DOI: 10.21045/2071-5021-2018-62-4-2

Velichko EA, Istomin NP, Nekrasov AYu
Clinical Center of Advanced Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russia

Contacts: Velichko Eugene A., e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
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. Heath protection is one of the urgent and most important problems of both Healthcare and the State in general. Negative changes in social and economic spheres, high morbidity and mortality rates lead to public health worsening and numerous problems in the Russian healthcare system resulting in higher demand for medical services with surgical services taking a special place in the structure of medical care. To ensure a more comprehensive evaluation of quality of care delivery and satisfaction level, scientific researches pay a special attention to sociological surveys.

Purpose: to study opinions of physicians and patients of surgery departments of multi-specialty hospitals about quality of care and factors that affect it.

Methods. The study used a survey method, expert appraisals and statistical processing. The study generalized results of the survey of 432 patients with different surgical pathologies treated in the surgery departments of the town of Novogorsk in 2015-2017 and 156 surgeons of two multi-specialty hospitals (general surgeons, thoracal, cardio, vascular, and neurosurgeons, urologists, proctologists, traumatologists and gynecologists) with different length of service, professional categories, scientific degrees and academic ranks.

Results. The study showed that in the majority of cases (87.3%) the patients were satisfied with hospital services, 11.3% - were not satisfied and 1.4% - not fully satisfied. Analysis of the reasons of dissatisfaction with hospital services gave the following results: 78.5% - lack of medications; 6.4% careless attitude of nurses; 10.2% lack of the relevant diagnostic method; and 4.9% - careless attitude of doctors.

Length of service ensures a more comprehensive and deeper evaluation of quality from different points. The study has identified a direct correlation between the number of factors affecting quality of surgical care and length of service – the longer the higher the number of factors. Young doctors can identify 3-5 factors, while doctors with a 25 year service and longer can identify over 15 factors.

Keywords: quality; satisfaction; patients of surgery departments of multi-specialty hospitals.

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DOI: 10.21045/2071-5021-2018-62-4-3

Saraev V.G., Popov P.L., Tcherenev A.A.
V.B. Sochava Institute of Geography, Siberian Branch, Russian Academy of Sciences, Irkutsk, Russia

Contacts:Saraev Vladimir Grigoryevich. e-mail This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Saraev V. G., http://orcid.org/0000-0002-3414-1480
Popov P. L., https://orcid.org/0000-0002-2770-6826
Tcherenev A. A., https://orcid.org/0000-0002-8274-4606
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Significance. Identification of social economic structures of the Siberian regions, including in health sector, is necessary for successful management of their development. Non-profit organizations are one of their essential components.

Purpose. To review non-profit organizations in the health sector of the Irkutsk region.

Materials and methods. The research is based on data of the Unified State Register of Legal Entities presented at the websites of the Ministry of Justice and Federal Tax Service, and data at the websites of the Government of the Irkutsk region and websites of non-profit organizations. The authors used the descriptive method.

Results. The total number of non-profit organizations in the health sector adds up to about 100 organizations of 9 legal organizational forms. Autonomous nonprofit organizations (37%), public organizations (29%), and institutions (16%) prevail. Most of the non-profit organizations in the health sector are located in the cities, in Irkutsk mainly. Their activities generally cover the entire Irkutsk region, and their members are persons of many settlements.

The authors have outlined all types of activities of non-profit organizations in the health sector of all legal organizational forms. According to the Russian National Classifier of Types of Economic Activity main types of economic activities of the majority of autonomous non-profit organizations and institutions fall into different groups and classes of the "Activity in the field of Health Care and Social Services" section. The majority of social organizations are represented by the group of "Activity of other social organizations which are not included in other groups", including all their activities, except for policy. Major activity types of only two social organizations fall in the group of "Activity of the professional member organizations". Their activities are focused in specific spheres.

The study shows that functioning of many non-profit organizations in the health sector is not transparent.

Conclusions. Activities of many non-profit organizations in the health sector, mainly of all social organizations, are focused on consolidating medical community. Their contribution in care delivery, diagnostics and prevention is essential. Often organizations with different legal organizational forms implement identical types of activities.

Scope of application. The obtained results can be used by administrative structures of the healthcare system.

Keywords: health care; Irkutsk region; non-profit organization; social organization; health workers; legal forms of the organizations; activity; OKVED (All-Russian Classifier of Types of Economic Activity).

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DOI: 10.21045/2071-5021-2018-62-4-4

Contact information: Shikina Irina, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Mikhaylova Yu.V., http://orcid.org/0000-0001-6779-726X
Nechaeva O.B., http://orcid.org/0000-0002-9651-2662
Shikina I.Â., http://orcid.org/0000-0003-1744-9528
Sorokin V.N., http://orcid.org/0000-0003-4581-4318
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interests.

Russia is one of the countries experiencing a substantial influence of migration on the population development. Within the context of positive migration effects such as demographic, labour and economic, one can’t underestimate its health risks to population. To estimate migration impact on the TB and HIV epidemic situation in Russia, the authors have analyzed legislative and normative basis determining organization of diagnostics, treatment and statistical registration of TB and HIV cases in migrants (foreign citizens) as well as official statistics (forms #33 and #8 on TB and #4 and #61 on HIV testing and HIV patients contingents).

The study showed that foreign citizens do not significantly affect the TB and HIV epidemic situation in Russia. In 2017 the share of foreign migrants among newly detected TB cases equaled to 3.5% (3.8% in 2015 and 3.6% in 2016).

The similar situation is with newly detected HIV cases among foreign migrants (4,672 cases in 2015, 3,285 in 2016, and 3,160 in 2017).

Among newly detected TB and HIV cases in migrants the share of Ukraine citizens increases while the share of representatives of other NIS countries reduces.

Information about migrants’ health status including socially sound infections (TB and HIV) requires verification because on one hand there could be repeated medical examinations due to change of place of residence or place of work, on the other hand – underestimation of actual number of disease cases in illegal migrants.

In this respect it is appropriate to develop a unified automated monitoring system “Migrants’ health”. Cooperation across boundaries between medical and social services of Russia and the NIS/EU countries requires legislative regulation to treat active TB prior to the migrant’s entrance to the country to ensure safety of the population.

Keywords : external migration; epidemic situation; tuberculosis; HIV-infection.

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DOI: 10.21045/2071-5021-2018-62-4-5

Zubko A.V., Sabgayda T.P., Zaporozhchenko V.G.
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow

Contact information: Sabgayda T.P., e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Zubko A.V., http://orcid.org/0000-0001-8958-1400
Sabgayda T.P., http://orcid.org/0000-0002-5670-6315
Zaporozhchenko V.G. http://orcid.org/0000-0002-6167-7379
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interests.

Abstract

Significance. Decrease in mortality from leading diseases of the circulatory system automatically increases importance of mortality prevention from less common diseases, vascular surgical diseases in particular. Effectiveness of their surgical treatment is determined by timeliness of detection; social profile of relevant patients will contribute to early detection of vascular surgical diseases.

Purpose: compile a social profile of patients with vascular surgical diseases

Methods. The authors have analyzed results of a questionnaire survey of 366 patients with vascular diseases who underwent surgical treatment during 2016 in four departments of vascular surgery of medical organizations in Moscow and the Moscow Region. The authors have grouped patients by their diagnosis and compared the groups by history of tobacco smoking and level of alcohol consumption, working conditions and family history.

Results. Tobacco smoking, alcohol consumption, high physical and psychological activity increase incidence of occlusive diseases of lower limb arteries, while genetic predisposition increases incidence of varicose veins of the lower extremities. Increased physical activity is associated with a protective effect in patients with varicose veins of the lower limbs. Also, protective effect of increased physical activity was observed for occlusive arterial diseases of the upper extremities, but occurence of aneurysm of abdominal aorta and occlusive arterial diseases of the lower extremities is higher in thr presence of hereditary history of such diseases.

Conclusions. There is no general social profile of patients with vascular surgical diseases. Adherence to a healthy lifestyle with regular physical activity significantly reduces the risk of vascular surgical diseases. Occupational hazards are likely to influence development of varicose veins of lower extremities, aneurysms of abdominal aorta, embolism and thrombosis of extremities arteries.

Keywords: risk factors of occlusive diseases of lower limb arteries; detection of surgical vascular diseases; patients of hospital vascular departments

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DOI: 10.21045/2071-5021-2018-62-4-6

Obuhova O.V., Brutova A.S., Dergachev A.V., Bazarova I.N., Starodubov V.I.
Federal Research institute for Health organization and informatics of Ministry of Health of the Russian Federation, Moscow

Contacts: Obuhova Olga, e-mail This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Starodubov V.I., https://orcid.org/0000-0002-3625-4278
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Abstract

Increased access to high-tech medical care has been one of the important objectives of the State in the recent years. To fulfill these objectives, methods of high-tech care, which are characterized by high replication, are being gradually immersed into the basic program of compulsory health insurance every year. This approach allows delivery of high-tech care by medical organizations of different levels and forms of ownership in the volumes demanded by population.

The purpose of the study is to assess prospects to transfer high-tech care within the «traumatology and orthopedics» profile into specialized medical care covered by the compulsory health insurance by clinical and statistical disease groups.

Material and methods. The study includes data from the Federal Compulsory Health Insurance Fund on methods of high-tech care included in the basic program of the compulsory health insurance for 2015-2016.

Methods of scientific knowledge included: bibliographic, statistical, mathematical.

Results.

By level of replication, three out of 16 methods have a value of less than 500 cases per year, 2 methods are annually performed in the volumes exceeding 15 thousand cases. Delivery of high-tech medical care within the "traumatology and orthopedics" profile was implemented by virtually all subjects of the Russian Federation, the minimum coverage of the number of subjects participating in the method equaled to 20%.

The analysis showed that methods of high-tech care within the “traumatology and orthopedics” profile are hardly supported by normative documents that determine the scope and structure of medical care (standards of medical care, clinical recommendations); treatment methods do not correspond to the positions of the Nomenclature of Medical Services - this fact reduces possibility of transferring methods into clinical and statistical groups of diseases.

Conclusions. The study of the high-tech medical care within the «traumatology and orthopedics» profile made it possible to evaluate prospects of transferring methods of high-tech medical care into clinical and statistical groups of diseases. According to the results of the study, all 16 methods of high-tech medical care within the «traumatology and orthopedics» profile included in the basic program of compulsory health insurance can be gradually transferred to clinical and statistical groups of diseases.

Key words: high-tech medical care; compulsory health insurance; clinical and statistical groups of diseases.

Abstract

One of the important tasks of the state in recent years is to increase the accessibility of the country's population to receive high-tech medical care. To this end, the methods of this type of medical care, which are characterized by high replication, are gradually immersed every year in the basic program of compulsory medical insurance. This approach allows us to provide high-tech medical care by medical organizations of different levels and forms of ownership in the volumes necessary for the population.

The purpose of the study is to assess the prospects for the transfer of high-tech medical assistance in the field of «traumatology and orthopedics» into specialized medical care paid for by clinical and statistical disease groups from mandatory medical insurance.

Material and methods. The study includes data from the Federal Compulsory Medical Insurance Fund on methods of high-tech medical care included in the basic program of compulsory health insurance for 2015-2016.

As methods of scientific knowledge used: bibliographic, statistical, mathematical.

Results. According to the results of the study, all 16 methods of high-tech medical care on the profile of «traumatology and orthopedics», included in the basic program of compulsory medical insurance, can be gradually transferred to clinical and statistical groups of diseases.

By level of replication, 3 methods out of 16 have a value of less than 500 cases per year, 2 methods are annually performed in a volume exceeding 15 thousand cases. Provision of high-tech medical assistance in the field of "traumatology and orthopedics" was carried out by virtually all subjects of the Russian Federation, the minimum coverage of the number of subjects participating in the method was 20%.

The analysis showed low availability of methods of high-tech medical assistance in the field of traumatology and orthopedics with normative documents determining the scope and structure of medical care (standards of medical care, clinical recommendations), the lack of conformity of treatment methods to positions in the Nomenclature of Medical Services, which reduces the possibility of translating methods into clinical and statistical groups of diseases.

Conclusions. The study of the high-tech medical care on the profile of «traumatology and orthopedics» made it possible to evaluate the methods of high-tech medical care for their readiness for transfer to clinical and statistical groups of diseases.

Key words: high-tech medical care; compulsory medical insurance; clinical and statistical groups of diseases.

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DOI: 10.21045/2071-5021-2018-62-4-7

Contacts: Pastbina Irina, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Pastbina I.M., https://orcid.org/0000-0003-1475-1529
Menshikova L.I., http://orcid.org/0000-0002-1525-2003
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Abstract

Organization of early initiation and continuation of exclusive breastfeeding during the first six months of life are crucial for both optimal development of the child and maternal health. Introduction of modern technologies to improve and support breastfeeding into practice of obstetrical facilities has a positive effect on initiation and duration of exclusive breastfeeding.

Purpose: to evaluate the existing practice of the interregional obstetric center for women with low and medium perinatal risks to support exclusive breastfeeding to further improve perinatal care delivery in the region.

Methods. A survey covered 226 women in the obstetric center for women with low and moderate perinatal risk and 6 months later the discharge. Several variables were assessed: participation in prenatal training, attitude to partner delivery, rooming in, initiation, support and duration of exclusive breastfeeding.

Statistical analysis. Statistical analysis was performed using program SPSS version 21.0. The Pearson chi-square test was used to compare two qualitative variables; Mann-Whitney criteria – to compare a quantitative data with non-normal distribution; McNemar’s test - to find out relationship between two dichotomous variables in «before-after» cases.

Results. The study showed a low coverage of pregnant women with prenatal training (less than 30%), denial of partner delivery (75%), late initiation of breastfeeding (30%), widespread use of formulas and giving water to healthy newborns (over 50%); influence of several factors on early discontinuation of breastfeeding.

Conclusions. Prenatal education, early attachment of full-term baby to breast, length of "skin to skin" contact and partner births are insufficiently provided to women with low and medium perinatal risk.

The study has identified social determinants and factors of the perinatal period that discourage and encourage mothers to prolong breastfeeding. Along with the increasing partner births this information can be used to further improve perinatal care in the region.

Scope of application: antenatal clinic, obstetric hospitals, pediatric clinic.

Keywords: healthy newborns; partner birth; rooming-in; exclusive breastfeeding.

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DOI: 10.21045/2071-5021-2018-62-4-8

Zhuravleva I.V., Lakomova N.V.
Institute of Sociology of the Federal Center of Theoretical and Applied Sociology of the Russian Academy of Sciences, Moscow

Contacts: Zhuravleva Irina, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Zhuravleva I.V., https://orcid.org/0000-0002-7758-3940
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Abstract

Relevance. Youth as a promising age group of the population represents an important potential for social development, and an important object of social policy in the field of health. But the number of age groups of young people is constantly decreasing, and the incidence is increasing. The maximum growth rates are typical for the spread of the human immunodeficiency virus (HIV), and in adolescents - for obesity and diabetes. In general, the health indicators of young people cause concern and require the adoption of adequate measures.

The goal is to find out whether the social policy in the sphere of health really influences the changing attitude of young people towards health.

Methods. The method of analyzing legal and statistical documents is used, as well as secondary analysis of sociological data.

Results. The state policy in the social sphere is expressed in the adopted laws, ensuring their financing and in the practical implementation of laws and regulations. At present, public health issues are regulated by more than 40 federal laws. But most of them concern the problems of sick people and their treatment, while the health of healthy people and prevention issues are not the subject of serious consideration. In Russia, for half a century there is no ideology of health. This is expressed in the nature of the legal aspects of social policy in the sphere of health, in the insufficient funding of spheres of life relevant to the health of the population (this is, apart from health, work, physical culture and sports, leisure, education). The final stage of social policy is the implementation of the adopted resolutions - in the case of implementation, it leads to significant positive changes. This is evidenced by the results of the study "Student Health".

Conclusions. As a result of implementing a positive social policy in the field of health aimed at promoting healthy lifestyles, creating conditions for its implementation, the formation of appropriate social norms: 1) the nature of the attitude of young people to their own health changes - for the first time so many respondents (40% of boys and 28% of the girls), the main motive of health care was called "the desire to be stronger and healthier" than "deteriorating health", as before; 2) the quality of health of young people (on self-assessment) in the cities where the health promotion is promoted is increasing, as a result of the increasing importance of the health care factor "the efforts of the person himself" and the strengthening of the motive "the desire to be stronger and healthier".

Keywords: health of youth; social policy; healthy way of life; attitude towards health.

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DOI: 10.21045/2071-5021-2018-62-4-9

Stasevich N.Yu., ¹Bulatov V.Yu., ¹Gabrielyan A.R., ¹Torubarov S.F., ²Ovechkina J.V.
¹Institute of advanced training, Federal Medial and Biological Agency, Moscow, Russia
² All-Russia Research Institute of Railway Hygiene, Moscow

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
Ovechkina J. V. http://orcid.org/0000-0003-0621-5152
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. At the present stage of the healthcare development, prevention, especially of occupational diseases, has a special importance. However, there are some professional groups that are out of the focus of health professionals and health authorities.

This relates to cultural and art workers, who have a great impact on other people.

To our opinion, only health care organizers are able to clearly convey messages of this issue to the practical healthcare and would be able to develop a methodological framework for an integrated approach to preventive measures among these professional groups, to unite experts in different fields of medicine and create a direction in Art medicine.

Purpose: scientific rationale for developing an "Art-medicine" branch of activities to conduct scientific research and subsequent organizational and methodical activities to organize specialized care delivery to cultural and art workers.

Methodology. Moscow state Conservatory (MGK) named after P.I. Tchaikovsky – a higher musical educational institution in Moscow, one of the leading music universities in Russia and abroad served as a study base.

We have surveyed students of the 1st, 2nd and 3rd year of vocal, orchestral and piano departments - 556 respondents in total.

The present study was conducted using expert evaluation, statistical methods. A sample method was used in the survey. A combined sampling method was used.

Results. In 72% of cases, occupational diseases of artists of creative professions were diagnosed in ages 18-23, which coincides with the period of education in a music school or Conservatory.

86.5-93.7% students suffer from diseases of the musculoskeletal system (scoliosis); 2.3-16.8% have hand diseases (dyskinesia, Raynaud's disease, carpal tunnel syndrome-neuromyositis); 4.7-58.2% - muscle diseases (muscle neuralgia, static muscle contracture, muscle spasm); 1.5-2.6% - vascular diseases (varicose veins); 4.8-31.2% -respiratory diseases; 14,5% - diseases of the voice ligaments; 59,9-63,8% - stomatitis; and 17.3-45.1% - diseases of the gastrointestinal tract.

Conclusions.

In the country there is no organizational framework for specialized care for prevention and treatment of occupational diseases of creative workers.

By their third year in the Conservatory students develop problems with the cardiovascular system (18.9% of string instruments student; 19.3% of brass and percussion students; and 23.6% of art management of the orchestra students). The number of students with chronic laryngitis is increasing adding up to 32.7%.

Keywords: cultural workers; prevention; morbidity; measures to provide specialized care.

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DOI: 10.21045/2071-5021-2018-62-4-10

Contacts: Bashmakov O.A., e - mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Bashmakov O. http://orcid.org/0000-0023-2965-1235
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. Currently, healthcare management is impossible without adequate and evidence-based selection of managers and their special training in all related topics.

A step-wise solution of problems related to maintenance and development of human resources ensures a more rational use of healthcare resources providing a framework for quality improvement of medical services.

Modernization of the Russian healthcare requires adjustment of methods and technologies to manage the principal healthcare resource – its personnel, adding new contents to the personnel management to ensure incorporation with the strategic approach and new effective models of cooperation with the social environment.

Purpose: to substantiate importance of using sociological methods to improve personnel management technologies.

Methods. The study used expert appraisals, statistical methods, T-survey method and mathematical modelling. The survey used a combined sampling method.

Results. The study showed that technologization of staffing processes is a totally new approach in the management science and is crucially important for improving performance of the Russian healthcare.

The term “technology” as a complex of professional knowledge about methods and means for achieving organization’s goals and objectives arises from the Greek “techno” – skill and “logos” – science, theory. The purpose of the management technologization is optimization and regulation of the staffing processes.

It is necessary to develop frameworks to ensure guaranteed achievement of the purpose of adequate staffing in health. Such approach substantially corresponds to the definition of technologization presented by professors V.N. Ivanov and V.I. Patrushev: “strictly consistent and clearly defined statement of rules to be followed in order to translate initial data into the envisaged result of the managerial task solution”. That’s why it seems practical to technologize management of human resources in the healthcare system.

Keywords: management; human resources in healthcare; technologization; managerial tasks.

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DOI: 10.21045/2071-5021-2018-62-4-11

Nemtsov A.V., Kuznetsova-Moreva E.A.
V.P. Serbsky National Medical Research Centre for Psychiatry and Narcology, Ministry of Health of the Russian Federation, Moscow

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

Bibliometric measures are only a tool and like any tool, from a hammer to atomic power should be used for the purpose intended
Eugene Garfield

Abstract

A scientometric research of 51 scientific research institutes subordinate to the Ministry of Health of the Russian Federation has been conducted. The authors studied two indicators cumulatively: the number of publications and citations. The research was based on 860 thousand citations, 200 thousand publications and 27 thousand authors, recorded in the Russian index of scientific citation. The research showed that the number of publications and their citations is dependable upon the number of authors (employees), while the institutes differ in the number of employees 150-fold.

In order to neutralize this circumstance, further work was carried out on the basis of standardization of the absolute number of publications and citations by the number of authors (relative indices). Standardization resulted in reorganized ratings of institutes by publications and citations. The standardized indices of publications do not depend on the absolute number of authors, publications and citations. These indicators level the institutes by the authors' productivity. The institutes of the Ministry of Health of the Russian Federation are characterized by a relatively low citation: 93% of all publications are cited no more than 10 times, including 112 thousand publications or 53% of the total number of publications have not been cited at all (zero citation). The number of citations is mainly made up by publications cited over 50 times: 1.3% of such publications account for 41.2% of citations. In institutes with a small number of employees (less than 400), the relative citation rate is significantly lower compared to institutes with a large number of employees.

Keywords: scientometrics; research institutes; Ministry of Health of the Russian Federation; publications; citation; authors.

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