Репозиторий Университета

In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This study examined the differences in health spending within the World Health Organization (WHO) Europe region by comparing the EU15, the EU post-2004, CIS, EU Candidate and CARINFONET countries. The WHO European Region (53 countries) has been divided into the following sub-groups: EU15, EU post-2004, CIS, EU Candidate countries and CARINFONET countries. The study period, based on the availability of WHO Global Health expenditure data, was 1995 to 2014. EU15 countries have exhibited the strongest growth in total health spending both in nominal and purchasing power parity terms. The dynamics of CIS members’ private sector expenditure growth as a percentage of GDP change has exceeded that of other groups. Private sector expenditure on health as a percentage of total government expenditure, has steadily the highest percentage point share among CARINFONET countries. Furthermore, private households’ out-of-pocket payments on health as a percentage of total health expenditure, has been dominated by Central Asian republics for most of the period, although, for the period 2010 to 2014, the latter have tended to converge with those of CIS countries. Western EU15 nations have shown a serious growth of health expenditure far exceeding their pace of real economic growth in the long run. There is concerning growth of private health spending among the CIS and CARINFONET nations. It reflects growing citizen vulnerability in terms of questionable affordability of healthcare. Health care investment capability has grown most substantially in the Russian Federation, Turkey and Poland being the classical examples of emerging markets.

© EV Arsentyev,. The article deals with the main turning points in the life and work of N.A. Semashko, the first People’s Commissar of Health of the RSFSR, from 1920 to 1925. The authors of the article proceed from the fact that the historical and biographical data available about Semashko are interpreted according to ideologically tinted stereotypes that were formed in the Soviet historiographic school. Based on various sources (mainly documents from the State Archives of the Russian Federation and Semashko’s family archive), as well as critical analysis of data from literature, an attempt was made to give an ideologically neutral assessment of the participation of Semashko in the organization of the sanatorium and resort sector in the RSFSR and the assistance provided to Soviet Russia from foreign public organizations. New facts were discovered about Semashko’s life, which in particular made it possible to clarify his role in helping medical personnel in Crimea during political repressions there (after the Bolsheviks established power on the peninsula). The authors of the article point out that despite the difficulties that existed at that time, in many respects, it was only due to Semashko’s authority and organizational abilities that the famous Soviet All-Russia health resort was established in Crimea. While work was carried out on the archives, data were found on the supply of humanitarian aid to the People’s Commissar of Health by US public organizations, sympathizing with Soviet Russia in the first half of the 1920s. It is concluded that the formation of Semashko’s scientific biography, which assumes an objective assessment, in particular, concerning his contribution to the organization of medical care, will make it possible in general to move on to an objective analysis of the features of the Soviet health care system and the transformation of the Soviet model (the Semashko model) into the modern Russian model of health care.

For the purpose of studying the possibility of labor functions development for public health and healthcare during training in the educational organizations the comparative analysis of provisions of the professional standard with the materials stated in textbooks and national manuals of the corresponding profile was carried out. It was found that in the development of Federal state educational standards of higher education in dentistry (specialization level), updating educational methodological publications on dentistry and public health, the formation of a unified database of evaluation tools for accreditation of specialists and obtaining or confirming qualification categories, it is necessary to take into account the content of labor functions of the professional standard in each discipline.

© 2018, Media Sfera. All rights reserved. Modern public healthcare practices are constantly being improved by the medical community, which involves approval and implementation of professional standards such as including public health activities in the responsibilities of medical specialists. To understand how well such skills can be mastered by the specialists, we have conducted a comparative analysis of ophthalmologist qualifications found in the most often used guidelines and textbooks. With logical, analytical and hypothetical analysis, books and guides published before 2018 were found to have insufficient coverage of the public health responsibilities. Improvement of the public healthcare in terms of professional standards is an important course of development for the medical field. The continued work on Russian Federal State Educational Standard (Higher Education) for Ophthalmology - index number 31.08.59 - should include actualization of educational materials with modern public health notions, development of a universal learning evaluation database for specialist accreditation, as well as evaluation tools for the obtainment and confirmation of their qualification. The professional standards for ophthalmologists should fully account for the job responsibilities they acquire. Training of ophthalmologists in the public healthcare should utilize the following textbooks published in 2018: «Organization of medical aid in the Russian Federation» under the editorship of V.A. Reshetnikova, «Healthcare and public health» under the editorship of G.N. Tsarik, and «Public health and healthcare» by V.A. Medic.