[A comprehensive evaluation of the management effectiveness in a multi-specialty hospital]. / Kompleksnaia otsenka éffektivnosti v upravlenii mnogoprofil'noi bol'nitsei.

The medical-and-economic efficiency, involving the traditional, newly designed and tested methodic approaches, was evaluated in respect to 19 inhospital department of a multidiscipline hospital in the city of Yekaterinburg. A necessity was proven to use the integral indices in assessing the medical efficiency. The economic and medical efficiencies were found to coincide in 62.5% of cases, which is indicative of that it is not always the case, when the amount of the spent means directly influence the activity output. The study results showed that the technology of integral assessments of the medical-and-economic activity efficiency enables the hospital's manager to define the best and worst functioning units and to make subsequently the appropriate correcting managerial decisions.

[Economic problems of a regional hospital under conditions of the development of medical services market]. / Ekonomicheskie problemy oblastnoi bol'nitsy v usloviiakh razvitiia rynka meditsinskikh uslug.

Administration of hospitals has to organize their activities under conditions of limited financing. Improvement of the efficiency of finances utilization is the subject of financial policy of an institution, which adapts to changes in the mechanism of Russian public health functioning.

[Main principles of rapid diagnosis and intensive care in emergency states: their realization in expert systems]. / Osnovnye printsipy ékspress diagnostiki i intensivnoi terapii neotlozhnykh sostoianii: ikh realizatsiia v ékspertnoi sisteme.

A retrospective analysis of 543 case histories over 1980-1990 in the town of Yekaterinburg and analysis of published data permitted the authors to single out the signs characterizing the most frequent syndromes requiring urgent intensive care. By either diagnostic value, these signs are distributed into main, accessory, and ruling out. An expert system has been created, making use of the productive-Freimont's approach to representing information on the basis of blurred multiplicities and ambiguous logics. The diagnosis was made by stages: first the main signs were analyzed, determining the severity of patient's status, then (after first aid was rendered) accessory and ruling out signs, which help make the diagnosis more precise. The system was tried in 231 patients, 102 of these with acute respiratory failure, 63 with acute hemodynamic insufficiency, and 66 with acute cerebral insufficiency. Primary diagnosis of the underlying syndrome was correct in 87-89% of cases, of the concomitant syndrome in 92-97%. Repeated evaluations (in 1-3 and 24 h) taking account of the time course of the symptoms and of the results of unsophisticated instrumental examinations increased the share of correct diagnoses to 92-96%.

[Postoperative peridural analgesia with morphine, fentanyl and dipidolor]. / Posleoperatsionnaia peridural'naia anal'geziia morfinom, fentanilom i dipidolorom.

The experience with peridural analgesia used in the postoperative period in 183 patients has shown advantages of morphine, phentanyl and dipydolor over routine methods of analgesia. The peridural injection of the drugs mentioned has been shown to give a longer analgetic effect than local anesthetics, to facilitate stabilization of hemodynamics in the postoperative period.