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Dear colleagues,

By Decision of Presidium of the Higher Attestation By Decision of Presidium of the Higher Attestation Commission of the Ministry of Education and Science of the Russian Federation from January, 27th 2016 Online scientific journal "Social aspects of population health" was included into the "List of the leading peer-reviewed journals and editions where main scientific results of dissertations for the degree of Philosophy Doctor and Doctor of Science should be published".

 
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ORGANIZING PAIN MANAGEMENT FOR PATIENTS WITH BLOOD DISORDERS. SYSTEMATIC REVIEW
Monday, 25 December 2017

DOI: 10.21045/2071-5021-2017-58-6-1

1Levchenko OK, 2Berseneva EA, 3Kosolapova NV, 1Galstyan GM, 1Savchenko VG
1
National Research Center for Hematology, Moscow
2
N.A. Semashko National Public Health Research Institute, Moscow
3
Russian Economic University named after GV Plekhanov, Moscow

Contacts: Levchenko Olga, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Levchenko O.K.,
http://orcid.org/0000-0003-1425-4370
Berseneva E.A., http://orcid.org/0000-0002-9343-9279
Kosolapova N.V., http://orcid.org/0000-0002-3624-0626
Galstyan G.M., http://orcid.org/0000-0001-8818-8949
Savchenko V.G., http://orcid.org/0000-0003-2935-4040
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

bstract. Pain is one of the most common reasons for care seeking. Pain control in the developed countries is a quality indicator of health care delivery. Along with other diseases, blood disorders (such as hemophilia, multiple myeloma, Gaucher's disease, porphyria and others) are accompanied by acute and chronic pain. Treatment of the pain syndrome in such patients has its own peculiar characteristics and requires organization of a special service.

The purpose of this study is to analyze possibilities of designing a pain management system for patients with blood disorders and a subsequent development of basic concepts of this service.

Methods. To achieve this purpose, available domestic and foreign sources of literature were analyzed. The literature search was conducted in the scientific libraries eLIBRARY and PubMed to identify studies with terms and concepts related to pain, pain control, organization of pain management for patients with blood disorders in articles, titles or abstracts - more than 200 sources, 44 out of them were selected for analysis and synthesis. The other sources were excluded due to lack or incomplete information necessary for the study implementation.

Results. Despite the existing many recommendations on pain management, the world still registers inadequate and untimely diagnosis and treatment of pain. The main causes of ineffective pain management are: insufficient knowledge of pain management recommendations by the medical staff, frequent lack of appropriate documentation for assessment and treatment of pain in patient records, insufficient time for identifying pain and its characteristics due to stress, high intensity of work of physicians.

Discussion. Pain in patients with blood disorders is common and has peculiar characteristics and requires timely diagnosis, therapy, monitoring, and prevention. Due to complex pathogenesis and variety of pain types in hematological diseases, care should be of an interdisciplinary nature, that is, being provided by specially organized teams of specialists. Weaknesses and strengths of pain management organization for patients with blood disorders in hematology have been identified, proposals for the pain relieve service have been made.

Conclusions. Organization of pain management for patients of hematologic profile will result in better availability and quality of health care and decreased complications opening up the possibilities of early social rehabilitation of patients and regaining ability to work.

Keywords: hematology; pain; organization; pain management

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JANUARY DEATHS IN RUSSIA, 2004-2016
Monday, 25 December 2017

DOI: 10.21045/2071-5021-2017-58-6-2

NemtsovA.V.
V. Serbsky National Medical Research Centre for Psychiatry and Narcology, Ministry of Health of the Russian Federation, Moscow

Contacts: Nemtsov Alexandr, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about author: http://orcid.org/0000-0003-1150-5146
Conflict of interests. The author declares no conflict of interest.
Acknowledgments. The study had no sponsorship.

Abstract

Purpose of the study: to estimate whether and how the total number of deaths in January exceeds the number of deaths in the remaining months of the year.

Objectives of the study: to analyze distribution of the total number of deaths, as well as deaths from alcohol poisoning, pneumonia, respiratory infections and influenza by months in 2004-2016 with a focus on January.

Material and methods. The subject of the study was the total number of deaths in Russia (a total of 26993487) according to the Rosstat operational data from January 2004 to December 2016 (n = 156 months). Over the period under study there was a regredient decrease in the number of deaths that can be satisfactorily described by a cubic polynomial. Therefore, data were converted into a linear format. Then, a linear function for January and other months was identified. Constant member of those functions served as an estimation of deaths in January and other months in 2004-2016. Deaths caused by alcohol poisoning served as an indirect indicator of actual alcohol consumption (according to the Rosstat operative data). As the morbidity and mortality from colds and infectious diseases increase in winter, the Rosstat operative data on deaths from pneumonia, respiratory infections and influenza were used, as well as data on deaths from influenza of the Institute of Influenza. Data on the average air temperature in the country were received from the Rosstat website.

Results. The constant term of the linear regression for January and other months equals to 185460 and 167370 deaths per year respectively with the difference of 18090 deaths. This is the average excess of January over the remaining months in 2004-2016. It adds up to 10.8% of the total number of deaths in January. The excess of January over the remaining months ranges from 12000 to 21000 deaths.

The number of deaths from pneumonia in males and acute respiratory viral infection in males and females correlates with alcohol consumption. This means that these deaths are closely related to the use of alcohol and partly included in the January "excess".

Conclusion. Synchronicity of dynamics in the total number of deaths and deaths from alcohol poisoning with a maximum in January indicates that the excess in the January deaths is associated with alcohol abuse. The additional loss of 18000 lives as a result of the annual holidays in January should become a public health concern and requires administrative, and possibly political interference to reduce this loss, especially against the background of the impending depopulation.

Keywords: deaths in January; New Year and Christmas holidays; alcohol poisoning; pneumonia and acute respiratory viral infections.

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COHORT AND AGE/GENDER SPECIFIC ALCOHOL-ATTRIBUTABLE MORTALITY IN THE SUBARCTIC REGIONS OF THE EUROPEAN NORTH OF RUSSIA, 2006-2015
Monday, 25 December 2017

DOI: 10.21045/2071-5021-2017-58-6-3

Mordovsky E.A.
Northern State Medical University, Arkhangelsk

Contacts: Mordovsky Edgar, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about author:
Mordovsky E.A., http://orcid.org/0000-0002-2346-9763
Acknowledgments. The study had no sponsorship.
Conflict of interests. The author declares no conflict of interest.

Abstract

Significance. Alcohol consumption and alcohol dependency determine the existing level of social welfare in Russia. Their various negative consequences (including alcohol-attributable mortality) are recognized as a threat to national security.

The purpose of the study is to identify cohort and age/gender characteristics of alcohol-attributable mortality in the Murmansk and Arkhangelsk regions and the Republic of Komi in 2006-2015.

Methods. Crude and standardized death rates from acute and chronic alcohol-attributable conditions of the population of the Subarctic regions (by gender and age) were calculated. Procedures of the APC-analysis (Age-Period-Cohort analysis) were performed to evaluate the "age effect", "cohort effect" and "period effect" in the dynamics of age/gender death rates from the above-mentioned groups of conditions.

Results. The decline rates in the values of standardized mortality from alcohol-attributable conditions added up to 34.5% in the Murmansk region, 36.4% in the Arkhangelsk region, and 18.2% in the Republic of Komi in 2006 - 2015. The risk group of excess alcohol-attributable mortality included men aged 35-64.

Decline in alcohol-attributable mortality in the Murmansk and Arkhangelsk regions was due to "cohort" and "period" effects; in the Republic of Komi it was due to the "cohort effect" only. At present, high values of alcohol-attributable mortality indices among the subarctic population are associated with the excessive death rates in older generations (born in the 1940s and 1950s).

Conclusions. Results of the APC-analysis prove significant differences in the mechanism of alcohol-attributable mortality evolution in the Murmansk and Arkhangelsk regions in comparison with the Republic of Komi in 2006-2015.

Scope of application. Results of this study can be used to develop regional programs on preventing excessive alcohol-attributable mortality, tailored for representatives of different generations and age/gender groups.

Keywords: alcohol-attributable mortality; Subarctic territories; Murmansk region; Arkhangelsk region; Republic of Komi; APC-analysis; age effect; birth-cohort effect; period effect.

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DIFFERENTIATING SUBJECTS OF THE FAR EAST FEDERAL DISTRICT (BASED ON A MULTIFACTORIAL CLUSTER ANALYSIS OF CLIMATIC, GEOGRAPHIC, SOCIO-ECONOMIC, DEMOGRAPHIC, MEDICAL AND EPIDEMIOLOGICAL INDICATORS)
Monday, 25 December 2017

DOI: 10.21045/2071-5021-2017-58-6-4

Bogachevskaya S.A.
Federal Centre for Cardiovascular Surgery, Khabarovsk, Russia

Contacts: Bogachevskaia Svetlana, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about author:
Bogachevskaia S.A., http://orcid.org/0000-0001-7150-2620
Conflict of interests. The author declares no conflict of interest.
Acknowledgments. The study had no sponsorship.

Abstract

The article presents a multifactorial cluster analysis of the subjects of the Far East Federal District with due regard to medical care for the circulatory system diseases. The article also suggests priority areas for reforming medical care according to results of the macro-region multifactorial clustering.

The purpose of the study: to evaluate performance of the three-level system of medical care for cardiovascular diseases to the population of the Far Eastern Federal District.

Materials and methods. Clustering of the nine subjects of the Far East was carried out through the hierarchical analysis and analysis of k-averages by 26 economic, demographic, resource and climatic, epidemiological and medico-social indicators (cardiovascular profile).

Results. The generalized cluster analysis shows that the Far Eastern region is divided into the three functionally and territorially isolated cluster systems.

The first cluster included Primorsky territory, Khabarovsk territory, Amur region and Sakhalin region, Kamchatka territory, Jewish Autonomous region (the territories of the Near North and South within the main infrastructure corridor). This cluster can be considered as a system-forming element of the territorial organization of medical care delivery for the circulatory system diseases to population of the Far East Federal District as well as the entire economy of the Russian Far East. Because of its isolation on major basic parameters of clustering the second cluster was formed by the Republic of Sakha (Yakutia), while the third cluster was formed by the Chukotka Autonomous district.

Discussion. Low population density, specific climatic and geographic conditions and marked heterogeneity of territorial accessibility of the regional and federal centers by the subjects limit the all-Russia concept of healthcare reforming. It requires adaptive approaches to resource-consuming medical care for the circulatory system diseases in each of the cluster as well as their cooperation in the general model of care delivery.

Peculiarities of the second cluster of the macro-region require expanded capacities of care delivery within the subject. The third cluster determines the need for specific patient routing in the system of high-tech medical care to ensure transport accessibility.

Authority crossover of the regional and federal levels (including research institutes) in the three-level system of high-tech care for the circulatory system diseases results in ineffective redistribution of patient flows between clinics, reducing the overall system performance.

Conclusions. The marked heterogeneity of the subjects of the Far East Federal District requires a differentiated approach to organize care for the circulatory system diseases in the entire region. The article outlines the presented approach.

Keywords: availability and quality of medical care; circulatory system diseases; a multifactorial cluster analysis.

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STUDYING ADHERENCE OF PARENTS TO IMMUNIZATION OF CHILDREN ATTENDING KINDERGARTENS AND SCHOOLS
Monday, 25 December 2017

DOI: 10.21045/2071-5021-2017-58-6-5

Moskvicheva M.G., Popov E.A., Zlakomanova O.N.
South Ural State Medical University, Ministry of Health of the Russian Federation, Chelyabinsk

Contacts: Popov Yevgeniy, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Moskvicheva M.G., http://orcid.org/0000-0001-5009-8120
Popov E.A., http://orcid.org/0000-0003-1624-3878
Zlakomanova O.N., https://orcid.org/0000-0001-6554-6248
Acknowledgments. The study had no sponsorship.
Conflicts of interests. The authors declare no conflict of interest.

Abstract

This article presents results of the adult questionnaire on adherence to immunization of children. A number of barriers to immunization have been identified.

Significance. High level of social, epidemiological and economic importance of infectious diseases makes them the most significant characteristic of health and sanitary and epidemiological well-being of the population. Despite the ongoing preventive immunization, new cases of infectious diseases and associated mortality are still being registered, including among children, therefore, the epidemiological situation requires constant analysis and incidence control, including through immunization in line with the National Immunization Schedule.

At present, one of the factors reducing pediatric immunization coverage, and, therefore, effectiveness of preventive immunization, is trend towards increased numbers of refusals from immunizing children due to publications in mass media and appearance of people on TV who are strongly against immunization. .

In a megalopolis, with marked migration processes and high population density, the risk of epidemic outbreaks of infectious diseases is extremely high, which only stresses out significance of the problem to improve parental adherence to immunization and reduce refusals from preventive immunization of children.

Purpose. To analyze results of the questionnaire survey of parents whose children attend kindergartens and schools in the city of Chelyabinsk.

Materials and methods. A survey of respondents selected by a blind continuous sampling was conducted. A total of 934 people took part in the survey - parents (legal representatives) of children visiting the Children's polyclinic in the city of Chelyabinsk. Statistical data analysis was carried out using SPSS 19.0.

Results. The parental survey identified a number of trends in the development of adherence to preventive immunization. Younger respondents are less aware of the importance to immunize their children. Women turned out to be least supportive to immunization out of all respondents.

Respondents with higher education are more loyal to immunization, have a better understanding of the need for their children to be immunized and a better apprehension of immunization as a means to prevent infectious diseases.

Conclusion. Directions to improve immunization of children have been identified, including: working with target groups of parents to raise their awareness of the need for immunization, strengthening the status and gravitas of doctors as a reliable source of information on immunization.

Keywords: preventive immunization; refusal from immunization; adherence to immunization; questionnaire survey.

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ORGANIZATION OF CARE FOR CHILDREN WITH ORPHAN DISEASES IN MOSCOW: PROBLEMS AND OPPORTUNITIES ACCORDING TO THE SURVEY OF PARENTS
Monday, 25 December 2017

DOI: 10.21045/2071-5021-2017-58-6-6

Vitkovskaya I.P.
Research Institute for Health Organization and Medical Management of the Healthcare Department of Moscow, Moscow

Contacts: Vitkovskaya Irina, email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about author:
Vitkovskaya I.P., http://orcid.org/0000-0002-0740-1558
Acknowledgments. The study had no sponsorship.
Conflict of interests. The author declares no conflict of interest.

Abstract

Significance. The problem of care organization for children with rare (orphan) diseases is a universal one. The World Health Organization (WHO) notes that none of the 27 member States of the European Union can offer treatment for the entire spectrum of rare diseases [17], while orphan diseases account for 35% of deaths during the first year of life, for 10% of deaths within 1-5 years of life and 12% of deaths within 5-15 years of life [15]. Development of the system, an integral component of which is involvement of parents will contribute to early detection, treatment and rehabilitation of children with rare (orphan) diseases. In Russia this system is yet to be tuned as evidenced by the Government Order No. 1839-R as of 31.08.2016, that approved the "Concept for developing early care until 2020". In this regard, evaluation of the system of care for children at the level of Moscow as a subject of the Russian Federation and participation of parents of the patients will allow to identify the existing problems from the perspective of the medical service consumers and make timely corrections.

The purpose of the study: to analyze opinion of parents of children with rare (orphan) diseases about availability and quality of medical care in Moscow.

Materials and methods. Analysis of opinion of parents of children suffering from rare (orphan) diseases was conducted at the Reference center for congenital genetic diseases, genetic abnormalities, and other rare orphan diseases of the Morozov Childrens City Hospital of the Moscow Healthcare Department. The opinion survey included 158 parents. Research tool: a specially designed questionnaire consisting of 69 questions. Object of the study: family with a child suffering from a rare (orphan) disease. The awareness evaluation criteria included quality indicators, defined by the number of correct answers from the options and their quantity, in % (know /dont know). Data were processed in the Statistica 5.0 (Statsoft, USA) program and Microsoft Excel.

Results. In Moscow, the following things have a negative impact on availability and quality of care to children with rare (orphan) diseases: doctors insufficiently inform parents about health prognosis of the child; low capacity of facilities (lack of genetic testing within the system of Compulsory Health Insurance); lack of services needed by the patient (services of psychologists, speech therapists, speech pathologists, physiotherapists, physiatrists, specialists in physical therapy) in the individual rehabilitation program; the need to retain paid medical services.

Keywords: children; orphan diseases; information; rehabilitation; medical services.

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FAMILY PLANNING, RATES OF FAMILY MAKING AND REPRODUCTIVE HEALTH OF PREGNANT WOMEN
Monday, 25 December 2017

DOI: 10.21045/2071-5021-2017-58-6-7

Artyukhov I.P., Kapitonov V.F., Shurova O.A., Pavlov A.V.
Krasnoyarsk State Medical University named after Professor V.F. Vojno-Yasenetsky, Ministry of Healthcare of the Russian Federation, Krasnoyarsk

Contacts: Kapitonov Vladimir, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Artyukhov I.P., http://orcid.org/0000-0002-5939-6017
Kapitonov V.F., http://orcid.org/0000-0001-9212-3910
Shurova O.A., http://orcid.org/0000-0002-6511-8451
Pavlov A.V., http://orcid.org/0000-0002-6170-6504
Acknowledgments. The study had no sponsorship.
Conflicts of interests. The authors declare no conflict of interest.

Abstract

Significance. Impact of family planning, especially, the birth of a firstborn, on the status of reproductive health of pregnant women and neonates remains underexplored.

Purpose: to study relationship between family planning, rates of family making and reproductive health of pregnant women.

Materials and methods. Primary data were collected through a survey of parturient women in Krasnoyarsk. Data were complemented by information from medical documentation (medical record of the pregnant woman and the puerpera - Form No. 111/y). Morbidity in pregnant women was analyzed on the basis of International Classification of Diseases, Tenth Revision (ICD-10). The received information was analyzed using absolute and relative values, correlation coefficients. Significance of differences in the relative indicators was assessed by the criterion t.

Results. Considering the purpose of the study, which implies division of the respondents into age groups and parity of births, we interviewed 1236 women in Krasnoyarsk, whose pregnancy ended in childbirth. For the analysis, the respondents were divided into six age groups: 15-19 years; 20-24 years; 25-29 years; 30-34 years; 35-39 years; and 40 years and over. The analysis showed that, in general, uncomplicated pregnancy was reported by 317 (25.6%) women; prevalence of diseases and pathological conditions prior to or during pregnancy added up to 1563.1 26.7, increasing with age.

Differences in the duration of pathogenetic and intergenetic intervals by age groups were identified.

Discussion. Analysis of the health status of women with a ten-year pathogenetic interval or over showed that uncomplicated pregnancy was registered in only 12.5% of cases, while there was not a single case of uncomplicated pregnancy registered in women with a 20 year interval or over. Prevalence of diseases and pathological conditions prior to or during pregnancy was 1.4 and 1.9 times higher than the whole sampling (2179.3 and 2963.9 vs 1563.1 26.7 respectively; p < 0.01).

Conclusion. Thus, the study identified the following: age-specific total fertility rates changed; there are two models of family making: the accelerated model and the delayed one; duration of the protogenetic interval has a significant impact on the course of pregnancy and prevalence of diseases and pathological conditions prior to or during pregnancy.

Keywords: family planning; protogenetic and intergenetic intervals; health of pregnant women.

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INEQUALITY IN THE DEGREE OF ENVIRONMENTAL EXPOSURE AND BEHAVIORAL RISKS AMONG PARTURIENT WOMEN IN TWO REGIONS OF RUSSIA
Tuesday, 26 December 2017

DOI: 10.21045/2071-5021-2017-58-6-8

Ilchenko I.N., Boyarskaya T.V., Ignatieva M.V.
I.M. Sechenov First Moscow State Medical University (Sechenovsky University), Ministry of Health of the Russian Federation Moscow

Contacts: Irina Ilchenko, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Ilchenko I.N., http://orcid.org/0000-0002-5966-7307
Boyarskaya T.V., http://orcid.org/0000-0003-0199-058X
Ignatieva M.V., http://orcid.org/0000-0002-4886-1008
Acknowledgments. The survey in the Moscow region was funded by the Russian Academy of Sciences within the framework of the Fundamental sciences to medicine program in 2013. The survey in the Republic of Karelia was funded by the United Nations Environment Program; World Health Organization, WHO Regional Office for Europe, Development of a Plan for Global Monitoring of Human Exposure to and Environmental Concentrations of Mercury Project, Component 3 in 2016 (reference number EUPCR1612113).
Conflict of interests. The authors declare no conflict of interest.

Abstract

Impact of environmental and behavioral risks is one of the causes of poor health. Depending on socio-economic and territorial determinants, impact of environmental and behavioral risk factors varies across different population groups. The purpose of the study was to analyze the degree of environmental exposure and behavioral risks during pregnancy among female residents of the Moscow Region and Republic of Karelia. In two epidemiological studies carried out according to the WHO standard methodology, within the framework of projects on harmonizing approaches to monitoring mercury content in the human body and assessing prenatal exposure in the early stages of life, 120 parturient women were examined in the Moscow Region and 240 women - in the Republic of Karelia. Industrial factors, environmental conditions at the place of residence and individual exposure to mercury were considered as indicators of environmental exposure. Smoking and drinking during pregnancy were analyzed as a behavioral risk.

Rosstat data were used for a comparative analysis of regional indicators. The survey results indicate significant inequalities in the degree of exposure of women to environmental and behavioral risks. The most serious inequalities were associated with socio-economic determinants, especially with low education of women living in rural areas in the Republic of Karelia.

Comparative analysis of medico-demographic, socio-economic and natural-geographic indicators at the regional level revealed a significantly higher burden of socio-economic disadvantages in the Republic of Karelia in comparison with the Moscow region. The results illustrate the scale and distribution of inequalities among parturient women in two regions of Russia and help identify potential target groups and priority areas for inter-sectoral actions.

Keywords. Environmental risk, pregnancy and prenatal exposure, behavioral risk factors, health equity, socio-economic determinants, equity-sensitive surveillance systems.

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HEADS OF HEALTH CARE FACILITIES AS A SUBJECT OF HEALTHCARE MANAGEMENT
Tuesday, 26 December 2017

DOI: 10.21045/2071-5021-2017-58-6-9

Uiba V.V., Stasevich N.Yu., Olenev A.S., Aliev A.K.
Institute of advanced training, Federal Medical and Biological Agency (FMBA), Moscow, Russia

Contacts: Stasevich Natalya, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
StasevichN.Yu., http://orcid.org/0000-0002-2965-4986
Acknowledgments. The study was supported by the Russian Federal Medical and Biological Agency.
Conflict of interests. The authors declare no conflict of interest.

Abstract.

Significance. Formation of new social and economic relations requires fundamentally different systems and mechanisms of management: management in the new context should be more adaptive to mechanisms of the market self-regulation. Healthcare system itself becomes qualitatively different and requires an innovative approach to manage a health care facility.

Problems of strategic planning and management are related with the evolving management systems where heads of health care facilities play a key role.

Purpose: to typologically classify heads of health care facilities making managerial decisions as a subject of the healthcare system.

Methods: the study used expert estimations, statistical methods, grapho--analytical method and simulation. The survey used sampling. A mixed sample was used.

Results. To identify typological features of head physicians of the Moscow health care facilities the survey used the following two questions: "What guides you in making administrative decisions?" and "What would do you do if job descriptions conflict with your experience?".

Responses to the second question helped to divide all heads of health care facilities into the following three groups:

1. The nonconformists (heads who can refuse performing a wrong in their opinion order and are ready to deal with the higher authorities for its change or cancellation (52%).

2. The conformists (heads who neither express a straight refusal to comply with superior orders nor rush to fulfill them (34%).

3. The capitulators (heads, unconditionally implementing any orders coming from above (13%). 

Conclusions. 1. Most heads consider reforming of healthcare a necessity; almost half of them believe that the reforms are being implemented in the wrong direction.

2. Most head physicians consider maintenance of compulsory health insurance the main direction of healthcare reforming, acknowledging however, that reforming should not be limited solemnly to this.

Keywords: head physicians; heads of health care facilities; compulsory health insurance; healthcare reforming; provision with resources; satisfaction of heads of medical institutions with their position.

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PROBLEMS AND DEVELOPMENT PROSPECTS OF A PRE-COURT DISPUTE RESOLUTION BETWEEN MEDICAL INSTITUTIONS AND PATIENTS BY A PROFESSIONAL MEDIATOR
Tuesday, 26 December 2017

DOI: 10.21045/2071-5021-2017-58-6-10

Allamyarova N.V.
Moscow Branch of the S.M. Kirov Military Medical Academy, Moscow

Contacts: Natalia Allamyarova, email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about author:

Allamyarova N.V., http://orcid.org/0000-0001-8138-6141
Acknowledgments.The study had no sponsorship.
Conflct of interests. The author declares no conflict of interest.

Abstract

Significance. Recently, there has been an increase in the number of disputes arising from provision of medical services; mainly, disputes are related to the failure or improper performance of the contract for service provision, billing for non-provided services, provision of medical care of inadequate quality. Patient is not necessary the weak and "affected" party. It is not infrequent that due to the lack of proper paper flow, untimely and careless filling in of patient's medical records, habitual negligence of professional duties by attending physicians, and impossibility to prove their innocence, medical organizations become participants in litigations and the object of criticism in mass media, sustaining tangible financial and reputational losses. Voluntary pre-court resolution of disputes through a mediation procedure is the fastest and least costly way to manage conflicts.

Purpose: to analyze development prospects of mediation as a way of pre-court resolution of disputes between medical organizations and patients.

Materials and methods: The study used the system, conceptual, process and situational approaches, as well as comparative legal and logical analysis.

Results. Currently, the mediation procedure is yet to be widely used in the medical community. The term mediation is known to a fairly narrow circle of specialists and is almost unknown to medical workers and patients. To some extent, the problem stems from the lack of understanding of merits of the mediation procedure and its alternative advantages. The mediation procedure is based on the principles of freedom and informed voluntary involvement of the dispute parties and mediators, principles of independence, non-competiveness and equality of the parties.

Conclusions. To successfully promote the institute of mediation, it is necessary:

  • to develop a state policy in mediation and alternative dispute resolution and to design special measures aimed at its promotion and dissemination;
  • to improve legal culture of the population;
  • to develop effective cooperation with the judicial system;
  • to expand possibilities for better training of mediators

Keywords: administrative dispute resolution procedure; claim procedure; arbitration tribunal; voluntary pre-court dispute resolution; mediation; professional mediator; medical institution; patient.

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DEVELOPING INFORMATION SYSTEM OF SCIENTIFIC RESEARCH MANAGEMENT IN HEALTH SCIENTIFIC INSTITUTIONS
Tuesday, 26 December 2017

DOI: 10.21045/2071-5021-2017-58-6-11

1,2Lebedev G.S., 2Krylov O.B., 2Leljakov A.I., 2Tkachenko V.V.
1Sechenov First Moscow State Medical University, Moscow
2Federal Research Institute for Health Organization and Informatics, Moscow

Contacts: Krylov Oleg, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Lebedev G.S., http://orcid.org/0000-0002-4289-2102
Krylov O.B., http://orcid.org/0000-0002-3001-1160
Acknowledgments. The study had no sponsorship.
Conflicts of interests. The authors declare no conflict of interest.

Abstract

Within this article, the automated system of scientific research management means management of government contracts, management of work acceptance and evaluation as well as development, update and maintenance of information database of scientific research of the Ministry of Health of the Russian Federation.

In the context of limited resources for scientific research, development of a government assignment plan is a relevant task. Future of the Russian healthcare much depends on quality of this task execution.

To execute this task it is advisable to use known methods of scientometrics, system analysis and operational research.

Currently in Russia there are automated systems of scientific research management in operation in various areas of knowledge, however, the mentioned system is missing in the Ministry of Health of the Russian Federation. Development of the automated management system of the Ministry of Health should consider specifics of the industry requiring redesign of the known approaches.

For the first time ever this article offers a comprehensive approach to management of scientific research in the Ministry of Health that takes into account specifics of the industry, involving in particular implementation of dynamic result evaluation of the completed studies and analysis of the evaluation as a feedback on the management process.

Quality improvement of information support for decision-making is suggested by means of creation of a unified information space containing information about experts, research groups, scientific works and scientific results, which will allow to fully apply known methods of scientometrics.

Scientific research management is considered as a single business process, the result of which is scientific research results, and its administrative actions - allocation of resources for research. Based on this approach, it is possible to use cost effectiveness indicators.

At the same time to ensure quality of scientific research management it is necessary to have feedback on the process results. The article outlines stages of the process of scientific research management, basic principles of management, evaluation of scientific results and feedback.

Keywords. Scientific research; automated systems; medical information systems; scientific research management.

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SIGNIFICANT AND ANNIVERSARY DATES OF THE HISTORY OF MEDICINE IN 2018
Tuesday, 26 December 2017
Egorysheva I.V., Sherstneva E.V.

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WHO. Information Bulletin. October, 2017
Tuesday, 26 December 2017

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WHO. Information Bulletin. November, 2017
Tuesday, 26 December 2017

2017 .

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WHO. Information Bulletin. December, 2017
Tuesday, 26 December 2017

2017 .

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