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Scientific journal «Current problems of health care and medical statistics»
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CYSTIC FIBROSIS: PROBLEMS IN ORGANIZING MEDICAL CARE FOR PATIENTS AND WAYS TO RESOLVE THEM

Kondratyeva E.I.1, Sherman V.D.1, M.A. Ivanova2, O.I. Sachek2, V.V. Liutsko2
1. Federal State Budgetary Scientific Institution Research Centre for Medical Genetics, Moscow, Russia
2. Central Research Institute of Organization and Informatization of Health Care, Ministry of Health of Russia, Moscow, Russia
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Summary:
Cystic fibrosis is a systemic genetic disease with an autosomal recessive type of inheritance, characterized by a multi-organ nature of lesions. The life expectancy of patients is mainly determined by the severity of the chronic bronchopulmonary process, the presence of chronic respiratory tract infection. According to the "Register of patients with cystic fibrosis in Russia for 2017", which includes 81 subjects of the Russian Federation, the total number of patients with CF is 3096 people. Outpatient care is the basis for active follow-up of patients with cystic fibrosis. The purpose of the study: to determine the weighted average cost of working time of pediatricians, pulmonologists, dietitians, physical therapy doctors when visiting one patient with cystic fibrosis. Materials and methods: data from photochronometric observations of the work process of 2 pediatricians (pulmonologists), 2 internists (pulmonologists), dietitians, 2 kinesotherapy specialists (a doctor in physical therapy and a specialist with higher (non-medical) education (a methodologist instructor in physical therapy) who provide medical care to patients with cystic fibrosis, conducted within 10 working days. To conduct the study was adapted to the special computer program "Calculation of standard time and workload of the medical staff" entry in the database results fotohronometra research workflow specialists. The computer program has state registration in the Federal service for intellectual property ("Rospatent") no. 2016663650 dated 13.12.2016. Results. The largest share of working time spent by pediatricians (pulmonologists) who provide outpatient medical care to children with cystic fibrosis when visiting one patient by type of activity falls on the main activity (54.4%), work with documents (25.6%); pulmonologist (therapist)-on the main activity (47.8%), work with documents (30.8%); dietitian-on the main activity (72.4%), then work with documents (16.5%); a doctor in physical therapy or a specialist with higher (non-medical) education (instructor-Methodist in physical therapy) - basic (66.4%) and auxiliary (23.1%). The cost of working time per visit by a patient with cystic fibrosis to a specialist doctor was: a) General practitioner (pulmonologist) for adult patients – 119 minutes; b) pediatrician (pulmonologist) for children-112 minutes; C) rehabilitation doctor – 96 minutes; d) dietitian - 114 minutes. Conclusion. The establishment of new standards of time for visiting specialists by one patient will significantly improve the quality of medical care for patients with cystic fibrosis, primarily at the outpatient stage, which will undoubtedly affect the quality and life expectancy of patients, significantly reduce the need for hospitalization of these patients, and allow more rational use of labor and human resources. At the same time, it should be noted that changes in the workload of medical specialists who provide medical care to patients with cystic fibrosis will inevitably lead to changes in the staffing table, which will entail the need to adjust the funding of medical organizations to ensure adequate remuneration for specialists.
Keywords cystic fibrosis, medical specialists, photo-timing studies, working hours, weighted average time

Bibliographic reference:
Kondratyeva E.I., Sherman V.D., M.A. Ivanova, O.I. Sachek, V.V. Liutsko, CYSTIC FIBROSIS: PROBLEMS IN ORGANIZING MEDICAL CARE FOR PATIENTS AND WAYS TO RESOLVE THEM // Scientific journal «Current problems of health care and medical statistics». - 2020. - №4;
URL: http://healthproblem.ru/magazines?textEn=560 (date of access: 18.04.2024).

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