Organization of internal control of quality of medical care (Faculty Clinics of Irkutsk State Medical University)

Currently, there is no normative document at the federal level that determines the format of the organization of internal control of medical care quality in a medical organization. The system of standardization in the sphere of public health of the Russian Federation remains incomplete. In this regard, in the multidisciplinary medical organization, innovative approaches have been developed and implemented in the management of the medical care quality and ensuring the safety of medical activities: the development of a number of local regulatory documents; strengthening the expert institute (setting up a department for quality control and safety of medical activities); increasing the role of the internal expertise of the quality of medical care; standardization of medical care; improving the organization of work of middle and junior medical links; strict adherence to the three-stage internal quality control with the obligatory presence of self-control when monitoring the quality of work of medical, middle and junior medical personnel. The authors show the dynamics of the main indicators of the quality of care at the stages before and after the introduction of new approaches to improve the internal quality control of medical care. The presented data testify to the effectiveness and expediency of the proposed measures

ANALYSIS OF VACANCIES AND JOB OFFERS FOR DOCTORS IN STATE MEDICAL ORGANIZATIONS OF THE IRKUTSK REGION

The analysis of vacancies and job offers for doctors, especially information on the declared amount of wages and benefits, allows  not only to study the need for personnel, but also to study the level  of motivation of candidates for medical posts. The aim of the study  was to analyze vacancies and job offers for doctors from state  medical organizations of the Irkutsk region. The study was  conducted using the method of continuous statistical analysis of job  offers for physicians posted on the official website of the Ministry of  Health of the Irkutsk region. The public sector of the healthcare  system in the Irkutsk region provides a large number of vacancies  for unemployed doctors and young professionals. Declared in job  advertisements, the salary level of doctors is below the level  reflected in regional state reports on the health of the population and  the organization of health care. There is a lag in the salaries of  medical workers from the average for the region, as well as the  backlog of the Irkutsk region in this indicator from the Russian  Federation. When comparing the municipalities of the region to the  maximum and minimum declared wage levels, it is revealed that the  difference between them is almost fourfold. Although the most  demanded are doctors who provide primary health care, the need for these specialists does not correlate with the level of wages offered to them in vacancy announcements. Fourfold excess of the maximum  declared wage level over the minimum in the municipal formations of the region is not a consequence of taking into account difficult  working conditions in hard-to-reach areas, but is due exclusively to factors of economic nature

Sociological Research of the Adherence of Medical Students to Employment by Specialty Received at a University

Background. A significant number of medical students refuse to work on a specialty obtained in medical universities after its completion or during the first years of professional activity.Purpose of the study: to conduct a sociological study of the adherence of students of a medical university to employment in a specialty received at a university, as well as factors of its motivation.Methods. A sociological survey of graduate students of ISMU was conducted using specially designed questionnaires.Results. It was revealed that more than 5 % of students do not plan to work on the received specialty after graduating from a medical university. Only every fourth respondent after graduation is going to return to his place of permanent residence, one of four intends not to return, and half have not yet decided on the choice of a further place of work and residence. Work with undergraduates about bringing them to the territory of the initial residence is organized by the administration of municipal entities and medical organizations poorly. Meanwhile, the requirements of graduates presented to a potential employer in terms of the level of wages and the creation of conditions for residence and professional activity are not overstated.Conclusion. Working with graduates and taking specific steps to implement their requirements is the most logical option for joint activities of medical universities, health authorities, administrations of medical organizations and local self-government bodies to create favorable conditions for securing young professionals in their chosen field of activity

Charge density distributions and related form factors in neutron-rich light exotic nuclei

Charge form factors corresponding to proton density distributions in exotic nuclei, such as $^{6,8}$He, $^{11}$Li, $^{17,19}$B and $^{14}$Be are calculated and compared. The results can be used as tests of various theoretical models for the exotic nuclei structure in possible future experiments using a colliding electron-exotic nucleus storage ring. The result of such a comparison would show the effect of the neutron halo or skin on the proton distributions in exotic nuclei.Comment: 11 pages, 4 figures, to be published in International Journal of Modern Physics

Correlation effects in single-particle overlap functions and one-nucleon removal reactions

Single-particle overlap functions and spectroscopic factors are calculated on the basis of the one-body density matrices (ODM) obtained for the nucleus $^{16}O$ employing different approaches to account for the effects of correlations. The calculations use the relationship between the overlap functions related to bound states of the (A-1)-particle system and the ODM for the ground state of the A-particle system. The resulting bound-state overlap functions are compared and tested in the description of the experimental data from (p,d) reactions for which the shape of the overlap function is important.Comment: 11 pages, 4 figures include

Effects of Short-Range Correlations in (e,e'p) reactions and nuclear overlap functions

A study of the effects of short-range correlations over the (e,e'p) reaction for low missing energy in closed shell nuclei is presented. We use correlated, quasi-hole overlap functions extracted from the asymptotic behavior of the one-body density matrix, containing central correlations of Jastrow type, up to first-order in a cluster expansion, and computed in the very high asymptotic region, up to 100 fm. The method to extract the overlap functions is checked in a simple shell model, where the exact results are known. We find that the single-particle wave functions of the valence shells are shifted to the right due to the short-range repulsion by the nuclear core. The corresponding spectroscopic factors are reduced only a few percent with respect to the shell model. However, the (e,e'p) response functions and cross sections are enhanced in the region of the maximum of the missing momentum distribution due to short-range correlations.Comment: 45 pages, 15 figure

Analysis of the physicians staff in the state medical organizations of the Irkutsk region

The results of the analysis of medical staff, especially of physicians, are highly relevant for the decision-making process by the health organizers and the administration of municipalities, are in demand by graduates of medical universities and young specialists coming to the medicine, and are of interest to scientists in the field of public health. In this regard, the indicators characteristic of medical institutions of state medical organizations of the Irkutsk region in the context of municipalities and the most important special areas in the dynamics are analyzed. The study was conducted using the method of continuous statistical analysis using specially developed statistical data sheets, where data was entered from the official primary statistical documentation of state medical organizations of Irkutsk region. Over the eleven years, the coverage of the population of the region by doctors fell by almost 10%, however, during the same period, the reduction in the number of physicians' persons reached almost 15%. Only every fifteenth doctor works in the rural territories. The proportion of physicians who don’t have a qualification category continues to increase. In-depth analysis made it possible to identify leading and lagging territories in terms of the most important indicators characterizing the staff potential, including in the context of individual medical specialties. The revealed decrease in the level of provision of the population of the region by doctors became a consequence of an even more significant reduction in the number of physicians' persons, but was masked by a decrease the population of the region.Результаты анализа медицинских кадров, особенно, врачей, имеют высокую актуальность для процесса принятия управленческих решений организаторами здравоохранения различного уровня, востребованы выпускниками медицинских ВУЗов и молодыми специалистами, приходящими в отрасль, небезынтересны ученым в сфере общественного здоровья. В связи с этим, проанализированы показатели, характеризующие врачебные кадры государственных медицинских организаций Иркутской области в разрезе муниципальных образований и важнейших специальностей в динамике. Исследование проведено методом сплошного статистического анализа с использованием специально разработанных статистических карт, куда вносились данные из официальной первичной статистической документации государственных медицинских организаций Иркутской области. За одиннадцать лет показатель обеспеченности населения области врачами снизился почти на 10%, однако за этот же период сокращение количества физических лиц врачей достигло почти 15%. При этом лишь каждый пятнадцатый врач работает на селе. Продолжает возрастать показатель удельного веса врачей, не имеющих квалификационной категории. Углубленный анализ позволил выявить лидирующие и отстающие территории по важнейшим показателям, характеризующим врачебные кадры, в том числе, в разрезе отдельных специальностей. Выявленное снижение показателя обеспеченности населения области врачами стало следствием еще более существенного сокращения количества физических лиц врачей, однако «скрадывалось» снижением численности населения региона

Scientific evaluation of the personnel potential of primary health care assistance medical organizations of the large industrial region (on the example of the Irkutsk region)

For the purpose of a scientific assessment of the staff potential of medical organizations in a large industrial region providing primary health care (PHC), the capacity of outpatient and out-patient clinics and emergency medical stations, the provision of the population with physicians and nurses and other key indicators, characterizing the staff of the primary health care system for the period 2013-2017 has been studied. In the context of municipalities, the population of the region has been provided with physicians of the main specialties – district therapists and pediatricians. The provision of the population with medical personnel employed in the PHC has slightly increased. High their coefficient of part-time, especially among physicians, continues to be. In the structure of qualification characteristics of employers in medical organizations providing PHC, persons without a qualification category prevail, and their share increases. The growth of the index of the provision of the population of the studied territory with medical employers of PHC in the last five years is largely due to the reduction in the population, while the availability of the most sought-after primary care physicians – district therapists and pediatricians – declined slightly during this time. The magnitude and dynamics of these indicators differ significantly between municipalities, reaching a critically low level in a number of territories.С целью научной оценки кадрового потенциала медицинских организаций крупного промышленного региона, оказывающих первичную медико-санитарную помощь (ПМСП), на примере Иркутской области изучены мощность амбулаторно-поликлинических учреждений и станций скорой медицинской помощи, обеспеченность населения врачами и средним медицинским персоналом и другие важнейшие показатели, характеризующие кадровый потенциал первичного звена системы здравоохранения за период 2013-2017 гг. В разрезе муниципальных образований изучена обеспеченность населения региона врачами основных специальностей – участковыми терапевтами и педиатрами. обеспеченность населения медицинскими работниками, занятыми в первичном звене, незначительно возросла. Высоким продолжает оставаться их коэффициент совместительства, особенно у врачей. В структуре квалификационных характеристик работников медицинских организаций, оказывающих ПМСП, преобладают лица без квалификационной категории, причем их доля возрастает. рост показателя обеспеченности населения изученной территории медицинскими работниками первичного звена за последние пять лет во многом обусловлен сокращением численности населения, при этом обеспеченность наиболее востребованными в первичном звене врачами – участковыми терапевтами и педиатрами за это время незначительно сократилась. Величина и динамика данных показателей существенно различаются между муниципальными образованиями, на ряде территорий достигая критически низкого уровня

Sociological assessment of the adherence of young doctors to the chosen Profession

A sociological assessment was made of the adherence of doctors of the Irkutsk region, the issue of work experience in medical organizations up to three years inclusive, to the chosen profession. Also, the factors determining it, including the motives for choosing a specialty and the place of employment for beginning doctors, were studied. The survey was conducted in medical organizations of the Irkutsk region, where young specialists were concentrated. It was found that the main reasons for choosing a future specialty, as well as for finding new doctors, are the demand for the chosen line of activity, the level of remuneration and social support measures expressed in additional financial support, which, however, young specialists are not satisfied. The results of the questionnaire testify that at the stage of employment with doctors there was poorly organized work on their labor adaptation, including, professional development, supervision or acceptance for the position as an intern. Many of the young specialists performed in the first months of work not reduced, but increased amounts of workload. The level of wages of many beginning doctors remains relatively low, as a result, almost 40% of respondents are not satisfied with the level of wages. It is extremely unfavorable that, according to the most optimistic estimates, approximately every fourteenth of the young professionals surveyed negatively views their current professional activities, and every twentieth plans to change either the place of work or the profession.Была произведена социологическая оценка приверженности врачей Иркутской области, имеющих стаж работы в медицинских организациях до трех лет включительно, к выбранному направлению профессиональной деятельности. Также были изучены обусловливающие ее факторы, включая мотивы выбора специальности и места трудоустройства начинающими врачами. анкетирование проводилось в медицинских организациях Иркутской области, где были сосредоточены молодые специалисты. Было установлено, что основными мотивами как при выборе будущей специальности, так и при трудоустройстве начинающих врачей являются востребованность выбранного направления деятельности, уровень оплаты труда и меры социальной поддержки, выражающиеся в дополнительном финансовом обеспечении, которыми, однако, молодые специалисты не удовлетворены. результаты анкетирования свидетельствуют, что на этапе трудоустройства с врачами была слабо организована работа по их трудовой адаптации, в том числе, повышение квалификации, кураторство или принятие на должность в качестве стажера. Многие из молодых специалистов выполняли в первые месяцы работы не пониженные, а повышенные объемы нагрузки. Уровень заработной платы многих начинающих врачей остается на относительно низком уровне, в результате почти 40% опрошенных не удовлетворены уровнем оплаты труда. Крайне неблагоприятным является тот факт, что по самым оптимистичным оценкам, примерно каждый четырнадцатый из опрошенных молодых специалистов негативно относится к своей текущей профессиональной деятельности, а каждый двадцатый планирует сменить либо место работы, либо вообще сферу деятельности