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2017г. №4 Print E-mail

CONTENTS

Sadykova T.I. Editor-in-chief of the scientific-practical journal «Public health and healthcare» Professor Ildus Galirzinovich Nizamov is 80 years old............................................................................. 5

HEАLTH АND SOCIETY

Bayanova N.A., Avdeeva M.V. Medical and social problems of the population of the therapeutic district as the cause of potential uptake in healthcare institutions....................................................... 8

Rzakulieva L.M., Alieva L.M., Mamedova S.N. Regional special aspects of frequency of abdominal deliveries in Azerbaijan Republic......................................................................................... 13

Alizadeh G.A. Comorbidity in patients with hemophilia in Baku...................................................................................... 17

PROTECTION OF MATERNITY AND CHILDHOOD

Khmelnitskaya E.A., Kiku P.F., Beniova S.N., Sabirova K.M. Complex assessment of health state of children......... 22

Bagirov I.A. Morbidity rate of acute lymphoblastic leukemia of ALL among children in Azerbaijan................................ 28

HEАLTH CАRE SPECIАLIZED SERVICES

Burganova A.M. The prevalence of glaucoma in the conditions of large industrial city.................................................. 33

ORGANIZATION AND IMPROVEMENT OF PROTECTION SYSTEM MANAGEMENT OF PUBLIC HEALTH

Shipova V.M., Gadzhieva S.M., Berseneva E.A. Modern methodical approaches in planning of number of physicians in sanatoria............................................................................................ 37

Choloyan S.B., Sheenkova M.V., Ekimov A.K., Danilova L.V., Baygazina E.N. Process approach as a new paradigm of management in healthcare institution...................................................................................................... 43

Karakina M.L. Оptimization of medical care for immunocompromised patients in therapeutic clinic.............................. 50

EXCHANGE OF EXPERIENCE

Smirnov A.O. Experience of Tatarstan Republic health personnel activity during XXII Olympic Winter Games and XI Paralympic Winter Games in Sochi................................................................................................................. 54

Saitgareev R.R. International practices of effectiveness of out-patient care................................................................... 57

 

EDITOR-IN-CHIEF OF THE SCIENTIFIC-PRACTICAL JOURNAL «PUBLIC HEALTH AND HEALTHCARE» PROFESSOR ILDUS GALIRZINOVICH NIZAMOV IS 80 YEARS OLD

Abstract. The article is devoted to the professional achievements of the famous Russian scientist in the field of public health and healthcare management, Honored Scientist of the Russian Federation and the Republic of Tatarstan, Professor I.G. Nizamov — editor-in-chief of the theoretical and practical journal «Public Health and Health Care».

 

MEDICAL AND SOCIAL PROBLEMS OF THE POPULATION OF THE THERAPEUTIC DISTRICT AS THE CAUSE OF POTENTIAL UPTAKE IN HEALTHCARE INSTITUTIONS

Natalia A. Bayanova, Candidate of Medical Sciences, Associate Professor of public health and healthcare sub-faculty № 1 of Federal State Educational Institution of Higher Professional Education of Health Ministry of the Russian Federation [460000 Orenburg, Parkovy ave., 7, educational building № 3; ]

Marina V. Avdeeva, Doctor of Medical Sciences, Associate Professor of the public health, economics and health management sub-faculty of FSBEI «I.I. Mechnikov State Medical University» of Health Ministry of Russia [194100 St. Petersburg, Litovskaya str., 2]

Abstract. The purpose of the research was to determine the frequency and structure of health and social problems, increasing the risk of morbidity and to evaluate the reasons of the potential uptake for help in healthcare institutions of the residents of the therapeutic district. Stratificationby category Z00-Z99 XXI of class ICD of 10 features of family history, lifestyle, health and structural components of the life quality of residents the therapeutic district, which could degrade the health and increase the need for medical care, had been made according to the results of medical and sociological research. It was found that the potential health risk, due to burdened personal or family history (90,2%) was the most common. The diseases of musculoskeletal system and connective tissue (82,3%), pathology of the digestive system (44,0%) and diseases of the circulatory system (27,2%), eating and metabolic disorders (13,3%), malignant neoplasm’s (12,9%), smoking (66,4%), alcohol (22,1%) are often present in the personal history. Medical and social circumstances that prevent the normalization of lifestyle and metabolism among residents of therapeutic district are: dissatisfaction with the quality of medical preventive counseling (88,1%), non-compliance with physician prescribed dietary recommendations, failure to comply with treatment procedures (70,0%), sleep-wake disorder (39,8%), the tension of daily work schedule (50,0%) and insufficient demand for ready-made analyzes for medical explanations of the results (77,2%). Population of the therapeutic district has a diverse range of hereditary medical, social, psychological and behavioral problems, which gives micro-social specific character to professional activities of the physician.

Key words: primary health care, primary care physician, therapeutic medical district, local service.

 

REGIONAL SPECIAL ASPECTS OF FREQUENCY OF ABDOMINAL DELIVERIES IN AZERBAIJAN REPUBLIC

Leyla M. Rzakulieva, Doctor of Medical Sciences, head of obstetrics and gynecology sub-faculty of Azerbaijan A. Aliyev State Physicians’ Continuing Education Institute [AZ1022 Azerbaijan, Baku, Tbilisi ave., 3165 quart.; ]

Lyaman M. Alieva, Health Ministry of Azerbaijan Republic, gynecologist of W riters’ Union Polyclinic [Baku, Azerbaijan ave., 41]

Sevinge N. Mamedova, Candidate of Medical Sciences, director of Azerbaijan Republican Perinatal Center [AZ1025 Baku, Yusif Safarov str., 22 (former 12)]

Abstract. Purpose of the study was to carry out a comparative assessment of frequency of abdominal delivery in regions of Azerbaijan before and after legislative regulation of Caesarean section operations. Observation has been carried out in maternity institutions of Lenkaran, Masalli, Geygel, Udjar, Beylagan, Tovuz, Sheki, Guba and Shemakhi regions, Shirvan, Mingechaur and Sumgait cities of Azerbaijan. The lowest frequency of Caesarean section operations was in Shemakhi region [(5,1±0,55)%] and the highest one — in Mingechaur city [(27,5±1,21)%] in 2012. The frequency of Caesarean section operations of less than 15% (the upper limit recommended by WHO) had been registered in 2012 in Masalli [(13,4±0,62)%], Beylagan [(8,8±0,8)%] and Shemakhi [(5,1±0,55)%] regions. The higher probability of abdominal delivery (?20%) had been registered in Lenkaran [(21,4±0,68)%], Tovuz [(23,4±0,76)%], Guba [(20,8±0,81)%] regions and Shirvan [(20,5±1,09)%], Mingechaur [(27,5±1,21)%] and Sumgait [(25,5±0,55)%] cities. The frequency of abdominal deliveries is high in regions of Azerbaijan and has changes within wide ranges [from (5,1±0,55)% to (57,2±1,33)%]. The predominant reason for the use of caesarean section is a previous surgery on the uterus [(25,3±1,8)% of all abdominal deliveries]. Dynamics of frequency of abdominal deliveries before and after acceptance of legislative regulation of Caesarean section operations in regions of Azerbaijan has multidirectional character.

Key words: frequency, abdominal deliveries, regional features.

 

COMORBIDITY IN PATIENTS WITH HEMOPHILIA IN BAKU

Gunel A. Alizadeh, Assistant of hematology sub-faculty of Azerbaijan A. Aliyev State Physicians’ Continuing Education Institute [AZ1022 Azerbaijan, Baku, Tbilisi аve., 3165 quart.; ]

Abstract. Purpose of the study was the assessment of co-morbidity at patients with hemophilia in Baku and the identification of its features in terms of application of demanded homeostatic therapy. Survey was held in Baku city. Monitoring of continuous coverage of all patients (625 patients), including 118 patients with severe, 197 with moderate and 310 with mild form of hemophilia was applied. Taking into consideration the dependence of co-morbidity from age for each group of patients with hemophilia there were formed groups by age and gender by method «copy — pair». Data of all patients about chronic diseases in five years have been copied from ambulatory cards. Chronic viral hepatitis C at patients with severe, moderate and mild hemophilia respectively in 57,6±4,6; 35,5±3,4 and (5,8±1,3)% cases was diagnosed. Index value was less than (3,4±1,7)% In control groups. Prevalence of chronic hepatitis C is significantly high at severe and moderate hemophilia (relative risk, respectively, was 16,9 and 14,2 in comparison with the control group). Prevalence of chronic hepatitis C at mild form of hemophilia did not differ from that in the control group (5,8±1,3; 3,2±1,0; р?0,05). Co-morbidity is characteristic for patients with severe and moderate form of hemophilia (5,84 и 5,05 chronic diseases per patient) due to the very high risk of chronic viral hepatitis [57,6±4,6 and (35,5±3,4)%], anemia (100%), diseases of the oral cavity (100%), musculoskeletal system (100%), and increased risk of diseases of peripheral nerves and nerve roots (32,2 and 23,8%), gastric ulcer and duodenal ulcer (46,6 and 36,0%), liver, gall bladder and pancreas (45,8 and 25,9%), kidney and urinary tract (12,7 and 7,1%). Composition of groups of patients with severe and moderate hemophilia is similar and due to the proportion of individuals with 3—4 [46,5±4,6 and (50,8±3,6)%], 5—6 [24,0±3,9 and (27,4±3,2)%], 7 or more [18,5±3,6 and (15,2±2,6)%] chronic pathologies similar. Marked co-morbidity at patients with hemophilia generates the need for cooperation of medical specialists during medical examination of patients.

Key words: homeostatic therapy, co-morbidity, hemophilia.

 

COMPLEX ASSESSMENT OF HEALTH STATE OF CHILDREN

Ekaterina A. Khmelnitskaya, Head of city health center for adults and children SBHI «Vladivostok Clinical Diagnostic Center», postgraduate student of basic and clinical medicine department, Biomedicine School of Far Eastern Federal University [690950 Vladivostok, Sukhanov str., 8; ]

Pavel F. Kiku, Doctor of Medical Sciences, Professor of basic and clinical medicine department, Biomedicine School of Far Eastern Federal University [690950 Vladivostok, Sukhanov str., 8; ]

Svetlana N. Beniova, Doctor of Medical Sciences, Professor of basic and clinical medicine department, Biomedicine School of Far Eastern Federal University [690950 Vladivostok, Sukhanov str., 8; ]

Ksenia M. Sabirova, Student, 5th year, medical biophysics sub-faculty of Biomedicine School of Far Eastern Federal University [690950 Vladivostok, Sukhanov str., 8; ]

Abstract. The article presents the results of comprehensive assessment of the health status of children and adolescents who underwent the examination at Health Center on the basis of Vladivostok Clinical and Diagnostic Center. The purpose was to draw up a program for improving the health of the children, taking into account the most frequent risk factors fo chronic non-communicable diseases. According to the results of the study, the most identified risk factors were identified: inadequate nutrition, excess body weight, stress, hypodynamia. The proportion of each factor in each age group was different. The obtained results make possible to determine the directions of work to preserve the health of children.

Key words: children, adolescents, comprehensive assessment, health, quality of life.

 

MORBIDITY RATE OF ACUTE LYMPHOBLASTIC LEUKEMIA OF ALL AMONG CHILDREN IN AZERBAIJAN

Iskender A. Bagirov, PhD in Medicine, research supervisor of hemoblastosis department of Azerbaijan B.A.Eivazov Scientific Research Hematology and Transfusiology Institute [AZ1003, Azerbaijan, Baku, M. Gashgay str., 87; ]

Abstract. The purpose of the study was to determine the main trend of morbidity of ALL among children in Azerbaijan according to materials of study in 1998—2014. The study has been realized on basis of B.A. Eyvazov Azerbaijan Scientific and Research Institute of Haematology and Transfusiology, which is also the center of diagnostics and treatment of patients with ALL. Information about quantity of children population of the republic is presented in annual reports of the State Statistical Committee. Children population and patients with ALL have been divided according to ages (0—4, 5—9, 10—14 years). ALL morbidity rate was calculated per 100 thousand children of corresponding ages, the average error was determined. During the observation period the lowest morbidity rate of ALL among children (0—14 years old) was in 1998 — 1,32 cases per 100 000 children (table 1). The highest morbidity rate of ALL was observed in 2011 (3,64 cases per 100 000). The annual morbidity rate changed. Morbidity rate was higher in 1999, 2001, 2004, 2006, 2008, 2010 and 2011, and decreased in 2000, 2002, 2003, 2005, 2007, 2009, 2012, 2013. ALL morbidity rate among 0—4 years old children is the lowest in 1998 [(2,5±0,57)0/0000; 95% confidence interval 1,36—3,640/0000] and didn’t changed significantly till 2008 (р>0,05). ALL morbidity rate among 5—4 years old children changed within the interval from (1,1±0,35)0/0000 [95% confidence interval 0,4—1,80/0000] till (3,5±0,74)0/0000 [95% confidence interval 2,02—4,980/0000]. ALL morbidity rate among 10—14 years old children changes in 1998—2014 within the interval from (0,5±0,24)0/0000 [95% confidence interval 0,02—0,980/0000] till (1,2±0,40)0/0000. ALL morbidity among children population of the republic changes in 1998—2014 within the interval from 1,32 till 3,640/0000 and its main trend is linear growth. ALL morbidity among children population depends on age, it is maximal at the age of 0—4 years (2,5—6,20/0000 in 1998—2014), minimum rate is at the age of 10—14 years (0,5—1,20/0000 in 1998—2014). Trends of morbidity of children of different ages with lymphocytic leukemia in 1998—2014 are nearly equal, but there are significant differences according intervals size between maximal and minimum rate of morbidity, which is wide for 0—4 years, and narrow for 10—14 years.

Key words: morbidity, acute lymphoblastic leukemia, children.

 

THE PREVALENCE OF GLAUCOMA IN THE CONDITIONS OF LARGE INDUSTRIAL CITY

Alsu M. Burganova, Ophthalmologist, OJSC «Municipal Clinical Hospital № 12» [420036 Kazan, Lechebnaya str., 1; ]

Abstract. The article presents study’s results of the prevalence of glaucoma among the population of Kazan, depending on age, gender and social status. The study’s results of prevalence of glaucoma showed that glaucoma is detected in 0,5% of cases in Kazan at the age of 30—39 years. However, glaucoma constitutes 33,7% at the age of 60—69 years and increases to 53,0% in the age group over 70 years. The prevalence of glaucoma among women is significantly higher than among men. The rate at women of 40—49 years old is 49,9% higher than at men. This difference is 50,6% at the age of 70 years or more. The highest percentage of prevalence of glaucoma is seen at workers of education and construction areas.

Key words: prevalence, glaucoma, a large industrial city, planning, dispensary work.

 

MODERN METHODICAL APPROACHES IN PLANNING OF NUMBER OF PHYSICIANS IN SANATORIA

Valentina M. Shipova, Doctor of Medical Sciences, Professor, chief researcher of FSBSI «Semashko National Research Institute of Public Health» [105064 Moscow, Vorontsovo Pole str., 12, build. 1; ]

Saida M. Gadzhieva, Head physician of Children’s Sanatorium № 42 of Moscow Healthcare Department [123103, Moscow, Tamanskaya str., 15, build. 2; ]

Evgenia A. Berseneva, Doctor of Medical Sciences, Head of high and additional professional education department of FSBSI «Semashko National Research Institute of Public Health» [105064 Moscow, Vorontsovo Pole str., 12, build. 1; ]

Abstract. Topical issues of planning of number of physicians in sanatoria are considered in the article. Our aim was the development of modern methodical approaches to planning of number of physicians in sanatoria. The following methods are used in the study: statistical, economic, analytic and research, analytical and calculated, methods of labour rate setting, expert. Modern methodical approaches to planning of number of attending physicians in sanatoria are developed. The use of the presented methodical approaches in planning of number of attending physicians of sanatoria allows to carry out scientific justification of norms of work. Besides, the technique can be widely used in pricing and the economic analysis of activity of establishment. It is expedient to apply materials of the expert assessment of volume of medical care when developing clinical protocols of treatment in sanatoria.

Key words: labour rate setting, sanatoria for children.


PROCESS APPROACH AS A NEW PARADIGM OF MANAGEMENT IN HEALTHCARE INSTITUTION

Salim B. Choloyan, Doctor of Medical Sciences, Head physician of SAHI «Children’s Municipal Clinical Hospital» [460001 Orenburg, Turkestanskya str., 43; ]

Marina V. Sheenkova, Candidate of Medical Sciences, Head of «Medguard-Orenburg», Ltd. [460014 Orenburg, Bereg Urala str., 4; ]

Alexander K. Ekimov, Economist of SAHI «Children’s Municipal Clinical Hospital» [460001 Orenburg, Turkestanskya str., 43; ]

Lyubov V. Danilova, Physician of SAHI «Children’s Municipal Clinical Hospital» [460001 Orenburg, Turkestanskya str., 43]

Elena N. Baygazina, Software developer of SAHI «Children’s Municipal Clinical Hospital» [460001 Orenburg, Turkestanskya str., 43; ]

Abstract. Healthcare institution management in Russia is implemented on the base of the functional model at the present. The last one is less and less met requirements of the population and the administrating authorities of healthcare. A new management model named the process model of organisational management has been appeared over the last two decades. The main management principle on the base of the functional model constitutes in performance of functions assigned to employees. The key management principle on the base of the process model is development of information system tracking performance of the processes that eventually lead to obtaining of socially significant result.

Key words: healthcare institution management, functional model of organisational management, process model of organisational management, advantages of process model of organisational management.

 

ОPTIMIZATION OF MEDICAL CARE FOR IMMUNOCOMPROMISED PATIENTS IN THERAPEUTIC CLINIC

Marina L. Karakina, Candidate of Medical Sciences, Allergist and Immunology of SBHI «Sverdlovsk Regional Clinical Hospital № 1» [620102 Ekaterinburg, Volgogradskaya str., 185; ]

Abstract. There are a lot of immunocompromised patients in current clinical practice of therapists and specialists. The purpose of the study was the optimizing of medical care for immunocompromised patients in therapeutic clinic. The study was carried out in SAHI «Sverdlovsk Regional Clinical Hospital № 1», Ekaterinburg. The immunocompromised patients have the risk of severe infections, so the infectious diseases prevention is one of the ways to optimize patient care. The article describes the work of the immunological services for the prevention of infections at the patients; the algorithms of the work are presented. We conclude the possibility of reducing of infectious diseases incidence in this group of patients and mortality rate.

Key words: optimizing of medical care, immunocompromised patients, immunological services, immunological support.

 

EXPERIENCE OF TATARSTAN REPUBLIC HEALTH PERSONNEL ACTIVITY DURING XXII OLYMPIC WINTER GAMES AND XI PARALYMPIC WINTER GAMES IN SOCHI

Aleksey O. Smirnov, Candidate of Medical Sciences, Assistant of public health, economics and healthcare management department of Kazan State Medical Academy — Branch Campus of FSBEI of HPE «Russian Medical Academy of Continuing Professional Education» of Health Ministry of the Russian Federation [420012, Kazan, Mushtari str., 11; ]

Abstract. The purpose of the study was to present the experience of medical care management during XXII Olympic and XI Paralympic Winter Games in Sochi. 222 medical workers from Tatarstan Republic were sent to the Games to work at the Olympic and Paralympic facilities: the stadium for the opening and closing of Fishte Games, the ski hill complex Russian Hill, the polyclinic of the Additional Mountain Village, the Mountain Media Center). The largest part of the specialists constituted physicians in the specialties: «emergency and emergency medical care» (18,3%), surgery (14,5%), traumatology and orthopedics (10,7%). Health personnel have registered more than 3 thousand health encounters, more than 140 persons were sent to hospital. 137 health encounters were registered in ski complex «Russian Hills» including 13 cases of evacuation to hospital. The experience of medical support management in Winter Games has the practical importance in the context of the preparation of the upcoming international sports competitions in Russia.

Key words: medical support, XXII Olympic and XI Paralympic Winter Games in Sochi.

 

INTERNATIONAL PRACTICES OF EFFECTIVENESS OF OUT-PATIENT CARE

Ruslan R. Saitgareev, Director of Health and Pharmacy Department of Yaroslavl Region [150000 Yaroslavl, Sovetskaya str., 11/9; ]

Abstract. Closer attention at the state level is given to the choice of the most effective method of payment for medical care provided in outpatient conditions. Recent foreign studies on the selection of effective methods of payment for outpatient care have shown their main direction towards the use of incentive mechanisms in addition to the basic approaches to recovering the costs of health care providers. The article describes the modern international approaches to reimbursement of expenses for outpatient care. The advantages and disadvantages of each of these methods are investigated. According to the results of the study of international practices, the most popular one is the mixed version of the per capita principle of financing with payment for indicators of the performance of the health care provider. The role of the provider is given to legally independent general practitioners. The main factors affecting the efficiency of general medical practices in terms of per capita financing are presented in the article.

Key words: payment system of medical care, per capita payment principle, payment for performance, outpatient care.