HEАLTH АND SOCIETY
Khabriev R.U., Mingazova E.N., Shigabutdinova T.N. The main trends of medical and demographic
indicators in the Republic of Tatarstan (1991–2018)...........................................................................................5
Urazmanov A.R., Radchenko O.R. Dynamics of changes in family-marriage values and reproductive
goals in young people, living in Tatarstan Republic (comparative analysis of inquiry in 2008 and in 2018).........10
Kudrina V.G., Suslonova N.V., Antonova I.V., Smirnova T.L., Zhuravleva N.V., Barsukova E.V.
Analysis data of demographic situation in the region as the basis for the national and federal projects’
formation...........................................................................................................................................................16
Sogiyaynen A.A. Physical condition of military conscription servants as an indicator of prophylactic
activities’ efficiency during preparation of citizens for military service ..............................................................21
Shishkin E.V. Age and gender characteristics of accidents’ victims.....................................................................25
HEALTH OF ECONOMICALLY ACTIVE POPULATION
Agalarova L.S., Omarova O.A. Studying aspects of the relationship of the working urban population
to the formation of healthy life style ..................................................................................................................35
HEАLTH CАRE SPECIАLIZED SERVICES
Turaev R.G., Burykin I.M., Shulaev A.V., Khafizianova R.Kh., Sibgatullina L.N., Talipov A.D., Gabaidullin A.G., Khakimova R.I., Tukhvatullina E.R., Shvetsova D.K. The use of lean technologies to
improve the efficiency of blood transfusion service of the Republic of Tatarstan..............................................41
Kirillova E.V., Lipatov O.N., Maksimov G.G., Muzafalov F.F., Masyagutova L.M., Akhmetov V.M.,
Aznabaeva Ju.G. Epidemiological aspects of the incidence of lung cancer: the current state of the
issue (analytical review of the literature)...........................................................................................................49
Ter-Israelyan A.Yu., Belostotsky A.V.Some topical issues of dispensary inpatient psychiatric care
in Moscow.........................................................................................................................................................54
Garipov R.Z., Shulaev A.V., Sadykov M.N., Khairullina L.M., Knyazeva D.A. Cardiovascular diseases
development risk factors and population sanitary literacy issue (literature review) ..........................................59
Alieva I.D. Interregional special aspects of the level, dynamics and volatility of the morbidity risk of type 2
diabetes among the population in the western regions of the Republic of Azerbaijan......................................65
ORGANIZATION AND IMPROVEMENT OF PROTECTION
SYSTEM MANAGEMENT OF PUBLIC HEALTH
Berseneva E.A., Mendel S.A., Tairova R.T., Shkarin V.V., Kurakov D.A., Savostina E.A. Activity of the
hospitals in clinics of the Ministry of Internal Affairs of the Russian Federation in 2013–2017.........................70
Karimova D.Yu., Gaynetdinova A.N., Zakalsky V.A., Karimov B.N., Shamurzaeva M.M. Performance
optimization of outpatient clinics at the stage of creating a new model of healthcare institution ......................75
Konovalov O.E., Serov D.V. Problem areas and opportunities of «Moscow outpatient clinic standard» by
the results of a pilot study .................................................................................................................................80
QUALITY OF MEDICO-SOCIAL SERVICES OF THE POPULATION
Gordova L.D. Ways to improve the quality of specialized trauma care for children in the Kursk region in
order to reduce the level of child disability........................................................................................................84
THE MAIN TRENDS OF MEDICAL AND DEMOGRAPHIC INDICATORS
IN THE REPUBLIC OF TATARSTAN (1991–2018)
Ramil U. Khabriev, Academician of the Russian Academy of Sciences, Scientific Director of N.A. Semashko
National Scientific Research Institute of Public Health [105064 Moscow, Vorontsovo pole str., 12, building 1;
tel.: 8(495)917-48-86; e-mail:
]
Elmira N. Mingazova, Corresponding Member of TR AS, MD, Professor, chief researcher of N.A. Semashko
National Research Institute of Public Health [tel.: 8(495)917-48-86]; Professor of N.I. Pirogov Russian
National Medical University [117997 Moscow, Ostrovityanov str., 1; e-mail:
]
Tatyana N. Shigabutdinova, deputy head physician for obstetrics and gynecology of State Autonomous
Healthcare Institution «Municipal Clinical Hospital № 7» of Kazan [420103 Kazan, Marshal Chuykov str., 54;
tel.: 8(843)223-02-72; e-mail:
]
Abstract. Tatarstan Republic is one of the developing regions of the Russian Federation. Objective: to study the
characteristics of medical and demographic indicators in Tatarstan Republic in 1991–2018. The study used the data
from Federal State Statistics Service. It was established that the natural population movement has been characterized
by a decline in 1991–2010, and the birth rate has been higher than the death rate since 2011. The birth rate among
the rural population has been higher on average by 1,8 per 1 000 population from 1991 to 2002. The increasing trend
for both urban and rural population has been seen since 2003 and steady upward trend in the age-specific fertility
rate after 2010.
DYNAMICS OF CHANGES IN FAMILY-MARRIAGE VALUES
AND REPRODUCTIVE GOALS IN YOUNG PEOPLE, LIVING IN TATARSTAN REPUBLIC
(comparative analysis of inquiry in 2008 and in 2018)
Artur R. Urazmanov, PhD in Medicine, Associate Professor of public health and healthcare organization sub-faculty
of Kazan State Medical University of Health Ministry of Russia [420012 Kazan, Butlerov str., 49; tel.: 8 (987) 297-82-82;
e-mail:
]
Olga R. Radchenko, MD, Associate Professor, Professor of preventive medicine and human ecology sub-faculty, common
hygiene sub-faculty Kazan State Medical University of Health Ministry of Russia [tel.: 8(843) 236-69-02, 8(903)341-54-65 (моб.);
e-mail:
]
Abstract. The article presents comparative results of the young people sociological survey conducted in 2008 and 2018.
Differences of young people opinion on the family-marriage values system and reproductive goals of two generations are
revealed that is considerably caused by the systematic carried-out work at the federal and regional levels. The percent of
youth with family values has increased. Nevertheless, the available differences in results answers of girls and young men
demonstrate that this work has to be continued. At the same time, it is necessary to study changes in requirements and
young people values constantly, as well as factors, influencing these changes.
Key words: valuable orientations, young people, demography, preventive actions.
ANALYSIS DATA OF DEMOGRAPHIC SITUATION IN THE REGION AS THE BASIS
FOR THE NATIONAL AND FEDERAL PROJECTS’ FORMATION
Valentina G. Kudrina, MD, Professor, head of medical statistics and informatics sub-faculty at Russian Medical
Academy of Continuing Professional Education [125445 Moscow, Belomorskaya str., 19; tel.: 8(499)-458-95-67;
email:
]
Nina V. Suslonova, MD, Professor, Advisor to the Governor of the Moscow Region [143407 Moscow region,
Krasnogorsk-7, Stroiteley Boulevard, 1; tel.: 8(498)-602-04-20; email:
]
Irina V. Antonova, Deputy Director on medical statistics at Medical Information Analytical Centre of Health Ministry
of Chuvashia [428000 Cheboksary, Kalinin str., 112; tel.: (8352)-26-00-03; email:
]
Tatyana L. Smirnova, PhD Medicine, Associate Professor of obstetrics and gynecology sub-faculty of I.N. Ulyanov
Chuvash State University [428000 Cheboksary, Moscow av., 15; tel.: 8-927-845-84-21; email:
]
Nadezhda V. Zhuravleva, PhD Medicine, Associate Professor of general medicine sub-faculty of I.N. Ulyanov Chuvash
State University [tel.: 8-903-358-71-78; email:
]
Elena V. Barsukova, PhD Medicine, Head Physician of Republican Clinical Hospital of Health Ministry of Chuvashia
[428000 Cheboksary, Moscow аv. 9; tel.: (8352)-58-16-11; email:
]
Abstract. The article presents the assessment of current demographic situation in Chuvashia. Statistical analysis
of population dynamics and age-gender composition, birth rate and mortality has been realized. We made a conclusion
that the main trends determining further development of demographic situation in Chuvashia were: population decline
as a result of decrease in birth rates, the total fertility rate and migration population losses. It is necessary to implement
effectively the interdepartmental plans aimed at reducing mortality from cerebrovascular diseases, coronary heart disease,
oncological diseases, respiratory and digestive diseases as well as from controllable «external» causes in order to prevent
further population decline in Chuvashia.
PHYSICAL CONDITION OF MILITARY CONSCRIPTION SERVANTS
AS AN INDICATOR OF PROPHYLACTIC ACTIVITIES’ EFFICIENCY DURING
PREPARATION OF CITIZENS FOR MILITARY SERVICE
Alexander A. Sogiyaynen, PhD Medicine, Head physician of Innovative Technologies Medical Center
[141002 Moscow Region, Mytishchi, Komarov str., 2, build. 3; email:
]
Abstract. The purpose of this study was to analyze the trends in physical condition of military conscription servants.
Materials and methods. We carried out a statistical analysis of the annual reports of military-medical commissions of
military healthcare institutions of the Moscow region (n=182) and Primorsky region (n=57), data of the Ministry of Defense
of Russia, published on the official website (http: //mil. ru), annual statistical data of Main Military Medical Directorate of
the Ministry of Defense of Russia (physical condition’s indicators of military personnel of the Armed Forces of the Russian
Federation, as well as the activities of military medical units, departments and organizations in 2010–2017). Results. The
ability indicator for military service has grown by 8% and has reached 77% of the total number of recruits since 2009
according to the data of the Ministry of Defense of Russia. Thus, the number of citizens fit for military service on conscription
(category A) has increased since 2009 by 5% and has reached 42%. The number of those who are limitedly eligible for
military service (category B) has decreased over this time by 7% and has reached 18%. 59% of conscripts were healthy,
32% were practically healthy, 9% had chronic diseases and needed regular follow-up in 2010–2015 according to official
data of the Ministry of Defense of the Russian Federation. The overall incidence of military conscription servants is currently
2 079 ‰. It grew by 16% from 2010 to 2015. Primary morbidity of 18–26-year-old residents undergoing military service
by conscription was 1 211‰; the increase has constituted 25% from 2010. Hospitalization was 1 098‰; the increase hasconstituted 25%. The number of days away from service for conscripts is 11 439‰, the increase of this indicator was 16%.
The rate of leaving military service among conscripts is 3,2 times higher than among contract servicemen and remains high
for the last 5 years (+ 1% in 2010–2015) and is 20‰ today. The mortality rate of this category is slightly lower than among
contract soldiers (in 3,3 times) and is variable between 0,3–0,4‰. Analysis of the evidence of the illness of servicemen in
military units of the Moscow region revealed that the main share in the structure of the diseases that caused the dismissal
from military service on conscription are: diseases of the digestive organs, diseases of the musculoskeletal system and
connective tissue, diseases of the circulatory system. Mental disorders and behavioral disorders, diseases of the circulatory
system, diseases of the eye and its appendage apparatus, and diseases of the digestive system take leading positions
in Primorsky region. Findings. There is a negative trend in the basic health indicators of conscripts (general morbidity,
primary morbidity, dismissal due to health, hospitalization, number of days away from service) against the background of
growth in the category of fitness for military service. It indicates insufficient work on preparing citizens for military service
in the field and defects during military medical examination during the initial military registration and enlistment. Special
attention should be paid to the prevention of diseases of the digestive system, diseases of the musculoskeletal system
and connective tissue, the circulatory system, as well as mental and behavioral disorders when forming regional programs
for the preparation of citizens for military service.
AGE AND GENDER CHARACTERISTICS OF ACCIDENTS’ VICTIMS
Evgeny V. Shishkin, PhD Medicine, Director of Troitsky Medical College, teacher of public health and healthcare sub-faculty
of Institute of Additional Professional Education «South Ural State Medical University» [454100 Troitsk, Klimov str., 17;
e-mail:
]
Abstract. The article analyzes the age and gender characteristics of injury mortality according to the data of the regional
bureau of forensic examination. The totality of all the deadly violent deaths in the Chelyabinsk region in 2012–2018 was
taken in data selection. The analysis showed that injuries ranked first among the main reasons. Mortality as a result of
injuries has pronounced age and gender characteristics, men become victims three times more often than women. Thegreatest difference in mortality between men and women is observed with injuries with sharp objects – 4,5 times. Despite
the fact that the majority of the dead are represented by people of working age, the most vulnerable is the age group of
80 years old and more. Exceptions are deaths in traffic accidents, where the leading group is people aged 20–24 years
(27,3 cases per 100 thousand population on average in 2012–2018), as well as deaths due to injuries from sharp objects,
where the age group of 35–39 years old ranks the first (17,3 cases per 100 thousand population). Organizational measures
taken by the healthcare services, related to the organization of a network of trauma centers in the regions of Russia, have
significantly reduced the mortality rate. However, the downward trend has stopped in 2018, which is most likely due to the
achievement of maximum results, taking into account the introduced organizational technologies. The decline in mortality
in subsequent years is controversial without further improving the organization of medical care for injured people. The
identified risk groups, including the elderly, where mortality by age and gender groups exceeds the average by three or
more times in a number of individual causes, indicates the need to organize and improve geriatric services, including its
organization in trauma centers.
STUDYING ASPECTS OF THE RELATIONSHIP OF THE WORKING URBAN
POPULATION TO THE FORMATION OF HEALTHY LIFE STYLE
Luiza S. Agalarova, MD, Associate Professor of public health and healthcare sub-faculty of Dagestan State Medical University
[367012 Makhachkala, Lenin square, 1; tel.: 8-960-409-45-97; e-mail:
]
Olesya A. Omarova, Postgraduate Student of public health and healthcare sub-faculty of Dagestan State Medical University
of HM of RF [tel.: 8-928-558-28-36; e-mail:
]
Abstract. The purpose of the work is to develop recommendations for the formation of healthy lifestyle of the urban
population. Material and methods. The study was conducted in 2017–2018 on the basis of Republican Health Center
and 3 municipal polyclinics of Makhachkala of the Republic of Dagestan. The method of anonymous questioning
studied the attitude of 488 working urban population to the formation of healthy lifestyle. Special questionnaire with 30
questions was developed to collect the data. Sociological and statistical methods were used in the work. Results. The
study showed that 2/3 of respondents looked positively to measures for the formation of healthy lifestyle, every fifth was
indifferent. The third part (32,6%) of respondents do not keep track of their health. The study of sources of information
about healthy lifestyles showed that the Internet ranked first place (41,1%), health personnel ranked the second place
(39,5%), the television ranked the third place (16,7%), friends ranked the fourth place (13,7%) and newspapers and
magazines ranked the fifth place (9,2%). Tobacco was regularly consumed by 37,2% of men and 6,6% of women, and
alcohol – by 29,8% of men and 11,9% of women. Findings. Low medical activity of the population has been revealed.
27,6 % of respondents did not go to the doctor in the case of the disease, 15,1% of respondents did not visit the doctors
for examination. A low patient adherence to prescribed treatment has been found out. 42,6% of respondents followed
medical advice in the case of illness, 49,3% of respondents followed medical advice partially, 12,5% of respondents
didn’t follow medical advice.
Key words: healthy lifestyle, sources of information, population motivation, medical activity, public awareness.
THE USE OF LEAN TECHNOLOGIES TO IMPROVE THE EFFICIENCY
OF BLOOD TRANSFUSION SERVICE OF THE REPUBLIC OF TATARSTAN
Ramil G. Turaev, PhD Medicine, head physician of Republican Blood Center of Health Ministry of Tatarstan Republic
[420140 Kazan, Pobedy av., 85, tel.: 8(843)237-69-00; e-mail:
]
Igor M. Burykin, MD, Associate Professor of General hygiene sub-faculty of Kazan State Medical University of Health
Ministry of Russia [420012 Kazan, Butlerov str., 49; tel.: 8(843)236-06-52; e-mail:
]
Aleksey V. Shulaev, MD, Professor, Vice-rector for regional health development, head of General hygiene sub-faculty
of Kazan State Medical University of Health Ministry of Russia [tel.: 8(843)236-06-52; e-mail:
]
Rofiya Kh. Khafizianova, MD, Professor of pharmacology sub-faculty of Kazan State Medical University of Health Ministry
of Russia [tel.: 8(843)236-06-52; e-mail:
]
Lilia N. Sibgatullina, Deputy Head physician for treatment of Republican Blood Centre of Health Ministry of Tatarstan Republic
Ayrat D. Talipov, Deputy Head physician for organizational and methodical work of Republican Blood Centre of Health Ministry
of Tatarstan Republic
Asgat G. Gabaidullin, Deputy Head physician for clinical and expert work of Republican Blood Center of Health Ministry
of Tatarstan Republic
Ramzia I. Khakimova, Deputy Head physician in the laboratory diagnostic of Republican Blood Centre of Health Ministry
of Tatarstan Republic
Elena R. Tukhvatullina, epidemiologist of organizational-methodical department of Republican Blood Centre of Health
Ministry of Tatarstan Republic
Dilyara K. Shvetsova, Director of Republican Medical Library-Information Centre [420059 Kazan, Kh. Taktash str., 125;
tel.: 8(843)570-22-82; e-mail:
]
Abstract. The purpose of the work was to study the possibility of using lean technologies to improve the organization
of the transfusion blood service in the Tatarstan of Republic. Materials and methods. The effectiveness of implementation
of various tools of lean technologies in the activities of the transfusion blood service for 3 years has been analyzed using
the statistics and analytics methods. Results. The possibility of effective use of lean technology in the organization of
blood sampling and scoring has been proved. It was shown that lean technology tools can be successfully used in the
improvement of the institution’s activities. Implementation of lean technology, improvement and process optimization
let reducing the possibility of staff’s errors and the laboratory tests in 6 times. Improving and optimizing processes has
reduced the time of laboratory testing in six times. Financial effect of lean improvements has been evaluated. Analysis
and mapping of processes highlighted the resources for increasing the efficiency of working hours of the staff. Using
of the combination of «Kairyo» and «Kaizen» improvements reduced the losses in different levels. The study concludes
that lean technology is one of the tools to improve the organization of blood transfusion service. The experience can be
replicated in other healthcare institutions to improve their activities.
Keywords: lean technologies, efficiency of medical care, organization of healthcare, blood service.
EPIDEMIOLOGICAL ASPECTS OF THE INCIDENCE OF LUNG CANCER:
THE CURRENT STATE OF THE ISSUE
(analytical review of the literature)
Elvira V. Kirillova, radiologist of Republican Clinical Oncology Dispensary of Health Ministry of Bashkortostan Republic
[45005 Ufa, October av., 73/1; tel.: (347) 273-61-81; e-mail: e-kirillova@ yandex.ru]
Oleg N. Lipatov, MD, Professor, head of oncology and pathological anatomy course of Bashkir State Medical University
[tel.: 8 (937) 301-01-01; e-mail:
]
Gennady G. Maksimov, MD, Professor of therapy and occupational diseases sub-faculty of Bashkir State Medical University
[450106 Ufa, Stepan Kuvykin str., 94; tel.: (347) 255-50-75; е-mail:
]
Fagim F. Muzafalov, MD, Professor, Deputy Head physician of Republican Clinical Oncologic Dispensary of Health Ministry
of Bashkortostan Republic [tel.: +7-905-005-86-25]
Lyaylya M. Masyagutova, MD, Head of laboratory research methods department of Ufa Research Institute of Occupational
Medicine and Human Ecology [450106 Ufa, Stepan Kuvykin str., 94; tel.: (347) 255-19-48; e-mail:
]
Vil M. Akhmetov, PhD Medicine, Associate Professor of healthcare mobilization preparations and disaster medicine of Bashkir
State Medical University [450079 Ufa, Lenin str., 3; tel. (347) 273-61-81; e-mail:
]
Julia G. Aznabaeva, PhD Medicine, Associate Professor of propaedeutics of internal diseases sub-faculty of Bashkir State
Medical University [450054 Ufa, October av., 73/1; tel.: 8-987-251-25-10; e-mail: Julia Aznabaeva
]
Abstract. The purpose of the work was to analyze the domestic and foreign literature on epidemiology, carcinogenic
factors of development of malignant neoplasms of the respiratory tract, including lung cancer. Methods: the results of the
researches, published in foreign and domestic literature, as well as the analysis data of statistics received from official
sources. Results. The significant influence of socio-demographic, economic, genetic, environmental and other factors to thedevelopment, the course of diseases, the quality of the subsequent life and the survival of patients has been demonstrated.
The conclusion about the insufficiency of studies on development trends and changes in the oncologic epidemiological
situation has been done. The basic directions of the further research have been identified.
Key words: morbidity, malignant neoplasms of the lung, prevalence.
SOME TOPICAL ISSUES OF DISPENSARY INPATIENT PSYCHIATRIC CARE
IN MOSCOW
Alexey Yu. Ter-Israelyan, PhD Medicine, Head physician of the Psychiatric Hospital №13 of Healthcare Department of Moscow
[109559 Moscow, Stavropolskaya str., 27; tel.: 8(495)350-35-80; e-mail:
]
Andrey V. Belostotsky, MD, Professor, head of organization and management in the field of medicines’ circulation sub-faculty
of I.M. Sechenov Moscow State Medical University No.1 of Health Ministry of Russia [127018 Moscow, Skladochnaya str., 1;
p. 17; tel.: 8(495)318-00-11; e-mail:
]
Abstract. The data of the study of the organization order of psychiatric care in out-of-hospital conditions and problematic
issues of dispensary inpatient care for patients in the dispensary have been demonstrated. The article presents the results
of the organization of inpatient care for patients; their composition was studied on the basis of SBHI «Mental Hospital№ 13 of Healthcare Department of Moscow» in 2015–2017. The number of patients treated in the dispensary and day
hospital was analyzed by nosological forms, by sex, by age, by structure of the professional status. The main indicators
of day hospital (the average length of stay of patients, the turnover of beds, the number of bed days) have been studied
in 2015–2017. The analysis of financing of dispensary inpatient care for treated patients during the study period has been
done. The emphasis was placed on the provision of out-of-hospital inpatient care.
Key words: topical issues, day hospital, mental disorders, social characteristics, new organizational form, psychiatric
outpatient module, compliance.
CARDIOVASCULAR DISEASES DEVELOPMENT RISK FACTORS
AND POPULATION SANITARY LITERACY ISSUE
(literature review)
Ruslan Z. Garipov, Head of the reception unit of Interregional Clinical Diagnostic Center [420101 Kazan, Karbyshev str., 12а;
e-mail:
]
Aleksey V. Shulaev, MD, Professor, Vice-Rector for regional healthcare development of Kazan State Medical University
of Health Ministry of Russia [420012 Kazan, Butlerov str., 49; e-mail:
];
Marat N. Sadykov, PhD Medicine, Health Minister of Tatarstan Republic [420111 Kazan, Ostrovsky str., 11/6;
e-mail:
]
Leysan M. Khairullina, head of the clinical and expert department of Republican Clinical Ophthalmology Hospital of TR HM
[420097 Kazan, Butlerov str., 14; e-mail:
]
Dina A. Knyazeva, the fifth year student of general medicine department of Kazan State Medical University of Helth
Ministry of Russia [e-mail:
]
Abstract. Cardiovascular diseases are still the issue of the day for many countries of the world, including Russia.
Mortality rate from circulatory system diseases remains high in spite of the taken measures in the field of healthcare
over recent years. The literature review presents data analysis of mortality from circulatory system diseases in Russia
in comparison with other countries and literature data analysis of cardiovascular diseases development risk factors. The
article focuses on the study of the cardiovascular diseases main behavioral risk factors (hypertension, smoking, elevated
cholesterol, low physical activity, poor diet, excessive alcohol consumption).
Key words: mortality, circulatory system diseases, risk factors, hypertension, low physical activity, dietary habits, bad
habits.
INTERREGIONAL SPECIAL ASPECTS OF THE LEVEL, DYNAMICS
AND VOLATILITY OF THE MORBIDITY RISK OF TYPE 2 DIABETES
AMONG THE POPULATION IN THE WESTERN REGIONS
OF THE REPUBLIC OF AZERBAIJAN
Irada D. Alieva, PhD Medicine, Associate Professor of internal diseases sub-faculty III of Azerbaijan Medical University
[AZ1012 Baku, Enver Kasimzade str., 14; tel.: +994 50 320-51-00; е-mаil:
]
Abstact. Purpose of the study was to assess the importance of interregional difference of level, dynamics and volatility
of the morbidity risk of type 2 diabetes through the example of population of western regions of the Azerbaijan Republic.
Methods and materials were the data of the State Statistical Committee, which collected data about morbidity and prevalence
of type 2 diabetes in accordance with the State Program. Data about western regions have been taken for analysis; these
data had differences in climatic, geographical, medical and demographic characteristics on the background of common
economic and domestic activities. The actual and age-standardized type 2 diabetes morbidity rates have been calculated
and compared. Standardization was carried out by a direct method; age composition of the population of Azerbaijan has
been used as age standard. Results. The biggest value of the indicator in 2012 was detected in Goranboysky district, the
smallest – in Dashkesansky district [respectively (334,3±18,2) and (32,2±9,7)о
/
оооо]. Standardized morbidity coefficient for
type 2 diabetes changes between 30–347о
/
оооо, it confirms the preservation of the actual depth of the interregional difference
of the level of this pathology. Relatively lower level of morbidity rate of type 2 diabetes in 2012 was in Dashkesansky,
Samukhsky and Bardinsky districts (≤ 66,1±6,6о
/
оооо), and high level – in Tovuzsky, Gekgelsky and Goranboysky districts
[≥ (244,0±12,0)о
/
оооо]. Chronological five-year morbidity level of type 2 diabetes in western regions changes within the
interval from 74,4±14,7 (Dashkesansky district) to (346,6±23,7)о
/
оооо (Gekgelsky district). Dashkesansky, Shamkirsky,
Bardinsky and Tertersky districts are different with low level of chronological five-year morbidity rate of type 2 diabetes
[≤ (128,1±15,8)о
/
оооо]. High level of morbidity rate is characteristic for Gekgelsky and Goranboysky districts [≥ (317,3±17,7)о
/
оооо].
Conclusion. Significant interregional difference of morbidity rate of type 2 diabetes of population is watched in western
regions of Azerbaijan against the differences of medical-demographic and social–economic situation; these changes are
from (32,2±9,7)о
/
оооо to (487,8±28,0)о
/
оооо.
Key words: type 2 Diabetes, interregional special aspects of rate, dynamics and volatility.
ACTIVITY OF THE HOSPITALS IN CLINICS OF THE MINISTRY
OF INTERNAL AFFAIRS OF THE RUSSIAN FEDERATION IN 2013–2017
Evgenia A. Berseneva, MD, Head of the Center of Higher and Additional Professional Education of N.A. Semashko National
Research Institute of Public Health [105064 Moscow, Vorontsovo Pole str., 12/1; e-mail:
]
Sergey A. Mendel, PhD Medicine, chief of Clinical Hospital of Ministry of Internal Affairs of the Russian Federation in Moscow,
doctor of the highest qualification category [127299 Moscow, Novayа Ipatovka str., 3A; е-mail:
]
Raisa T. Tairova, PhD Medicine, Senior Researcher of Research Institute of Cerebrovascular Pathology and Stroke of Pirogov
Russian National Research Medical University [117997 Moscow, Ostrovitianov str., 1; e-mail:
]
Vladimir V. Shkarin, PhD Medicine, head of public health and healthcare sub-faculty of the faculty of continuing medical
education of Volgograd State Medical University of Health Ministry of Russia [400131 Volgograd, Fallen fighters square, 1;
e-mail:
]
Dmitry A. Kurakov, head of the demographic policy department of Healthcare Committee of the Volgograd region
[400001 Volgograd, Raboche-Krestyanskaya str., 16; e-mail:
]
Elena A. Savostina, MD, Associate Professor of medical statistics and informatics sub-faculty of Russian Medical Academy
of Postgraduate Education [123242 Moscow, Barrikadnaya str., 2/1, bldg. 1; е-mail:
]
Abstract. Purpose of the study: the hospitals activities’ analysis of the clinics of the Ministry of Internal Affairs (MIA)
of the Russian Federation in 2013–2017. The analysis of the data is presented in the dynamics for the period 2013–2017
according to the medical statistics of the Ministry of Internal Affairs of Russia. The analysis of the activity was carriedout according to the following indicators: hospitalizations, bed-days, average duration of treatment with using the lexical
analysis of medical documentation. The increase in the number of hospitalizations in 30% was found out in comparison
with 2017: the average time of hospitalization was 2,4 days. Conclusion: the volume of inpatient care delivered to the
contingent attached to the Ministry of Internal Affairs of the Russian Federation, is significantly lower than those of the
general network of Russian public health institutions. There is a significant differentiation and multidirectional dynamics
of indicators of medical care in round-the-clock hospitals of the clinics.
PERFORMANCE OPTIMIZATION OF OUTPATIENT CLINICS AT THE STAGE
OF CREATING A NEW MODEL OF HEALTHCARE INSTITUTION
Dania Yu. Karimova, MD, Professor of public health and healthcare sub-faculty of A.I. Burnazyan Federal Medical
Biophysical Center of FMBA of Russia [1231812 Moscow, Zhivopisnaya str., 46; tel.: 8-495-753-46-75;
е-mail:
]
Alsu N. Gaynetdinova, PhD Medicine, Assistant of hospital therapy sub-faculty of Kazan State Medical University
of Health Ministry of Russia [420012 Kazan, Butlerov str., 49; tel.: 8-904-666-06-15; е-mail:
]
Vyacheslav A. Zakalsky, Director- Head physician of AO «Medical Center «Zenit-Medservice» [143403 Krasnogorsk,
Sovetskaya str., 9; tel.: 8-985-761-99-82; е-mail:
]
Bulat N. Karimov, PhD (Econ.), Associate Professor of public health and healthcare sub-faculty of A.I. Burnazyan
Federal Medical Biophysical Center of FMBA of Russia [tel.: 8-916-333-31-76; е-mail:
]
Madina M. Shamurzaeva, Head physician of Central Railways Hospital at the station Gudermes of OAO «Russian
Railways» [366208 Gudermes, Kh. Isaev str., 38; tel.: 8-8-871-522-25-60; е-mail:
]
Abstract. The purpose of the study was to evaluate the preliminary results of the implementation of lean technologies’
clinic at the stage of creating a new model of healthcare institution according to the project’s realization. Material
and methods. The study was conducted on the basis of outpatient clinics of Krasnogorsk of Moscow Region, Kazan,
Nizhnekamsk, Naberezhnye Chelny of the Republic of Tatarstan, Gudermes of Chechen Republic. Anonymous questioning
was conducted by self-registration of patients who applied for medical help or consultation in healthcare institutions of
the chosen cities. The questionnaire covered three sets of questions: accessibility of medical care, conditions in the
outpatient clinic and politeness of staff. The study used the following methods: the study and synthesis of experience,
analytical, statistical and logical. Processing of the collected data was carried out on the basis of classical variation
statistics. Results. Traditionally, patients continue to make an appointment when they go directly to the reception unit:
from (30,0±1,4) to (61,0±6,8)% in the cities of the Republic of Tatarstan and in Gudermes of the Chechen Republic and
(90,0±3,8)% in Nizhnekamsk. That’s why there is the queue at the reception unit. At the same time, another (13,0±3,3) –
(22,0±4,4)% patients were enrolled by the registry telephone, thereby distracting the medical record keepers from
servicing the existing queue of patients. The authors analyzed the attitude of patients and the degree of their mastering
electronic services and other information materials, the comfort of staying in the clinic and other organizational moments
on the stage of the formation of a new model of healthcare institution. Conclusion. The study suggests that, in general,
outpatient clinics restructure their work in accordance with the «Lean polyclinic» program, but each institution has to
solve a number of tasks to create a new model. First of all, all healthcare institutions of the Russian Federation must
fully switch to digital methods of work. It is necessary to conduct educational work and training of personnel with the
psycho-communicative skills of the «friendly clinic». The special task is to raise awareness of the population about the
project and the possibilities of digital services and to carry out a set of organizational measures that contribute to the
complete transfer of records to the reception in digital technology.
Key words: outpatient clinics, lean polyclinic, patient satisfaction, new model of healthcare institution.
PROBLEM AREAS AND OPPORTUNITIES
OF «MOSCOW OUTPATIENT CLINIC STANDARD»
BY THE RESULTS OF A PILOT STUDY
Oleg E. Konovalov, MD, Professor of public health, healthcare and hygiene sub-faculty of Medical Institute of Russian
Peoples Friendship University [117198 Moscow, Miklukho-Maklay str., 10, build. 2; e-mail:
]
Denis V. Serov, Research Officer of Research Institute of Healthcare and Medical Management of Healthcare Department
of Moscow [115088 Moscow, Sharicopodshipnikovaya str., 9; e-mail:
]
Abstract. The article deals with study of problem areas and prospects for implementation of the «Moscow outpatient
clinic standard» (MOS). The aim of our work was the analysis of factors told by medical staff, affecting the efficiency
of the implementation of innovative projects in healthcare. The assessment of physicians’ and nurses’ altitude to the
changes, caused by implementation of innovative projects and readiness to work in new format has been also studied.
730 medical professionals of outpatient clinics (358 physicians and 374 nurses) took part in the pilot survey, using specially
designed questionnaire. It was established that the implementation of MOS has contributed to the revision of a number of
responsibilities and to activation of medical staff, focusing them on the satisfying the requirements of population for health
services. Thus, the MOS fits into WHO strategy, orienting primary health care institutions on including the integrated model
of medical care. At the same time MOS significantly freeds up time of physicians for working directly with patients. The
activity of nurses has also changed and now they received much more independence in their work. Therefore, the domain
of usage of received results is the healthcare authorities of Moscow and leadership of outpatient healthcare institutions.
In General, physicians and nurses evaluate the changes positively. The new working conditions are stressful factors and
need to be corrected. This should be taken into account by the heads of healthcare institutions.
Key words: the project «Moscow outpatient clinic», realization, problem areas, prospects of implementation.
WAYS TO IMPROVE THE QUALITY OF SPECIALIZED TRAUMA CARE
FOR CHILDREN IN THE KURSK REGION IN ORDER TO REDUCE
THE LEVEL OF CHILD DISABILITY
Lyudmila D. Gordova, Head of medical-social examination bureau № 6 of Main Bureau of Medical-Social Examination
in the Kursk region of Ministry of Labor of Russia [305048 Kursk, Gremyachenskaya str., 15; tel.: 8-910-270-4826;
e-mail:
]
Abstract. The pressing problem in the Kursk region is a high level of primary childhood disability due to injuries.
These indicators in the Kursk region are 2 times higher than those in the Russian Federation (0,8 in the Kursk region and
0,4 in the Russian Federation). The expert assessment maps were used; they included a block of questions on the lead
time, the volume of the activities carried out under the evaluation of the actual therapeutic rehabilitation measures at the
inpatient, outpatient and polyclinic stage. The purpose of the study was to determine the main directions of improvement of
specialized trauma care provided to children with injuries leading to disability. Analysis of the study showed that the state
of trauma and orthopedic care for children in the Kursk region cannot be considered as satisfactory. The unsatisfactory
condition of the trauma and orthopedic service is primarily due to organizational problems. Therefore, this article analyzes
topical issues of improving the organization and quality of specialized orthopedic and trauma care for the child population
in the Kursk region, which is a priority in reducing primary childhood disability due to injuries.
Key words: traumatism, children with disabilities, quality of medical care, prevention, organizational and tactical,
medical and rehabilitation measures, improvement of specialized orthopedic and trauma service.
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