Number Of Medical Staff Research Articles

Hospital Disaster Management – Evacuation of Perinatal Intensive Care Units Based on Emergency Management Plan

The purpose of this study is to illustrate the special cases of a fire in a hospital especially in a perinatal intensive department, that may be encountered by the firefighters. Due to these special circumstances, the evacuation time of the facility can be significantly increased. There are unusual evacuation and rescue methods, which require special devices and more intense human resources. The evacuation requirement of a hospital is more than a usual evacuation plan, the goal is to maintain the health care services during and after the evacuation, so it is necessary to apply the Evacuation Plan of the Hospital Disaster Plan during a fire evacuation. This requires much more accurate and complex training from both the firefighters and the medical staff. Also, its effectiveness depends to a large extent on the architectural and fire protection design of the building, its modernity, the available medical and rescue equipment and the number of medical staff. The study examines the approximation and joint applicability of the plans above, based on the experience of a hospital evacuation exercise.

General Medicine Departments of Japanese Universities Contribute to Medical Education in Clinical Settings: A Descriptive Questionnaire Study.

BackgroundIt is unclear how much effort Japanese university general medicine (GM) departments, which teach basic medical skills and have a high affinity for clinical practice, devote to medical education, particularly undergraduate education. This study aimed to clarify the contribution of GM departments of Japanese universities to medical education.Patients and MethodsThis was a questionnaire-based descriptive study of GM departments of Japanese universities. We sent the questionnaire created using Google Forms by email, and the universities responded by Internet. The department chairperson of the universities’ main hospital was responsible for completing the questionnaire. It covered the number of staff, inpatients over the previous 3 years, affiliated hospitals, classroom lectures, and practical training sessions per year for each academic year in medical faculty and students accepted for clinical clerkship. Items also included the effort for clinical training, research, and education and the effort for undergraduate, initial clinical residency, and specialty program training.ResultsIn all, 46 of 71 universities responded, and we included 43 in our analysis. The median number of medical staff was 7; the median number of inpatients over the previous 3 years was 76. The median number of classroom lectures of the GM department was 1 for 1st-year, 5 for 3rd-year, 9 for 4th-year, and 0 for 2nd-, 5th-, and 6th-year students. The median total number of accepted students for clinical clerkship was 120. The median educational effort of the GM department was 30. With total educational effort set at 100, the median effort for undergraduate education was 45, for postgraduate residency 30, and for specialty program training 20.ConclusionThe undergraduate medical education by GM departments of Japanese universities was provided mainly in clinical settings for almost all medical students. A focus on exposing students to GM in early academic years would improve the educational environment.

Triage admission protocol with a centralized quarantine unit for patients after acute care surgery during the COVID-19 pandemic: A tertiary center experience in Taiwan.

During the COVID-19 surge in Taiwan, the Far East Memorial Hospital established a system including a centralized quarantine unit and triage admission protocol to facilitate acute care surgical inpatient services, prevent nosocomial COVID-19 infection and maintain the efficiency and quality of health care service during the pandemics. This retrospective cohort study included patients undergoing acute care surgery. The triage admission protocol was based on rapid antigen tests, Liat® PCR and RT-PCT tests. Type of surgical procedure, patient characteristics, and efficacy indices of the centralized quarantine unit and emergency department (ED) were collected and analyzed before (Phase I: May 11 to July 2, 2021) and after (Phase II: July 3 to July 31, 2021) the system started. A total of 287 patients (105 in Phase I and 182 in Phase II) were enrolled. Nosocomial COVID-19 infection occur in 27 patients in phase I but zero in phase II. More patients received traumatological, orthopedic, and neurologic surgeries in phase II than in phase I. The patients' surgical risk classification, median total hospital stay, intensive care unit (ICU) stay, intraoperative blood loss, operation time, and the number of patients requiring postoperative ICU care were similar in both groups. The duration of ED stay and waiting time for acute care surgery were longer in Phase II (397 vs. 532 minutes, p < 0.0001). The duration of ED stay was positively correlated with the number of surgical patients visiting the ED (median = 66 patients, Spearman's ρ = 0.207) and the occupancy ratio in the centralized quarantine unit on that day (median = 90.63%, Spearman's ρ = 0.191). The triage admission protocol provided resilient quarantine needs and sustainable acute care surgical services during the COVID-19 pandemic. The efficiency was related to the number of medical staff dedicated to the centralized quarantine unit and number of surgical patients visited in ED.

Percutaneous Dilatational Tracheostomy

Percutaneous dilatational tracheostomy (PDT) is an increasingly popular method with several advantages, such as being able to perform at bedside with a simple kit, with a less number of medical staff and less amount of time. PDT is easier to perform, offers less bleeding risks and post-operative infection rates compared to conventional surgical tracheotomy. However, PDT is being performed more in the pulmonology and intensive care medicine than in otolaryngology. Herein, we introduce PDT and share our experiences, hoping otolaryngologists use our procedure more.

A graph based recommender system for managing Covid-19 Crisis

The paper aims to present a graph based recommender system for managing the Covid-19 crisis by considering patient and medical staff data. Working with limited number of medical staff, require optimization when creating the appropriate medical staff to assist patient. Patient medical files usually contain more information about the patient diseases and symptoms. In this paper the recommender system at first analyses the patient medical files to find and decide which profile of medical staff could assist efficiency this patient in a crisis situation. Second the recommender system by taking into account the availability of the medical staff will try to propose others doctors with the same profile and the nearest competencies.

The medical support of large-scale international events

The medical support is one of the most important components of effectiveness of international sports events. The purpose of the study is to analyze results of implementation of organizational approaches to medical support of international sports competitions at the World Skills Championship 2019 in Kazan, previously developed and successfully approved on the model of the 2013 World's Students Games (Kazan). The medical support plan included preparation of regulatory base, resources of medical infrastructure at sports venues, including personnel training and measures to eliminate the medical and sanitary consequences of emergencies. At the objects of the Championship, 21 medical aid posts, 23 mobile medical teams functioned, and 22 ambulance teams were on duty. The estimated number of medical staff involved in work at the Championship venues was 120 people, or 8.9 people per 100 contestants. There were 1883 registered medical requests. The largest percentage of requests fell on staff (29.6%), volunteers (20.4%), contestants (18.1%) and visitors (10.7%). Among the accredited persons, the most requested medical assistance was for respiratory diseases (8.5 ‰), diseases of the nervous system (8.4 ‰) and injuries (7.2 ‰). The application of developed approaches to medical support of international sports competitions for the World Skills World Championship allowed to organize provision of medical care to client groups at high level.

Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review.

Background: COVID-19 pandemic caused by SARS-CoV2 has seriously impacted the global economy. Medical facilities around the world were not prepared for the enormous challenges posed by the growing number of patients each day, the shortage of personal protective equipment, and insufficient numbers of medical staff. Governments have tried to counteract the impact of the pandemic, but the measures taken have not always been sufficient to maintain access to and quality of health services at the same level as before the pandemic. The disruption of health services has resulted in more and more research reports from different parts of the world on the accessibility of health services during the COVID-19 pandemic.Methodology: This review article presents 21 selected scientific studies on access to health services in different regions of the world. Articles were found in PubMed, GoogleScholar, Medline, and ScienceDirect databases, then grouped, and significant data were extracted from each article. The results were summarized in a table.Results: The range of limited health services included a variety of specialties, including primary care, psychiatry, orthopedics, cardiology, neurosurgery, and more. Methods used in the studies were based on retrospective analysis or on the subjective assessment of patients in the form of a questionnaire or interview. Most authors claimed a decrease in accessibility to health services during the COVID-19 pandemic compared to the pre-pandemic period, including a decrease in planned surgeries, doctor appointments, patient admission to hospital or ER, and access to medicines. Additionally, some authors observed an increase in the mortality rate. One of the few medical services that have expanded rapidly during the pandemic was online appointments.Conclusions: The COVID-19 pandemic has most certainly affected the accessibility of health services worldwide. Lessons should be learned to prevent inaccessibility to medical services, especially as experts predict another wave of COVID-19 cases.

Cue-based versus scheduled feeding for preterm infants transitioning from tube to oral feeding: the Cubs mixed-methods feasibility study.

There is a lack of evidence of the effect of cue-based feeding compared with scheduled feeding on important outcomes for preterm infants. The objectives were as follows: (1) to describe the characteristics, components, theoretical basis and outcomes of approaches to feeding preterm infants transitioning from tube to oral feeding; (2) to identify operational policies, barriers and facilitators, and staff and parents' educational needs in neonatal units implementing cue-based feeding; (3) to co-produce an intervention for feeding preterm infants in response to feeding cues; (4) to appraise the willingness of parents and staff to implement and sustain the intervention; (5) to assess associated costs of implementing cue-based feeding; (6) to determine the feasibility and acceptability of a future trial; (7) to scope existing data-recording systems and potential outcome measures; and (8) to determine stakeholders' views of whether or not a randomised controlled trial of this approach is feasible. This was a mixed-methods intervention development and feasibility study comprising (1) a systematic review, case studies, qualitative research and stakeholder consensus; (2) the co-production of the intervention; (3) a mixed-methods feasibility study; and (4) an assessment of stakeholder preferences for a future evaluation. Three neonatal units in the UK (two level 3 units and one level 2 unit). Developmentally normal, clinically stable preterm infants receiving enteral feeds (n = 50), parents (n = 15 pre intervention development; n = 14 in the feasibility study) and health-care practitioners (n = 54 pre intervention development; n = 16 in the feasibility study). An evidence-informed multicomponent intervention comprising training, a feeding protocol, feeding assessment tools, supplementary training materials [including posters, a film and a narrated PowerPoint (Microsoft Corporation, Redmond, WA, USA) presentation] and the 'Our Feeding Journey' document. The main outcome measures were recruitment and screening rates, infant weight gain, duration of the intervention, feeding outcomes, implementation outcomes (contextual facilitators and barriers, acceptability, adoption, appropriateness and fidelity) and stakeholder preferences for a future evaluation. The systematic review of 25 studies concluded that evidence in favour of cue-based feeding should be treated cautiously. The case studies and qualitative research highlighted contextual barriers to and facilitators of the implementation of cue-based feeding. The telephone survey found that many neonatal units are considering implementing cue-based feeding. We recruited 37% of eligible infants, and there was good retention in the study until discharge but a high loss to follow-up at 2 weeks post discharge. The mean number of days from intervention to transition to full oral feeding was 10.8, and the mean daily change in weight gain was 25 g. The intervention was acceptable to parents and staff, although there was dissatisfaction with the study documentation. Intervention training did not reach all staff. A cluster-randomised design with a composite outcome was suggested by stakeholders for a future study. The intervention was available only in English. Intervention training did not reach all staff. There was low recruitment to qualitative interviews and observations. Only a small number of medical staff engaged in either the training or the interviews. It is feasible to implement a cue-based feeding intervention with improved training and documentation. Further work is needed to assess the feasibility of a future trial, noting evidence of existing lack of equipoise. The next steps are to digitalise the intervention and conduct a survey of all neonatal units in the UK. This study is registered as PROSPERO CRD42018097317 and ISRCTN13414304. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 74. See the NIHR Journals Library website for further project information.

Implementation of Conflict Resolution Strategies for Hospital Nurses during the Novel Coronavirus Pneumonia Pandemic and Its Impact on Nurses’ Stress Levels

The sudden and large-scale outbreak of the new coronavirus virus requires a large number of medical staff to treat and care for patients with new coronary pneumonia. Nurses not only have to undertake a large amount of nursing work, but also need to face the risk of infection, need special protection, and be affected by work. Forced isolation and away from the family and some patients are critically ill. Understand the implementation of conflict resolution strategies for nursing staff in hospitals during the new coronavirus pneumonia pandemic and its impact on nurses’ stress levels, providing references for improving nursing staff’s physical and mental health and work efficiency, as well as nursing staff in future public health emergencies Take various response strategies to provide a basis.

Impact of the COVID–19 pandemic on the life expectancy of the population of the Republic of Kazakhstan

The purpose of the article is to identify factors affecting life expectancy of the population in the context of the COVID–19 pandemic. Today the main aim all of humanity and each country individually is to improve and prolong human health. It should be noted that health, first of all, is the basis of normal human life. This is a multidimensional process that reflects the mental, physical and socio-economic well-being of people and the country as a whole, realizing themselves in society, covering the social, demographic and medical spheres. In addition, human health is the most important problem of society, labor potential and human capital. In connection with such issues, this article conducts a correlation analysis of factors affecting life expectancy in the Republic of Kazakhstan during COVID–19. This analysis shows that there is a significant and strong correlation between life expectancy, on the one hand, the level of digital literacy of the population and health care costs, on the other hand. Such factors as the number of doctors of all specialties and the number of medical staff positively affected the life expectancy of the population. Factors such as the number of hospital beds and the number of hospital organizations showed a negative relationship. Therefore, improving people’s health, increasing their life expectancy in modern conditions require significant improvement of the healthcare system, the introduction of digital technologies, medical information systems, as well as improving the digital literacy of the population.

New Metrics for Assessing the State Performance in Combating the COVID-19 Pandemic.

Previous research has noted that many factors greatly influence the spread of COVID‐19. Contrary to explicit factors that are measurable, such as population density, number of medical staff, and the daily test rate, many factors are not directly observable, for instance, culture differences and attitudes toward the disease, which may introduce unobserved heterogeneity. Most contemporary COVID‐19 related research has focused on modeling the relationship between explicitly measurable factors and the response variable of interest (such as the infection rate or the death rate). The infection rate is a commonly used metric for evaluating disease progression and a state's mitigation efforts. Because unobservable sources of heterogeneity cannot be measured directly, it is hard to incorporate them into the quantitative assessment and decision‐making process. In this study, we propose new metrics to study a state's performance by adjusting the measurable county‐level covariates and unobservable state‐level heterogeneity through random effects. A hierarchical linear model (HLM) is postulated, and we calculate two model‐based metrics—the standardized infection ratio (SDIR) and the adjusted infection rate (AIR). This analysis highlights certain time periods when the infection rate for a state was high while their SDIR was low and vice versa. We show that trends in these metrics can give insight into certain aspects of a state's performance. As each state continues to develop their individualized COVID‐19 mitigation strategy and ultimately works to improve their performance, the SDIR and AIR may help supplement the crude infection rate metric to provide a more thorough understanding of a state's performance.

EFFECTS OF COMMUNITY AND SOCIAL DEVELOPMENT PROJECTS ON WELFARE OF RURAL FARM FAMILIES IN NIGER STATE, NIGERIA

This study examined the effect of community and social development projects (CSDP) on welfare of rural farm families in Niger State, Nigeria. A multi-stage sampling technique was used to select 300 beneficiaries. Structured questionnaire and interview schedule were used to collect primary data and analysed using descriptive and inferential statistics. The result revealed mean age of 42 years while majority (97.3%) of the beneficiaries acquired formal education with mean household size of 8 people. Majority (84.0%) of the beneficiaries were members of cooperative societies. The effect of CSDP intervention in health sector includes; number of children enrolment in schools (z = 8.94), number of students studying science courses (z = 5.93) all increased but distance to schools (z = -18.11) was reduced. The effect of CSDP intervention in water sector include; time taken to get water (z = -7.34), number of reported water-borne diseases (z = -32.84), cost of buying water (z = - 3.83) all reduced but number of people using borehole water (z = 7.63) increased. The effect of CSDP intervention in transport sector includes; number of vehicle plying the road per day (z = 10.40) increased but time taken to travel (z = -15.58) was reduced. The effect of CSDP intervention in health sector includes; number of medical staff deployed (z = 2.96), number of people seeking medical counseling (z = 2.54) were increased while distance to heath center (z = 6.42) was reduced. On perception, the results revealed that provision of educational facilities (= 2.17), water supply to the community (= 2.20), provision of healthcare facilities (= 2.28) and provision of motor able roads (= 2.19) were perceived to be effective. Meanwhile, intervention such as provision of agricultural inputs ( = 1.35) and provision of extension services (= 1.25) were perceived not to be effective. Poor mobilization and time consuming rank 1st and 2nd in terms of severity of the problems while problem of site location rank lowest 12th. The study concluded that CSDP had significant effect on the income of the beneficiaries as well as on their welfare. It was recommended that extension agents should increase their contacts in order to reach out to large number of farmers for greater mobilization and participation in the project; also the program should be scaled up in other Local Government Areas (LGAs) of the State and the project should have flexible policy that removes bureaucracy for easy access to micro-projects.

Infection control in operating rooms for COVID-19 patients

Background: Surgeries performed for patients with coronavirus disease 2019 (COVID-19) place the medical staff at very high risk of infection. We suggest recommendations for appropriate operation preparation, anesthetic management, and infection control for COVID-19 patients in operating rooms.Current Concepts: Surgeries must be performed in an airborne infection isolation room, such as a negative-pressure operating room. It is recommended that scheduled surgeries for COVID-19 patients be postponed to an acceptable extent, with the exception of emergency cases. Moreover, the number of medical staff participating in the surgery should be minimized. Medical staffs should practice proper hand hygiene and wear an appropriate level of personal protective equipment depending on the infection risk. While performing surgery and inducing anesthesia in COVID-19 patients, endotracheal intubation should be performed by trained anesthesiologists with a video laryngoscope, preferably using high-efficiency viral filters, which can prevent contamination in the anesthesia machine. Use of disposable equipment or COVID-19 patient-specific devices is recommended to prevent the spread of infection, but instruments that require sharing among multiple patients must be thoroughly cleaned and disinfected before their use for the next patient.Discussion and Conclusion: Medical staff performing surgeries for COVID-19 patients are at very high risk of infection. Therefore, the use of appropriate personal protective equipment, high-efficiency viral filters in breathing circuits during anesthesia, and disinfection of contaminated equipment after the operation are mandatory.

Are preventive measures adequate? An evaluation of the implementation of COVID-19 prevention and control measures in nursing homes in China

BackgroundThe novel coronavirus disease 2019 (COVID-19) pandemic has become a challenge for nursing homes in China. Nursing homes are particularly dangerous places in terms of the spread of COVID-19 given that they house vulnerable, high-risk populations. As such, several useful guidelines for coping with COVID-19 in nursing homes have been provided. However, the actual implementation rates of such guidelines are unknown. This study aims to document the adherence of nursing homes to the Ministry of Civil Affairs guidelines for COVID-19 prevention and control in nursing homes.MethodsA cross-sectional study was conducted among 484 nursing homes in 136 cities of 28 provinces in China. A self-report questionnaire was created based on the Ministry of Civil Affairs guidelines for COVID-19 prevention and control in nursing homes (first edition). The questionnaire and the Transformational Leadership in the Public Sector Scale were sent to nursing home managers via the Wenjuanxing app online from February 7 to 29, 2020. Ultimately, 461 of 960 nursing homes participated, for a response rate of 48.0%.ResultsThe average overall implementation rate of COVID-19 prevention and control measures was 80.0% (143.97/180). The average implementation rates for hygienic behaviour management and access management were lower, at 75.3 and 78.7%, respectively. Number of medical staff and transformational leadership score of nursing home’s manager were associated with total implementation score (p < 0.05). A total of 69.8% (322/461) of the nursing home managers had serious resource problems, and inadequate protective supplies (72.0%) and staff shortages (47.7%) were the two primary problems. The nursing homes that located in urban, with large nursing home size, had hospital-nursing home cooperation and the transformational leadership score of manager> 60, had a lower risk of having serious resource problems.ConclusionsOverall, the implementation of prevention and control measures by nursing homes are insufficient during the epidemic in China. More medical staff, adequate resource, cooperation with hospitals, and higher transformational leadership of manager are required to improve the implementation rate. It is urgent for nursing homes to maintain the safety of residents and staff.

Analysis of the spatial range of service and accessibility of hospitals designated for coronavirus disease 2019 in Yunnan Province, China

COVID-19 poses a major threat to global health care systems, and the recent surge in mortality rates confirms the importance of timely access to care. The capacity of medical service providers is reflected both in the spatial accessibility of medical institutions and in the spatial scope of their services. Therefore, this study aims to investigate the spatial scope of services and spatial accessibility of COVID-19-designated hospitals in Yunnan Province, China. Data are collected from multiple sources and included COVID-19 case data, road data, and data from designated hospitals for COVID-19 in Yunnan Province. The optimal spatial service range for designated hospitals is delineated using a weighted Voronoi diagram that takes into account the number of medical staff and the number of beds in the hospital. Traffic accessibility coefficients are introduced to analyze the spatial accessibility of COVID-19-designated hospitals, and the spatial accessibility of each designated hospital is visualized using the inverse distance weighting interpolation algorithm. The results show the following: (1) COVID-19 cases in Yunnan Province are concentrated in the central and northern regions. The largest single cells in the weighted Voronoi diagram are mainly Pu'er (59168 km2), Honghe (35569 km2), and Baoshan (46795 km2), and the time cost of attainting medical treatment is greater for residents in marginal areas. (2) Within the service space of designated hospitals, 90.24% of patients could obtain medical assistance within 2 h. Those in 52 (36.36%) counties within a municipal jurisdiction could obtain medical services within 2 h, and 76.47% of counties have above-average spatial accessibility. (3) Medical resources in Yunnan Province should be shifted toward the high-risk east-central region and the less spatially accessible in southern and western regions.

Inequity in paediatric oncology in South Africa – The neuroblastoma case study

Background: The South African Constitution affords everyone the right to access healthcare services, but in children the care must ensure survival. Aim: This study aimed to determine whether there was access to equitable paediatric oncology services for the management of neuroblastoma in South Africa. Setting: Paediatric oncology services in South Africa between 2000 to 2014. Methods: A literature review was carried out, focussing on access to healthcare in South Africa for children with neuroblastoma. Services were classified in accordance with the International Society of Paediatric Oncology resource settings for neuroblastoma diagnosis. Supplementary data from a retrospective study of the management of neuroblastoma in South Africa were evaluated. Results: The neuroblastoma care services in South Africa were not uniformly resourced and accessible across the provinces. Two provinces (2/9 provinces) had excellent healthcare services that included access to transplant facilities, whilst three (3/9 provinces) had no services. Traveling distances to healthcare services pose major challenges, whilst number of medical staff providing oncology care were unequally distributed. The Constitution did not define basic healthcare for children, nor did the National Cancer Control plan acknowledge childhood cancer as a defined entity without provision until 2022. Conclusion: Children diagnosed with neuroblastoma do not have equitable access to healthcare as stated in the South African Constitution. The case of neuroblastoma highlights the inequitable access to childhood care as a whole in South Africa. As the health of children is a national priority, it is therefore necessary to sensitise policymakers to the needs of children with cancer.

Kultursensibles Training in der Versorgung chronisch kranker, geriatrischer Patienten: Konzept und Evaluation

BackgroundThe number of patients with an immigration background in geriatric healthcare institutions in Germany is growing continuously. The number of medical staff with a migration background is also increasing because of the shortage of qualified employees in the healthcare sector. Therefore, the ability to act culturally sensitive is essential.A training course for employees caring for chronically ill elderly patients with a migration background was developed, tested and evaluated. MethodsThe training was developed on the basis of interviews with experts and research literature and took place over half a day. It was then tested in a pilot study in three hospitals (geriatric, orthopaedic, cardiologic clinics) and evaluated with respect to content and implementation using both guided interviews, which were subjected to content analysis, and a questionnaire. ResultsThe training was feasible and well received by the participants, and a high demand for interventions on cultural sensitivity could be derived from the interviews. Improvements were achieved on the dimensions of self-reflection (recognizing one's own and others’ cultural imprint), communication with patients and their relatives, and teamwork. DiscussionThe participants asked for a more extensive and broader training. A multiplier training should be considered in order to implement the contents nationwide and sustainably in clinics. A randomized controlled design is necessary to verify the assumed effects. ConclusionBased on the results and the need for culture-sensitive training, the training should be carried out within a wider timeframe and in a bigger population.

Geographical disparities in access to hospital care in Ontario, Canada: a spatial coverage modelling approach

ObjectivesPrevious studies on geographical disparities in healthcare access have been limited by not accounting for the healthcare provider’s capacity, a key determinant of supply and demand relationships.DesignThis study proposed a...

НАУЧНОЕ ОБОСНОВАНИЕ ФОРМИРОВАНИЯ СТРУКТУРЫ ПОЛИКЛИНИКИ ЦРБ

Significance. The existing personnel imbalance in health care, including the number of medical staff and occupied positions in the central district hospitals (CDH) of the constituent entities of the Russian Federation and structural units of these hospitals, makes it difficult to improve availability and quality of primary health care (PHC). Development and implementation of the standard CDH models with the standard staffing table, on the basis of which it is possible to form the optimal structure of the central district hospital with the optimal staffing table based on the justified need for human resources, will contribute to improving quality and availability of primary health care at the municipal level. Purpose of the study: to significantly substantiate the regular number of medical personnel of the central district hospital with differently sized catchment areas. Material and methods: Forms of the federal statistical observation (FSN) No. 30 in the pilot territories in three constituent entities of the Russian Federation in the three different federal districts, procedures for care delivery by specialty. Analytical and statistical methods. Results. Actually, a doctor position should be included in the CRH staffing table if the standards allow for the full-time position. Certain health specialties allow for part-time positions if the outpatient and inpatient positions of the specialists can be combined into one full-time position, or part-time positions in the related specialties in the polyclinic with due regard to the population demand. Results. The structure of the CDH polyclinic and the list of full-time medical positions considerably differ depending on the size of the attached population. The adequate number of specialty doctors is ensured by the CDH work organization, distribution of specialists across separate subdivisions that are part of the CDH structure, and the use of telehealth technologies.

METHODOLOGY OF PUBLIC ADMINISTRATION OF THE RIGHT OF PERSONS WITH DISABILITIES TO HEALTH CARE IN DEMOCRATIC COUNTRIES

In 2009, Ukraine signed the Convention for the Protection of the Rights of Persons with Disabilities, and since 2010 has ratified its provisions. Accordingly, committing to the implementation and harmonization of national legislation in the field of social protection of persons with disabilities. Ukraine has become one of 163 signatories and 181 parties, comprising 180 states and the European Union. Under Article 25 of this Convention, persons with disabilities are guaranteed the right to health. However, the provision of this right in each of the participating countries is different, depending on the economic and social development of the country, public policy and the system of government in the field of health, and so on. It is noted that Ukraine is one of those countries that, although ratified the provisions of the Convention for the Protection of the Rights of Persons with Disabilities, however, can not fully ensure its effectiveness and full implementation. Thus, in this case, it is worth focusing on the general state of health care, the ineffectiveness of state policy on social protection of persons with disabilities, the constant reduction of state budget funds provided for the development and increase of social protection of vulnerable groups. Include persons with disabilities, the lack of appropriate mechanisms for the socialization of persons with disabilities in society, as well as the lack of mechanisms to encourage employers to employ persons with disabilities. Separately, I would like to draw attention to the fact that people with disabilities and people who have friends and relatives of people with disabilities in their environment emphasize the deterioration of their situation and thus complicate access to health care and medical services due to epidemics, pandemics in the country. Caused by the introduction of certain administrative restrictions. In this case, it complicates not only the quality and probability of receiving medical and other services, medicines, orthopedic prosthetics, etc., but also the opportunity for those with disabilities who could get them on their own, because there are new physical and material barriers. It is emphasized that according to the results of our survey, 95% of respondents said that the level of health care in Ukraine is in unsatisfactory condition. The reasons given by the respondents were: – lack of proper material support of the sphere; – high cost of medicines and drugs, as well as orthopedic and prosthetic products; – the presence of permanent queues in health care facilities; – remoteness and inability to reach medical facilities to receive medical care; – Insufficient number of medical staff, and this problem is especially acute in remote areas; – lack of local programs for the development and support of people with disabilities; – Lack of static and monitoring data on the state of use of local and state budget funds, etc. It is proved that attention should be paid to the international experience of ensuring the right to health of persons with disabilities in those countries which: first, belong to highly developed countries, and their level of protection of the right to health of persons with disabilities is high; secondly, they ratified the Convention on the Rights of Persons with Disabilities and almost simultaneously with Ukraine began to implement the provisions of this act in the norms of national legislation.