession of women in Russia, 18th to early 20th centuries

The authors study the institutionalization of midwife specialization among women in Russia in the period from the 18th through the early 20th centuries. The main sources are legislative acts, clerical documents, as well as reports on the activities of medical institutions and maternity departments. The authors use the approaches of gender history, and the concept of professionalization as developed by E. Freidson. Midwifery was the first area of womens work that was officially recognized by the state. There were three main stages on the way to professionalizing the midwifery profession among women. The first stage (covering the 18th century) is associated with attempts to study and systematize the activities of midwives. The practical experience of midwifes was actively sought by doctors whose theoretical knowledge was limited. The second stage of professionalization (corresponding to the first half of the 19th century) was associated with the normative regulation of midwife work and the formation of a professional hierarchy in midwifery. The third stage (comprising the second half of the 19th century and the early 20th century) saw a restriction of the midwives spheres of activity, as well as the active inclusion of male doctors in practical obstetrics and their rise to a dominant position. With the development of obstetric specialization, operative obstetrics, and the opening of maternity wards, midwives were relegated to a subordinate position in relation to doctors. In contrast to the United States and Western European countries, Russia did not have professional associations of midwives. Intra-professional communication was weak, and there was no corporate solidarity. In Soviet medicine, finally, the midwives subordinate place in relation to doctors was only cemented.

Commercialization of the activities of medical institutions — a steady trend

The features of the economic activity of budgetary institutions, including the restrictions and prohibitions established by the current legislation in relation to budgetary institutions, the interests of the state and medical institutions from the position of further improving the efficiency of their activities in the provision of paid medical services are considered. The analysis of the novelties of the legislation regulating paid services provided, including by budgetary medical institutions, is carried out; legislative initiatives to expand the independence of budgetary institutions, including in terms of the disposal of income received by them from income-generating activities; recent changes in the legal organization of medical activities, including clarification of the contractual mechanism for the provision of paid specialized services by medical institutions.

USE OF ELECTRONIC INFORMATION RESOURCES IN THE FIELD OF HEALTHCARE OF UKRAINE

Purpose of the article. The article considers topical issues of the introduction of electronic information resources in the field of health care of Ukraine. Scientific research analyzes the most common forms of application of e-documents in the medical field, namely: concluding an e-declaration with a family doctor, online registration with a doctor, video consultations with a doctor, e-register of insulin-dependent patients, electronic medical card, e-medical program Baby, e-hospital, creating a patient profile, electronic card of a pregnant woman. The author also investigates the economic effect of the introduction of various types of electronic services that are becoming widespread in domestic medicine. The methodology includes the use of the descriptive method, method of analysis, and synthesis to identify the significance of the use of electronic information resources in the medical field. The scientific novelty lies in comprehensive characterization of most typical forms of e-documents used in the modern Ukrainian medical field. Conclusions. A detailed analysis of the term "e-health" proves that it has been actively used in practice since the beginning of the XXI century. Much earlier, the concept of "e-document" entered the practice of European and American physicians, but in recent years in connection with medical reform is becoming popular in Ukraine. The development of information technology significantly changes the process of providing medical services, reorienting the activities of medical institutions to patient-centered care. The use of electronic information resources in the health care system has a number of advantages associated with saving time, a significant increase in the pace of service delivery, the inclusion of cost reductions, and so on. In addition, the ability to communicate with the patient through the media significantly reduces the need for forced travel, which is extremely important in a COVID-19 pandemic. The introduction of electronic documents makes it impossible to forge and falsify them. Electronic service in the medical field of Ukraine has wide prospects for the introduction of its new forms.

New Strategy Formation Outlines for The Organizational and Managerial Support of The Southern Federal District Oncology Service Activities

The article presents the results of the new strategy outlines development for organizational and managerial activities support in the framework of the previously support considered areas: personnel policy; assessment of competencies; infrastructure and digital environment; specialized medical care; scientific policy; quality assessment policy. The basis of the methodological framework is formed by the strategic approach in economics and management. During the empirical part of the study, the following methods were used: the method of expert assessments, the method of SWOT analysis. The resources, external and internal factors, strengths and weaknesses, opportunities and threats of implementing activities in the field of healthcare institution organizational and managerial support were analyzed on the example of the Federal State Budgetary Institution " NMRC of Oncology" of the Ministry of Health of the Russian Federation as the " head " organization of the Southern Federal District in the field of "oncology". The instruments of SWOT analysis were carried out in several stages using qualitative and quantitative methods. The article presents a final review of the results of the SWOT analysis, which allows us to draw conclusions about the choice of the contours of organizational and managerial support strategies (the strategy of extreme optimism, which is based on measures to implement existing opportunities, as well as a conservative strategy, which is based on measures that use the strengths of the organization in order to overcome threats). The study confirmed the hypothesis that the contours of the strategy of organizational and managerial support of activities contribute to the strategizing of common goals and objectives and the design of key areas of activity of medical institutions in order to ensure a high level of involvement of employees at all levels in achieving performance indicators and increasing indicators of scientific performance.

The role of motivation mechanisms in increasing the efficiency of nursing staff management in a medical organization (literature review)

Motivating healthcare professionals is a critical function of healthcare management. Without solving the problems of motivation, it is impossible to really improve the quality and culture of providing medical care to the population, as well as to increase the efficiency of the activities of medical institutions and the industry as a whole on the basis of the competent use of all types of resources, material, financial and personnel. The use of motivation also helps to reduce the number of errors in work due to the human factor associated with its low level and with an insufficiently serious attitude to work.

Forming Trust in the Medical System Through Marketing Activities of Medical Institutions of Certain Territories

The peculiarity of social development in modern life is the development of the role of knowledge and information in society, in the intensive promotion of information technology, and in the formation of new qualitative forms of information interaction between people. Systematization literary sources and approaches for solving the problem indicates that social relations between doctor and patient are built on the basis of practical mutual trust. The better the communication between them, the better the result. This has a positive effect on the patient’s satisfaction with the quality of medical care provided and, in turn, increases the reputation and loyalty to the medical institution. The object of the study is the reasons for patients’ distrust of doctors of government agencies and the medical system of Ukraine as a whole. The subject is informational and marketing activities in public medical institutions in order to increase the level of trust. The target audience is patients and managers of public medical institutions. The purpose is to provide recommendations to the management of medical institutions on information activities to build trust in the medical system. To achieve the goals used these research methods: comparative, analytical, statistical, questionnaire method. The information base of the study is the analysis of the results of research, analysis of the regulatory framework, analysis of scientific literature, materials of scientific and practical conferences, statistical reference books and Internet resources. The information base of the field quantitative research is a questionnaire survey of the population on social networks and public hospitals. In February 2021, a representative survey was conducted on the attitude of people to public medical institutions among the population of Sumy region. 203 respondents took part in this survey: 117 (58%) women and 86 (42%) men. People answered questions about the assessment of trust and the state of the medical system, the reasons for choosing a public or private institution, the criteria that are considered when choosing a family doctor and the patient’s communication channels with the doctor. Analyzing the regulatory framework for informatization in the field of medicine in Ukraine, it was found that the current problem is the poor system of organization and provision of information. According to the survey, 68.5% of the population do not trust the medical system of Ukraine and assess the state of medicine as satisfactory. But the level of trust as a whole is improving. Unfortunately, little attention is paid to information and communication policy in Ukraine. Employees of medical institutions are not interested in developing and keeping up with innovations. Only 37% of respondents use alternative methods of communication with a doctor (internet, telephone). Most respondents said that communication between doctors and patients needed to be improved. Guidelines have been developed for healthcare professionals to improve communication as based on marketing with patients and increase the information literacy of professionals. The results of the study may be useful for the management of health facilities in certain territories, for family physicians who communicate directly with patients and for other institutions and their representatives involved in the health system and are responsible for information and communication component of interaction with consumers.

Development of elements of the concept of determining the future demand for medical services based on the results of analysis of data of different nature

Planning and organizing the functioning of health care institutions is a priority area of activity of their founders. The purpose of such management activities is to ensure the timeliness, quality and completeness of medical services provided to the clients of the institution. At the same time, an important step is to predict the needs for medical services in future periods of time. Forecasting should be carried out taking into account the socio-demographic, medical and behavioral characteristics of persons – potential consumers of medical services and the characteristics of the population structure of the territory in which the medical institution operates. Thus, the object of research is the processes that arise during the analysis of operational and retrospective statistical, medical and social, expert and other data to determine the forecast values of the levels of demand for certain medical services. The results of the analysis should become the basis for making management decisions on planning and organizing the activities of health care institutions in future periods.In the course of the research, a systematic approach, methods of mathematical modeling and other general scientific methods were used.The research result is a developed method for forecasting the demand for medical services in future periods of time. The method consists in the implementation of four sequential stages of the analysis of the initial data. In this case, it becomes necessary to solve the problems of clustering, classification, identification and forecasting. The accuracy of the predicted values depends on the choice of methods and algorithms for solving the problems posed and on the completeness of the initial data. As a result of applying the method, it is possible to obtain:аdivision of persons – potential consumers of medical services into groups in accordance with their socio-demographic portraits, medical data and behavioral characteristics;– relationship between the number of educated groups and the demand for various medical services;– predicted values of the number of groups, as well as the demand for medical services.The results can serve as a basis for making managerial decisions on organizing the activities of medical institutions in future periods of time.

On the question of obstetric and gynecological help in provinces

Self-knowledge is the only correct way to resolve practical issues. The task of Russian medicine to prevent and heal the diseases of the Russian people will only be best resolved when it follows this path. From this point of view, the appearance of reports on the medical activities of medical institutions and individuals is desirable, if they (reports) contribute some material for such self-knowledge and, in part, outline ways to solve practical issues. These considerations prompted me to continue the report on my rural surgical activity, and after the report on the eye operations I propose a report on obstetric and gynecological.

MODERNIZATION OF INFORMATION AND COMMUNICATION SUPPORT OF MEDICAL INSTITUTIONS

Purpose. The purpose of the article is to substantiate the need to modernize the information and communication support of medical institutions of Ukraine to improve the quality of medical care and medical services. Methodology of research. The theoretical and methodological basis of the study are the fundamental provisions of modern economic theory, scientific works of leading foreign and domestic scientists, international and domestic regulations on health care. General scientific and special research methods are used to achieve this goal, in particular: the method of system analysis – to study the information and communication support of medical institutions as a system; the method of structural analysis – to study the structure of the software of the medical information system “Doctor Eleks”; the method of comparison – to compare different methods of information processing in the studied medical information system. Findings. The need for modernization of information and communication support of medical institutions is determined. Prospects for the introduction of medical information systems in health care facilities, such as the “Doctor Elex” information system, are substantiated. Examples of introduction of the medical information system "Doctor Eleks" in foreign and domestic medical institutions are considered. The advantages of the researched medical information system “Doctor Eleks” for: management staff, medical staff and registry staff are formed. The software of the medical information system “Doctor Eleks” is analysed in detail in the context of the main modules: “registry”, “doctor”, “laboratory”, “administration”, “templates”. It is proved that the introduction of the medical information system “Doctor Eleks” in the activities of medical institutions will significantly increase the level of coordination of its staff and will positively affect the quality of medical care and medical services. Originality. The mechanism of introduction of modern information technologies in activity of medical institutions as the factor of increase of quality of medical service on the basis of use of the information system “Doctor Eleks”, which is developed for automation of work of medical institutions is offered. Practical value. The detailed analysis of the advantages of the medical information system “Doctor Eleks” can be useful for directors of domestic medical institutions in choosing the priorities of modernization of their information and communication support. Key words: medical institutions, information and communication support, e-medicine, medical information systems, innovative technologies.

Оценка качества оказания медицинской помощи населению и комплекс предложений по улучшению охраны здоровья граждан

This paper examines the health status of the popula-tion of Russia, viewed through the category of pub-lic health, at the same time understood as a system of practical measures affecting the healthcare sec-tor. The quality of medical care for the population was assessed as part of a study of the statistical indicator of the newly detected incidence. For in-stance, for the period of 2005–2018, it increased by 5,2 %. At the same time, the increase in the indicator for certain classes of diseases reached more than 40 % in some positions. The results of a sociological study conducted in 2018 by the Institute of Social and Economic Research of the Ufa Federal Research Center of the Russian Academy of Sciences made it possible to form a definite idea of the effectiveness of the healthcare system in the city of Ufa. The sur-vey showed that for the majority of respondents (64,6 %), frequent queues in medical institutions, the inability to see a doctor at a convenient time (47,1 %), and the poor organization of the registry (37,6 %) seriously reduce accessibility and effective-ness of medical care. The growing incidence of the population, as well as the problems of providing effective medical care, in particular, organizational difficulties in the activities of medical institutions, which, in our opinion, are no less important than the professionalism of medical personnel, emphasize the urgency of the issue of public health. In this regard, the directions of managerial influence are proposed to contribute to the satisfactory develop-ment of the domestic health care system.

Информационно-аналитическая система как основной инструмент организации деятельности медицинского учреждения

The article is devoted to the role of the information and analytical system in the activities of medical institutions. The functional generalized model of the system for providing diagnostic services to medical institutions is analyzed with the indication of specialized studies, as well as some private processes of working with patients based on IDEF-0 diagrams. The hierarchical structure of storing data about patients of medical institutions in information and analytical medical systems is presented. The resulting data concludes that at this stage of development of the organization of health care institutions necessary to improve the quality of services through the development of requirements to information and analytical systems, which should cover nearly all aspects of healthcare facility management.

Особенности информатизации хирургических подразделений МО. Планирование и управление операционной деятельностью в многопро- фильном стационаре с применением МИС Интерин

The article is devoted to the automation of the process of planning and management of operational activities in a multidisciplinary hospital – the basic principles and features, parameters and factors affecting the formation of the operation plan are formulated, the model of the business process is described and criteria for its effectiveness are given, the methodological foundations for organizing the planning of operational activities are shown – shown the leading role of the relationship between the plan of operations and the plan of hospitalizations, the role of the medical information system in the automation of operational activities is determined. All identified methods of increasing the efficiency of the operational activity of medical institutions by means of MIS were tested on the example of using MIS Interin PROMIS Alpha at the Federal Research and Clinical Center of the FMBA of Russia. The results that were achieved as a result of the practical application of these methods with the use of MIS in the organization of the daily process of the activities of surgeons in the Federal Research Center of the Federal Medical and Biological Agency of the Federal Medical and Biological Agency of Russia are considered.

Забезпечення публічного інтересу у сфері донорства крові

Забезпечення публічного інтересу у сфері донорства крові