Healthcare Management

The article provides a review of scientific publications in the field of higher medical education of the Russian Federation for the period 2010-2023. The method of study is scoping review. More than 18.5 thousand articles were found. Of these, 2.6 thousand articles were selected for analysis. It was found that the largest number of publications on this topic is dedicated to the organization of the educational process, scientific and methodological activities of the university and the introduction of new educational technologies (about 70%). A small number of articles (2.5%) are addressed to the study of remuneration and qualifications of teaching staff. There are no scientific publications on the strategic development of medical education, forecasting the need for healthcare workers and financing medical education with a quantitative assessment of data. The methodology of scientific research in some cases has disadvantages, the main ones that are lack of numerical indicators and comparisons with other universities. An analysis of full-text showed the effectiveness of the introduction of accreditation and simulation educational technologies but also revealed trends in reducing the motivation of graduates to work in the profession and the burnout of professors In order to fulfill the task set by Russian President Vladimir Putin on December 21, 2023 to develop 5-year forecasts of the personnel needs of the economy in the context of industries and professional qualifications, it is necessary to organize scientific research on the following topics: forecasting the need for healthcare workers in terms of their number and competencies, forming a strategy for the development of medical education with an assessment of the necessary conditions for its implementation.

Analysis of morbidity indicators for diseases of the endocrine system, nutritional disorders, metabolic disorders, provision of the population with personnel of endocrinologists, appropriate bed capacity, conducting a medical and economic assessment of modern labor standards in endocrinology.

Material and methods. Data from the collections “Healthcare in Russia”, collections of statistical indicators of the Ministry of Health of Russia, orders of the Ministry of Health of Russia on labor standards were used as research materials. The main research methods are statistical, information-analytical, medical-economic.

Results. The study materials established an accelerated growth in the incidence of diseases of the endocrine system, nutritional disorders, and metabolic disorders in the population compared to these data for all classes of diseases.

The dynamics of staffing of endocrinologists was determined; an analysis of labor standards for providing medical care to adults and children is presented; changes in planned and normative indicators of the volume of medical care in endocrinology are indicated in accordance with territorial programs for the provision of medical care.

Issues of economic efficiency and profitability are of great importance when organizing a telemedicine project. The development and implementation of projects carries certain costs. There are still no unified methods for assessing economic efficiency.

Aim – to analyze the economic efficiency of the telemedicine project of remote ECG consulting on the basis of regional hospital No. 3 in Chelyabinsk.

Material and methods. Methods of mathematical-statistical and economic analysis were used. The sources of information were official data of state statistics for the Russian Federation, statistical materials of the Territorial Body of the Federal State Statistics Service for the Chelyabinsk Region for the period from 2008 to 2020, data from the forms of state statistical reporting for 2008–2020 of the Unified Consultative and Diagnostic Center for Functional Diagnostics.

Results. The economic efficiency of the telemedicine project of remote ECG consulting is shown not only due to cost reduction, but also due to the rational redistribution of funds. Using a unified approach to assess economic efficiency will allow you to compare and analyze various projects.

The procedure for providing medical care in the field of oncology to adult patients, regulated by order of the Ministry of Health of Russia on February 19, 2021 No. 116n, caused fundamental controversy in the medical community even at the preparation stage, and was repeatedly edited. At the same time, even after the adoption of the normative act, the intense debate did not stop and continues to this day.

The aim of the research question was to conduct a legal analysis of the “new” requirements for the organization and procedure for providing oncological care to the adult population by medical organizations at the regional level, including private health care systems operating in the field of compulsory medical insurance.

The materials of the study were the works of Russian scientists related to the analysis and experience gained from the implementation of the “new” procedure for providing medical care in the field of oncology to adult patients. In order to study the research question, 31 sources of literature were analyzed, directly or indirectly affecting the problems of practical application of the norms of the current legislation regulating the procedure for providing medical care to the adult population in the field of oncology, including the experience of the region.

Methods of system analysis, comparison, systemic and integrated approaches, as well as the method of problem modeling were used.

The results obtained indicate the need to review, clarify and harmonize a number of provisions of the “new” order regulating the procedure for routing patients, the functions of the oncology council and the regional commission, the patient’s choice of doctor and medical organization with the requirements of the basic legislation in the field of healthcare.

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.

Honesty is an ethical ideal for a healthcare professional. Honesty to yourself, your colleagues and patients. This implies, among other things, honesty in the provision of information, even if it can negatively affect the professional image of a specialist. However, in modern realities, ethical ideals often come into conflict with possible legal consequences for a medical worker. This is a significant barrier to building a trusting relationship between doctor and patient.

To date, both in Russia and around the world, there is a growing trend of using a new, promising medical technology – fecal microbiota transplantation (FMT) – a method that is based on the introduction of healthy fecal material from a donor to a recipient in order to restore the disturbed intestinal microbiota of the latter. The selection of a healthy donor for FMT is not only one of the key factors for the success of the procedure as such, but also implements a thorough screening of the health of a volunteer – a potential donor of fecal microbiota. The presented work reveals these aspects.

The study included 73 healthy volunteers, only 4 people met the selection criteria for FMT donation as a result of the screening, which was 1.6%. The creation of fecal microbiota biobanks with samples obtained from donors who have undergone a thorough, rigorous screening procedure can be attributed to promising areas of future medicine development.

The article highlights the main stages of the biography of the outstanding scientist Vladimir Aleksandrovich Negovsky (1909–2003) – a major pathophysiologist, Doctor of Medical Sciences (1943), professor (1947), Academician of the USSR Academy of Medical Sciences (1975).

Scientist and science organizer V.A. Negovsky was a man of extraordinary abilities. He is the founder of a new medical science – resuscitation, the subject of study of which is pathology, therapy and prevention of terminal conditions. He also became the founder of the school of domestic resuscitators, the creator of the world’s first Research Institute of General Reanimatology (SRIOR RAMS), the discoverer of a new nosological unit (post-resuscitation disease), a laureate of the Stalin Prize of the second degree and the USSR State Prize.