Vol 64, No 4 (2020)

Introduction. The priority direction of reforming the national healthcare system is to improve the quality and accessibility of medical care against the background of the rational and effective use of resources of medical institutions.

Purpose of research. To identify reserves in optimizing the bed Fund based on evaluating the effectiveness of its use on the territory of the Federal districts of Russia.

Material and methods. The study used analytical, logical, and statistical methods. The primary material on the number of beds and indices of their use from 2016 to 2018 was taken from the statistical collections of the Ministry of Health of Russia.

Results. The study found the ongoing reform of inpatient medical care to be characterized by a reduction in the number of hospital beds and their availability to the population, a reduction in the average number of days of the bed use per year and the average number of days of the patient stay in the bed and an increase in bed turnover. To determine the effectiveness of the use of the bed Fund, it is advisable to use the method of comparing the number of hospitalized patients, calculated as the product of the number of deployed beds on the average number of days of the bed use per year, divided by the average number of days of the patient stay in the bed, by alternately (isolated) replacing existing indices with planned values.

Discussion. Rational reform of the bed Fund can be carried out with the widespread use of effective management methods in health care practice, the development of outpatient clinics, and the introduction of inpatient replacement technologies. Increasing the average number of days of bed use per year should be aimed at reducing unscheduled waiting times for the next hospitalization of the patient. Reducing the average length of stay of patients in a bed should be carried out taking into account the requirements of medical standards and clinical recommendations (treatment protocols).

Conclusions. The main reserves for improving the efficiency of the use of the bed Fund are increasing the average number of days of the bed use per year to the target of 340 days and optimizing the average length of the stay of patients in a bed, taking into account the achievements of medical science and practice.

Background. The epidemiology of loss of consciousness or syncope in Russian children’s population is unknown.
Aim of the study. To determine the frequency of syncope in children and adolescents. In the study of the EPISODE (EPIdemiology of Syncope in schOol chilDren and adolEscents), there were surveyed parents from 85.5% of all school children from one of the central districts of Russia (Vladimir city area, Petushki district). There were 5728 questionnaires with questions about the syncope in their children, cases of sudden death (SD) in the family were common. 1732 questionnaires were returned (30.2%), the girls and boys were 50.8% vs 49.2% respectively. There were divided in 4 groups: A) syncope — 4.2%; B) presyncope — 13.8%; B) Sudden Death (SD) before 50 years old in the family —18.2%; D) 81,9% — without symptoms and SD in the family. In group A, girls dominated as 5.7% versus 2.7%, p <0.00005. The SD in group A was more common than in the children without syncope (42.5% versus 17,1%, p <0.00005).
Conclusions: The prevalence of syncope among school children in Russia amounted to 4.2%. Syncope is found mainly in girls. The combination of syncope and SD in the family forms a group of children, in which, first of all, family diseases with the risk of SD should be excluded.

Introduction. The territory of the Republic of Khakassia is endemic for goiter, in this regard, both the prevention and correction of iodine deficiency are very important. University students are a part of society, which makes up its main reproductive reserve, and the increased level of intellectual load on the background of adaptation to new living conditions and the educational process requires the adequate provision of iodine, the lack of which can negatively affect their health.

The purpose of research. Assess the level of awareness and commitment to preventative behavior of University students.

Material and methods. To assess the level of awareness about the negative consequences of iodine deficiency and its prevention, a questionnaire was developed for students. 452 freshmen (281 girls and 171 boys) of Khakass State University took part in an anonymous sociological poll voluntarily.

Results. When analyzing interview data, it was determined only 61.6% of students to be aware of the problem of biosphere iodine deficiency in the republic; 18.8% of students found it difficult to name the clinical manifestations of iodine deficiency conditions and the most sensitive periods of ontogenesis to iodine deficiency. Methods for the prevention of iodine deficiency 25% of students consider inaccessible and expensive. 39.6% of students buy iodized salt, but only 65.5% of them are aware of the peculiarities of its storage at home and 37.5% are correctly used in cooking (before serving and at the end of cooking). It was noted the low level of regular consumption of foods rich in iodine: in 70% of respondents, these dishes were in the diet less than once a week; and 38.9% of students practically do not eat seafood. Only 2.1% of respondents constantly took iodine-containing drugs; 53.9% of the students did not use the medicine at all, and the rest of the students received iodine occasionally. However, only 4.7% of students taking drugs received an adequate prophylactic dose of iodine.

Discussion. Despite the activities carried out in Khakassia in 2014-2016 as part of the program for the prevention of diseases caused by micronutrient deficiency, the study participants have an average awareness of the consequences and availability of measures for the prevention of iodine deficiency. Even among students who are aware of the problem of iodine deficiency conditions, less than half of the respondents understand the importance of eating iodized salt to reduce the overall incidence rate, maintain intellectual performance and reproductive well-being. Our results are consistent with data from surveys conducted in other regions of the country.

Conclusions. To preserve and improve the somatic, mental and reproductive health of youth of Khakassia, it is necessary to strengthen the educational component of regional programs for the prevention of iodine deficiency diseases.

Based on the study of the results of legislative activity, the directions of legal regulation in the field of public health in Russia are determined. The existing legislative framework that defines the protection of citizens’ health and the possibility of systematization and codification of laws is considered. The main directions of the development of legislation in the field of healthcare of the Russian Federation for the coming years are determined.

Introduction. Patient safety is the absence of preventable harm to the patient in the course of medical care and the reduction of the risk of unnecessary harm associated with medical care to an acceptable minimum. Over the past two decades, the problem of patient safety has become the object and target area of public health for specific efforts to improve it.

The study aims to analyze modern scientific literature to consider problems related to clinical safety, the global burden of harming patients.

Material and methods. In the context of studying the problem, the results of modern research were used to identify the causes of medical errors and to find ways to prevent them.

Results. The desire to improve the level of safety and the quality of medical care is growing in the world. Consequently, significant measures to evaluate the safety of medical care and its quality will be of paramount importance. To date, there is no gold standard or established array of quality indices (QI) for measuring the quality and safety of medical care. However, many indices have been developed, and some have even been tested to measure specific aspects of patient quality and safety. Such studies are in demand to achieve a clinically significant reduction in the incidence of medical errors.

Conclusion. Despite the growing recognition of the role of human medical error in medicine, to prevent or mitigate their consequences requires the search for adequate ways both at the individual and systemic levels.

Our predecessors (V.A. Lisichkin, Yu.L. Shevchenko, S.P. Glossiev) either had no information about the letters of the surgeon and Bishop Luke (Voino-Yasenetsky) in 1932-1933 or had partial information about their contents (Metropolitan of Simferopol and Crimea Lazar (Shvets). The introduction of these rarities into scientific circulation for the first time allowed establishing the terms of treatment of the surgeon and Bishop Luke (Voino-Yasenetsky) at the Leningrad Cancer Institute (March-April 1932), as well as the call to the Central apparatus of the United main political Directorate (Moscow, OGPU, September-October 1932) during the Arkhangelsk exile (1931-1933). At the same time, there was revealed the relationship between these events, which were the first and second stages of the so-called “review of the investigative case” of the exiled surgeon and Bishop. Offering early release from the Arkhangelsk exile, employees of the Central office of the OGPU persuaded him to renounce the dignity of an Orthodox Bishop. The refusal of a surgeon and a Bishop to remove an Orthodox Bishop from office in exchange for early release from exile and prospects for further employment in the medical profession has been documented. There are quoted original archival documents, including letters from the surgeon and Bishop Luke (Voino-Yasenetsky), and answers to them of historical significance are selectively provided.

Энциклопедия «Удмуртская Республика. Здравоохранение» является одним из первых региональных изданий, посвященных становлению отрасли края. Это историческое издание позволяет проследить этапы развития здравоохранения на протяжении XVIII–XXI вв. Оно подготовлено на основании архивных документов большей частью (3/4 материалов, не опубликованных и впервые выводимых на обозрение широкого круга читателей). Их актуальность заключается в выборе для исследований новых тем, анализе первичных документов по истории медицины в традициях академической науки на примере развития здравоохранения Вятской губернии, одной из крупнейших в Российской империи с числом населения более 3 млн человек, и на территории, соотносимой с границами современной Удмуртской Республики (УР). Эти архивные материалы, несомненно, являются источником новых поисков и, возможно, открытий.

22 августа 2020 г. исполняется 85 лет со дня рождения академика РАМН, профессора, заслуженного деятеля науки России Анатолия Ивановича Потапова.