MEDIS – International Journal of Medical Sciences and Research最新文献

{"title":"STUDY OF REVENUE CHANGE IN UNIVERSITY MULTIPROFILE HOSPITALS FOR ACTIVE TREATMENT IN BULGARIA","authors":"Hristo Stoyanov, Rumyana Yaneva","doi":"10.35120/medisij020301s","DOIUrl":"https://doi.org/10.35120/medisij020301s","url":null,"abstract":"The success of a hospital medical care system needs to be measured by how efficiently and effectively it addresses the needs of the users of the services it provides. The difficulties caused by the spread of COVID-19 did not prevent the University Multiprofile Hospitals for Active Treatment from continuing to perform their public service functions - they took over the treatment of the most significant part of patients with SARS-CoV-2 infection, while at the same time continued to provide the necessary conditions for conducting practical medical education for future medical specialists. The aim of the study is to perform a comparative analysis of the change in revenue of the University Multiprofile Hospitals for Active Treatment for the period 2019 – 2021. Methodology: The following methods were used for processing and analyzing the received information: Documentary method - the source of the information is the annual reports of the medical facilities for hospital care, which are received and processed annually at the National Center for Public Health and Analyzes at the Ministry of Health; System analysis method; Comparative-analytical method; Economical analysis; Financial and accounting analysis; Statistical methods, including: analysis of the dynamics of phenomena and graphic analysis - to visualize the obtained results. Results: There is a trend of increasing the total revenues of UMHAT for the studied period by 32.6%. The first year since the onset of the COVID-19 pandemic (2020) has seen the strongest increase in revenue from the Ministry of Health, followed by revenue from donations. In 2021, the increase in revenues from voluntary health insurance companies was most pronounced, but there was a decrease in revenues from the Ministry of Health. Discussion: In the Report on the health of citizens of the Minister of Health, it is stated that the growth of costs in 2020 compared to those reported in 2019 in the system of the Ministry of Health by more than 58% is due to the complicated epidemic background, in connection with which the ministry initiated a number of activities to ensure the treatment of those affected and limit the spread of the infection. Conclusion: Based on the changes in the environment, as well as to the dynamically changing needs of hospital services, a more flexible adaptation to them is necessary for the modern university hospitals, in which teaching activities are carried out in addition to treatment. Recommendations: An essential condition for University Hospitals to ensure the quality that patients and future medical specialists are looking for is the attraction of additional financial resources, both to improve their material base and as a means of conducting a successful personnel policy.","PeriodicalId":494529,"journal":{"name":"MEDIS – International Journal of Medical Sciences and Research","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135154216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORNEAL EDEMA AFTER CATARACT SURGERY - CHANGES IN CORNEAL ENDOTHELIUM CELL CHARACTERISTICS","authors":"Biljana Ivanovska Adjievska, Violeta Buckoska","doi":"10.35120/medisij020237i","DOIUrl":"https://doi.org/10.35120/medisij020237i","url":null,"abstract":"
 Corneal edema is a common complication of cataract surgery, although tremendous improvements have been made in the surgical techniques, which decreased surgical eye trauma and complication rates. Normal endothelial cell density is 2000-3000 cells/mm2 in older individuals, which maintains the corneal clarity. Even ‘perfect’ cataract surgery does some damage to the endothelium. A significant postoperative endothelium density decrease can impair its ability to maintain corneal clarity, resulting in corneal edema, blurring of vision and ocular pain. Aggressive topical treatment in the first month after surgery may lead to recovery of the endothelial cells. Our aim was to establish the effects of cataract surgery on the characteristics of the corneal endothelium. We performed a prospective interventional clinical study of 30 patients, mean age 65±12 years, with senile cataract. Over 80% were hard cataracts: 18% hypermature, 66% grade 4 (brunescent) and 16% grade 3 cataracts. Uneventful phacoemulsification with IOL implantation was performed by one experienced phaco-surgeon in an outpatient setting. Preoperative parameters included: best-corrected visual acuity (BCVA) in Snellen decimal units, IOP, cataract density (slit lamp examination), corneal endothelium cell density (ECD) and hexagonality measured with a specular microscope. Intraoperative parameters included: phacoemulsification time and energy, irrigation–aspiration suction time. Standard phacoemulsification cataract surgery was performed with in-the-bag IOL implantation. Mean baseline parameters were: BCVA=0.1±0.13, IOP=15.7±2.7 mmHg, ECD=2,497±290 cells/mm2, cell hexagonality was 54.3±9.4%. Mean surgical parameters were: surgical time=9,3±2.9 minutes, phacoemulsification time=35.6±26.1 seconds, phacoemulsification energy=13.3±10.9J, irrigation–aspiration suction time=81.3±45.9 seconds. Acute postoperative corneal edema occurred in 4 eyes (13.3%). After one-week BCVA was 0.5±0.2. 9 eyes (30%) had visual acuity ≤0.5. They were treated aggressively with antibiotics (moxifloxacine), corticosteroid (dexamethasone) and hypertonic eye drops (sodium chloride (5%) and mannitol (20%)), every hour during the first week and gradually tapered in the 1 month. Antiglaucomatose eyedrops (timolol, brinzolamide) were used to control the IOP below 20 mmHg. After 1 month mean BCVA increased to 0.85±0.15 and all eyes reached BCVA higher than 0.6. IOP was stable at 15.4±2.0 mmHg. The mean endothelial cell loss was 19,1%. None of the eyes progressed to chronic edema. Corneal edema is a common complication after surgery of difficult cataracts. Even though the cataract density directly influences the postoperative condition of the corneal endothelium, surgical trauma is still considered the most common cause of corneal endothelial decompensation. Preoperative specular microscopy is very important to predict possible postoperative complications of the corneal endothelium and apply appropriate surgical technique","PeriodicalId":494529,"journal":{"name":"MEDIS – International Journal of Medical Sciences and Research","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135269890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MUD THЕRАPY – А NАTURАL CHONDROPROTЕCTION OF JOINT CАRTILАGЕ","authors":"Еvgеniyа Vlаdеvа","doi":"10.35120/medisij020229v","DOIUrl":"https://doi.org/10.35120/medisij020229v","url":null,"abstract":"Ostеoаrthritis is а joint disеаsе in which thеrе is dеgеnеrаtion аnd dеstruction of thе аrticulаr cаrtilаgе with subsеquеnt formаtion of ostеophytеs аnd chаngеs in thе joint cаpsulе. It is а disеаsе thаt аffеcts аll structurеs of thе joint аnd thе surrounding tissuеs (musclеs, tеndons, ligаmеnts).Intеrеst in non-mеdicinаl аnd non-surgicаl mеthods for thе prеvеntion аnd trеаtmеnt of ostеoаrthritis is growing strongly. Hеrе, thе mеthods of physicаl аnd rеhаbilitаtivе mеdicinе аnd mud thеrаpy comе into considеrаtion аbovе аll.Limаn mud hаs pronouncеd аnti-inflаmmаtory, pаin-rеliеving аnd immunе-stimulаting propеrtiеs, improvеs blood circulаtion аnd аctivаtеs thе mеtаbolism. It hаs а positivе еffеct on mеtаbolism аnd tissuе nutrition аnd promotеs tissuе rеgеnеrаtion. Thе hеаling mud intеrаcts in а complеx wаy with thеrmаl, chеmicаl, mеchаnicаl, еlеctrodynаmic, biologicаl аnd othеr fаctors. Thе thеrmаl аnd chеmicаl fаctors аrе of pаrticulаr importаncе for thе hеаling rеsults.","PeriodicalId":494529,"journal":{"name":"MEDIS – International Journal of Medical Sciences and Research","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135269652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DYNAMICS IN COSTS AND THE NUMBER OF PATIENTS OF THE FIVE MOST RESOURCE-CONSUMING DISEASES PAID WITH PUBLIC FUNDS FROM THE NATIONAL HEALTH INSURANCE FUND FOR HOME TREATMENT","authors":"Rumyana Yaneva, Hristo Shimerov","doi":"10.35120/medisij020201y","DOIUrl":"https://doi.org/10.35120/medisij020201y","url":null,"abstract":"On a global scale, health care costs are constantly growing, with a large part of them taking up the costs of medicinal products. The trend for the increase in the consumption of medicinal products is due to the following main reasons: the aging of the population, the possibility of medical treatment of more and more diseases and the development of new medicinal products. A challenge for the governments of individual countries is how, with limited financial resources, to ensure access for the widest possible range of patients to the best medicines. One way to contain health care costs is the reimbursement method. At the same time, a guarantee is needed that decisions to pay for publicly funded medicines are based on cost-effectiveness criteria.The purpose of the current study is to track the dynamics of the costs of medicinal products, medical devices and dietetic foods for home treatment and the number of sick health insured persons from the five most resource-intensive diseases, paid with public funds from the National Health Insurance Fund in Bulgaria for 2021 and 2022.Materials and methods: Documentary method - monthly statements of the National Health Insurance Fund for costs and number of patients for medicinal products, medical devices and dietary foods for home treatment, according to the ICD code of the disease; Economical analysis; Medical statistical methods; Tabular and graphical analyzes - to visualize the obtained results.Results and analysis: Based on the results obtained from the study, it is clear that for the observed period the total costs of medicinal products for home treatment reimbursed by the NHIF increased by 11.43%. Of the five most resource-intensive diseases, the disease for which the most public funds are spent on medicinal products for home treatment is Non-Insulin-Dependent Diabetes Mellitus, with neurological complications, and the highest rate of increase in spending in 2022 is Non-Insulin-Dependent Diabetes Mellitus, without complications – with 18.3%.Conclusion: In contrast to the upward trend in the costs of medicinal products, we observe a slight downward trend in the total number of sick persons with mandatory health insurance in 2022 compared to 2021. In the total number of patients for whom public funds were spent on medicinal products for home treatment by the NHIF, the reduction was 0.97%. Despite the general trend, with the most resource-intensive diseases under consideration, the number of patients slightly increased, with the exception of only one of them.","PeriodicalId":494529,"journal":{"name":"MEDIS – International Journal of Medical Sciences and Research","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135269814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}