Vol 65, No 5 (2021)

Introduction. Digital technologies are an essential condition for the development of modern health care. New forms of interaction between the supplier and the consumer of medical services determine the need to understand the attitude of the doctor and the patient to this employment operation.

Purpose. Assess the change in the quality of communications between the doctor and the patient with the widespread introduction of electronic medical records. 

Material and methods. Within the framework of the project, a content analysis of media materials was held. Mass (questionnaire) survey of doctors and patients in November–December 2020 was executed. The comprehensive survey had 482 respondents, including 168 doctors and 314 patients.

Results. Most (61.5%) of medical professionals indicate a decrease in time costs during the patient’s reception, an increase in time to work with patients is noted in 47.4% of respondents. 55% of doctors report that the service helps better focus on the provision of medical care, and 47.6% of respondents believe that the conduct of medical documentation in electronic form allows reducing the frequency of passing a significant pathology. Among patients, 52.2% believe that introducing electronic medical records will enable you to increase the time that the doctor pays to the patient during the reception. 68.9% of patients indicate an improvement in the interaction between doctors and patients.

Conclusion. High-quality results can be achieved only if there is a medical staff with the skills of using modern digital technologies and new communication skills with a patient when using electronic medical records.

Introduction. The increase in financial resources on the part of the state for the procurement of medicines for treating patients with malignant neoplasms makes the issue of calculation the need in medicinal preparations (MP) actual.

The aim of the work is to develop a special tool (oncology calculator) that standardizes the method for determining the need for drugs and can calculate the need for medications for the treatment of malignant neoplasms in a particular constituent entity of the Russian Federation.

Material and methods. To develop an oncology calculator, we analyzed the need for the drugs for the treatment of patients with the most common malignant neoplasms was analyzed based on current clinical guidelines approved and published on the Ministry of the Russian Federation website. The number of patients at each stage of a specific cancer was calculated. The frequency of application of a particular treatment regimen was calculated based on the approved standards of medical care for patients with cancer or from a project. The number of patients was calculated on the official statistics presented in the P.A. Hertsen Moscow Oncological Research Institute — branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” by the Ministry of Health of Russia. 

Results. We have developed a tool called the “Oncology calculator” that standardizes the methodology for determining the need of a constituent entity of the Russian Federation or a medical institution for drugs based on clinical guidelines, as well as facilitating the planning of the volume of medical care in the conditions of round-the-clock and day hospitals, and in the provision of medical care to patients with malignant neoplasms in outpatient settings.

Conclusion. The existing approaches to calculating the need for drugs for the treatment of patients with cancer in the constituent entities of the Russian Federation are scattered, which leads to the ineffective use of funds from the federal budget, compulsory medical insurance funds, budgets of the constituent entities of the Russian Federation. A uniform approach to calculating the need for drugs to treat malignant neoplasms should be based on clinical guidelines containing drug regimens for treating patients.

Aim. To study the population of the Chuvash Republic awareness of depression and methods of its treatment. 

Material and methods. Seven hundred sixty-four residents of the Chuvash Republic (472 women, 292 men) aged 18 to 83 years old (average age — 35.5 ± 14,3 years old) were interviewed anonymously. Urban residents were 75.5%, rural — 24.5%, with medical education — 5.9%. Two K. Griffiths et al. vignettes described patients with normal depressive state and depression accompanied by suicidal thoughts. After reading the picture, the respondents had to answer seven short questions. Mathematical and statistical processing included the calculation of the mean, standard deviation and χ² distribution. 

Results. 39.0% of the respondents correctly identified the state of depression in the vignettes. This mental disorder was reliably better recognized by the respondents with a medical or higher education, urban residents and those who met such patients in life. The respondents most often (44,5%) recommended receiving psychological assistance, consultations and medical treatment (33,5%). They often suggested various “popular interventions”, did not know which specialists to contact and how to treat such a pathology, or suggested doing nothing at all, even if there were suicidal thoughts. More than 75% of the respondents expressed an improvement in patients’ condition in the case of their referring to specialists, the best results were given by the respondents who correctly recognized depression. 

Conclusion. The study showed a low level of depression awareness of the population of Chuvashia. This circumstance is reflected in the appeal of the people for medical (psychiatric, psychotherapeutic) help and expectations regarding the treatment of this mental disorder. A high proportion of incorrect answers about depression require educational work with the population, better psychiatric preparedness of specialists in the psychological profile and doctors of the general somatic network.

Introduction. High mortality from noncommunicable diseases (NCDs) leads to significant economic losses, both direct associated with increasing costs for the health system and indirect associated with a decrease in labour potential due to disability and premature mortality of the population. It is known that the same risk factors (RF) determine the occurrence of major chronic diseases. To reduce mortality rates, it is necessary to change the population’s risk profile to reduce the prevalence of RF.

Goal. To identify the health effects of major non-communicable diseases in Russia by monitoring risk factors.

Оbjectives:
1. Determine the structure and weight of risk factors for noncommunicable diseases.
2. Study systems for monitoring the risk factors of non-communicable diseases.
3. Analyse international and domestic experiences in the prevention of major non-communicable diseases. 

Material and methods. Statistical compilations by Rosstat, Ministry of Health of Russia. Medline database was used to find some sources.

Results. The creation of an evidence-based health policy and strategy is based on a well-organized, reliable information system. Monitoring the NCD RF by regularly examining representative samples using standard methods is critical for such a system. Regular assessment of the population’s risk profile allows tracking the dynamics of health indicators and predicting mortality rates. Monitoring RF can assess the effectiveness of health care and population-based prevention programs in the regions and the country as a whole.

Conclusions. In addition to the influence of lifestyle and the physical and social environment, the health of the population depends on many components: the principles of the organization of the health system, it’s financing, and, to a large extent, on the standard of living of the population, income and their distribution in society. On this basis, health problems associated with various socio-economic, environmental and other living conditions of the population should be addressed jointly by many sectors and departments by creating a supportive physical and social environment for a healthy lifestyle of the population.

Introduction. The choice by medical personnel of a particular trend in their professional behaviour has a direct and significant impact on the functioning of health care institutions in general. The labour behaviour of doctors and nurses is determined by many different external factors and the formed personal characteristics of the health workers themselves.

The aim of the study. Identification of current models of professional behaviour of employees of the capital’s medical organizations.

Material and methods. Sociological research in the form of a mass survey of doctors and nurses; multivariate data analysis using structural and logical typology (factor and cluster analysis).

Results. The selection of four models of professional behaviour of employees of the capital’s medical organizations based on factor analysis (matrix of factor loadings) has been substantiated. The four models shown reflect the relationship between the personal characteristics of the personnel of healthcare institutions and working conditions (the ability to qualitatively fulfil the responsibilities for the provision of medical services and build a professional career).

Discussion. The differences in the preference for behavioural trends of doctors and nurses in the workplace revealed in the study showed an uneven distribution by behavioural models: the greater importance of professional (qualification) qualities for some and personal characteristics for others.

Conclusion. The systematization of behavioural models of medical personnel is in demand from the standpoint of the need to make effective management decisions in healthcare institutions in situations where it is necessary to identify and remove obstacles to achieving specific goals: increasing job satisfaction and providing quality medical care.

Introduction. This study focuses on the formalization of the institution of mentoring in health care. The mentoring system in Russia has existed for a long time. Still, there is a particular interest in this topic since the requirements for the quality of medical care are changing, new challenges arise in the healthcare sector, and reducing staff turnover and retaining highly qualified specialists in the workplace arises.

Targets and goals. The aim of the study is to clarify the need for institutional consolidation of the institution of mentoring. The tasks of the work included identifying factors motivating or demotivating medical workers to participate in the mentoring system, as well as the search for problems of formalizing the institution of mentoring.

Material and methods. The author conducted a sociological study in Moscow: a mass questionnaire survey among doctors and nurses in 6 medical institutions subordinated to the Department of Health of the city of Moscow and a series of in-depth structured interviews with representatives of medical organizations in charge of mentoring in their organizations (17). Analysis of quantitative data was carried out using the construction of classification trees using the CHAID method.

Results. The main issue that experts propose to spell out when formalizing mentoring is the skills and abilities. Employee willingness to become mentors varies. The study found that physicians over the age of 27 are most likely to become mentors convinced of the need to introduce and expand mentoring in the workplace. Young doctors under the age of 27 are less likely to take on the mentoring function due to a lack of confidence in their qualifications, as well as older colleagues who are dissatisfied with the working conditions in the workplace and do not consider it necessary to introduce or expand a mentoring system in their organization.

Conclusion. The study showed that experts have a positive attitude to ​​formalizing the institute of mentoring, noting that there should be a single document of a recommendatory nature.

The identification of research fronts and the setting of priorities is a significant challenge in science and policy. 

The Global Research Front cluster of scientific articles is united by co-citing in other papers at a particular time. SciVal (online platform for monitoring and analyzing international research using visualization tools and modern citation metrics, economic and social efficiency) has three subject areas: Clinical Medicine, health management, and public health. 

By the total number of articles and the share of the direction in the research area of InCites Citation Topics, determine the global research fronts: neuroscanning, immunology, diet, orthopaedics and psychiatry. Today, the world is witnessing large-scale scientific programmes aimed at understanding human beings and their health. Because of the growing burden of significant brain diseases worldwide, scientists need to find effective means to apply modern biotechnology fully and address current clinical medicine issues. 

The threats of infectious diseases and the development of new vaccines have reinforced the pronounced response of the Global Immunology Observatory and related products in the field of system immunology. 

The scientific communities have embarked on a comprehensive consultation that should lead to a global strategy on diet and diet, physical activity, and reducing musculoskeletal and musculoskeletal diseases. 

Orthopaedic surgeons are developing new procedures and technologies to optimize patient care based on a science-based approach. 

The scale of mental health problems is at the heart of the global health and development plan of the World Bank, WHO and other national and international organizations, highlighting the scale of these challenges and successes that can be achieved if we work together to solve them.

Introduction. Last decade significant progress was made in the development of cancer care algorithms. In this regard, new challenges are constantly being presented to the quality control of medical activities in actual practice.

Aims. To summarize the outlines regarding the most relevant criteria for assessing the quality in oncology.

Material and methods. The PubMed database (Medline) was used to identify the relevant and reliable sources of literature. The thematic methodology for obtaining information was used. 

Results. In total, over 80 most significant publications were identified, thoroughly studied and analyzed. International experience indicates the advantages for assessing the quality of cancer care by determining and measuring certain indicators. The model for quality assessment proposed by Donabedian A. (1966) is broadly applied in current medical practice. This model distinguishes the following: 1) structural indicators, 2) process indicators, 3) outcome indicators. Feedback is critically important in the organization of the audit of medical activities. It allows one to adapt the assessment methods by focusing on the tasks immediately during the control process. Because of cancer heterogeneity, there are apart requirements for developing quality indicators for each specific type of cancer because of cancer heterogeneity. 

Conclusions. Monitoring of medical activities is a crucial pillar for a robust healthcare system. The introduction of essential, practical and specialized audit techniques helps to improve the quality and safety of medical technologies used in cancer care. There is an increasing need to develop optimal indicators and standard operating procedures for the control of cancer care.