The article analyzes the main changes in health care over the past five years, using an institutional approach (Richard Scott). The survey based on in-depth interviews with physicians, focus groups with patients in three types of cities in Russia (large, medium and small), as well as data on the mass survey of physicians and the public.
Summing up the consideration of the positions of key system participants it can be concluded that there is a clear imbalance of resources, obligations and responsibilities, in particular, to medical institutions and healthcare providers. Ongoing transformation of institutional rules in 2012-2016 was mainly motivated by economic logic, which does not coincide with the logic of consumers (patients) and professional institutional logic (doctors). Imperfection of the state healthcare system is compensated by doctors who give priority to professional standards moving away from formal rules encouraged by the current system. Reproduction of «old» norms applies only to the most qualified specialists; young professionals are more susceptible to following formalist approach
The article deals with determining the zones where it would be reasonable to use robotic-surgical systems (complexes) in conducting abdominal operations (liver surgery). It is not only the economic interests of a clinic, but the safety and the health of a patient that are regarded as criteria for optimality, as well as convenience and fatigability level of medical personnel. The article is based of the content analysis (CA) of the publications relating to the description of respective medical cases.
Worksite wellness programs have become very popular in developed countries. They produce benefits to employees, employers and the whole society by providing ways to change behaviors associated with risk factors (such as smoking, alcohol consumption, poor diet, physical inactivity, stress etc.). Workplace wellness programs are viewed as investment in human capital. That’s why in many countries worksite wellness programs are supported by federal and regional authorities. While Russian government understands the importance of healthy lifestyle, employees- sponsored health programs have not seen any significant support by now. The article therefore describes the benefits associated with worksite wellness programs; examines the ways authorities promote such programs in developed countries (e.g. tax allowances, grants, special initiatives to help small and medium enterprises, national health programs, pilot projects, and a wide range of measures aimed at providing enterprises with information about best practice examples). After studying evidence from developed countries we discuss what health policy initiatives could be taken in Russia in order to promote worksite wellness programs
High cost of robotized complex and expendables is significant difficulty for its acquisition and introduction of robot-assisted operations. Critical estimation of economic aspect is necessary for further development of robot-assisted surgery in our country. Because of robotic variant is alternative to laparoscopic technique we assessed the prime cost of robot-assisted and laparoscopic operations. The results may be used to assess recovery of expenses by state for high-technology care in clinic and to increase volumes of high-technology care using robotic techniques.
The article addresses the understudied phenomenon of digital quantification of the body and everyday life, which has arisen due to the spreading of wearable and mobile fitness technologies. The author reviews a number of recent studies which have contributed significantly to the conceptualization of digital self-tracking. Examining various approaches and directions in the study of self-tracking the author focuses on three aspects: a) on the manifestations and discourses of self-tracking; b) on its styles and practices; and c) on its social contexts and effects. The works under review show how trackers of physical and social activities can transform people’s everyday practices and how users interact with fitness technologies, interpret quantified data and construct their own embodied identity. Importantly, the efficiency of self-tracking tools is associated with their “sociability” and “intelligence” — the qualities achieved through anthropomorphization of digital devices and creating a culture of sharing. It is also underscored that the practice of self-tracking goes beyond individual experience, actively invading other social worlds, and may eventually become an inherent feature of a “sensor society”. Summarizing the outcomes of current research, the author comes to a conclusion that further conceptualization of digital self-tracking must take into account its complex and multi-vector nature. On the one hand, self-tracking is productive, as it contributes to broadening the possibilities for self-knowledge and self-management, on the other hand, it can have disciplining, discriminating, coercive and alienating effects.
The paper presents results of a comprehensive analysis of the cardiovascular diseases (CVD) situation, both in the global and Russian contexts. It introduces original data illustrating the declining mortality rate from CVD, and the diminishing contribution of these diseases to overall mortality rate — globally and, to a larger extent, in developed countries. The paper also analyses the reasons for continuing CVD epidemic in Russia. Based on factual evidence, it argues that those include insufficient expenditures on treating CVD patients, and critically inadequate funding of prevention programmes. Unsatisfactory use of these funds to subsidise Russian regions (without taking into account their actual needs determined by the CVD mortality rate) only makes the problem worse. Through modelling, “average” efficiency of the Russian health care system in reducing CVD mortality was revealed. The paper describes various scenarios for future development of the Russian CVD situation. In the context of innovation-based scenario, the advantages of technological foresight are analysed; specifically, the authors summarise major S&T development trends in the health sector (using data of the Russian S&T Foresight 2030), which could significantly contribute to stopping the CVD epidemic in Russia.
The article presents an analysis of the demographic losses from the main causes of death in Russia, in the Republic of Bashkortostan and in OECD countries. Based on analysis of the numbers of deaths and potential years of life lost (PYLL), there was shown the position of external factors in the structure of total mortality in these regions. Although the number of deaths from external causes in both sexes before age 70 was on the 2nd place in 1992-2012 and in all ages one became on the 3rd place since 2006, in terms of PYLL premature loss from these causes had become the biggest threat to public health at least since 1990. There were specified peculiarities of calculation of the PYLL according to the methodology of the Organisation for Economic Cooperation and Development (OECD). The basic conditions of the reduction of mortality from external causes are considered: the formation of vital behaviors among the population, creating a safe environment, an increase in expenditure on health care. Because almost all of the external causes of death are preventable, preventive measures play a major role in the limiting of risk factors, so Russian health system approach should be aimed not only on treatment but first of all on prevention. In addition, there were shown the analytical capabilities of the Haddon Matrix in the classification of the main factors of risk of death from external causes on the example of the suicide.
The article discusses the current state of psychological research problems of smoking. Consideration of this issue is conducted at three levels of study: macro-, micro-social and personal. The factors contributing to the smoking initiation are being discussed. Socio-psychological characteristics affecting the process of smoking initiation are considered in the article.