Medical examination in resource-limited settings

• Miroslav B. Ibragimov
• Leyla A. Alieva

Abstract

Scientific publications of domestic authors on the organization of medical examinations have been studied. A large proportion of studies is addressed to problem of organizing medical examination of the population in conditions of limited resources, shortage of primary health care staff and long-term underfunding of the industry. The modern conditions have served as an impetus for current low medical activity and dissatisfaction of the population with the quality of clinical examination. The study also highlights legislative measures taken by the state to increase citizens’ responsibility for their health.

Aim. To develop recommendations for improving the quality of clinical examination organization, taking into account the current situation and the shortage of primary care staff.

Objectives. To study of the Scientific Community opinion on assessing the organization of clinical examination of the adult population; identify the main problems of medical examination that limit its effectiveness and the possibility of high-quality implementation.

Material and methods. An analysis of scientific literature, a formal-logical analysis of the norms of Russian legislation, and an analysis of indicators for organizing medical examinations in the Republic of Dagestan for 3 years (2020–2022) were carried out.

Conclusion. Clinical examination carried out in conditions of depleted primary health care does not fulfill its objectives of improving public health indicators. To carry it out efficiently, it is necessary to fill the shortage of general practitioners and paramedics. It is possible to use new lean technologies to save time for the population when undergoing medical examination.

Keywords:coverage with preventive examination; clinical observation; medical activity

References

1. Capewell S., Ford E.S., Croft J.B., Critchley J.A., Greenlund K.J., Labarthe D.R. Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America. Bull World Health Organ. 2010; 88: 120–30.

2. Semashko N.A. Prevention and medical examination. In: A. Mol’kov, N. Semashko, A. Sysin (eds). Fundamentals of Prevention in Medicine. Collection. Moscow, 1927: 7–16. (in Russian)

3. Russian statistical yearbook 2021. Statistical compendium. In: Rosstat. Moscow, 2021: 90 p. (in Russian)

4. Order of the Ministry of Health of the Russian Federation dated June 2, 2015 No. 290n «On approval of standard industry standards of time for performing work related to a visit by one patient: a local pediatrician, a local general practitioner, a general practitioner (family doctor), a neurologist, a doctor – otorhinolaryngologist, ophthalmologist, obstetrician-gynecologist». (in Russian)

5. Ulumbekova G.E. Analysis of budget expenditures of the budget system of the Russian Federation in the section «Healthcare» for 2022 and for the planning period 2023–2024. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VShOUZ [ORGZDRAV: News, Opinions, Training. Bulletin of VShOUZ]. 2021; 7 (4): 7–15. (in Russian)

6. Gadzhiev R.S., Agalarova L.S., Gamzaeva M.A. Study of the quality of clinical examination of the working population in urban clinics. Spravochnik vracha obshchey praktiki [Directory of General Practitioners]. 2017: (3): 15–22. (in Russian)

7. Sheyman I.M., Shishkin S.V., Shevsky V.I., Sazhina S.V., Ponkratova O.F. Clinical examination of the population: expectations and reality. Mir Rossii [World of Russia]. 2021; (4): 6–29. (in Russian)

8. Khodakova O.V., Koshevaya N.V. Population satisfaction with the organization of medical examination of certain groups of the adult population using the example of a constituent entity of the Russian Federation. Menedzher zdravookhraneniya [Health Care Manager]. 2019; (5): 45–52. (in Russian)

9. «Labor Code of the Russian Federation» dated December 30, 2001 No. 197-FZ (as amended on August 4, 2023) (as amended and supplemented, entered into force on September 1, 2023). (in Russian)

10. Taut D.F., Ivanov I.V., Minulin I.B., Shcheblykina A.A., Tataurshchikov S.A., Popova A.A. Assessment of the quality of dispensary observation of patients suffering from chronic non-infectious diseases, based on practical recommendations of Roszdravnadzor. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VShOUZ [ORGZDRAV: News, Opinions, Training. Bulletin of VShOUZ]. 2022; 8 (3): 34–44. (in Russian)

11. Sandakov Ya.P. Relevance of research into the organization of dispensary observation in the provision of primary health care. Sovremennye problemy nauki i obrazovaniya [Modern Problems of Science and Education]. 2017; (2): 122. (in Russian)

12. Usacheva E.V., Berteneva M.E., Kalinushkina N.B. Dispensary observation – as the basis for the preventive work of a local physician. Poliklinika [Policlinic]. 2019; 5-2: 13–7. (in Russian)

13. Rosstat/Statistical tables/Completing medical examinations and medical examinations, seeking medical help. URL: https://rosstat.gov.ru/free_doc/new_site/GKS_KDU_2021/index.html (in Russian)

14. Federal Law «On the fundamentals of protecting the health of citizens in the Russian Federation» dated November 21, 2011 No. 323-FZ (latest edition). (in Russian)

15. Law of the Russian Federation on the amendment to the Constitution of the Russian Federation dated March 14, 2020 N 1-FKZ «On improving the regulation of certain issues of the organization and functioning of public authority», paragraph «g» of Art. 72 of the Constitution of the Russian Federation. (in Russian)

16. Salagay O.O., Soshkina K.V. The concept of personal responsibility for maintaining health: legal aspect. Zhurnal rossiyskogo prava [Journal of Russian Law]. 2020; (8): 94–104. (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)