[Organizational and managerial problems of the risks in the health service system and the safe medical practice].

For the creation of the safety of the medical aid it is necessary to make a complex systems efforts, which includes a lot of professional, organizational, juridical and psychological actions for the improvement of the treatment and diagnostic process, the promotion of the real conditions for the risk-management in the organizational and clinic practice.

[The role of medical personnel training in public health development].

The strategy of development and innovations of the Russian Federation up to 2015 specifies that public health system, public sectors of medical science and higher education are to acquire a new paradigm status on the basis of technically equipped large-scale practical, research and education organizations with qualified professional staff. In Russia, the strategy of development of medical education is based on the need in education and advanced training of medical professionals considering the particular specialists' demands of subjects of the Russian Federation. In new social economic conditions, in public health the actual value is attached only to a highly educated physician, being able to flexibly rearrange the directions and content of one's own activity because of sectorial needs.

[Management as a key professional competence of preventive medicine specialists].

The paper deals with the strategy of training specialists in preventive medicine and improvement of their professional skills for the management of activities aimed at the maintenance of adequate population health status and prevention of adverse effects of environmental factors. Integration of managerial issues into curricula and teaching courses for preventive medicine specialists may be instrumental in upgrading their professional level.

[Organizational and socio-medical problems of palliative care in Russia].

The system of palliative care to the population is being formed in Russia. This article considers stages of this work and results of research on organizational and socio-medical aspects of palliative care. Scientifically substantiated proposals on the development of the hospice service in all territorial units of the Russian Federation based on recommendations of the World Health Organization are presented.

[Conseptual approaches to evaluation of the cost of quality of medical care: international practice].

The article presents analysis of the basic approaches to evaluation of the cost of medical care quality that are used in the practice of a range of European countries and the USA. There are three processes considered in terms of the general management of the quality - value management from the point of view of a) business, the patient, c) healthcare personnel. Hence, benefits from the results depend on the quality of activity. The authors present a new point of view that connect constant improvement of quality with reengineering (re-design) of medical providence process so that their costs be lower than expenses caused by bad quality.

[Development of Public Health Department with course of economy]. / Stanovlenie i razvitie kafedry obshchestvennogo zdorov'ia i zdravookhraneniia s kursom ékonomiki.

Transition of Russia to marketing economy necessitated reformation of public health system, which, in turn, necessitated economic education of medical staff. I. M. Setchenov Moscow Medical Academy accumulated sufficient experience in the solution of this problem many-year research validated the need in economic education of medical staff under conditions of public health reforms. This paper sums up the results of organization and experimental studies of introduction of public health economy in the curriculum.

[Principles of public health pricing]. / Osnovy tsenoobrazovaniia v zdravookhranenii.

The development of various organizational and legal enterprises, including those in medicine and public health makes it necessary for medical and sanitary workers to know basic pricing. Their knowledge will assist in making correct managerial decisions.

[Problems in prophylaxis under the conditions of public health reform]. / Problemy profilaktiki v uskoviyakh reform zdravookhraneniya.

The indicators of medicosocial significance of prophylaxis in present-day Russia have been determined on the basis of published data and authors' findings. The weak and strong aspects of the problem are assessed, as are the potentialities of solving it and factors threatening its realization. Problems in the prophylactic activities of general practitioners (family physicians) and problems in the development of prophylaxis within the framework of medical insurance are discussed.

[Monitoring in the system of specialized medical care management (exemplified by the study of burns--specialized care for burn victims)]. / Monitoring v sisteme upravleniia spetsializirovannoi meditsinskoi pomoshch'iu (na primere kombustiologii--spetsializirovannoi pomoshchi postradavshim ot ozhogov).

Technological revolution involves an increased risk of negative impact of adverse factors on human health in the whole world. The authors analyze the tendencies of burn traumas incidence in Russia in the latest decade. They necessitate creation in each district of centers for monitoring burnt patients, which should be engaged in registration of burn traumas, organization of emergency care and specialized outpatient and inpatient care, medical and sociopsychological rehabilitation of the victims.

[The management of resuscitative services in a multi-specialty clinic]. / Upravlenie reanimatsionnoi deiatel'nostiu mnogoprofil'noi bol'nitsy.

The authors present the results of research on validation and creation of an information mathematical model of resuscitation activity of a multiprofile hospital as an example of simulation of operative management of therapeutic and diagnostic process in medical structures of all profiles. Profound economic transformations in public health system put forward new problems before managers, economists, and administrators, who are to develop criteria for assessment of the activity of a therapeutic center and a medical worker, to define the scope and quality of work performed, to assess financial expenditures which should be adequate to the services rendered, to develop systems for continuous follow-up of grave patients and monitor the quality of the care rendered, etc. Information mathematical simulation of resuscitation activity of a multiprofile hospital will help get a detailed characterization of patients and of the activity of resuscitation wards, help assess the contribution of physicians and paramedics and the level of mastering present-day medical technologies by them.

[Medical and economic problems in the reform of health maintenance]. / Mediko-ékonomicheskie problemy reformy zdarovookhraneniia.

The paper summarizes the results of comprehensive studies into the management efficiency of therapeutical-and-prophylactic institutions under new economic relations in this area. Transition to public health insurance changes the relations between the system's subjects, determines the need of standardization, pricing, and quality estimation of medical services. The basic directions of the health perform are defined.

[Technology of dynamic follow-up of patients in an urban polyclinic]. / Tekhnologiia dinamicheskogo nabliudeniia za bol'nymi v usloviiakh gorodskoi polikliniki.

The procedure of follow-up of patients with chronic socially important diseases within an urban outpatient department is a closed cycle of ++medico-technological processes with constant involvement of new population groups. The study of traditional follow-up procedure revealed its inadequate efficiency. It also revealed a strong association between the dynamics of health status and strict observance of follow-up procedure (K = 0.652; p less than 0.05). The realization of the functional model of follow-up procedure suggested by the authors for patients with chronic socially important diseases would allow its efficiency to be increased under conditions of an urban out-patient department.

[Evaluation of the methods of analysis of diagnostic errors]. / Otsenka metodik analiza diagnosticheskikh oshibok.

The article provides a critical analysis of validity of existing modifications in the methods of evaluating the quality of diagnosis (E. E. Ben, E. R. Guglina, N. S. Sokolova et al, M. N. Petrov). The authors suggest a technology for calculating the indices of diagnosis quality adapted for applied public health and consisting of five consecutive operations. A new additional indicator of comprehensive polyclinic diagnosis (P) is introduced--the ratio (in %) of the number of diagnoses made by the polyclinic and confirmed by the hospital to the general number of diagnoses made by the hospital.

[Trends in the development of hospital services for the population]. / O tendentsiiakh razvitiia bo'lnichnoi pomoshchi naseleniiu.

Main trends of development of inpatient care for the population are analyzed. A multivariant classification of inpatient facilities is proposed with regard to a set of characteristics, i.e., population groups, the type and amount of the specialized inpatient medical aid rendered, the order of hospital admissions, work regimen, the degree of treatment and care intensity.

[Experience with improving the system of postgraduate training of public health administrators in Moscow]. / Opyt sovershenstvovaniia sistemy poslediplomnoi podgotovki organizatorov zdravookhraneniia Moskvy.

Proceeding from the sample survey of the state of training Moscow health administrators, a functional model of continuous postgraduate education for the heads of health care facilities is proposed. The study tackles the problems of training of the manpower reserve. The problems of more effective training combined with the use of active instruction methods are discussed.