Healthcare Management

The article is devoted to the experience of formation of personnel reserve of heads of medical organizations at the regional level on the example of the Republic of Buryatia. Modern scientific and methodological approaches to the development of competencies of managerial personnel are considered. SWOT-analysis of the current situation in the training and selection of managerial personnel is presented. The procedure of initial selection and training in the “School of personnel reserve” of the Ministry of Health of the Republic of Buryatia for inclusion in the personnel management reserve is developed. The article presents the results of sociological research and psychological testing of the first set of the “School of Personnel Reserve”, which revealed qualitative and psychological characteristics of its students, on the basis of which an average portrait of a candidate is formed.

The education and training of pharmaceutical workforce in Russian Federation is very actual problem in connection with market requirements (shortage of qualified personnel), the need to develop the domestic pharmaceutical industry, as well as the introduction of new technologies at all stages of drug development. This article analyzes the duration and structure of higher and secondary pharmaceutical education and qualification requirements for positions of specialists with higher pharmaceutical education in the Russian Federation and developed countries. The countries in which pharmaceutical production and pharmaceutical care are highly developed (Great Britain, EU countries, USA, etc.) are selected. As a result, it was revealed that in the Russian Federation and these countries the duration of higher pharmaceutical education is close (on average 5 years), but in the Russian Federation, compared with them, fewer hours are dedicated to medical sciences and mathematics. In the Russian Federation, the nomenclature of specialties of pharmaceutical workers is related to different types of work in pharmacy, in developed countries – to all stages of drug treatment from product development to its pharmacies. In the Russian Federation, unlike the countries under consideration, the requirements for appointment to the position of pharmacy manager are not clearly defined and the labor functions of specialists with higher and secondary pharmaceutical education are insufficiently differentiated. In developed countries, only specialists with higher pharmaceutical education and relevant specialization can perform work on the adjustment of drug therapy for patients, in the Russian Federation – now in some cases even consultants without pharmaceutical education release drugs to patients. In Russia, compared with developed countries, there are serious differences in the requirements for the quality of training for industrial pharmacy and their work functions. Specialization, qualification requirements and the nomenclature of positions of employees with higher pharmaceutical education in the Russian Federation require further study and updating in accordance with the requirements of the labor market and the experience of developed countries.

The cancer incidence in the Russian population continues to grow. Thus, according to the results of the analysis of state medical statistics data according to form No. 7 “Information on malignant neoplasms”, presented by specialists from the Moscow Research Oncological Institute named after P.A. Herzen, at the end of 2022, the incidence rate of malignant tumors in the country (raw count) as a whole was 425.9 per 100 thousand population. The increase in incidence leads to expected increase in government spending on the treatment of diseases of this profile, their prevention and subsequent rehabilitation: this trend requires new approaches to both determining the need for the volume of oncological care and assessing the objectivity and clinical feasibility prescribed antitumor treatment. For this purpose, in the compulsory health insurance system of the Sverdlovsk region since 2019 molecular genetic testing for the diagnostics of oncological and oncohematological disorders and for the tumor biomarkers identification for the targeted therapy were charged in a volume significantly exceeding the established federal standards. This led to positive impact on certain socio-demographic factors associated with cancer mortality and also increased the purity of prescribing expensive anticancer agents (targeted therapy).

The article presents the results of a study on the formation of a list of estimated performance indicators of outpatient clinics for the adult population. Based on the principles of the balanced scorecard, it is proposed to adjust the current resource management Quality standard and create it based on two blocks of evaluation indicators. One is to assess the state of resources and the effectiveness of their use, and the second is to assess the results of medical activities, taking into account the actual data of the activities of a medical organization. In order to increase the objectivity of the assessment of the accessibility and quality of medical care conditions, it is proposed to supplement the second block with evaluation indicators characterizing the results of public opinion.

Background. An effective organizational management model is the basis for the successful operation and development of an organization, which is especially important in situations with a high degree of uncertainty.

Aim – to investigate the basic factors contributing to and hindering the formation of an organizational management model in healthcare institutions.

Material and methods. The content-analysis of domestic and foreign publications on the formation of organizational management models is carried out.

Results. The most significant external and internal factors contributing to the formation of effective management models in medical organizations have been identified.

Analysis of morbidity and its dynamics is of significant medical and social importance, allowing us to obtain data for planning the healthcare system, developing preventive measures, and improving the quality and accessibility of medical care.

Aim of the study is to assess the dynamics of the incidence of diseases of the ear and mastoid process in St. Petersburg for 2013–2022 and the provision of the population with otorhinolaryngologists in comparison with indicators for the Russian Federation.

Material and methods. In the course of the work, an analysis of official statistics data for 2013–2022 was carried out, obtained as a result of copying information from statistical materials of Rosstat, Petrostat and the St. Petersburg Medical Information and Analytical Center. In the process of statistical processing, intensive coefficients, visibility indicators, and Spearman’s rank correlation coefficient were calculated.

Results. These studies indicate that in the period from 2013 to 2022 in St. Petersburg, there were multidirectional dynamics in the overall incidence of diseases of the ear and mastoid process, since in the period from 2013 to 2018 there was an increase in the indicator by 16.4%, and since 2018 there has been a decrease of 11.5%. In general, from 2013 to 2022 there was a weak dynamics of growth in overall morbidity (+2.3%). At the same time, the primary incidence of diseases of the ear and mastoid process in St. Petersburg has been growing steadily, with the exception of the period of the COVID-19 epidemic, and its increase was 18.6%. The level of general incidence of ear and mastoid pathology in St. Petersburg was higher than in the Russian Federation. In the period from 2013–2015 primary morbidity rates did not exceed the national average, but in subsequent years there was a steady increase in the rate, with the only exception being the period of the COVID-19 epidemic. The supply of otolaryngologists in St. Petersburg is significantly higher than that provided for by regulatory documents, which indicates the presence of sufficient personnel potential. There was no correlation between the number of otorhinolaryngologists and the level of both general and primary morbidity.

The article analyzes the effectiveness of existing methods for detecting cancer, including the use of mobile applications and artificial intelligence (hereinafter referred to as AI) for identifying malignant skin tumors in countries around the world. An overview of such visual methods as ABCDE, the Ugly duckling sign, the Glasgow system, the use of dermatoscopy, ultrasound diagnostics, reflectance confocal microscopy, and total-body photography is presented. The review also presents and evaluates the effectiveness of AI-based methods for automatic image analysis. The use of AI methods in telemedicine and on mobile platforms in the form of mobile applications opens up new prospects in the early detection of cancer. The article presents examples of mobile applications with various operating algorithms, both for self-diagnosis (Skin Self-Exam, SSE) and for use by specialists.

The purpose of this review is to search in reliable scientific databases for articles on the effectiveness of modern methods for detecting cancer, including the use of mobile applications and artificial intelligence.

Research methods. To search for literature sources, the databases PubMed (Medline), CyberLeninka, and RSCI among English-language and Russian-language publications were used. The study used thematic and semantic methodology for obtaining information. Keyword queries were entered into the search bar: skin, skin malignancies, melanoma, basal cell skin cancer, mobile applications, telemedicine technologies. At the first stage, 1304 articles on the topic of modern diagnostic methods were found, from the received articles the following categories were identified: visual methods, instrumental and methods using information technology, at the second stage queries were entered into these groups, 646 articles were received, duplicates were excluded, description of clinical cases. The review presents 42 articles on methods for diagnosing cancer.

Results and discussion. After searching reliable scientific databases for articles on the effectiveness of modern methods for detecting cancer, including the use of mobile applications and artificial intelligence, the sensitivity of the methods was compared. Despite the advantage of relative ease of use, visual methods show low sensitivity and specificity. Among the achievements of recent years, one can note the use of AI-based tools. Studies based on the analysis of NK images show high sensitivity and specificity. The results obtained may inspire some optimism, but so far the use of such technologies in clinical practice is relatively rare.

The use of mobile applications, both using neural networks and applications for self-diagnosis, is still at the stage of searching for the most effective approaches, despite the fact that in some countries regulatory authorities have approved the use of such solutions in clinical practice, there is a small number of high-quality studies on the effectiveness of these technologies. In certain cases, the use of apps can lead to increased healthcare costs.

Conclusion. Since in recent years there has been an increase in the incidence of cervical cancer, the burden on the healthcare system is increasing, and there is a need to search for and implement new approaches. Along with traditional methods, the search for solutions in the field of using telemedicine technologies, in particular in the form of mobile applications with various algorithms, has wide prospects. Thus, the search and research of effective methods for detecting malignant tumors is becoming one of the most promising tasks for researchers at the intersection of various scientific disciplines and fields of knowledge.

2024 marks the 150^th anniversary of the birth of N.A. Semashko and 75 years since his death. Considering the significant contribution of Nikolai Alexandrovich to the development of our state, the creation of a fundamentally new healthcare system, the improvement of medical education and science, numerous anniversary events are planned and will be held this year, which will allow us to pay tribute to the memory and respect of this outstanding figure in national healthcare and using examples from his life and work to carry out professional education of the modern generation of medical specialists.