Topic number
№ 4 . 2020
Above all

The technologies of health care management during COVID-19


The COVID-19 pandemic has created multiple challenges for whole healthcare industry, including non-COVID-19 diseases care. For example, in USA new procedure of prioritization of surgical operations based on associated risk and urgency of care was implemented. In some hospitals in USA were introduced virtual processes of hospitalization and "hospital waiting rooms". In United Kingdom, patients with COVID-19 were managed by healthcare workers at home by "virtual wards": monitoring and treatment through phone calls and mobile applications. Regulatory documents regarding anti-epidemic measures in hospitals are listed. The role of IT-technology and distant care in healthcare during COVID-19 pandemic is described. New important challenges for management of healthcare institutions are raised by COVID-19. Positive, clear and constant communication of all healthcare managers with staff and communities in especially demanded in the era of COVID-19.

Actually today

Demographic, social and economic effects of menopause hormonal therapy


In 85% of women menopause is associated with pathological symptoms as "hot flashes" and other vasomotor symptoms, vulvovaginal atrophy, higher risk of depression and anxiety. Also, this period of women's life is associated with constantly increasing risk of chronic and severe conditions such as: osteoporosis and fractures, diabetes and cardio-vascular diseases. Menopause hormonal therapy is used as for relieve of symptoms as well for decreasing risk of chronic conditions. In this article demographic, social and economic effect of menopause hormonal therapy (MHT) are assessed and calculated in relation to risks associated to therapy. It is shown that MHT decrease vasomotor symptoms by 75%, decrease of osteoporosis related hip fractures by 30%, reduce number of new cases of diabetes by 30% and cardiovascular mortality by 12-54%. Moreover, one scientific study showed decrease of all-cause mortality in group of women taking MHT in the age of 50-59 years by 31%. The economic effect calculated in terms of the number of days of medically related absenteeism and saved lives was 9.1 bln rubles. Rub per year even only 1.3% women in age between 45-69 years take this type of treatment in Russian Federation. Taking into account the possible risks of this type of treatment (which in economic terms is less significant than the effect of therapy), as well as the cost of purchased medicines, effect of taking MHT is 3.97 billion rubles per year. Currently, the use of MHT in the Russian Federation as a percentage of women aged 45 to 69 years is 2.5 times lower than in the EU countries, where this share is 3.4%. If in the Russian Federation the same number of women will be treated as in developed countries, the medical, demographic and economic effects will increase by 2.5 times compared to the current level. And in the ideal scenario, in case of MHT treatment will be prescribed to all women with severe symptoms of menopause (10.7% aged 45 to 59 years) and excluding those who have contraindications to the appointment of this therapy, these effects will increase by 4.8 times.

Financial and economic rationale of proposals to increase the federal budget on healthcare in 2021-2023


The global coronavirus pandemic has made adjustments to the implementation of fiscal policy in 2020. However, contributing to the achievement of the country's national development goals remains a key fiscal policy objective. This determines the foundations for the formation of the federal budget for 2021 and for the planning period of 2022 and 2023, focused, to a large extent, on solving urgent problems of the social sphere, including strengthening the health care system. However, the funds envisaged by the draft federal budget for financing health care still do not allow to eliminate the accumulated problems and do not provide opportunities for further sustainable development of the industry, the importance of which, in the context of a pandemic, has increased many times

The technologies of health care management during COVID-19

Effective management

Management of a modern healthcare facility: an innovative approach


City Clinical Hospital No. 67 named after L. A. Vorokhobov is one of the largest medical hospitals in the North-West of Moscow, that has started transition from the command-administrative principle of management to a decentralized system in order to increase the medical, social and economic efficiency of the hospital. The article presents the structural and functional organization of technological processes, carried out by centers of competence, which have significant autonomy in the process of medical management.

Lean technologies in healthcare: current state of affairs and future opportunities in Russia. Analytical review


Despite the fact that Lean interventions in healthcare are actively supported by the Russian government and arouse keen interest among healthcare management specialists, in regard to scientific and expert assessment of effectiveness of the measures being carried out there's still a lot of nuances that remain poorly investigated. The main aim of the present review is to analyze the lean technologies' current status within the scientific discourse and with respect to introduction into medical organizations.

Methods. An analysis of literature sources was conducted among publications up to 2019. Full-text analysis was used to reveal existing trends among relevant literature and to determine methods and instruments of lean technologies most commonly implemented in Russian medical organizations.

Results. From 2011 to 2019 the amount of relevant publications has been significantly growing, with particularly substantial increase after the year of 2016 (which was the year when the "Lean polyclinic" project was introduced). 46% of sources are theoretic, 54% are empirical. Most of the empirical studies report an introduction of the lean technologies into outpatient clinics, inpatient wards are described in 5% of studies; besides, some other units are found, for example: dental clinics, blood donation centers trauma centers and emergency rooms.

Among analytical instruments being used most popular are value stream mapping (described in 43% of studies), followed by timing (38%), questionnaires (26%). Among implementation instruments 5S system is prevalent (38%), as well as solutions provided by "Lean polyclinic" project (50%).

Guzel E. Ulumbekova
MD, MBA from Harvard University (Boston, USA), Head of the Graduate School of Healthcare Organization and Management (VSHOUZ)
Medicine today

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