[On the restructuring of the blood service].

The issue of the restructuring of the blood service is discussed. The actuality and and the need of this process is substantiated. Four alternative organizational models of the blood service institutions (the centralized model, the regional model, the model based of the hospital ground and the mix model) acclaimed by the international community are proposed to be adapted to the Russia conditions. The model of the blood service of the Sverdlovsk oblast is discussed.

[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.

[Analysis of efficiency of the region's health facilities]. / Analiz éffektivnosti diiatel'nosti uchrezhdenii zdravookhraneniia raiona.

A comprehensive study of the efficiency of activities of 5 principle therapeutic-and-preventive institutions (TPI) was conducted in a typical Ural industrial region by using the traditional and newly developed approaches. Both the medical and economic efficiency of their activities was found to be not high in a majority of them. The analysis results were used to work out a scientifically substantiated program for reforming the health care system of the region.

[Evaluation of the efficiency of medical and economic activities of a large hospital]. / Otsenka éffektivnosti meditsinskoi i ékonomicheskoi deiatel'nosti krupnoi bol'nitsy.

Medical and economic efficiencies of one of the Tyumen hospitals are analyzed. The medical efficiency of outpatient and inpatient clinics was evaluated in terms of a new set of parameters determined by Russian specialists. These parameters were calculated on the basis of annual reports, the values were compared with standard values and analyzed for every year.

[Evaluation of the efficiency of the activities of therapeutic and preventive services]. / K otsenke éffektivnosti deiatel'nosti lechebno-profilakticheskikh uchrezhdenii.

Two methodological approaches to evaluation of the efficiency of medical activities, based on estimation of an integral index and expert evaluations, were investigated in 14 hospitals of Chelyabinsk. Both approaches are based on 12 parameters characterizing the work of outpatient clinics and hospitals and are routinely used in medical statistics. Comparison of classifications of treatment-and-prophylaxis institutions of Chelyabinsk in 1994-1998 obtained with the use of both methods showed that the method based on estimation of the integral parameter is more objective. Its another advantage is the possibility to modify the number of signs used and thus to evaluate the efficiency of the entire medical institution and its structural units (outpatient center, hospital). The efficiency rating can serve as the basis for adopting appropriate managing decisions.

[Morbidity and physical development of children's homes residents]. / Zabolevaemost' i fizicheskoe razvitie vospitannikov detskikh domov.

The data on morbidity and physical development of 647 children of preschool age from six children's homes of general type are provided. It was found that with age the number of children who come under I and II groups of health is decreasing and those who come under III and IV groups of health are increasing in number. The indices of physical development of these children are below the regional standards. On the average the physical development of these children is delayed approximately by one year. Health-promoting activities for children raised in children's preschool homes should include the follow-up by specialists, the optimization of general and motor regimen, proper nutrition.

[Hygienic aspects of motor activity and the quality of nutrition in 5- to 7-year-old children from children's preschool institutions]. / Gigienicheskie aspekty dvigatel'noi aktivnosti i kachestva pitaniia 5-7letnikh vospitannikov doshkol'nykh detskikh domov.

The data on the effect of locomotor activity on daily energy losses of inmates of preschool children's homes are presented. Caloric value of food ration and the degree of its adequacy to children's locomotor activity are hygienically assessed. It is established that additional lessons of swimming and ryhthmics in winter increase general daily energy losses by 5.3-8.8%. For the purpose of providing the nutrition compensating the energy losses and elevation of locomotor activity it is recommended to spend not less than 5 hours a week on physical training at preschool Children's homes.