[The financial activity of district hospitals of the Irkutsk general-governorship in the end of XIX century].

The article presents results of the study of archive sources and reference publications. The unknown facts of subsidization of district hospitals of the Irkutsk general-governorship, items and amount of current and supernumerary expenses and sources of financial allocations are revealed. The scope of financial accountability made up by directors and hospital supervisors, office and council of hospitals as well care of charge of patients is impressive. The concrete data concerning food allowance of employees and servants of civilian hospitals and provision of clothing and salaries is presented. The prices of bread, forage and goods permit to evaluate income level of physicians working in the Eastern Siberia. The role of the Department of Public Charity in financing of civil hospitals of the Irkutsk general-governorship in last third of the XIX century is revealed. The article uses terminology corresponding to analyzed time period.

[On fertility of female population of large-scale industrial agglomeration of cities of the Irkutsk Oblast].

The article considers the most important demographic indicator of natural movement of population - the natality. The dynamics of age-specific fertility of female population residing industrial highly urbanized areas of the region is demonstrated. The increase of total fertility was established. The dynamics of common and standardized coefficients of age-specific fertility of female population revealed process of aging (motherhood). However, the cleared, accurate net-coefficient of population reproduction indicates that positive dynamics of general, age-specific fertility ensures only simple character of population reproduction in city of Angarsk. The population of cities of Irkutsk and Shelekhov remains in narrowed character of population reproduction. The special coefficients of fertility make it possible to obtain accurate age-specific qualitative characteristic of fertility of female population and to forecast demographic situation in the region.

[The means of optimization of dispensary monitoring of patients in psycho-neurological dispensary].

The actual direction of improving provision of mental care of population is increasing of efficiency of specialized primary medical sanitary care of patients with mental disorders in conditions of implementation of biopsychosocial model of its realization. The study of mental disorders morbidity demonstrated that qualitative changes occurred in structure of contingents of mental institutions towards decreasing of number of dispensary patients and corresponding increasing of number of patients receiving medical and consultative assistance. The analysis of indicators of movement of contingents with mental disorders testifies decrease in effectiveness of dispensary observation that is confirmed by decrease of rate of de-registration due to recovery, by increase of de-registration due to death, increase in number of suicidal attempts and in disability among patients with mental illness of able-bodied age. It was established that problems in ensuring quality of medical care are conditioned manly by lack of actual organizational and methodological support of dispensary observation of patients, predominance of passive dynamic observation by local psychiatrist. Based on the results of study of organization of functioning of district psychiatrist, medical and organizational measures were developed to improve organization of dispensary observation of patients with mental disorders.

[The comparative evaluation of heterogeneity of urban and rural population aging at the regional level].

The article considers the process of population aging, which is evidently specific in economically developed countries for last quarter of the XX century. The increasing of population size older than able-bodied age in urban and rural population in the Irkutsk Oblast that is demonstrated by aging coefficient dynamic. In all studied territories increasing of this coefficient is revealed that characterizes transition of aging process in most areas of residence of urban and rural population to the level of III-IV stages (old and deeply old population). The dynamics of average age indicator is characterized by its stabilization at the level of stage II as aging population. The pensionary load on urban and rural population is increasing and it is higher in rural population. The increasing of this indicator is reflected in transformation of aging population (stage II) to old and deeply old population (stage III-IV). In most areas, coefficient of longevity is characterized by its increase in urban and rural population. The heterogeneity of aging differences between urban and rural population is smoothing out.

[The Irkutsk department of the Society of struggle with contagious diseases: history of establishment, structure, tasks, sources of financial appropriations].

The article considers chronologies of events of the opening in the city of Irkutsk of the Irkutsk branch of the Society of struggle with contagious diseases, located in St.Petersburg. It is emphasized that socially necessary need for protection against contagious diseases contributed to organization of the Branch of the Society of Struggle with Contagious Diseases. The history of organization of the structure of the Society's branch, the criteria of recruiting the founding members, collaborating members and competing members, including description of their duties are explored. The mechanism of formation of financial allocations and the state of available capital owned by the Branch of the Society are studied. The structure of financial expenses is demonstrated. The role of benefactors and donations collected for needs of struggle with contagious diseases are emphasized. The correspondence of well-known honorary citizens of Irkutsk concerning issues of increasing the number of donations is presented. The objectives and tasks of the Branch of the Society related to struggle with contagious diseases are considered. The necessity of spreading health culture among population to prevent occurrence of contagious diseases is demonstrated. The conclusion is made about progressive role of the Branch of the Society in the Irkutsk Guberniya.

[MEDICAL AND SANITATION PROVISION FOR THE REFUGEES IN THE IRKUTSK PROVINCE IN 1914-1916].

On the basis of the archival documents, the article studies and provides information on the creation of medical and sanitary bodies, public organizations to provide the refugees of the Irkutsk province with medical care in 1914-1916, to carry out comprehensive anti-epidemic measures to combat the emerging epidemics of diseases characteristic of wartime. The study shows the role of medical and sanitary bodies, committees, commissions to ensure the epidemiological well-being of the refugees. The dynamics of an increase in the number of beds, the number of hospitals, the opening of infectious barracks, an increase in financial allocations for the provision of medical assistance to refugees were noted.

The history of becoming of syphilitic hospitals at the North-Eastern outlying districts of Eastern Siberia in XIX century.

In the XIX century, process of joining of the North-East lands to the Russian empire was completed. The syphilis that spread in XVIII-XIX centuries stroke indigenous population of the Eastern Siberia and out-migrants from other territories. The article attempts to highlight little-studied aspects of organization of syphilitic hospitals and medical care of newly come population and non-Russian communities in northern Okrugs of Yakutsk, Kamchatka and Primorye areas of Eastern Siberia. On the basis of archive materials, the investigation was applied to the most important components of organization of medical care of patients with syphilis: the organization of syphilitic hospitals, history of correspondence and decision-making on funding sources, building of yurts, choice of buildings for hospitals, delivery of medications, invitation and appointment of physicians, medical assistants and healers to assist population with medical care. The role of the Irkutsk Prikaz of Public Charity and the Irkutsk Medical Board in this process is noted. The establishment of syphilitic hospitals in outlying territories of Yakutia, Kamchatka and Primorye was the most important onset of struggle with syphilis epidemic in population.

[The historical case of discussion on sanitary anti-epidemic activities during period of revolutionary events of 1917 in Irkutsk].

The article presents analysis of historical case of discussion about organization of anti-epidemic measures needed because of one-time arrival of large number of wounded and killed in consequence of counter-revolutionary mutiny in Irkutsk during defense of the White House country-house in December 1917. The problem of burial of fallen soldiers and Red Army men was determined during extraordinary session of the City Duma of Irkutsk with further publication of open letter to the Irkutsk Presidium of the Soviets. The well-reasoned positions expressed by physicians and engineers against burial of the killed in common grave on the banks of the Angara River received no support from the revolutionary government. The chronology of the decision taking had political character.

[The trends of spreading of tuberculosis combined with HIV-infection among population the Siberian Federal Okrug].

In The Russian Federation, the current epidemic situation of tuberculosis is characterized by stabilization and decreasing of morbidity with simultaneous increasing of number of cases of tuberculosis combined with HIV infection within the structure of newly diagnosed diseases and contingents of patients with tuberculosis. In the Siberian Federal Okrug, the indices of morbidity of tuberculosis combined with HIV infection exceed similar ones by almost twice that testifies significant input into burden of morbidity of tuberculosis in the subjects of the Siberian Federal District and their role in further dynamics of morbidity. The shift in morbidity of tuberculosis combined with HIV infection towards increasing of age both in patients with diagnosed HIV infection for the first time and in entire accumulated contingent of HIV patients. The positive dynamics of indices of efficiency of anti-tuberculosis measures in contingents of HIV-infected patients being registered testifies availability of reserves for improving medical care quality. The priority directions of developing program activities to achieve control over spreading of tuberculosis combined with HIV infection are early detection and increasing of commitment to dispensary observation of patients with HIV infection and decreasing infection of population with tuberculosis and increasing efficiency of treatment of patients with tuberculosis.

[The sociological aspects of organization of operation of district psychiatrists in modern conditions].

The article presents results of sociological survey of district psychiatrists that revealed actual difficulties and shortcomings in organization of medical care for mental patients. The problem of personnel high workload, inopportuneness and inadequate completeness of necessary medical care of mental patients are explained by a number of difficulties in organization of functioning of psychoneurological organizations. They included not only shortage of personnel and unsatisfactory material technical support of mental institutions, but also incompleteness of normative legal support mental care organization. The physicians identified the following priority targets to be implemented in practice will eliminate a number of actual problems in district psychiatrist work: organization of procedure of interdepartmental interaction of various services (GUFSIN, the Ministry of Internal Affairs, social protection agencies, passport office), development and approval of procedure of dispensary observation of mental patients, approval of procedure of interaction with territorial polyclinics and full implementation of medical care standards for patients with mental disorders. The administration of neuropsychiatric organizations from position of systemic approach is a priority direction of improving quality of medical care for mental patients.

[The effect of medical organizational factors on morbidity of mental and behavior disorders].

Currently, the characteristic of dynamics of morbidity of mental disorders of population of the Russian Federation is its increasing simultaneously with changing in structure of contingents in the direction of decreasing number of patients subjected to dispensary monitoring. The study of influence of medical organizational factors on morbidity of mental disorders demonstrated the role of provision with psychiatrists in dynamics of prevalence of mental disorders. The improvement of management of patients with mental disorders should be supported by appropriate resources and adaptation of mental service to actual conditions, in particular, solving the problem of manpower deficiency of psychiatrists.

[About experience of developing concept of personnel policy in health care at the level of the subject of the Russian Federation].

The personnel policy is one of priority areas of developing national health care. Its effective implementation requires evidence-based development of relevant program documents, the most important of which is the Concept of health care personnel policy that currently exists only in a number of regions of the Russian Federation. In this regard, the purpose of the study was to develop approaches to scientific justification and development of the Concept of health care personnel policy at the level of region of the Russian Federation, as exemplified in the Irkutsk oblast. The article describes progress of this large-scale and lengthy study, its main results included. The developed approaches resulted in comprehensive organizational technology of development corresponding Concept. The results of this experience can be implemented in other regions of the Russian Federation. Therefore, it is of scientific and practical interest for all potential developers of similar program documents and wide range of specialists in health care organization.

[The Complex Evaluation of Labor Migration of Graduates of Medical University as an Important Factor of Formation of Personnel Potential of Regional Health Care System].

On the basis of educational activities in the Irkutsk State Medical University, an assessment of directions and intensity of labor migration of medical graduates, started their professional activities in 2013-2017. The originally developed statistical tool was applied in scientific analysis of various educational and professional trajectories of graduates, from admission to the university to professional employment. It is established that only 34.9% of graduated physicians returned to their area of residence after completion of education, while 65.1% of graduates changed their place of residence after completion of education. These facts make it possible to consider higher medical education as a powerful mobilization factor for young specialists. The main direction of labor migration of University graduates of in 2013-2017 was Irkutsk (21.8%). The migration of graduated physicians reflects impact of urbanization processes. The directions and intensity of labor migration of young specialists graduated from University in the context of municipal formations of the Irkutsk region made it possible to obtain detailed information concerning the role of particular territories of the Oblast in development of human resources potential of the regional health care system.

[The Integral Evaluation of Level of Qualification of Physicians in the Irkutskaia Oblast].

The originally developed technique of integral evaluation of level of qualification of physicians is applied for establishing the level of the given criterion in municipal physicians of the Irkutskaia oblast. The levels of criterion in 2005-2015 were calculated. The results are ranked on the level of criterion. The integral evaluation was implemented to particular medical specialties and subsequent ranking of obtained results was made.

[The Sociological Aspects of Development of Organization and Enhancement of Quality of Hospital Medical Care of Patients with Tuberculosis].

The specially developed questionnaire on studying opinions of physician-phthisiatrician concerning hospital medical care of patients with tuberculosis was applied to survey sampling of 58 physicians phthisiatricians. The questions of questionnaire related to analysis of efficiency of hospital treatment of patients with tuberculosis, satisfaction with consultative and diagnostic activities, support with pharmaceuticals, discovering measures permitting to increase commitment of patients to treatment in conditions of hospital.

[THE EVALUATION OF EFFECTIVENESS OF FUNCTIONING OF TUBERCULOSIS HOSPITALS AND CALCULATION OF NECESSARY NUMBER OF BEDS AT THE REGIONAL LEVEL].

The adequate planning of capacity of hospital medical care accounting regional characteristics of prevalence of tuberculosis infection and functioning of anti-tuberculosis institutions are one of activities increasing effectiveness of resources using. So far, in the Russian Federation no techniques was developed permitting to determine need of tuberculosis service of region in number of beds based on epidemiological indicators of tuberculosis. To bring nearer as much as possible to reliable level of such a need in the Irkutskaia oblast the technique was developed on the basis of listing of indications for hospitalization of tuberculosis patients. This technique permits to substantiate the need of the subject of the Russian Federation in necessary number of beds in consideration of regional characteristics of prevalence of tuberculosis. This approach supports development of organization, planning and increasing of effectiveness of anti-tuberculosis activities in modern conditions.

[The attitude of health workers to the new pay system for labor].

The paper provides the results of the sociological survey to ascertain the opinions of physicians and paramedical personnel on the introduction of the new pay system for labor in a federal budget institution. The findings indicate that health personnel positively responded to the introduction of the new pay system for labor, their personal interest in achieving the quality indicators of their work has increased.

[On the development of higher medical school in the East Siberia region].

The article deals with the major landmarks of the development of higher medical school in the East Siberia region from the moment of its formation up to the present time including its input into the development of public health of the region. The contribution of the prominent representatives of different clinical disciplines into the formation of theoretical and practical heritage of medicine and public health is discussed.

[The actual approaches to the economic analysis of effectiveness of functioning of multi-profile curative preventive medical institution].

The article deals with the technique of economic analysis of effectiveness of functioning of multi-profile curative preventive medical institution in the conditions of transition to the payment according the completed case of treatment. The necessity of the measures targeted to prevent the financial losses under the new form of payment for hospital care is proved.