Biomedical subjects
Publications and source records attributed to V I Starodubov.
Based on profound analysis of medical supplies, morbidity, work conditions and work safety during this period of economic reforms in Russia, the authors justified priority directions, goals and tasks of health care system in protection and improvement of workers' health state.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The need to reform health care in Russia became evident in the late 1980s when due to socioeconomic crisis, the government could not cover the expenses connected with this field and put the up-to-date expensive technologies into life. The introduction of the compulsory health insurance system (CHIS) is aimed at: 1) obtaining an additional financial source for health care by making the goal-oriented stable rates of deductions from the wage fund; 2) protecting the Russian Federation citizens' rights to have free medical aid of the guaranteed scope; 3) enhancing the quality of medial care delivered to the population by introducing a mechanism of movement of funds paid for a patient; 4) paying for medical care in relation to the volume and quality of the work done by simultaneously controlling the stipulated use of funds. Three-year experience of CHIS in Russia has indicated that there is a real mechanism of reformation and government regulation of health care under the conditions of transition to the market, with the interests of the general population and medical personnel in mind. Obvious legal, organizational, technological, and psychological problems and disadvantages have been found at all management levels, which are an obstacle in the way of the reforms and which whip up social tension and call for prompt decisions.
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The activities of hospital-replacing forms (HRF) of medical care are analyzed for the Samara and Tver regions. In the Samara region the number of HRF beds was 13.2 per 10,000 population, 9.3 of these at day-time hospitals of outpatient centers and 3.9 at hospitals. In the Tver region the number of day-time beds was 5.5 at hospitals and 0.97 at outpatient centers per 10,000 population. In the Samara region the estimated number of days of treatment at HRF was 475 per 1000 population, which is sufficient.
Incidence of diseases involving temporary disability among dentists in Tver is 81.2 cases and 939.2 days per 100 workers; according to the data of sociological interviews (with consideration for chronic diseases and self-treatment cases over 3 years), it is 120.5 cases per 100 workers. The percentage of dentists with chronic diseases is 69.9, which is lower than recorded in medical files (21.4%). This indicates a high percentage of nonrecorded diseases which are self-treated.
The statistics of population health and development of public health system is incomplete. Mortality values can be analyzed for 5-year intervals, while morbidity is represented for the following age groups: children, adolescents, adults aged 20-39 and 40-59 years. The authors suggest revising the structure and volume of statistical data on morbidity with regard for age and sex for 5-year intervals, which will help more reliably and correctly solve modern problems of public health.
The paper deals with a complex sociohygienic study of the basic indices of resource provision of the public health system in the Tver Region and with an analysis of the scope of inpatient care to the population of the Torzhok District, Tver Region. Based on an in-depth examination, the efficiency of the use of the bed fund of the central district hospital (CDH) was evaluated and economic losses from inadequate use of beds and economic effects of work of daily CDH-based hospitals were calculated.
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Morbidity assessed from consultation rate is one of the most important dynamic characteristics of population health. Hence, public health system financing should be directly related to the value of total morbidity parameters. A method for calculation of an insurance payment is presented, based on the existing morbidity. This method permits correction of the sum of an insurance payment with consideration for the scope of a local program of obligatory medical insurance.