Vol 21, No 3-4 (2018)

In the article is represented the analysis of the primary and repeated disablement of adult population on the classes and the separate diseases in g. To Moscow in 2017-2018 the yr., which showed that an increase in the dynamics of the number of persons VPI the decrease of the number PPI. In the structure VPI the leading positions occupied the invalids as a result of the diseases of the system of blood circulation with the decrease of their specific weight; as a result of the malignant new formations with an increase in their specific weight; as a result of the diseases of osteomuscular system and connective tissue with the decrease of their specific weight and invalids as a result of the mental disorders and the disorders of behavior with the tendency of an increase in their specific weight. In the dynamics was noted a decrease of the portion of invalids as a result of the diseases of nervous system, diseases of endocrine system, tuberculosis, consequences of injuries and poisonings and an increase in the specific weight of invalids as a result of the diseases, caused HIV, the diseases of eye and its additional apparatus, diseases of ear and mammiform branch, diseases of the organs of respiration and urino-genital system. In the structure PPI the leading nosologic forms were the diseases of the system of blood circulation with the decrease of their specific weight, an increase in the portion of malignant new formations, mental disorders and disorders of behavior, the decrease of the portion of invalids as a result of the diseases of osteomuscular system and connective tissue, by an increase in the share of the diseases of nervous system. In the dynamics was noted a insignificant increase in the portion of invalids as a result of tuberculosis, diseases, caused HIV, diseases of eye and its additional apparatus, diseases of ear and mammiform branch and decrease of the specific weight of invalids as a result of the diseases of endocrine system, diseases of the organs of respiration, digestion, consequences of injury and poisonings.

The article is devoted to an important problem - the evaluation of all the criteria for the quality of medical care provided in the clinic of the Children’s Scientific and Clinical Center for Infectious Diseases, from the standpoint of the independent opinion of patients and persons caring for patients in this institution. With the help of specially developed questionnaires, posted, including on the Institute’s website, a survey of patients and persons caring for children was conducted. Estimating the information availability it is established that according to the results of the survey 92% of respondents are satisfied with the completeness of the information provided on the Internet. Only 23.2% paid attention to the media, placed directly in the clinic. 3.5% of respondents were not satisfied with the equipment of the clinic with equipment for people with disabilities, and 56% - did not provide an answer to this question. A significant proportion of the respondents (91.4%) noted the high competence of all medical personnel, and 96.1% indicated that the medical staff was polite and benevolent. Materially thanked medical personnel for the assistance rendered by almost a quarter of respondents (24.1%). At the same time, it is important to emphasize that the absolute majority (96.8%) of the respondents expressed material gratitude on their own initiative. 14.2% of the respondents paid for additional diagnostic tests, but more than half of the respondents in this group (52.8%) paid for these studies in order to more accurately verify the diagnosis, ie, these studies were not prescribed in the procedures and standards of medical care. In conclusion, it is important to note that, in general, the interviewed people would recommend treatment in the clinic of the Children’s Scientific and Clinical Center. This fact is indicated by the results of the survey - 98.4% of the respondents confirmed this fact.

The article analyzes the structure of disability due to eye diseases, taking into account the nosological form in Moscow for a retrospective analysis the paper used the data form № 7-SBEs, statistical collections of the Federal Bureau of medical and social expertise of the Ministry of labor of Russia and statistical collections of Rosstat. The unit of observation for the first time and re-recognized as disabled due to diseases of the eye. The research is complete. Statistical processing of the study data was carried out using the software Statmed - 2010. The analysis of the contingent of disabled people showed that the largest proportion of disabled people were due to glaucoma (36%), the second place in the structure of disability is retinal disease (31%), the third place is degenerative myopia - (17%), the fourth place - diseases of the optic nerve (10%) and the fifth place - disabled due to corneal pathology (3%).

The article presents the results of the analysis of the long-term dynamics of indicators of primary disability due to malignant neoplasms of the adult population in the Russian Federation. The study volume was 1919677 people aged 18 years and older. An increase in the share of newly recognized disabled people (VPI) in the structure of the total number of VPI as a result of all diseases from 17.6% in 2008 to 32.4% in 2017 (an average of 24.2% per year) was found. In the structure of the primary disability due to ZNO, elderly and middle age IDDs prevail. The level of primary disability among the middle-aged population is decreasing, while among the young and elderly age segments, is increasing. The structure of primary disability due to ZNO by severity is characterized by the predominance of VPI II and I groups of disability with a lower proportion of VPI III group. It has been established that in the Russian Federation there is a regional differentiation of subjects according to the level of disability due to EIT, which allows us to identify regions with an unfavorable situation and the need to optimize measures for primary and secondary medical and social prevention and rehabilitation.

The article presents the results of a study of the dynamics of recurrent disability due to malignant neoplasms (ZNO) of the adult population in the Chechen Republic for the period 2008-2017. in comparison with the figures for the Russian Federation. In the Russian Federation, the dynamics of re-disability of the adult population due to the ZNO in the period 2008-2017 was characterized by an increase in the number of repeatedly recognized disabled (PPI), the level of which increased from 19.9 to 27.0 per 10 thousand people. Compared to 2008 (taken as 100%), the indicator of visibility of PPI was 135%. In the PPI contingent, the elderly prevailed with a negative trend of growth in their numbers. The proportion of young and middle-aged PPI decreased. In the Chechen Republic, the epidemiological picture of the disability of the adult population due to the ZNO was characterized by different dynamics. The number of PPI due to ZNO in the country decreased. Compared to 2008 (taken as 100%), the visibility index of the PPI was 57.0%; In the structure of recurrent disability due to ZNO, middle-aged and old-aged PPI prevailed, however, their proportion declined. There is a negative growth trend in the proportion of young people.

Drug reimbursement is one of the key elements of the effective health care system. The introduction of mechanisms to optimize the cost of drug provision can significantly reduce the costs of the state budget, expanding the availability of therapy and reducing long-term economic losses due to disability of the working population. The article analyses the specifics of drug provision programs in various regions of the world to determine the best practices for the purpose of subsequent introduction in the Russian Federation.

The article presents the results of comparison of the final clinical and forensic diagnoses in cases of deaths of patients with suspected poisoning by chemical etiology on the observations Of the Bureau of forensic medical examination of the Moscow region. We have determined the structure and causes of misdiagnosis and the lack of effectiveness of therapeutic interventions.

Achieving psychological well-being is one of the perspective tasks of psychological rehabilitation of patients with spinal cord injury. The aim of the study is the focusing of psychological factors making the greatest contribution to psychological well-being of the patients. Psychodiagnostic methods were used for the study, the indicators of which characterized psychological well-being, life hardiness, emotional status, and social environment. 50 patients undergoing in-patient rehabilitation were examined. Identified using correlation analysis of the ratio indicate the need for inclusion in the recovery process of psycho-diagnostic measures the diagnosis of the degree of life hardiness (stress resistance), emotional state, social networks and quality of communication, as well as on the diagnosis of motivational states. Understanding the factors that predict psychological well-being of patients with spinal cord injury is an important aspect of their psychological rehabilitation, since they can become foci that determine the intervention of the therapist.