Manager Zdravookhranenia最新文献

{"title":"Opinion of state medical organizations staff about the causes of fatigue at work.","authors":"N. Sharafutdinova, R. Khalfin, O. Mukhamadeeva, М. А. Sharafutdinov, M. V. Borisova, R. B. Nadyrgulov, R. R. Yakhina, I. R. Valiev","doi":"10.21045/1811-0185-2024-2-89-97","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-89-97","url":null,"abstract":"One of the indicators of dissatisfaction with a job or profession is “fatigue at work,” which more often means the presence of emotional burnout syndrome. In the domestic literature, the concept of “occupational fatigue” is more often used, which defines a person’s condition as a result of his long-term production activity. Studying the key causes of fatigue at work can become the basis for justifying measures to improve the performance of medical organizations. Purpose of the study: to examine the causes of fatigue at work among medical and other personnel in medical organizations of the Republic of Bashkortostan. Materials and methods. The information base for the analysis was the results of a sociological study of 1992 employees of medical organizations of the Republic of Bashkortostan. Questionnaire conducted was focused on determining the causes of fatigue at work. Questions were based on previous researches with republic trade union organization of medical personnel taking part in it. Survey forms were placed on medical organization sites. The causes of fatigue were studied according to age, duration of working time, total years of service and occupation. Results: it was found out that the most common cause of fatigue between staff is “the amount and intensity of work”, “work strain and lack of time”, “insufficient support and attention from manager and overhead staff”.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"393 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140757332","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":"Epidemiological aspects of the formation of new risks of morbidity and treatment of tuberculosis among the population.","authors":"E. V. Bulycheva, E.V. Bulychev","doi":"10.21045/1811-0185-2024-2-114-123","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-114-123","url":null,"abstract":"In accordance with the instruction of the Minister of Health of the Russian Federation No. 19 dated 02/07/2023, specialists currently face several important tasks: from 2015 to 2025, to reduce the incidence of tuberculosis, as well as the number of deaths from tuberculosis by 75%. To do this, it is necessary to identify all the risk factors that may create difficulties in achieving these goals. Purpose of the study is to characterize the epidemiological aspects of the formation of new risks of morbidity and treatment of tuberculosis among the population. Materials and methods. An analysis was carried out among newly identified patients with tuberculosis by molecular genetic (n=1682) and bacterial (n=1630) research methods in the period from 2017 to 2020 according to drug resistance indicators. Results. It was found that in the period from 2015 to 2017, the indicators of drug resistance in tuberculosis patients were almost at the same level. The leading antimicrobial drugs in demand among the population were ceftriaxone, azithromycin, levofloxacin, moxifloxacin. The maximum increase in sales in 2020 relative to 2019 data to 150% was determined among quinolone derivatives of moxifloxacin and levofloxacin, which began to be used in the treatment of coronavirus infection. At the same time, these drugs are traditionally used to treat tuberculosis, but in 2020, an alarming trend was revealed, which was that drug resistance was detected in patients with tuberculosis to these drugs. Among newly diagnosed tuberculosis patients, from 2018 to 2020, an increase in the proportion of patients with primary drug resistance to levofloxacin and moxifloxacin was established by 189-480%; whereas for other antibiotics, the increase averaged up to 60.8%. Findings. The findings suggest an alarming scenario in which drug resistance develops towards highly virulent and highly resistant to antibacterial drugs genotypes.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"39 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769008","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":"Portrait of regional health authority manager – 2023.","authors":"O. V. Khodakova, O. Kungurtsev, O. B. Pavlenko, V. I. Starodubov, O. Kobyakova, D. S. Tyufilin, I. Deev","doi":"10.21045/1811-0185-2024-2-64-72","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-64-72","url":null,"abstract":"The heads of regional executive authorities in the sphere of health protection are key figures in the implementation of the health care development strategy of the Russian Federation. The effective management of the healthcare system, as well as the achievement of national goals and target indicators of federal projects, requires highly qualified managerial staff. The annual study of the level of knowledge, skills, work experience and professional skills of regional ministers makes it possible to update information on the human resource potential of the top managers of regional health care systems, assess the changes and timely develop measures aimed at its improvement. The aim of the study was to assess the changes in human resource potential of the heads of regional executive authorities in the sphere of health protection of the Russian Federation in 2021–2023. Materials and methods. A single-stage, continuous sociological study was planned and conducted using a questionnaire developed by the experts of the Institute, which allows to assess changes in such characteristics as: age and gender composition of respondents, the level of higher and additional education, the professional competencies, and length of service in managerial positions. Results. We achieved a response from 86 respondents. It was found that during the last three years, there has been a significant decrease in the rate of rotation of the heads of regional health protection systems with a simultaneous increase in the level of their professional qualifications. The revealed trends are reflected in the growth of the average length of service as a regional minister (2021–2.1+1.9 years, 2022–2.3+2.5 years, 2023–2.9+2.2 years), 3,5 reduction in the number of respondents in the group with a length of service as a regional minister up to one year, an increase in the proportion of managers with professional qualification «Health Care Organization and Public Health». Conclusions. The study allowed to identify the key trends and changes that have occurred over the past three years in terms of the qualitative characteristics of the managerial human resource potential of regional health care systems in the Russian Federation. The heads of regional executive authorities in the sphere of health protection represent the most important resource of the field. Consistent and reliable decrease in the rotation of regional health care system managers is reflected in the growth of their professional skills, knowledge and experience, which allows to achieve the national goals in healthcare set by the President and the Government of the Russian Federation.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"110 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772247","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":"Ways to increase engagement of medical organization employees in online surveys.","authors":"N. K. Tikhonova, A. V. Semchenkov","doi":"10.21045/1811-0185-2024-2-83-88","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-83-88","url":null,"abstract":"Sociological research conducted among the personnel of a medical organization is one of the effective tools for making effective management decisions. The purpose of the study was to develop recommendations for managers of medical organizations to increase staff involvement in online surveys. Materials and methods. A repeated comparative study of the activity of participation in online surveys of medical staff of the clinic was planned and conducted. An analysis of the response rate to the survey was carried out before and after improving the survey methodology. Methods of open online questioning, qualitative analysis, protection of personal data of respondents, survey graphics, QR codes, and dashboard information were used. Results. Increasing the anonymity of the survey, introducing survey schedules, dynamic QR codes, and informing about the progress of the survey using dashboards reduced the time spent on online surveys and increased employee involvement in the survey from 54,1% to 94,6%. Findings. Increasing staff involvement in an interactive survey is one of the necessary quality tools and provides clinic management with information on improving teamwork. The proposed algorithm for conducting an online survey can be used as a tool for HR management of a medical organization to increase staff involvement in interactive surveys.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"209 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779928","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":"Opinion of the leaders of medical organizations about internal problems of health care.","authors":"D. Mushnikov, P. P. Korsunov, I. V. Yatsina, L. G. Ananyina, N. N. Uglanova","doi":"10.21045/1811-0185-2024-2-98-104","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-98-104","url":null,"abstract":"There are many problems in modern healthcare. In practice, these tasks will have to be solved at the level of specific medical organizations. In this regard, it is important to understand the structure of the problems that concern the heads of medical organizations. Objective: to study the opinion of the heads of medical organizations on internal health care problems. Materials and methods. The study was conducted on the basis of health care in the Ivanovo region. The collection of information included a survey of 250 heads of public and private medical organizations in the period 2023. Results and conclusions. The survey showed that at present, the «universal» problem of management in medical organizations of state and private ownership is the «personnel issue» associated with the lack of personnel with the appropriate level of competence. The established differences in the priority of management problems by levels and functional orientation of the activities of the heads of medical organizations should be taken into account in the formation of programs for advanced training and retraining of health care organizers.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"33 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771417","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":"On the issue of mortality and health problems in rural settlements.","authors":"O. B. Karpova, A. Zagoruychenko","doi":"10.21045/1811-0185-2024-2-105-113","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-105-113","url":null,"abstract":"In the Russian Federation, the problem of reducing population mortality, incl. in rural settlements. Strategic guidelines and initiatives adopted in regulatory documents at the federal level do not reflect the severity and depth of demographic challenges and processes of depopulation in modern conditions. The purpose of this study is to analyze current trends and mortality trends in rural areas in Russia, as well as health problems in rural areas, and make appropriate recommendations and adjustments. Materials and methods. At all stages of the study, analytical materials from official statistics (Rosstat and the Ministry of Health of the Russian Federation), data from modern literature sources and regulatory documents were used; processing of statistical data was carried out based on modern software packages SPSS, Excel‑2007. Research methods – study and generalization of experience, statistical, bibliographic. Results. Analysis of the accumulated data showed trends in the mortality of the rural population; specific areas and features inherent in rural healthcare and requiring special attention considering new challenges in the system were clearly shown and systematized. Conclusions. The data obtained can be applied when adjusting and recommendations to existing regional programs operating within the framework of preserving and strengthening the health of the rural population in the territory.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"13 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785151","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":"Territorial features of providing emergency surgical care to rural populations (on the example of the Republic of North Ossetia-Alania).","authors":"Z. R. Alikova, I. T. Totikova, I. A. Dzhioeva","doi":"10.21045/1811-0185-2024-2-47-53","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-47-53","url":null,"abstract":"The need to modernize healthcare dictates the study of healthcare organization at all levels. Special attention is paid to the territorial accessibility of medical care, including to the rural population, which differs in many specific features. The purpose of the study: to study the territorial features of providing emergency surgical care to the rural population, taking into account the number, density of population settlement, road infrastructure, and transport security in the Republic of North Ossetia-Alania. Research methods. Analytical and statistical research methods were used. The performance indicators of surgical departments of rural district hospitals for 2019–2022 have been studied. The analysis of the obtained data was carried out by the method of their structural description according to the selected main characteristics affecting territorial accessibility. Results. The Republic of Ossetia-Alania is characterized by high density and compactness of population settlement in rural areas. The creation of a modern transport infrastructure ensures the territorial accessibility of medical care. The republic has a fairly high level of provision with surgeons (2,53 per 10 thousand population) and a surgical bed fund (4,7 per 10 thousand population). However, there is a need to increase the efficiency of using the bed stock of rural surgical hospitals. The organization of surgical care in the republic in 2020–2021 was extremely negatively affected by the pandemic of coronavirus infection COVID‑19. The reduction of surgical and anesthesiological teams, beds and the volume of planned care due to the opening of additional infectious diseases hospitals has reduced the availability and quality of emergency surgical care. In rural district surgical departments, the bed function decreased from 283 days in 2019 to 243 days in 2020, and surgical activity up to 38,8%. In 2020–2021, planned medical care in the «surgery» profile has significantly decreased. The share of emergency hospitalizations increased to 79,7%. Negative trends in the growth of emergency hospitalization for surgical beds led to an increase in the hospital mortality rate compared to 2019 from 0,6% to 3,1% in 2021. The postoperative mortality rate has increased by more than 5 times. Our data correlate with similar trends of 33% increase in hospital mortality in the Russian Federation during the pandemic. Due to the creation of modern road transport infrastructure in the republic, high availability of surgical beds and surgeons, there is a potential to improve the quality indicators of rural surgical hospitals by improving the material and technical equipment and qualifications of surgical personnel.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"53 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785050","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":"A strategy for effective administrative control of antimicrobial therapy in the surgical intensive care unit: a retrospective pilot study.","authors":"I. I. Khayrullin, D. Protsenko, M. Magomedov, E. Shifman, I. N. Tyurin, D. A. Ostapchenko, L. A. Grishina, I. V. Kolerova, N. N. Turkova, S. V. Masolitin","doi":"10.21045/1811-0185-2024-2-54-63","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-54-63","url":null,"abstract":"Objective: To evaluate a strategy for effective administrative control of targeted antimicrobial therapy in surgical intensive care unit (ICU) patients. Materials and methods. The study included 3522 patients who were treated in ICU No. 1 in the period 2022 to 2023. The first group (control), treatment period 2022, included 1764 patients. The second group (research), treatment period 2023, included 1758 patients. In both groups, the use of antimicrobial drugs (AMP) was carried out in accordance with the antibacterial therapy control strategy (ASCT); in group 2, systemic administrative control was additionally carried out in the form of the use of the “Effective Hospital” program and a developed analytical system with monitoring the financial stability of the unit, aimed at daily monitoring of operating activities. A comparative analysis of the frequency of use of various classes of antimicrobial agents, the incidence of infectious complications, mortality rates and financial costs between groups was performed. Results. There was a significant decrease in the consumption of AMPs of the carbapenem group from 8194 vials in 2022 to 6577 vials in 2023, which was a decrease of 19.7%; a decrease in the consumption of tetracycline group AMPs in 2023 compared to 2022, from 2338 bottles to 1581 bottles, which amounted to 32.4%; reduction in the consumption of vancomycin and linezolid in 2023 compared to 2022 from 562 vials to 313 vials, which amounted to 44.3%. There was a decrease in the incidence of VAP from 59.3 (57.6; 62.9) in 2022 to 48.1 (38.65; 61.9) units in 2023, which amounted to 10.8% (p = 0.053). The increase in the frequency of deaths from 10.9% (9.1; 12.4) in 2022 to 11.5% (10.5; 12.7) in 2023 did not have significant differences (p = 0.67). The total expenditure on AMP in 2023 significantly decreased by 22.3%, which allowed saving 1,477,205.53 rubles (p = 0.012). Conclusion. The use of a daily strategy of administrative control of operational activities and the use of antimicrobial therapy in the ICU can reduce the costs of expensive antimicrobial agents, reduce the incidence of nosocomial infectious and inflammatory complications without changing overall mortality.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"356 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758610","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":"Reform of control and supervisory activities and inspection of medical organizations: myths and reality.","authors":"D. Piven, I. S. Kitsul, I. V. Ivanov","doi":"10.21045/1811-0185-2024-2-13-23","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-13-23","url":null,"abstract":"The analysis presented in the article convincingly shows that all changes occurring in recent years in the implementation of federal state control of the quality and safety of medical activities are implemented in strict accordance with the program “Reform of control and supervisory activities”, and at the same time these changes do not allow any – weakening in terms of the need to comply with mandatory requirements for this type of control (supervision). The reform of control and supervisory activities does not imply the abolition of all inspections of medical organizations, but the replacement of certain traditional control (supervisory) activities, first of all, this concerns scheduled inspections, with new types of control (supervisory) activities, i. e. for new types of inspections, and for preventive measures. Currently, priority areas of work in the state control (supervision) system are expanding the number and more precise adjustment of risk indicators, including with the aim of increasing the share of unscheduled control (supervisory) activities, i. e. unscheduled inspections conducted based on risk indicators. Medical organizations need to constantly ensure thorough preparation for carrying out preventive measures within the framework of federal state control of the quality and safety of medical activities as measures that are the most important part of the modern system of control (supervisory) activities; control (supervisory) activities without interaction with controlled persons; a wide range of unscheduled control (supervisory) activities, including unscheduled inspections carried out on the basis of risk indicators.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"44 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788908","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":"Changes in the directions and limits of the use of compulsory medical insurance funds from 2024.","authors":"V. I. Starodubov, F. Kadyrov, O. Obukhova, P. V. Mitroshin, A. M. Chililov","doi":"10.21045/1811-0185-2024-2-4-12","DOIUrl":"https://doi.org/10.21045/1811-0185-2024-2-4-12","url":null,"abstract":"The economic independence of medical organizations as legal entities presupposes their right to determine the direction of their expenses. However, the targeted nature of compulsory health insurance funds imposes restrictions on the freedom to use the income received from the provision of medical care in the compulsory health insurance system. And although the legislation defines the structure of expenses (tariffs), limiting them to the framework of compulsory health insurance programs, in practice, attributing expenses to certain groups often presents great difficulties, accompanied by sanctions and lawsuits. In this regard, recent changes in the legislation on compulsory health insurance, which expand the possibilities of using funds, seem to be very significant. This is also facilitated by an increase in the marginal cost of purchased equipment from 100 to 400 thousand rubles. However, such opportunities are due to a large number of restrictions and reservations, which requires a more detailed analysis of new legislative norms and an assessment of their impact on the conditions of medical organizations, which determined the relevance of this publication.","PeriodicalId":496589,"journal":{"name":"Manager Zdravookhranenia","volume":"71 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769605","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}