Vol. 4 No. 3 (2023): Архив

Introduction. Partial lockdown during the COVID-19 pandemic and difficulties in restoring social ties in the post-pandemic period led to noticeable changes in health awareness and attitudes toward personal health among young students.

Purpose. The goal was to identify the features of the self-assessment index of attitude toward personal health in students in the COVID and post-COVID periods.

Methods and materials. 645 adult students from Moscow universities participated in the study on a voluntary basis. They were provided with five author-developed surveys aimed at identifying levels of health, its types (general, psychological, and mental), and components (emotional, cognitive, practical, and behavioral scales of the index of attitude toward health, as well as the intensity indicator).

Results. The study showed that during the COVID-19 pandemic one of the main features of self-assessment index of attitude toward personal health among students was a high correlation between the average level of the cognitive scale of the index of attitude toward health and the above-average level of psychological and general health. It was proven that in the post-COVID period one of the main features of self-assessment index of attitude toward personal health among students was a high correlation between the above-average level of psychological health and the average level of emotional, cognitive and practical scales of the index of attitude toward health and the intensity indicator; the above-average level of general health and the average level of emotional, cognitive and practical scales of the index of attitude toward health and the intensity indicator. There is a noticeable correlation between the average level of health and mental health and the average level of emotional, cognitive and practical scales of the index of attitude toward health and the intensity indicator; the average level of emotional, cognitive and practical scales of the index of attitude toward health and the average level of the intensity indicator.

For citation: Polyakova O. B., Bonkalo T. I. Features of self-assessment index of attitude toward personal health in young students. City Healthсare, 2023, vol. 4, iss. 3, pp. 4-12. doi: 10.47619/2713-2617.zm.2023.v.4i3;4-12 (in Russian).

Introduction. Burnout is emotional exhaustion caused by chronic stress at the workplace, which is not adequately managed. Health care managers face high requirements for professional level and stress-resistance, which can lead to problems in the emotional sphere. The data about burnout prevalence and its determinants among health care managers is contradictory that demands further studying.

Objective. To define prevalence of burnout syndrome and to identify factors associated factors among health care managers within Orenburg region.

Materials and methods. The study was conducted within the period from March 1 to April 30, 2023 by the specialists of the Institute of Leadership and Health Care Management of Sechenov University with the support of the Ministry of Health of the Orenburg region. A total of 119 participants took part in the study. The questionnaire MBI (Maslach Burnout Inventory version for managers, adapted into Russian by Vodopyanova N.E. and Starchenkova E.S.) was used for burnout diagnostics. The questionnaires were distributed electronically. Statistical data processing was conducted in IBM SPSS Statistics v. 26 and StatTech v. 3.1.1.

Results. Burnout was defined as a result of the MBI questionnaire high degree burnout and extremely high degree burnout. Burnout was diagnosed in 76 respondents, or 63.9%. There was a direct correlation ρ = 0.389 and ρ = 0.337 between the severity of burnout and depression, and burnout and anxiety, respectively. Meanwhile, there was an inverse correlation between the severity of burnout and leadership potential ρ = -0.494. The odds of having burnout were significantly influenced by the challenges of managing a healthcare organization and the health status of the respondents. Burnout influenced the respondents' plans to resign from the healthcare organization or leave their jobs in the healthcare system.

Conclusions. Burnout is common among the management personnel of the health care system and has the following specific feature: significant influence of manager's professional qualities and self-esteem on burnout presence. Burnout decreases adherence to the profession and increases the chances of wanting to resign from the current position or change the profession. Overall, participants demonstrated high adherence to the profession, awareness of the negative effects of burnout, and willingness to participate in measures to prevent burnout among medical professionals.

Introduction. Health literacy and awareness, trust in healthcare workers and healthcare system are important factors in health-related decision-making.

Purpose. The aim of the study was to assess health awareness and the level of trust in health professionals, to identify prevailing opinions and preferences in health services, and to define possible links between these parameters and demographic indicators among a sample of adults.

Materials and Methods. A survey of 98 individuals aged 18-64 years was conducted. A subsequent frequency analysis was performed without estimating statistical significance of frequency distribution due to the small sample size. The findings were interpreted within the sampling frame. General conclusions were given as preliminary.

Results and Discussion. Respondents were well informed about HIV infection; however, the majority of them had little knowledge about the differences in hepatitis A and hepatitis B transmission routes. In case of sudden sharp abdominal pain, every second respondent would prefer to call the ambulance rather than self-medicate. 23% of participants under the age of 36 admitted that they did not know how to provide first aid in cases of arterial bleeding. Respondents aged 18-19 years showed higher trust in healthcare workers, while the lowest indicators were observed in the group aged 36–64 years. The majority of respondents with higher trust in healthcare workers showed a positive attitude toward vaccination. Every second woman would prefer admitting to a private Russian clinic, and every third man would choose a state health facility.

Conclusion. The results of the study can be applied to the programs assessing health literacy and trust in healthcare professionals.

For citation: Grechushkina N. A. Results of a Pilot Study of Health Awareness, Trust in Health Professionals, Preferences, and Opinions About Healthcare Among a Sample of Adults. City Healthсare, 2023, vol. 4, iss. 3, pp. 26-40. doi: 10.47619/2713-2617.zm.2023.v.4i3;26-40 (in Russian).

Introduction. Today, one of the primary drivers of global economic growth is digital transformation. Artificial intelligence tools, cloud solutions and telemedicine technology seem to be critical components in the growth of different economic sectors, including healthcare. Like other developed countries, Russia believes that artificial intelligence can enhance access to high-quality and affordable medical care. The relevance of this topic is further supported by the President of Russia’s recent statements delivered at the opening events of health facilities around the country, where he emphasized the importance of incorporating artificial intelligence into all aspects of healthcare, including management, medicine, patient care, to ensure technological sovereignty. However, along with the obvious advantages, digital technologies  particularly artificial intelligence, represent certain risks that are to be eliminated in order to achieve the core goal of improving the quality and accessibility of medical care.

The purpose of the study was to identify risks and new opportunities in the implementation of artificial intelligence tools into healthcare management.

Materials and methods. Desk research, expert interviews.

Results. Based on the systematization of the information obtained by the author in the course of the study, the main positive and negative aspects of the introduction of artificial intelligence tools into the healthcare system were determined.

Discussion. The implementation of artificial intelligence in medicine and healthcare is accompanied by a certain range of risks associated with inaccuracy of data, low levels of data security and ethical aspects.

Conclusion. The collected and systematized data obtained from desk studies and expert opinions can make a significant contribution to recommendations on the implementation of artificial intelligence tools into healthcare management.

For citation: Alikperova N. V. Artificial Intelligence in Healthcare: Risks and Opportunities. City Healthсare, 2023, vol. 4, iss. 3, pp. 41-49. doi: 10.47619/2713-2617.zm.2023.v.4i3;41-49 (in Russian).

Background. The key to building an effective healthcare system is to provide highquality treatment, take measures for disease prevention, and make medical care more accessible for all population groups. Today, the Russian healthcare system has a lot of serious issues in human resources management that require urgent solutions.

Purpose. To identify the specifics of staffing in Moscow healthcare, the motivation of medical personnel working in public medical organizations, and the problems and opportunities for managing human resources.

Materials and methods. The research data was collected within a qualitative sociological study conducted by the Research Institute for Healthcare Organization and Medical Management of the Moscow Healthcare Department in 2019. The study method was an expert survey using indepth, structured interviews. 15 expert interviews were devoted to the staffing of Moscow healthcare. The interview participants were the Moscow experts in the secondary professional medical education, the higher professional medical education, or the continuing professional education of medical workers, as well as the chief physicians of Moscow medical organizations.

Results. The availability of medical personnel in Moscow is quite high. In comparison with other regions, Moscow has competitive pay, career growth opportunities, and social protection, so the problem is not particularly acute. However, health professionals often move to the private sector due to the high workload of physicians and nurses in public health facilities.

Keywords: management, health workforce, development of personnel management system, health economics, labor economics, creation of talent pool, social and labor relations, medical personnel

For citation: Burdastova Yu. V. Challenges and Prospects for Health Workforce Management. City Healthсare, 2023, vol. 4, iss. 3, pp. 50-98. doi: 10.47619/2713-2617.zm.2023.v.4i3;50-98 (in Russian).

In Russia, healthcare facilities of any form of ownership provide paid medical services that are in high demand among all groups of Russian population. Due to the economic challenges and the high social significance of these services, specialists and healthcare public authorities pay close attention to this issue.

Changes in the regulations on paid medical services should eliminate existing difficulties and minimize the risk of issues in the future.

The author carried out a comparative analysis of the following documents: Rules for the provision of paid medical services by medical organizations (approved by the Decree of the Government of the Russian Federation No. 1006 dated 04.10.2012), and Rules on a similar topic developed by the Ministry of Health of the Russian Federation and amended during the preparation and publication of draft document at the platform regulation.gov.ru (approved by the Decree of the Government of the Russian Federation No. 736 dated 11.05.2023).

The author addressed the innovations introduced by the new regulations and evaluated their potential impact on the provision of paid medical services.

For citation: Smirnova E.V. Paid medical services in public healthcare organizations: policy management and prospects. City Healthсare, 2023, vol. 4, iss. 3, pp. 59-71. doi: 10.47619/2713-2617.zm.2023.v.4i3;59-71 (in Russian).

The article analyzes current conceptual approaches to developing algorithms for supporting doctor's decision-making process. The need for application of sorting algorithms to generate decision-supporting algorithms is explained. We suggest a concept of reference diagnostics based on systematization of topical and nosological series that determine the direction and sequence of diagnostic process. According to the concept, each possible pathological region localization and each disease are presented as a set of positive and negative reference signs. In order to demonstrate the sequence of diagnostic algorithm elaboration, a specific neurological pathology is used as an example. The prospects for the practical application of reference diagnostics in clinical medicine are defined.

For citation: Yakushin M. A., Vorobeva A. V., Vasiliev М. D., Kudrin A. P., Yakushina T. I., Arseenkova O. Y. Concept of Reference Diagnostics as the Foundation for Developing Diagnostic Algorithm to Support Doctor’s Decision-Making. City Healthсare, 2023, vol. 4, iss. 3, pp. 12-26. doi: 10.47619/2713-2617.zm.2023.v.4i3;12-26 (in Russian).

Erectile dysfunction is a multifactorial problem that requires various treatment approaches based on the factors affecting disease development. Erectile dysfunction is one of the most serious clinical and social issues among men. It’s obvious that a full sexual life is one of the most important components of physical and mental health. Recent sociological data show that sexual health is the key not only to a good quality of life, but also to a longer life expectancy. It is noted that combining the traditional three-stage therapy – oral drugs, penile injection therapy and penile implantation – with ongoing psychotherapy can significantly improve the treatment results. Accordingly, it becomes important and crucial for a specialist to be aware of the timely referral of a patient to a psychotherapist.

For citation: Vasiliev A. O., Astakhov N. V., Arutyunyan P. A., Aliev O. R., Khodyreva L. A., Pushkar D. Y. Psychogenic Erectile Dysfunction: A Multidisciplinary Problem. City Healthсare, 2023, vol. 4, iss. 3, pp. 87-94. doi: 10.47619/2713-2617.zm.2023.v.4i3;87-94 (in Russian).

Introduction. The segment of small and medium-sized enterprises is one of the top priorities for the strategy of economic development of the Russian Federation. Thus, studies on this topic seem to be relevant. The share of small and medium-sized entrepreneurship (SMEs) in the GDP of developed countries ranges from 35 to 65 %, while the share of SMEs in the GDP of the Russian Federation still does not exceed 20 %.

The current challenges affecting the economy of the Russian Federation, including the COVID-19 pandemic and the current geopolitical situation, as well as sanctions against the Russian Federation imposed by other countries, have had a significant negative impact on small and medium-sized enterprises.

Purpose of the study. The purpose of this study was to review and analyze current crisis phenomena and its impact on the development of importing companies from the SME segment in order to identify key areas requiring the development of new approaches to crisis management.

Results and conclusion. Study results show that modern crisis phenomena have had a significant impact on the development of the SME segment, thus forming a completely new market environment. New challenges have affected almost all activity areas of importing companies from the SME segment from the internal management policy (organization of the company's activities and personnel management) to the rules for importing goods, including logistics, calculations, value management, etc.

For citation: Petrova G. D., Kheifets M. I. Modern Crisis Phenomena and Its Impact on the Development of Small and Medium-Sized Enterprises. City Healthсare, 2023, vol. 4, iss. 3, pp. 95-104. doi: 10.47619/2713-2617.zm.2023.v.4i3;95-104 (in Russian).

Introduction. All over the world, the number of people forced to flee their homes due to conflict, violence, and persecution is now higher than at any time in human history. Migrants, refugees, and other citizens belonging to the category of internally displaced persons have the right to health and medical care in the host country based upon the basic principles of  humanitarian law and a number of international legal documents. However, the practice of providing medical care in the host country varies depending on the legislation and resources of the national healthcare system.

The purpose of this study was to consider the barriers to the accessibility of medical care for migrants, refugees, and other internally displaced persons.

Materials and methods. The research was mainly carried out using a content analysis of scientific literature published by foreign researchers on the accessibility of medical care to internally displaced persons, refugees, persons seeking citizenship, and other categories of migrants.

Results. The study showed that it was challenging to collect complete data on the number of people deprived of the right to medical care during the registration procedure in the host country. The health status of asylum seekers depends on environmental and social factors; in addition, they face unique problems related to the healthcare system of the host country. In general, the global situation concerning access to medical care should be considered catastrophic. Despite legislative and programmatic achievements both within the framework of international humanitarian law and within countries, the provision of health services to migrants, refugees, and stateless persons  remains a challenging issue. Thus, a huge number of people cannot  exercise their rights to health and medical care.

For citation: Dobrieva A.I., Ananchenkova P.I. The Right to Health and Barriers to Health Services for Refugees and Internally Displaced Persons:Review of Foreign Literature. City Healthсare, 2023, vol. 4, iss. 3, pp. 105-111. doi: 10.47619/2713-2617.zm.2023.v.4i3;105-111 (in Russian).

Introduction. Cardiovascular pathology is one of the leading causes of global mortality burden, being responsible for more than 30% of all deaths. Continuous monitoring of patients with heart failure is crucial in developing measures aimed at reducing cardiovascular mortality. The advancement of digital technologies in this field will improve the quality of monitoring and treatment of patients with heart failure.

Objective. The goal of the study was to summarize the results of implementation of some well-known approaches to digital healthcare for patients with heart failure.

Materials and methods. The data is obtained from PubMed databases and Google search results. Scientific articles in English were selected by the following keywords: “heart failure”, “information technologies”, “remote monitoring”, “digital technologies”, etc. In some cases, the search was also conducted in еру Russian Internet segment using such keywords as “сердечная недостаточность [heart failure]”, “распространенность [prevalence]”, etc.

Results.  The use of digital technologies for recording health indicators in people with heart failure has been examined. The aspects of self-monitoring of health indicators are considered, examples of sensor and artificial intelligence technologies for continuous remote monitoring of patients are given, the principles of digital patient management for achieving adherence to treatment are presented, aspects of remote rehabilitation using telehealth technologies are discussed.

Discussion. New elements of digital health provide a wide range of opportunities. Although the approaches listed in this paper are promising, further study of their effectiveness in controlled trials and in real practice is needed. It is necessary to continue developing the concept of continuous monitoring of patients with heart failure. Research programs should take into account all the possibilities of modern technologies in order to find and standardize the best approaches.

For citation: Kamynina N. N., Andreev D. A. Remote Digital Solutions For the Organization of Treatment and Monitoring of Patients With Heart Failure Abroad. City Healthсare, 2023, vol. 4, iss. 3, pp. 112-119. doi: 10.47619/2713-2617.zm.2023.v.4i3;112-119 (in Russian).

Introduction. The World Health Organization considers the implementation of healthy lifestyle recommendations a basic healthcare service and has already developed the necessary principles and recommendations. Currently, lifestyle medicine is actively developing abroad, and being defined as part of preventive medicine. In relation to the methodology of lifestyle medicine for medical staff, the principles of a healthy lifestyle are of particular importance abroad, as every medical staff, be it a doctor or a nurse, should set a good example for their patients and the general population. The principles of lifestyle medicine dictate that health professionals’ adherence to a healthy lifestyle is crucial since every health worker, whether a doctor or a nurse, should set a positive example for their patients and the general public.

Materials and methods. A search in the PubMed international database using the keywords "lifestyle medicine", "healthy lifestyle" and "medical staff" from 2013 to 2023 resulted in about a thousand relevant systematic reviews, meta-analyses, and articles. Outcomes of interest included professional health and work efficiency of health workers. After the final data selection and exclusion of scientific and practical data considered non-significant, 21 sources from 10 countries were included. The authors evaluated the quality of these reviews, meta-analyses, and articles and obtained generalized new data in the area.

Results and discussion. The review presents the results of the analysis and summary of 21 scientific papers (systematic reviews, meta-analyses, and articles) that describe the features of lifestyle medicine as part of medical, scientific and educational areas, as well as the health-improving power of everyday habits and practices. The identified foreign proposals and recommendations aimed at motivating medical staff, both doctors and nursing staff, to lead a healthy lifestyle are presented.

Conclusion. Modern scientific and practical achievements of lifestyle medicine presented in foreign scientific papers have been identified. Based on the available data concerning health and lifestyle of foreign medical staff, it is strongly recommended to adhere to healthy lifestyle, regular medical examinations, better nutrition with vegetables and fruits consumption, vitamins and supplements intake, regular physical activity and reduction in bad habits to healthcare professionals in Russia.

For citation: Aksenova, Е. I. Medical Lifestyle and Foreign Recommendations Aimed at Motivating Medical Staff to Lead a Healthy Lifestyle. Е. I. Aksenova, N. N. Kamynina, P. S. Turzin. City Healthcare, 2023, vol. 4, iss. 3, pp. 120-129. DOI: 10.47619/2713-2617.zm.2023.v.4i3;120-129

Background. In 2021, a new educational project “Scientific Laboratory ‘Moscow Polyclinic’” was launched. Its aim is to develop research competencies among primary health care workers and to boost activities such as journal publication and the organization of specialized scientific and practical conferences. The article briefly describes several characteristics and features of this project for two seasons (2021–2022).

Materials and methods. The author collected, aggregated, statistically processed, and analyzed the comparative data for two project seasons.

Results and discussion. The analysis included information on the project design (topic-based tracks, blocks “Transformation” and “Accelerator of Ideas”, sections “Science” and “Service Design”, Scientific Club), the results of sociological surveys and their interpretation, and the brief scientometric characteristics of participants’ publications. Between 2021 and 2022, 9818 specialists took part in the Scientific Laboratory; they were outpatient polyclinic care providers in the Moscow healthcare system. In addition, the number of speakers nearly doubled, and a community of mentors was formed from the active researchers in Moscow healthcare.

Conclusions. The project speakers included leading foreign and Russian scientists,  representatives of scientific journals and peer-reviewed research databases, and Moscow healthcare specialists. They shared with the participants their experience of planning, their methodology for conducting a study; algorithms for selecting a study topic, and the features of research data publication, including possible sources. The project mentors were the chief specialists of the Moscow Healthcare Department, and the heads of medical organizations experienced in carrying out the studies. As a result, the participants successfully published their articles in the peer-reviewed journals from the list of the Higher Attestation Commission (VAK). The project demonstrates that the employees of Moscow polyclinics are not only active professional physicians but also researchers with critical thinking and deep knowledge in clinical medicine.

For citation: Tarkhov K.Yu. Scientific Laboratory “Moscow Polyclinic”: experience of project implementation. City Healthсare, 2023, vol. 4, iss. 3, pp. 130-143. doi: 10.47619/2713-2617.zm.2023.v.4i3;130-143

Existence of medical law as a separate area of law in the legal system of the Russian Federation is considered. This article will be helpful in determining the legal basics of medical law, as well as scientific and historical aspects of its development.

For citation: Gavrilenko K. A. Medical Law as a Separate Area of Law. City Healthсare, 2023, vol. 4, iss. 3, pp. 144-149. doi: 10.47619/2713-2617.zm.2023.v.4i3;144-149 (in Russian).