Category: Statistics

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Jul;29(4):957-962. doi: 10.32687/0869-866X-2021-29-4-957-962.

ABSTRACT

In accordance with the Russian Federal Law No. 350 of January 2019 the retirement age for Russians is increased for men from 60 up to 65 years, for women from 55 up to 60 years that requires implementation of organizational technologies of health-preserving, promotion of life and labor potential of population of late able-bodied age. In this regard, the role of day hospitals (DH) functioning directed at maximal possible prolongation of autonomous life and working capacity of elderly population increases. Besides, DH also presents additional reserve of optimization of medical care costs. The purpose of the study is to elaborate guidelines of improving activities of DH for population of late able-bodied age, for the purpose of preventive hospitalization. The study was organized on the basis of pilot medical organization of the Moscow Oblast, consisted of hospital of 600 beds and day hospital of 120 beds. The methods applied included sociological survey, expert judgment, statistical direct observation. The primary data was obtained from the forms of federal and sectorial statistical monitoring for 2014-2018. The analysis of medical documentation concerning pilot medical organization functioning during the year of the study was applied. The sociological surveys of patients of late able-bodied age (5 years before retirement according to the new legislation – men 60-65 years old, women 55-60 years old) who received treatment in day hospital. The results. The analysis of main indices of round-the-clock functioning in-patient and day hospitals in the Russian Federation in 2014-2018 established trend towards improvement of using hospital beds due to development of day hospital. However, bed capacity of hospitals is used ineffectively and experts assume that more than 1/3 of patients could receive medical care or aftercare in day hospitals. The experimental study of planning hospitalization of patients with chronic diseases at out-patient level demonstrated that 11.5% of population of able-bodied age need planned and preventive hospitalization in day hospital. The cost of treatment of patient with chronic pathology is 2-3 times lower in day hospital than in common hospital at the stage of exacerbation. It is reliable to apply at the out-patient level experience of planning hospitalization of patients with chronic pathology in day hospitals followed by performance control. The organization of functioning of day hospital and common hospital requires particular enhancement, including issues of succession, financing of the DS, the remuneration of medical personnel through effective contract determining interest of physician in early discharge of patient to aftercare in day hospital. The day hospital functioning is to be implemented in 2-3 turns. The day hospital is to be located in detached placement and the departments of base medical institution are to used in fullness. The day hospital is be used more actively for purpose of health preservation of population of late able-bodied age who. This contingent suffers of chronic pathology and is in need of preventive and health-promoting therapy in conditions of day hospital.

PMID:34486865 | DOI:10.32687/0869-866X-2021-29-4-957-962

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Jul;29(4):963-965. doi: 10.32687/0869-866X-2021-29-4-963-965.

ABSTRACT

The enhancement of organization of palliative medical care to increase life quality of terminally ill patients is one of directions of development of health care system. To elaborate measures of improving accessibility and quality of palliative medical care, it is necessary to apply single unified methodology of calculating indices and criteria. One of them is provision of bed capacity. The purpose of the study is to elaborate methodology of calculating control indices of provision population with beds to render palliative medical care. The indices are calculated on the basis of statistical processing of monitoring corresponding data in the subjects of the Russian Federation.

PMID:34486866 | DOI:10.32687/0869-866X-2021-29-4-963-965

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Jul;29(4):971-976. doi: 10.32687/0869-866X-2021-29-4-971-976.

ABSTRACT

The common coding of main diagnosis (so-called “manual coding”) is accompanied by quite many errors associated with inobservance of classification algorithm and subjective causes that in statistical morbidity and mortality data corruption. The article presents the results of implementing automated system of diagnosis coding by the ICD-10 in the departments of the Medicosanitary Unit of MVD of Russia in City of Moscow. The functional and time losses and the error rate were studied under manual coding and automated coding system. In case of common coding of complete clinical diagnosis of one discharged patient per day, it takes from 5 to 15 minutes, for coding diagnoses of all discharged patients – about 1 hour. The number of errors in common coding made up to 14.1% (n=2472) and in case of automated coding it made up to 1.5% (n= 63, p>0.05). The application of automated coding system in medical organizations ensures exact correspondence of clinical and statistical diagnosis, unifies wording of clinical diagnosis, minimizes subjective deviations from algorithm of the ICD-10.

PMID:34486868 | DOI:10.32687/0869-866X-2021-29-4-971-976

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Jul;29(4):904-908. doi: 10.32687/0869-866X-2021-29-4-904-908.

ABSTRACT

This article discusses clauses of national standards compatible with international standards of ISO 9000-9001 family,in section of measurement of degree of satisfaction of patients with medical services quality. The main methods applied are sociological survey SERVQUAL focused on measurement of degree of satisfaction of patients, GAP-analysis (identification of discrepancies and gaps) and technique of management decision-making concerning improvement of medical services quality. The SERVQUAL survey with its five qualitative criteria was applied. The primary data was obtained from sampling of 500 well structured questionnaires. In total, 365 respondents participated in the study. The produced correlation matrix confirmed strong relations between criteria estimating expected and interpreted quality of medical services and full average interpreted quality. The analysis of reliability confirmed that questions of questionnaire are reliable and the results of statistical calculations can be used in further analysis. The analysis of descriptive statistics, correlation matrix, patient profile, reliability and qualitative GAP analysis were carried out. The requirements of assuring reliability and adequacy of questionnaire, representativeness of sample size to carry out high quality measurements were kept. The results on every criterion were obtained. The qualitative results of discrepancy of and perceptions of patients are received. The negative values of indices of discrepancy of the interpreted and expected outcomes of medical services are received. The level of satisfaction of patients remains insufficient. The study proposes to improve quality of medical services in hospital, especially by criterion “Materiality” to justify expectations of patients. The results of the study are of practical importance for executives of regional health care administrations, head physicians of medical organizations engaged in improvement of medical care quality and increasing of efficiency of medical services.

PMID:34486856 | DOI:10.32687/0869-866X-2021-29-4-904-908

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Jul;29(4):951-956. doi: 10.32687/0869-866X-2021-29-4-951-956.

ABSTRACT

The characteristics of development of vascular lines are important for development and improvement of of surgical treatment, decreasing risk of complications and development of personalized approach to treatment of patients. The purpose of the study is to reveal prevalence of different variants of development of common carotid artery bifurcation and to assess their significance for clinical medicine. The sample included 70 volunteers of average age 43.4 ± 10.7 years. The 3D reconstructions of MRI data 1.5 T Brivo 355 were evaluated. The observation data was grouped and processed using software Microsoft Excel 2007 and IBM SPSS Statistics 20. To summarize the data, 5 main variants of location of great vessels were identified. The most rare types of development and course of carotid arteries in bifurcation area were variants “II” and “III” (8.2% of all observations). The most common development options were “I” (51.4%) and “IV” (31.4%). The variants “I” and “IV” were determined relatively evenly.The variants “II” and “III” were found on the right in 60% and 66.7% correspondingly and “V” option was found on the left in 61.5%. The typical options of location of carotid arteries near the bifurcation (variants “I” and “IV”), 82.8% in total. The cases of ventral position of external carotid artery (variants “II” and “V”) were established in 12.9%. The variant III was found in 4.3% of all cases. The distribution of vascular development options depending on the gender of patients was investigated. The study did not reveal significantly pronounced deviations in distribution of variants of vascular development, taking into account the age factor. The mentioned data permits to judge with confidence about necessity of developing personalized treatment of diseases of carotid arteries, considering their anatomical features of development in bifurcation area.

PMID:34486864 | DOI:10.32687/0869-866X-2021-29-4-951-956

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Jul;29(4):865-870. doi: 10.32687/0869-866X-2021-29-4-865-870.

ABSTRACT

The article presents results of comparative analysis of morbidity and mortality of diseases of circulatory system in the Republic of Buryatia in 2003-2018. The population mortality depends on identification of risk factors for cardiovascular diseases, diseases of circulatory system and subsequent coverage of population with medical care, including dispensary monitoring. The analysis was based on data from State statistical reporting forms and official data of the Territorial Board of the Federal State Statistics Service in the Republic of Buryatia, including the form № 12 “The information on number of diseases registered in patients residing in area of medical organization servicing activity”; the form № 025-12/s “The Out-Patient Registration Card”; the form № 25-2/y “The Statistical Coupon for Final (updated) Diagnosis Registration”. The study was carried out using statistical, analytical and comparative analysis methods. Currently, in the Republic of Buryatia, diseases of circular system occupying second place in the structure of total morbidity (15.7%) and primary disability of adult population (28.6%) are among leading cause of total population mortality (41.6%).

PMID:34486850 | DOI:10.32687/0869-866X-2021-29-4-865-870

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Jul;29(4):871-876. doi: 10.32687/0869-866X-2021-29-4-871-876.

ABSTRACT

In The Russian Federation, increasing of life expectancy and decreasing of mortality related to diseases of circulatory system are the priorities of state policy. The purpose of study was to develop approaches to the classification of cardiovascular diseases by severity degree within the framework of development of general health management model based on health care activities at the regional level. The article describes methodology of calculating indices of cardiovascular diseases severity based on statistical data of appealability for out-patient, in-patient and emergency medical care. The set of balancing coefficients reflecting input of rate of accessing for various types of medical care, as well as aggravating input of concomitant pathology, based on expert evaluation of cardiologists involved is presented. On the basis of analysis of distribution of severity index in standard region of the Russian Federation, the system of criteria was developed to classify cardiovascular diseases (according to ICD-10 sub-classes) on four degrees of severity. The approbation of the proposed method demonstrated adequacy of the results obtained to judging of experts (cardiologists). So, in standard region of the Russian Federation, in the class of diseases of circulatory system (I00-I99), 79.6% of all cases are of first degree of severity, 8.6% of cases are of second degree of severity, 3.8% of cases are of third degree, and 8% of cases are of fourth degree. The methodology is unified and can be applied to classify entire spectrum of diseases by degree of severity. Besides, the proposed methodological approaches are suitable to be applied in population health management at the municipal, regional and national levels in the Russian Federation.

PMID:34486851 | DOI:10.32687/0869-866X-2021-29-4-871-876

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Jul;29(4):831-836. doi: 10.32687/0869-866X-2021-29-4-831-836.

ABSTRACT

The article describes, on the basis of the results of content analysis of posts and comments in social networks, the actual situation with coronavirus infection including its overcoming, security maintaining, possibility of risks and threats occurrence and acceptance/refusal of vaccination as well. The desk research technique was applied to analyze documents and publications of the WHO, live data from national resource www.стопкоронавирус.рф, statistical information, results of sociological surveys of leading sociological companies.It is demonstrated that how the situation concerning coronavirus and vaccination issues in various Russian regions changed, including causes of different dispositions of residents. Three stable social groups were identified, provisionally designated as optimists, moderate and pessimists. The classification is based on differences in assessment of the epidemiological situation.

PMID:34486844 | DOI:10.32687/0869-866X-2021-29-4-831-836

Int J Clin Pract. 2021 Sep 6:e14801. doi: 10.1111/ijcp.14801. Online ahead of print.

ABSTRACT

AIM OF THE STUDY: Multiple sclerosis (MS) is a degenerative disease characterized by autoimmune demyelination in the central nervous system. Yet, underlined genetics or environmental markers are still controversial. The impact of vitamin D and cholesterol on disease activity has been phrased by many studies, however, the data available for the Turkish population is very limited. Here, it is aimed to investigate the effect of vitamin D-related polymorphisms (VDBP and VDR) and cholesterol-related variants of ApoE on Turkish MS patients.

MATERIALS & METHODS: Total DNAs were extracted from peripheral blood samples of fifty-one MS patients and fifty healthy volunteers. rs4588 and rs7041 polymorphisms of VDBP, rs2228570 of VDR, as well as ε2, ε3, and ε4 variants of ApoE, were investigated by RT-PCR. Biochemical parameters which thought to be associated with MS were also measured. Results were evaluated statistically.

RESULTS: Homozygous mutant genotype and G allele of rs2228570 in VDR, as well as heterozygous genotype of rs4588 in VDBP, were found statistically high in patients. Total cholesterol, triglyceride, and LDL-C levels were found significantly high whereas HDL-C and vitamin D levels were low in patients. An association was found between rs4588 variation and high triglyceride levels. Similar correlations were found between ε2 genotype and low LDL-C level; ε3 genotype and higher LDL-C. Gender, triglyceride, HDL-C, and AA genotype in rs4588 had a significant effect on MS progression.

CONCLUSION: The variations of rs2228570 and rs4588, vitamin D deficiency, and biological parameters related to cholesterol metabolism may be associated with MS risk.

PMID:34486787 | DOI:10.1111/ijcp.14801

Se Pu. 2021 Sep;39(9):1006-1011. doi: 10.3724/SP.J.1123.2021.06022.

ABSTRACT

Currently, guanosine, adenosine, and uridine contents are specified as the quality criteria for related products in the quality standards for fermented Cordyceps powder preparations included in the 2020 edition of Chinese Pharmacopoeia. However, there are many other nucleosides in fermented Cordyceps powder, whose effect on the quality control has not yet been discussed. In this study, an ultra-performance liquid chromatography-ultraviolet detection (UPLC-UV) method was used for the quantitative analysis of 9 nucleosides (uracil, cytidine, guanidine, uridine, adenine, inosine, guanosine, thymidine, and adenosine) in 19 batches of fermented Cordyceps powder samples and products, and the corresponding fingerprints were established. In addition, a method for analyzing the index components was proposed based on statistics. By optimizing the sample extraction method, ultrasound-assisted extraction was selected to process 19 batches of samples. Chromatographic analysis was performed on an Agilent Eclipse Plus C18 column (150 mm×4.6 mm, 3.5 μm) using methanol and water as the mobile phases under gradient elution. The method was validated based on the calibration curves, accuracy, precision, repeatability, and recovery. The fingerprints of the 19 batches of samples were established, and 16 common peaks were obtained. Among them, nine nucleoside peaks were identified by standards, and their concentrations were determined by the external standard one-point method. Similarity evaluation of the fingerprints was conducted; the similarities of the 19 batches of samples were greater than 0.9. Then, chemical pattern recognition was performed. The same classification results were obtained by hierarchical clustering analysis (HCA) and principal component analysis (PCA). Thus, the samples could be segregated into five classes, and the fermented Cordyceps powders were classified as two types with different fermentation processes. Xinganbao capsules, Bailing capsules and Ningxinbao capsules were each separately classified into one class. This indicated that the chemical recognition pattern could effectively distinguish between the fermented Cordyceps powder and different products. PCA was used to calculate the weight value of each common peak for the first time, and the index components among the samples were selected according to the weight value. Finally, the selected index components were used to re-cluster the samples. The results were consistent with those obtained on the basis of the 16 common peaks, thus verifying the rationality of the index components. Therefore, uridine, guanosine, adenosine, adenine, and uracil are recommended for use as evaluation indicators for fermented Cordyceps powder and products, allowing for better distinction between the products on the market. In summary, the combination of liquid chromatographic fingerprints and chemical pattern recognition can provide a simple and reliable method for the analysis and quality control of fermented Cordyceps powder and products.

PMID:34486840 | DOI:10.3724/SP.J.1123.2021.06022