RESUMEN
The actual direction of improving provision of mental care of population is increasing of efficiency of specialized primary medical sanitary care of patients with mental disorders in conditions of implementation of biopsychosocial model of its realization. The study of mental disorders morbidity demonstrated that qualitative changes occurred in structure of contingents of mental institutions towards decreasing of number of dispensary patients and corresponding increasing of number of patients receiving medical and consultative assistance. The analysis of indicators of movement of contingents with mental disorders testifies decrease in effectiveness of dispensary observation that is confirmed by decrease of rate of de-registration due to recovery, by increase of de-registration due to death, increase in number of suicidal attempts and in disability among patients with mental illness of able-bodied age. It was established that problems in ensuring quality of medical care are conditioned manly by lack of actual organizational and methodological support of dispensary observation of patients, predominance of passive dynamic observation by local psychiatrist. Based on the results of study of organization of functioning of district psychiatrist, medical and organizational measures were developed to improve organization of dispensary observation of patients with mental disorders.
Asunto(s)
Trastornos Mentales , Derivación y Consulta , Humanos , Morbilidad , Psiquiatras , Hospitales Psiquiátricos , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia , Trastornos Mentales/epidemiologíaRESUMEN
On the basis of the archival documents, the article studies and provides information on the creation of medical and sanitary bodies, public organizations to provide the refugees of the Irkutsk province with medical care in 1914-1916, to carry out comprehensive anti-epidemic measures to combat the emerging epidemics of diseases characteristic of wartime. The study shows the role of medical and sanitary bodies, committees, commissions to ensure the epidemiological well-being of the refugees. The dynamics of an increase in the number of beds, the number of hospitals, the opening of infectious barracks, an increase in financial allocations for the provision of medical assistance to refugees were noted.
Asunto(s)
Enfermedades Transmisibles , Refugiados , Humanos , Saneamiento , Enfermedades Transmisibles/epidemiología , Enfermedades Transmisibles/terapia , OrganizacionesRESUMEN
In The Russian Federation, the current epidemic situation of tuberculosis is characterized by stabilization and decreasing of morbidity with simultaneous increasing of number of cases of tuberculosis combined with HIV infection within the structure of newly diagnosed diseases and contingents of patients with tuberculosis. In the Siberian Federal Okrug, the indices of morbidity of tuberculosis combined with HIV infection exceed similar ones by almost twice that testifies significant input into burden of morbidity of tuberculosis in the subjects of the Siberian Federal District and their role in further dynamics of morbidity. The shift in morbidity of tuberculosis combined with HIV infection towards increasing of age both in patients with diagnosed HIV infection for the first time and in entire accumulated contingent of HIV patients. The positive dynamics of indices of efficiency of anti-tuberculosis measures in contingents of HIV-infected patients being registered testifies availability of reserves for improving medical care quality. The priority directions of developing program activities to achieve control over spreading of tuberculosis combined with HIV infection are early detection and increasing of commitment to dispensary observation of patients with HIV infection and decreasing infection of population with tuberculosis and increasing efficiency of treatment of patients with tuberculosis.
Asunto(s)
Infecciones por VIH , Tuberculosis , Infecciones por VIH/epidemiología , Humanos , Morbilidad , Federación de Rusia/epidemiología , Tuberculosis/epidemiologíaRESUMEN
The article presents results of sociological survey of district psychiatrists that revealed actual difficulties and shortcomings in organization of medical care for mental patients. The problem of personnel high workload, inopportuneness and inadequate completeness of necessary medical care of mental patients are explained by a number of difficulties in organization of functioning of psychoneurological organizations. They included not only shortage of personnel and unsatisfactory material technical support of mental institutions, but also incompleteness of normative legal support mental care organization. The physicians identified the following priority targets to be implemented in practice will eliminate a number of actual problems in district psychiatrist work: organization of procedure of interdepartmental interaction of various services (GUFSIN, the Ministry of Internal Affairs, social protection agencies, passport office), development and approval of procedure of dispensary observation of mental patients, approval of procedure of interaction with territorial polyclinics and full implementation of medical care standards for patients with mental disorders. The administration of neuropsychiatric organizations from position of systemic approach is a priority direction of improving quality of medical care for mental patients.
Asunto(s)
Trastornos Mentales , Médicos , Psiquiatría , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Organizaciones , Atención al PacienteRESUMEN
The level of development of human resources in health care is determined by a number of factors, among which an important place belongs to turnover of medical staff. The turnover, or the process of unscheduled dismissal of staff, negatively affects functioning of the organization in any field, including health care. Although the analysis of staff turnover is widely applied in various fields of activity, relatively few studies are related to problems of assessing causes of this phenomenon in health care. The purpose of the study was to assess the characteristics and causes of turnover of medical staff in state medical organizations of the Irkutsk Oblast. The detailed information about the respondents obtained in the study made it possible to get a concept of intensity and characteristics of turnover of physicians and medical nurses, and to study causes of dismissal of respondents from their previous employment as well as causes that influenced current employment and to assess content and effectiveness of measures of professional adaptation and social support of hired specialists.
Asunto(s)
Reorganización del Personal , Médicos , Atención a la Salud , Humanos , Organizaciones , Recursos HumanosRESUMEN
Currently, the characteristic of dynamics of morbidity of mental disorders of population of the Russian Federation is its increasing simultaneously with changing in structure of contingents in the direction of decreasing number of patients subjected to dispensary monitoring. The study of influence of medical organizational factors on morbidity of mental disorders demonstrated the role of provision with psychiatrists in dynamics of prevalence of mental disorders. The improvement of management of patients with mental disorders should be supported by appropriate resources and adaptation of mental service to actual conditions, in particular, solving the problem of manpower deficiency of psychiatrists.
Asunto(s)
Trastornos Mentales , Psiquiatría , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Morbilidad , Prevalencia , Recursos HumanosRESUMEN
The medical personnel reallocation is the most important resource to ensure sustainable functioning and development of medical organizations and health care system as a whole. The purpose of the study was to assess reallocation of medical personnel of state medical organizations in the subject of the Russian Federation exemplified by the Irkutsk Oblast in 2015-2019. The study permitted to test approaches to application of methods for analysis of reallocation of medical personnel in respect of physicians. The results contribute to development of measures targeted to prevent and to reduce the medical personnel turnover and to increase efficiency of human resources management in health care.
Asunto(s)
Atención a la Salud , Médicos , Personal de Salud , Humanos , Organizaciones , Federación de RusiaRESUMEN
The formation of the number of medical personnel, the establishment of labor standards, the rational distribution and use of personnel are the most significant components of the system of labor rationing in health care. Standard norms of working time for TB doctors are not developed. There is an uneven workload and a plan implementation indicator in different offices and cabinets. The timing of the working process of phthisiatricians providing outpatient care to adults and children was carried out; work time was spent on individual elements of the labor process of district phthisiatricians accepting adults and children and a phthisiatrician without district work receiving patients in the office tuberculosis care for HIV patients. The concept of "visitation" is defined as applied to the working conditions of the TB service. According to the results of time-keeping observations, technological operations performed by TB doctors, including additional sections of work that are not related to the admission of patients, are highlighted; the normative indicator of the function of the medical post of the district TB specialist and the normative indicator of the time spent on one visit are determined.
Asunto(s)
Atención Ambulatoria , Adulto , Niño , Infecciones por VIH , Humanos , Médicos , Tuberculosis , Carga de TrabajoRESUMEN
The specially developed questionnaire on studying opinions of physician-phthisiatrician concerning hospital medical care of patients with tuberculosis was applied to survey sampling of 58 physicians phthisiatricians. The questions of questionnaire related to analysis of efficiency of hospital treatment of patients with tuberculosis, satisfaction with consultative and diagnostic activities, support with pharmaceuticals, discovering measures permitting to increase commitment of patients to treatment in conditions of hospital.