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Ghalehsari, Nima, Pragnan Kancharla, Neil S. Nimkar, Anita Mazloom, Farah Ashraf, Angelica Singh i Mendel Goldfinger. "An Institutional Retrospective Study on Recognizing the Delay in Multiple Myeloma Diagnosis". Blood 134, Supplement_1 (13.11.2019): 3430. http://dx.doi.org/10.1182/blood-2019-127625.
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Background Multiple myeloma (MM) is the abnormal proliferation of plasma cells in the bone marrow often resulting in debilitating symptoms ranging from ostealgia to pathological fractures from bone destruction. According to American Cancer Society, MM accounts for 1-2% of cancers and approximately 17% of hematological malignancies in the United States each year (1). Fifty percent of patients with symptomatic MM have three or more primary care visits before they are referred to a specialist, which is greater than any other cancer (5). It has been shown that a delay in diagnosing multiple myeloma negatively impacts the clinical course of the disease and hence the outcome in patients (2). Patients with longer diagnostic intervals also experience shorter disease free survival and more complications from treatment (4). Herein, a retrospective analysis was performed to determine the average delay in diagnosis of MM. Methods This is a retrospective electronic chart review of all indexed newly diagnosed MM cases between 1/1/2014 through 12/31/2018 at New York-Presbyterian Brooklyn Methodist Hospital (NYP BHM). NYP BMH is a Weill Cornell Medical College-affiliated hospital in Brooklyn, NY whose patient population includes those with private insurance, uninsured and Medicare/Medicaid. Data abstraction from the electronic medical record (EMR) was uniform and involved baseline characteristics such as age, gender and race. International Classification of Diseases (ICD)-10-CM code (C90.00) was used for extraction of data which identified 492 patients. After excluding patients with MGUS or a prior diagnosis of multiple myeloma, 104 patients were included in the final study. We calculated the number of days between the date of first abnormal laboratory value seen on bloodwork for a myeloma related sign (at least 90 days prior to diagnosis) to the date of bone marrow biopsy that confirmed the diagnosis. The inclusion criteria were anemia defined as hemoglobin <12gm/dl, Hypercalcemia defined by corrected calcium >10, kidney dysfunction with a creatinine >1.5 and total protein >8. Results Of the 104 patients with newly diagnosed MM, 69 patients were diagnosed within 90 days of the first abnormal lab value recorded in our electronic medical record (EMR). Thirty-five patients (34%) had a delay in diagnosis at least 90 days with a mean delay of 38 months. Isolated anemia was the most common abnormal lab finding with 29/104 (28%) having documented anemia at least 90 days prior to diagnosis of myeloma. The mean delay in diagnosis for patients with anemia was 41 months. There were four patients with anemia and elevated creatinine with an average delay of 23 months. Five patients had anemia and elevated calcium with an average delay of 21 months. Nine patients had anemia and elevated total protein with an average delay of 38 months. Conclusion: In the current era where we have effective therapies for MM it is now more important than ever to avoid a delay in diagnosis. We demonstrate that 34% of patients receiving care at an Urban Teaching Hospital had at least a 90 day delay in their diagnosis of MM. Our cohort consisted of 64% African Americans, suggesting that minorities are more commonly affected by this. There is a need for more awareness amongst clinicians to consider the diagnosis of MM in the workup of anemia. References: 1. Kariyawasan, C. C., D. A. Hughes, M. M. Jayatillake, and A. B. Mehta. 2007. "Multiple Myeloma: Causes and Consequences of Delay in Diagnosis." QJM: Monthly Journal of the Association of Physicians 100 (10): 635-40. 2. Siegel, Rebecca L., Kimberly D. Miller, and Ahmedin Jemal. 2019. "Cancer Statistics, 2019." CA: A Cancer Journal for Clinicians. https://doi.org/10.3322/caac.21551. 3. Vélez R, Turesson I, Landgren O, Kristinsson SY, Cuzick J. Incidence of multiple myeloma in Great Britain, Sweden, and Malmö, Sweden: the impact of differences in case ascertainment on observed incidence trends. BMJ Open. 2016;6:e009584. 4. Kariyawasan CC, Hughes DA, Jayatillake MM, et al. Multiple myeloma: causes and consequences of delay in diagnosis. QJM 2007;100:635-40. 10.1093/qjmed/hcm077 5. Lyratzopoulos G, Neal RD, Barbiere JM, et al. Variation in number of general practitioner consultations before hospital referral for cancer: findings from the 2010 National Cancer Patient Experience Survey in England. Lancet Oncol 2012;13:353-65. 10.1016/S1470-2045(12)70041-4 Disclosures No relevant conflicts of interest to declare.
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Balarajan, R., P. Yuen i D. Machin. "Socioeconomic differentials in the uptake of medical care in Great Britain." Journal of Epidemiology & Community Health 41, nr 3 (1.09.1987): 196–99. http://dx.doi.org/10.1136/jech.41.3.196.
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Viziriakina, O. "The need to train competent specialists in the field of health care with experience in some aspects of international models". Health-saving technologies, rehabilitation and physical therapy 3, nr 1 (10.10.2022): 15–18. http://dx.doi.org/10.58962/hstrpt.2022.3.1.15-18.
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The article examines the experience of the health care system, in particular medical rehabilitation: Germany, the Netherlands, Great Britain, which work with the application of the international Classification of Functioning. The measures and principles of the organization of the rehabilitation process as medical care are presented, which indicates the need to use new forms and approaches in the professional education of relevant specialists.
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Humphreys, H., i K. J. Towner. "Impact of Acinetobacter spp. in intensive care units in Great Britain and Ireland". Journal of Hospital Infection 37, nr 4 (grudzień 1997): 281–86. http://dx.doi.org/10.1016/s0195-6701(97)90144-4.
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Noland, Robert B., i Mohammed A. Quddus. "Improvements in medical care and technology and reductions in traffic-related fatalities in Great Britain". Accident Analysis & Prevention 36, nr 1 (styczeń 2004): 103–13. http://dx.doi.org/10.1016/s0001-4575(02)00132-x.
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Colgrove, James. "Reform and Its Discontents: Public Health in New York City During the Great Society". Journal of Policy History 19, nr 1 (styczeń 2007): 3–28. http://dx.doi.org/10.1353/jph.2007.0000.
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The health-care system was one of the most visible and contentious battlegrounds on which the social conflicts of the 1960s unfolded. To an unprecedented extent, health status—especially the stark disadvantage in access and outcomes for racial and ethnic minorities and the poor—became an object of public and governmental concern during the Great Society era, as clinicians, community activists, politicians, and policymakers sought to create new models of medical care that were more equitable and efficient than those of the past. The social science theories that informed the ambitious programs of Lyndon Johnson's administration gave an imprimatur to the idea that illness was both cause and consequence of the “cycle of poverty.”
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Yargin, Sergey V. "On medical insurance: considerations based on foreign experience". Health Care of the Russian Federation 60, nr 4 (24.05.2019): 214–16. http://dx.doi.org/10.18821/0044-197x-2016-60-4-214-216.
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The health care organization in Russia is similar to the same in Great Britain where exists public medical care system. At the same time, Russian health care, being insurance, bear resemblance with German health care. The significant characteristic of insurance medicine in Germany is availability of mechanism ofprice ofpoint that is shortly discussed in this article. The application of this mechanism leads to that in overall country the price of medical service is approximately the same independently of insurer. Accordingly, most of private medical practitioners and medical organizations receive all insured patients. The similar mechanism can successfully function only on the assumption of conscientiousness and higher level of professional knowledge of physicians who are not to prescribe pharmaceuticals and diagnostic procedures without sufficient indications. The adoption of mechanism ofpoint price by Russian health care would permit to redirect part of patients insured by mandatory medical insurance to private medical centers and private medical practitioners.
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Tavares, Jane, Marc Cohen i Ann Hwang. "Tracking Progress on Person-Centered Care for Older Adults: Are We Doing Right by Racial and Ethnic Minorities?" Innovation in Aging 5, Supplement_1 (1.12.2021): 546. http://dx.doi.org/10.1093/geroni/igab046.2098.
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Abstract Person-Centered care is integral and necessary to high-quality systems of care, providing a holistic approach and addressing the needs and preferences of individuals. Analyzing the 2014 and 2016 Health and Retirement Survey we measure the extent to which the health care system provides person-centered care, to whom and how its receipt affects satisfaction levels and service utilization. About one-third of individuals’ report that their preferences were only rarely or sometimes takes account. Results vary greatly by race, highlighting great disparities in person-centered care. One in four Hispanics and one in six Blacks report never having their preferences taken into account compared to roughly one in ten Whites. When people report that their preferences are ignored, they are more likely to forgo medical care and report lower satisfaction with the system. Strategies exist to strengthen and assure advancements in person-centered care, something particularly needed for people of color and low-income populations.
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Seston, Elizabeth Mary, Ellen Ingrid Schafheutle i Sarah Caroline Willis. "“A little bit more looking…listening and feeling” A qualitative interview study exploring advanced clinical practice in primary care and community pharmacy". International Journal of Clinical Pharmacy 44, nr 2 (22.11.2021): 381–88. http://dx.doi.org/10.1007/s11096-021-01353-9.
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AbstractBackground Growing demands on healthcare globally, combined with workforce shortages, have led to greater skill mix in healthcare settings. Pharmacists are increasingly moving into complex areas of practice, a move supported by policy and education/training changes. Aim To understand the nature of extended roles for pharmacists practising at an advanced level in primary care and community pharmacy settings, to explore how clinical and physical examination was incorporated into practice and to understand the impact of providing such examination on practice and on patient relationships. Method Telephone interviews (N = 15) were conducted with a purposive sample of pharmacists using clinical and physical examination in their practice in Great Britain. The sample included primary care pharmacists (N = 5), community pharmacists (N = 4), pharmacists working across settings (N = 5) and one working in another primary care setting. Participants were recruited through professional networks, social media and snowballing. Results Primary care pharmacists and community pharmacists were utilising clinical and physical examination skills in their practice. Some community pharmacists were operating locally-commissioned services for low acuity conditions. Incorporating such examinations into practice enabled pharmacists to look at the patient holistically and enhanced pharmacist/patient relationships. Barriers to practise included lack of timely sharing of patient data and perceived reluctance on the part of some pharmacists for advanced practice. Conclusion With growing opportunities to provide patient-focussed care, it remains to be seen whether pharmacists, both in Great Britain and elsewhere, are able to overcome some of the organisational, structural and cultural barriers to advanced practice that currently exist in community pharmacy.
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Waisel, David B. "The Role of World War II and the European Theater of Operations in the Development of Anesthesiology as a Physician Specialty in the USA". Anesthesiology 94, nr 5 (1.05.2001): 907–14. http://dx.doi.org/10.1097/00000542-200105000-00031.
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World War II was a time of growth and development of anesthesia as a physician specialty. Wartime training exposed neophyte physician-anesthetists to role models who showed the potential of anesthesiology and to the richness of practicing anesthesia. Wartime anesthesia required dexterity, imagination, and pluck, and surgeons and other physicians were suitably impressed. Drawing historical conclusions about cause and effect is hazardous. Recognized and unrecognized biases, preconceived notions, and the quality and type of resources available affect writers. With this in mind, consider how the effects of World War II on the growth of physician anesthesia loosely parallel the growth of anesthesia in Great Britain during the 19th century. Anesthesia became a medical profession in Great Britain because of the interest and support of physicians and the complexity of administering chloroform anesthesia. Similarly, World War II physician-anesthetists showed they could provide complex anesthesia care, such as pentothal administration, regional anesthesia, and tracheal intubation, with aplomb and gained the support of surgical colleagues who facilitated their growth within a medical profession. They returned to a medium ready to support their growth and helped to establish the medical profession of anesthesiology in the United States.
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Karpf, Ted, J. Todd Ferguson i Robin Y. Swift. "Light Still Shines in the Darkness". Journal of Holistic Nursing 28, nr 4 (3.08.2010): 266–74. http://dx.doi.org/10.1177/0898010109359310.
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Health care is in crisis at the global, national, and local levels, with hundreds of millions living without basic care, or with insufficient care. Current health care models seem to have ignored, muted, or excluded the voices of the people they were intended to serve, resulting in health systems and care delivery models that do not respond to the needs of the people. This article describes a values-based approach to health and health care services in which the voices of the people are heard and listened to, and in which individuals and communities are informed participants in their own care. We draw parallels between contemporary concerns for decency in care giving to Florence Nightingale’s path-breaking work, first with the British military medical system and then Great Britain as a whole.
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Zimenkovsky, А. B., i T. G. Gutor. "Medical standard as a historical component on the way of clinical audit". Acta Medica Leopoliensia 26, nr 4 (2020): 108–15. http://dx.doi.org/10.25040/aml2020.04.108.
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Aim - the search, analysis and systematization of historical facts concerning the formation and evo-lution of the world medical standartization; severance of its certain long-standing models for the optimization of settling and introduction of the existing, and future analogs, particularly, in the clinical audit format. Material and Methods. In order to study the medical standard as a historical component the fol-lowing methods were used: bibliographic, historical, analytical and methods of systematization and comparison. Results and Discussion. As a result of the conducted research the main historical events in the world development of the medical standartization starting from 1500 up till nowadays were col-lected. In order to study the evolution of the medical standartization, the analysis of the normative documents that have regulated the process of standartization, especially the Doctor's statute(s) in Russia, Minimal standard of the medical equipment and works of the American college of surgeons, was carried out. The scientific works that initiated the introduction of the clinical audit in the Health Care system in Ukraine, Turkey, the USA and Great Britain were throroughly analyzed. Conclusions. The improvement of quality as to rendering the medical aid is a job priority in the health care systems in many countries. For that reason, the search for its optimization was and is still retrieved for many centuries. The territorial formation of medical standartization is associated with England, Russia and the USA, but the occurrence of clinical audit is connected with Ukraine, Turkey, the USA and Great Britain. The foundations of the medical standardization was lauched in 1500 year, while the clinical audit - in 1854 year. The medical standartization is a reflection of the history of development of the organization of health care system, that's why the expertness (knowl-edge) of historical stages concerning the setting and the introduction of medical standartization may give a new impulse in its improvement and development under present-day conditions of reforma-tion in the medical sphere in Ukraine. The earlier beginning of implementation of the medical stan-dartization in the health care system in different countries makes it possible to actualize its introduc-tion into the clinical audit format, that, in its turn, allows to improve the quality of rendering the medical aid. Key words: medical standartization, clinical audit, quality of medical aid
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CRAWFORD, M. J., U. NUR, K. McKENZIE i P. TYRER. "Suicidal ideation and suicide attempts among ethnic minority groups in England: results of a national household survey". Psychological Medicine 35, nr 9 (wrzesień 2005): 1369–77. http://dx.doi.org/10.1017/s0033291705005556.
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Background. Socio-cultural factors impact on the extent of suicidal ideation and attempted suicide but the relative importance of these factors among people from different ethnic groups in Britain has not been explored. We examined the prevalence of suicidal ideation, the incidence of attempted suicide, and the extent of service utilization following attempted suicide among representative samples of White, Irish, Black Caribbean, Bangladeshi, Indian and Pakistani individuals living in England.Method. We conducted a secondary analysis of data from the EMPIRIC study, a cross-sectional survey of 4281 adults aged 16–74 years, living in private households in England.Results. Lifetime suicidal ideation was generally lower in ethnic minority groups but higher among those born in the UK than those who migrated to England as adults. Risk factors for suicidal ideation have much in common across different ethnic groups; current symptoms of mental distress being the most important. White British and Irish respondents were twice as likely to receive medical attention following attempted suicide than those from other ethnic groups.Conclusions. Services need to adapt in order to ensure that people from ethnic minorities receive appropriate psychological and medical care following attempted suicide.
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Fletcher, Andrew, Sheila Payne, David Waterman i Mary Turner. "PALLIATIVE AND END OF LIFE CARE IN PRISONS IN GREAT BRITAIN AND NORTHERN IRELAND – EXPERIENCES OF PHYSICIANS WORKING IN SPECIALIST PALLIATIVE CARE SERVICES". BMJ Supportive & Palliative Care 4, Suppl 1 (marzec 2014): A19.1—A19. http://dx.doi.org/10.1136/bmjspcare-2014-000654.51.
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Ashing, Kimlin Tam, Lenna Dawkins-Moultin, Marshalee George, Gerard M. Antoine, Marcella Nunez-Smith i Eliseo J. Pérez-Stable. "Across borders: thoughts and considerations about cultural preservation among immigrant clinicians". International Journal for Quality in Health Care 31, nr 8 (11.01.2019): G103—G105. http://dx.doi.org/10.1093/intqhc/mzy256.
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Abstract Immigrant clinicians make up 20–28% of the health workforce in many high-income countries, including Australia, Britain, Canada and the USA. Yet, the preserved culture of immigrant clinicians remains largely invisible in the medical literature and discourse. Research on immigrant clinicians primarily attends to medical professional requirements for the adopted country (medical board examination eligibility, fellowship training and licensing). Cultural preservation among immigrant clinicians has not been adequately considered or studied. This paper highlights this notable gap in healthcare delivery and health services research relevant to immigrant clinicians. We propose it is worthwhile to explore possible relationships between immigrant clinicians’ preserved culture and clinical practices and outcomes since immigrant clinicians cross borders with their academic training as well as their culture. The sparse literature regarding immigrant clinicians suggests culture influences health beliefs, attitudes about the meaning of illness and clinical practice decisions. Additionally, immigrant clinicians are more likely to serve rural, low-income populations; communities with high density of ethnic minorities and immigrants; and areas with primary care shortage. Therefore, cultural preservation among immigrant clinicians may have important implications for public health and health disparities. This area of inquiry is important, if not urgent, in health services research.
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VASYLENKO, Yuliia. "EUROPEAN EXPERIENCE IN THE TRAINING OF MEDICAL EDUCATION MANAGEMENT SPECIALISTS". Dnipro Academy of Continuing Education Herald. Series: Public Management and Administration, Vol. 1 No. 2 (2022) (31.08.2022): 43–47. http://dx.doi.org/10.54891/2786-6998-2022-1-7.
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The article examines the European experience in the field of training specialists in the management of medical education in Germany and Great Britain. It was determined that there is a widespread opinion in Ukraine that in the educational sphere of health care reforms were not implemented at all or were implemented ineffectively. This was facilitated by the vision that the main efforts of the executive authorities were aimed at preventing the collapse of the existing health care system and maintaining a minimum level of social security. On the basis of the analysis of the researches of domestic scientists, it was concluded that the results of their scientific researches make it possible to deepen the understanding of the problems of training specialists in the management of medical education. At the same time, the issue of applying foreign experience of such training has not been comprehensively reflected in the field of public administration knowledge. It was found that in the conditions of European integration, reforming the medical education system is impossible without taking into account the European experience, which will contribute to the development and implementation of a national comprehensive mechanism of public management of medical education. The reviewed various master’s programs in the field of medical education management in Germany and Great Britain revealed their advantages over those available today in Ukraine. It was determined that the introduction of standards for the training of masters of state management of medical education in European countries will contribute to the improvement of the content of domestic master’s programs, while creating greater employment opportunities on the domestic and global labor market. It was found that the professional training of the management personnel of the medical education system is extremely important and relevant today in Ukraine, due to the fact that in many European countries there is a growing interest in the training of highly qualified managers in the medical education system. The main efforts of European educational programs are aimed at increasing the level of requirements for the competence characteristics of managers of medical education institutions. Ways to overcome the problems of training medical education management specialists based on the introduction of new educational programs are proposed.
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Веригина, А. В., i В. Ю. Цибульникова. "About the differences in health systems and their financing". Applied Economic Researches Journal, nr 1 (30.03.2024): 75–80. http://dx.doi.org/10.47576/2949-1908.2024.1.1.009.
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Статья посвящена сравнительному анализу мировых моделей здравоохранения. Классифицированы системы здравоохранения, в которых отмечены преимущества, а также слабые стороны, на примере моделей стран США, Японии, Великобритании и Германии. Анализ проведен с точки зрения финансирования здравоохранения и оказания медицинской помощи гражданам. Представлено сравнение расходов на здравоохранение в указанных странах и в Российской Федерации. The article is devoted to a comparative analysis of global health models. Healthcare systems are classified, in which advantages as well as weaknesses are noted, using the example of models from the USA, Japan, Great Britain and Germany. The analysis was carried out from the point of view of financing health care and providing medical care to citizens. A comparison of healthcare costs in these countries and in the Russian Federation is presented.
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Ehrhardt, John D., i J. Patrick O'Leary. "The Rise of the Surgeon in the Seventeenth Century Virginia Colony". American Surgeon 84, nr 6 (czerwiec 2018): 763–65. http://dx.doi.org/10.1177/000313481808400615.
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Life in the early American colonies presented unique challenges to the British colonists. There was an acute need for health-care providers in the early Virginia colony at Jamestown. Many of the medical men who first arrived at Jamestown were surgeons who adapted themselves to fit the medical needs of the community. These men trained in the British system where they sat beneath physicians in a hierarchy that did not consider surgeons to be doctors. Through their service to the colonists, early surgeons earned the reputation traditionally given to physicians in Great Britain. The colonists in Virginia respected the surgeons and viewed them as doctors, which allowed surgeons to stand on equal ground with physicians as the colonies grew to eventually become the United States of America.
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KARPYSHYN, Nataliia, i Iryna SYDOR. "Financing of medical services: experience of foreign countries and Ukraine". Economics. Finances. Law, nr 8 (28.08.2020): 9–13. http://dx.doi.org/10.37634/efp.2020.8.2.
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Introduction. Research into the sources of health care funding is necessary to develop an effective policy to improve the domestic health care system and improve the accessibility and quality of medical care. The purpose of the article is to assess the sources of funding of medical services in foreign countries and in Ukraine in order to identify and analise current trends and prospects for financing the domestic health care system in the implementation of health care reform. Results. An analysis of trends in the financing of health services in foreign countries has shown that there is a certain imbalance between the country's economic growth and its health care expenditures. The share of health services expenditures in GDP averaged 8.8 % or almost $ 4,000 per OECD citizen in 2018 y . This cost figure is 24 times higher than the per capita health care costs in Ukraine and can be a guide to the amount of funding for medicine in the world community. Citizens of OECD countries, unlike Ukrainians, pay an average of 21 % of all health care costs. The priority sources of funding for one group of countries are budget funds (Norway, Denmark, Sweden, Great Britain, Canada), and for another – compulsory health insurance (Germany, Japan, France, etc.). Сonclusion. Funds of the population are the main source of funding for medical services in Ukraine – 53 %. This indicator is critical for the country, as low-income citizens are unable to pay for medical care and the number of chronic diseases, disability and mortality are increased. The transformational reform of the health care system in Ukraine was started in 2015 and according to international experts is successful and meets international practices of accessibility, quality and efficiency of medical services. Further consistent implementation of health care reform can provide financial protection for the population from excessive out-of-pocket spending, improve access to health care, and improve public health.
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Hampson, Judith, Jacqueline Southee, David Howell i Michael Balls. "An RSPCA/FRAME Survey of the Use of Non-human Primates as Laboratory Animals in Great Britain, 1984–1988". Alternatives to Laboratory Animals 17, nr 4 (czerwiec 1990): 335–99. http://dx.doi.org/10.1177/026119299001700407.
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A literature-based survey of the use of non-human primates as laboratory animals in Great Britain in 1984–1988 was carried out as a background to extending debate about the ethical and practical issues involved. The 289 publications considered were grouped in 15 subject areas and reviewed in terms of scientific purpose, methods employed, numbers and species of animals used, and their source, care and ultimate fate. In addition, the Association of the British Pharmaceutical Industry provided a comment on the use of non-human primates by pharmaceutical companies. Specific causes for concern were identified, and future prospects considered.
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Andrusenko, Sergey P. "A comparative study of the formation of doctrinal directions of the institution of legal protection of crime victims in the USA and the United Kingdom of Great Britain and Northern Ireland". RUDN Journal of Law 27, nr 4 (1.12.2023): 1028–42. http://dx.doi.org/10.22363/2313-2337-2023-27-4-1028-1042.
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The United States and the United Kingdom of Great Britain and Northern Ireland have a long history of forming and developing legal protection of the rights of crime victims, which is based on the recognition of state responsibility for the failure to protect society from crime and provision of comprehensive support to crime victims, including compensation, benefits, medical care, social services, support of specialized public organizations. At the same time, the norms of public law regulating state compensation for harm to victims of crime are important. In fact, a study of the leading legal institutions of the United Kingdom of Great Britain and Northern Ireland, which has accumulated positive regulatory and legal experience in ensuring the rights of crime victims and their legal protection, which can be perceived as legislative novelties in the Russian Federation, is indicative. The relevance of the topic is also conditioned by the social significance of the issue of legal protection of the rights of crime victims, as well as the legal reality that has developed in the Russian Federation in the field of legislative regulation of the status of victims of criminal offenses, which directly affects the right to compensation for harm caused to them.
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Micallef, Ricarda, i Reem Kayyali. "Interviews with Global Pharmacists and Healthcare Professionals in Great Britain to Establish Personal Experiences around Professional Development Activity". Pharmacy 10, nr 1 (1.01.2022): 7. http://dx.doi.org/10.3390/pharmacy10010007.
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Professional development activity is needed to ensure practitioners are up to date and providing optimal patient care. This includes, but is not restricted to, mandatory continuing professional development (CPD) or continuing education (CE) requirements, which differ by professions globally and within countries. This study aimed to investigate perceptions, participation, and individual practice for healthcare professionals in Great Britain (GB) and pharmacists globally to identify similarities and differences after the introduction of revalidation for pharmacists in GB. Qualitative data was received through interviews, which was analysed using content analysis. In total, 24 interviews were completed with pharmacists registered globally, and healthcare professionals registered in GB. A culture of CPD was seen for healthcare professionals in GB and globally for pharmacists; there was no consistent model. Face-to-face activity was common, with an increase in online provision, especially where large geographies were seen. Most learning was completed in the professional’s own time. Multiple providers were seen, with the evaluation of events using questionnaires being commonplace. Different formats of learning were useful for different topics, with skills learning being better when face-to-face. Although varied requirements were in place, regulation should support patient-based practice outcomes. This study showed that commitment to learning was similar in different professions in GB and by pharmacists globally, with similar benefits and challenges.
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Puzanovа, Olha. "Evidence Based Medical Prevention: International Experience". Family Medicine, nr 6 (30.12.2016): 34–37. http://dx.doi.org/10.30841/2307-5112.6.2016.249037.
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The objective: was to study the international experience of evidence based preventive medicine development as well as to estimate its perspectives in Ukraine.
Patients and methods. Main principles and methods of scientific knowledge and research have been used including universal ones, methods of systemic approach, quantitative and qualitative information analysis, classification and systematization of theoretical and empirical data, hystorical and logical methods, health statistics as well). In total 529 scientific information sources have been studied, particularly a number of evidence based medicine (EBM) computer databases, special task forces recommendations and Cochrane reviews on prevention, Register of medical and technological documents for health care standards in Ukraine et al.
Results. The contribution of foreign scientific schools in the development of EBM has been determined, as well as the crucial role of scientific works carried out in the US and Great Britain in 1930–80s as to the development of evidence based preventive medicine. The international experience of the development and functioning of evidence based practice centers’ and special task forces on prevention has been summarized, as the experience of the development and implementation of recommendations on prevention in primary health care (PHC) in high income countries acceptable for Ukraine. The concept of evidence based prevention has been first proposed. It is revealed, that EBM implementation in Europe has been prioritized in both the field of infectious diseases prevention and PHC, while there are both the development of differentiated evidence based prevention and early evidence based diagnosis in PHC in the US.
Conclusion. The results proved importance of taking into consideration of international experience while evidence based PHC is being developed as a priority in Ukraine.
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Naumenko, Natalya S., A. P. Nikonov, O. R. Astsaturova i A. V. Belova. "STRUCTURE OF INFECTIOUS SCREENING OF PREGNANTS: RUSSIAN AND OVERALL PRACTICE". V.F.Snegirev Archives of Obstetrics and Gynecology 5, nr 1 (15.03.2018): 26–30. http://dx.doi.org/10.18821/2313-8726-2018-5-1-26-30.
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Infectious diseases are still one of the main causes of perinatal losses worldwide. The consequences for the fetus and the newborn vary from asymptomatic infection to sepsis, malformations and the fetal death. Examination of pregnant women for the presence of infectious agents is an important part of the antenatal care program. The purpose of the work was to assess the structure of infectious screening in various medical institutions in Moscow, as well as the comparison of the recommended in Russia examinations with the main programs of antenatal monitoring in the world. Material and methods. The retrospective study was executed on the basis of four medical institutions: two state women’s clinics and two commercial clinics (the total number of patients - 902 people). The comparison was made with antenatal care programs of the antenatal observation in Centers for Disease Control and Prevention (CDC), 2015 (Centers for Disease Control and Prevention) in the United States of America, and the National Institute for Health and Care Excellence (NICE), 2017 (National Institute for Health and Medical Quality assistance), Great Britain. Results. Basic screening of pregnant women for infection in the Russian Federation includes 8 items (serological study of the blood for syphilis, HIV, hepatitis B and C, rubella, toxoplasmosis, microscopic examination of genital secretions on Neisseria gonorrhoeae and fungi of the genus Candida), which is significantly higher than in the USA and Great Britain (5 and 4 respectively). According to the results of our study, the volume of the compulsory examination of pregnant women is wider than abroad, due to serological examination of blood for the presence of antibodies to cytomegalovirus (CMV) and herpes simplex virus (HSV) of types 1 and 2, microbiological examination of genital secretions, molecular biological diagnosis (polymerase chain reaction - PCR, real-time PCR). Conclusion. Screening of pregnant women for infection in public and commercial clinics has a number of differences. The actual scope of the survey is higher than recommended by the state. The Russian list of tests in comparison with foreign analogs is much wider in terms of the number of nosologies and the frequency of the research. It is necessary to conduct multicenter epidemiological studies throughout the Russian Federation to create optimal regional programs for examining pregnant women for infection that meet the criteria for effective screening.
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Kotvitska, Alla, i Oleksii Prokopenko. "Determination of social and economic accessibility of drugs for treatment of Parkinson’s disease on the basis of modern approaches". Pharmacia 67, nr 3 (15.09.2020): 173–79. http://dx.doi.org/10.3897/pharmacia.67.e46586.
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In the context of the economic crisis, the availability of medicines for the population is one of the key issues facing pharmaceutical sector of healthcare system. Due to the fact of that, the purpose of the work was to study the social and economic accessibility of medicines, since such studies in the future may provide an opportunity for effective input of medicines costs reimbursement system, which will increase their availability, especially for socially vulnerable groups of population. The data analysis of the clinical protocols of Great Britain, Kazakhstan and Ukraine was conducted, and the indicators of social and economic availability within 2014–2018 were calculated. The obtained results indicate an adequate level of availability of medicines for the able-bodied population and, unfortunately, a low level of accessibility of medicines for people of retirement age with a tendency to further descension. These results point the necessity of the further research and development of government control systems and provision of pharmaceutical care for the population.
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Sussman, Sam. "The First Asylums in Canada: A Response to Neglectful Community Care and Current Trends". Canadian Journal of Psychiatry 43, nr 3 (kwiecień 1998): 260–64. http://dx.doi.org/10.1177/070674379804300304.
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Objective: Humane treatment and care of mentally ill people can be viewed from a historical perspective. Intramural (the institution) and extramural (the community) initiatives are not mutually exclusive. Method: The evolution of the psychiatric institution in Canada as the primary method of care is presented from an historical perspective. A province-by-province review of provisions for mentally ill people prior to asylum construction reveals that humanitarian motives and a growing sensitivity to social and medical problems gave rise to institutional psychiatry. The influence of Great Britain, France, and, to a lesser extent, the United States in the construction of asylums in Canada is highlighted. The contemporary redirection of the Canadian mental health system toward “dehospitalization” is discussed and delineated. Results: Early promoters of asylums were genuinely concerned with alleviating human suffering, which led to the separation of mental health services from the community and from those proffered to the criminal and indigent populations. While the results of the past institutional era were mixed, it is hoped that the “care” cycle will not repeat itself in the form of undesireable community alternatives. Conclusion: Severely psychiatrically disabled individuals can be cared for in the community if appropriate services exist.
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Löwy, Ilana. "“Nothing More to Be Done”: Palliative Care Versus Exerimental Therapy in Advanced Cancer". Science in Context 8, nr 1 (1995): 209–29. http://dx.doi.org/10.1017/s0269889700001964.
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The ArgumentPatients suffering from advanced, incurable cancer often receive from their doctors proposals to enroll in a clinical trial of an experimental therapy. Experimental therapies are increasingly perceived not as a highly problematic approach but as a near-standard way to deal with incurable cancer. There are, however, important differences in the diffusion of these therapies in Western countries. The large diffusion of experimental therapies for malignant disease in the United States contrasts with the much more restricted diffusion of these therapies in the United Kingdom. The difference between the two reflects differences in the organization of health care in these countries and distinct patterns of the professionalization of medical oncology in America and in Britain. The high density and great autonomy of medical oncologists in the United States encourages there the diffusion of experimental therapies (regarded by some as expensive and inefficient); the lower density of these specialists in the United Kingdom and their task as consultants and not primary caregivers, favors the choice of more conservative (for some, too conservative) treatments. Theoretically, the decision as to whether patients suffering from advanced, incurable cancer will be steered toward an experimental therapy or toward palliative care depends on the values and beliefs of these patients and their physicians. In practice, however, such choice does not depend exclusively on the individual' cultural background and ethical values, but is also strongly affected by the — culturally conditioned — Professional and institutional structure of medicine
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Shevchuk, Viktor, Mariietta Kapustina, Dmytro Zatenatskyi, Maryna Kostenko i Inna Kolesnikova. "Criminalistic support of combating iatrogenic criminal offenses: Information system prospects". Social Legal Studios 6, nr 4 (12.12.2023): 208–16. http://dx.doi.org/10.32518/sals4.2023.208.
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The research relevance is stipulated by the negative dynamics of the increase in the number of iatrogenic offences in Ukraine and the need to update the criminalistic support tools to effectively counteract these types of acts. Given this, the study aims to explore the prospects for developing an information system for recording cases of defects in the provision of medical care in Ukraine to promptly detect and investigate criminal offences in the field of medical practice. Various research methods were used, including analysis, synthesis, comparison, structural and functional, statistical, formal, and legal, and deduction. The study identifies the factors that necessitate the development of an information system for registering and studying cases of inadequate medical care to patients. In addition, the author examines the experience of Denmark, Germany, Great Britain, France, and other European countries in ensuring the operation of mechanisms for recording and reporting on adverse effects caused by defects in the provision of medical care. The advantages of information systems in the context of combating iatrogenic criminal offences are also revealed and proposals for the implementation of such mechanisms in Ukraine are developed. The study pays special attention to establishing the essence of iatrogenic criminal offences and identifying their specific features which create difficulties for the investigation of criminal offences in the field of medical activity since they are latent. The results obtained in the course of the study should be used to improve the competence of criminal justice officials whose activities are aimed at conducting pre-trial investigations of iatrogenic criminal offences through the use of innovative criminalistic tools
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Yusiuk, M. Yu, A. M. Yusiuk i L. A. Yusiuk. "HEALTH SYSTEM REFORM IN UKRAINE AND FOREIGN EXPERIENCE OF FINANCING MODELS". Eastern Ukrainian Medical Journal 8, nr 1 (2020): 100–107. http://dx.doi.org/10.21272/eumj.2020;8(1):100-107.
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Inroduction. Due to the fact that the reform of the healthcare system in Ukraine is in transition phase at the moment and, in addition, from April 1, 2020 changes are introduced at the second level of healthcare, it is advisable to describe the current state of medical reform in Ukraine, plans and prospects for further implementation and development, as well as the establishment of the features of various health financing systems and comparing the level of expenditures on the medical industry between countries, experience of which should be taken into account. Materials and Methods. The article uses the reports of the Ministry of Health of Ukraine and the analytical materials of medical experts. In addition, when analyzing various models of financing the health system and their features, quantitative indicators of expenditures of the countries surveyed are used. A comparison is made of the level of expenditures on the health care system between Ukraine and some European countries: Great Britain, the Czech Republic, Poland and Germany. Discussion. The main achievements of the first stage of the health care reform and plans for further changes are described. The strengths and weaknesses of each model of financing the health system are identified. It is proved that the level of government spending on the health care system in Ukraine is the smallest among the other countries examined, but one of the largest in terms of payments out of pocket. In addition, a model has been established for financing the health care system in Ukraine, which most fully meets it in modern conditions.
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KARPENKO, Lidiia. "DEVELOPMENT OF THE FINANCIAL MECHANISM FOR PROVIDING THE STATE GUARANTEES OF POPULATION MEDICAL SERVICE: FOREIGN PRACTICE". Herald of Khmelnytskyi National University 302, nr 1 (styczeń 2022): 289–95. http://dx.doi.org/10.31891/2307-5740-2022-302-1-48.
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Scientific research consists of substantiation and development of conceptual foundations and recommendations for the development of a financial mechanism for providing state guarantees of medical care to the population based on foreign practice. The paper substantiates the relevance of building an effective financial mechanism for ensuring state guarantees of medical care for the population for the Ukrainian medical sphere is: the need to reform the healthcare system in Ukraine; changing the paradigm of financing the medical industry; financing of the medical industry is experiencing critical problems; catastrophic situation in ensuring the provision of specialized and highly specialized inpatient care; imperfection of mechanisms for ensuring financing of the health care system of Ukraine. In this work, the author examines in detail the features of the three main models of healthcare at the global level, classifies the healthcare systems of leading countries according to three main models, systematizes in tabular form the practice of six countries – Israel, Sweden, France, the USA, Great Britain Germany, in which these models received the most bright embodiment. The aim of the work consist of studding the general principles of financing models and organization of the health care system in the coordinates of globalization changes and European integration; analysis and characterization of the financial mechanism that provides state guarantees in the field of medical care Applied aspects are based on the systematization of the instrumental base for modelling the financial mechanism for providing state guarantees of medical care to the population, taking into account foreign experience. In the work, the author analyzed the calculations of the ratio of costs and indicators of the effectiveness of the health care system in 2020, the analytical dependence of average life expectancy on per capita expenditures in the health sector, % of GDP. The analysis carried out on the selected research issues provides a conceptual basis for the formation of an effective financial mechanism for budget policy in Ukraine to ensure state guarantees of medical care for the population; forms a platform for the development of macroeconomic stabilization policy. The prospects for further research are the improvement of the issues of the mechanism for the effective functioning of the public sector and the implementation of integrated management analysis.
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Andreev, D. A., i A. A. Zavyalov. "Organizing the national prostate cancer audit in the UK (review of foreign literature)". Cancer Urology 17, nr 3 (11.11.2021): 154–64. http://dx.doi.org/10.17650/1726-9776-2021-17-3-154-164.
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Background. The growing number of patients with prostate cancer (PCa) imposes additional requirements on the quality control system in healthcare, including ensuring the widespread availability of innovative algorithms for early diagnosis and treatment. One illustrative example of quality management initiatives is national PCa audit in the UK. Objective. Highlighting the approaches to quality assessments within audit of PCa care in the UK.Materials and methods. The relevant scientific data have been retrieved from Google and PubMed. The search horizon covered the last 10 years. The queries included such wording as: "prostate cancer" AND "audit" OR/AND "Great Britain" AND "quality assurance", etc.Results. At least four basic parameters were used as signal indicators to check the consistency and overall quality of the collected data on PCa patients in England and Wales. The fundamental arrangement of clinical quality indicators for PCa care comprised not less than fourteen measures. The outliers for some indicators were allocated into two groups using such criteria as: 1) more than three standard deviations from the national average (definition of an alarm); 2) more than two but below three standard deviations from the national average (definition of an alert). The outlier policy is usually applied for three treatment outcome performance indicators.Conclusion. The multidisciplinary teams must actively collaborate to provide the best standards of cancer care to the community. The introduction of multicriterial assessments to monitor the performance of highly specialized professional groups would bring a great benefit for cancer patients, particularly, through increasing the affordability of state-of-the-art medical algorithms across the counties.
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Carmont, M. R., R. Daynes i D. M. Sedgwick. "The Impact of an Extreme Sports Event on a District General Hospital". Scottish Medical Journal 50, nr 3 (sierpień 2005): 106–8. http://dx.doi.org/10.1177/003693300505000306.
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Background: Extreme sports events are increasing in popularity, particularly in mountainous areas throughout Great Britain. Emergency medical care for these events is usually provided by voluntary organisations, providing event side first aid and referring patients to nearby District General Hospitals. The Fort William Mountain Bike Race is part of the UCI World Cup Series: 173 competitors racing in cross country, downhill and 4X events. The Belford Hospital provides year round medical care for the Lochaber community, which frequently swells during the tourist season. The hospital has 8300 new attendances per annum, 35 patient reviews per 24 hrs. Methods and Results: We have reviewed the impact of the event on the local hospital. In total 52 riders reported 61 injuries. The hospital treated 24 (14%) riders. Retrospective analysis of attendances has revealed 19 riders attended on race days, increasing attendees by up to 28%, 46% of injured riders were seen at the A&E department, 1 rider requiring admission for observation and 1 rider required inter-hospital transfer. Injury patterns (knee 20%, hand/wrist 18% & shoulder 18%) were similar to other reported series. Conclusions: We believe that extreme sports events can have considerable impact on small district general hospitals. Additional triage and staffing resources should be utilised and event organisers should anticipate the additional problems they present to the local community. District General Hospitals continue to provide a substantial contribution to the provision of health care for extreme sports within the UK.
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Antunes, Bárbara, Ben Bowers, Isaac Winterburn, Michael P. Kelly, Robert Brodrick, Kristian Pollock, Megha Majumder i in. "Anticipatory prescribing in community end-of-life care in the UK and Ireland during the COVID-19 pandemic: online survey". BMJ Supportive & Palliative Care 10, nr 3 (16.06.2020): 343–49. http://dx.doi.org/10.1136/bmjspcare-2020-002394.
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BackgroundAnticipatory prescribing (AP) of injectable medications in advance of clinical need is established practice in community end-of-life care. Changes to prescribing guidelines and practice have been reported during the COVID-19 pandemic.Aims and objectivesTo investigate UK and Ireland clinicians’ experiences concerning changes in AP during the COVID-19 pandemic and their recommendations for change.MethodsOnline survey of participants at previous AP national workshops, members of the Association for Palliative Medicine of Great Britain and Ireland and other professional organisations, with snowball sampling.ResultsTwo hundred and sixty-one replies were received between 9 and 19 April 2020 from clinicians in community, hospice and hospital settings across all areas of the UK and Ireland. Changes to AP local guidance and practice were reported: route of administration (47%), drugs prescribed (38%), total quantities prescribed (35%), doses and ranges (29%). Concerns over shortages of nurses and doctors to administer subcutaneous injections led 37% to consider drug administration by family or social caregivers, often by buccal, sublingual and transdermal routes. Clinical contact and patient assessment were more often remote via telephone or video (63%). Recommendations for regulatory changes to permit drug repurposing and easier community access were made.ConclusionsThe challenges of the COVID-19 pandemic for UK community palliative care has stimulated rapid innovation in AP. The extent to which these are implemented and their clinical efficacy need further examination.
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Karpyshin, Nataliia, i Svitlana Zhukevich. "OECD AND UKRAINE: TRENDS IN HEALTH CARE FINANCING". Міжнародні відносини, суспільні комунікації та регіональні студії, nr 1 (15) (30.03.2023): 254–67. http://dx.doi.org/10.29038/2524-2679-2023-01-254-267.
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The article examines current trends in healthcare financing in OECD countries and Ukraine. The focus is on assessing the dynamics of total healthcare spending and it is found that in 2020, the COVID-19 pandemic caused a significant increase in funding in all countries. In particular, only in 2019-2020, the share of healthcare costs in the GDP of OECD countries increased by 1% on average. Thus, advanced countries, realizing the impact of the healthcare industry on the economy and well-being of the country as a whole, tried to maximally strengthen its financial stability in general and to epidemic challenges in particular. The priority sources of health care financing were analyzed and it was found that the governments of the OECD countries diversify the sources of financing in the sector to protect their citizens from excessive financial burden and to ensure affordable and high-quality medical care. It was found that the direct costs of patients from OECR countries account for an average of 20% of all health care costs, while in Ukraine the population finances more than 46% of medical costs. It was noted that this indicator is threatening for the country, since the poor do not have access to medical care due to lack of funds and, as a result, the number of diseases, the level of disability, and mortality of citizens is increasing. It was established that the priority sources of financing for one group of OECD countries (Denmark, Sweden, Norway, Great Britain, Canada, etc.) are budget funds, and for another (Germany, Japan, France, etc.) - funds from the mandatory health insurance system. In recent years, there has been a tendency to increase the share of mandatory health insurance in the structure of financing sources of OECD countries, which increased by 2% on average and amounted to 39%. It was concluded that the Ukrainian health care system, in which the reform began in 2015, annually increases the amount of funding and has positive feedback from WHO and World Bank experts about the results of the reform. However, due to political changes in 2014 and economic constraints due to the COVID-19 pandemic, total health spending in dollar terms in 2020 did not reach the 2013 funding level. In addition, the war made adjustments to the activity of the industry, introducing a regime of maximum preservation of infrastructure, simplification of financing, and ensuring the availability of medical services. Despite this, the government developed a post-war healthcare recovery plan to revive destroyed facilities and radically transform the industry in peacetime.
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Strelchenko, Oksana G., Taisiіa G. Korzh-Ikaieva i Anastasiia O. Polovina. "CHARACTERISTICS OF DEMOGRAPHIC INDICATORS THAT AFFECT ADDITIONAL INSURANCE OF SUBJECTS OF MEDICO-LEGAL RELATIONS". Ukrainian educational and scientific medical space, nr 1 (1.12.2023): 37–46. http://dx.doi.org/10.31612/3041-1548.1.2023.05.
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Aim. To study the demographic situation affecting the voluntary social insurance of subjects of medico-legal relations who, fulfilling their professional duties as providers of medical services, do not always take care of their own life and health and are not insured, and consumers of such services, who also do not realize the severity of their disease and the risks of the need for treatment. Materials and methods. In the course of an in-depth study on the introduction of voluntary medical social insurance, 500 medical workers were interviewed about the feasibility and necessity of introducing medical social insurance in health care institutions of the Kyiv region. The results showed that the majority of medical professionals do not support the introduction of any type of insurance (76%) on the grounds that it will not cover the costs of treatment. The results. As of January 1, 2024, the number of insured persons in the Social Insurance Fund of Ukraine was 3,236,285 (in 2023, this number was 4,436,584, which indicates its decrease), of which: legal entities – 1,558,764, individuals – 1,677,521, voluntarily insured persons – 152. Based on the analysis of health care expenditures in comparison with the countries of the European Union for 2019-2023, it should be noted that 16.7% of GDP is spent on health care in the USA (at of GDP – 21.3 trillion USD), in Germany 11.1% (GDP – 3.8 billion USD), in Poland – 4.86% (GDP – 592 billion USD), in the Czech Republic – 7.4% (GDP – 414 billion US dollars), in Great Britain – 9.8% (GDP – 2830 billion US dollars) and in Hungary – 7.4% (GDP – 161 billion US dollars). Conclusions. The author formulates the main steps for increasing the legal recognition of the relevant categories and the role of both state social insurance and additional medical insurance in the process of providing and receiving medical services, in particular: 1) Medical services not covered by the medical insurance program and the contribution of an individual and legal entity in favor of the patient 2) clear definition of other cases in which medical services can be provided 3) development of pharmaceutical insurance; pharmaceutical insurance provides for the reimbursement of costs for the purchase of medicines and/or medical equipment; 4) increasing the level of cooperation between participants in the system of state financial guarantees of medical care for the population and private insurance companies; 5) simplification of the mechanism of introduction of additional medical insurance; 6) raising the level of public awareness.
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Mokia-Serbina, S. O., N. I. Zabolotnia i M. I. Mavropulo. "Post-traumatic stress disorder in children: early recognition and coordination of medical care in the conditions of war". Modern pediatrics. Ukraine, nr 4(132) (28.05.2023): 91–98. http://dx.doi.org/10.15574/sp.2023.132.91.
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At the current stage, when military operations continue and there is possible development of various manifestations of psychotraumatic stress disorders in children, the acuteness and urgency of solving the problem determines the need for early recognition of the symptoms of post-traumatic stress disorder, due to its frequency and high risk and indicators of negative consequences. Purpose - to improve the quality of life of children in wartime conditions by early recognition of symptoms of the risk of developing post-traumatic stress disorder and increasing the awareness of primary care physicians about this condition and coordination of medical and psychological care. Materials and methods. Practical guidelines on the early recognition of symptoms of the risk of developing post-traumatic stress disorder in children are presented in the national Adapted clinical guideline based on evidence (2016), Unified clinical protocol (primary, secondary (specialized) and tertiary highly specialized medical care) (2019), as well as the guidelines of the National Institute for Health and Clinical Improvement of Great Britain (NICE, 2018) and information from PubMed databases, UpTo Date. For determining these recommendations the new version of the International Classification of Diseases (ICD-11) was taken into account. Results. An analysis of clinical guidelines and scientific literature related to the study of post-traumatic stress disorder in children, in particular, its early recognition by primary care physicians, was carried out. The question of the peculiarities of the clinical course of psychotraumatic disorders depending on the time of their appearance after a traumatic event and the age of children is highlighted. In the context of the time that has passed since the traumatic event and the age of the children, a screening program for the early recognition of symptoms of the risk of developing post-traumatic stress disorder, which require immediate response by primary care workers, is presented. Special attention was paid to children from war zones, geographically remote regions, displaced persons, refugees. Conclusions. Early conducting of a short screening assessment of the risk of developing post-traumatic stress disorder in children, a timely decision on the provision of medical and psychological assistance, will contribute to the improvement of their quality of life in wartime conditions. No conflict or interests was declared by the authors.
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Gould, Simon W. J., Jess Rollason, Anthony C. Hilton, Paul Cuschieri, Laura McAuliffe, Susan L. Easmon i Mark D. Fielder. "UK epidemic strains of meticillin-resistant Staphylococcus aureus in clinical samples from Malta". Journal of Medical Microbiology 57, nr 11 (1.11.2008): 1394–98. http://dx.doi.org/10.1099/jmm.0.2008/003509-0.
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Since 1999, the European Antimicrobial Resistance Surveillance System (EARSS) has monitored the rise in infection due to a number of organisms, including meticillin-resistant Staphylococcus aureus (MRSA). The EARSS reported that MRSA infections within intensive care units account for 25–50 % of infections in many central and southern European countries, these included France, Spain, Great Britain, Malta, Greece and Italy. Each country has defined epidemic MRSA (EMRSA) strains; however, the method of spread of these strains from one country to another is unknown. In this current study, DNA profiles of 473 isolates of MRSA collected from the UK and Malta were determined by PFGE. Analysis of the data showed that two countries separated by a large geographical distance had a similar DNA profile pattern. Additionally it was demonstrated that strains of EMRSA normally found in the UK were also found in the Maltese cohort (EMRSA 15 and 16). A distinct DNA profile was found in the Maltese cohort, which may be a local EMRSA, and accounted for 14.4 % of all Maltese isolates. The appearance of the same MRSA and EMRSA profiles in two separate countries suggests that MRSA can be transferred out of their country of origin and potentially establish in a new locality or country.
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Weight, Christopher J., Brett Watson, Lucas Labine, Jacob Albersheim-Carter i Badrinath R. Konety. "Factors affecting the risk of erroneous interpretation of online surgeon rating websites among the general population." Journal of Clinical Oncology 35, nr 6_suppl (20.02.2017): 121. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.121.
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121 Background: Several websites present estimated individual surgeon complication rates for surgeons in both the United States and Great Britain. Though some researchers have raised questions as to the validity and appropriateness of these publicly displayed outcome measures, there remains very little research into how the general public may interpret these data to make health care decisions. Methods: We invited attendees of the 2016 Minnesota State Fair who met entry criteria, (adults > 18 years old, English speakers who were able to use a tablet computer) to complete our survey. Demographic data was presented along with various screen shots from online surgeon rating websites. Patients were then asked to interpret these graphics and report complication rates. Some graphics displayed complications rates for one surgeon alone, while others compared multiple surgeons side-by-side. Results: 392 participants completed the survey from a broad geographic distribution from the upper Midwest (179 unique zip codes). Median age was 49 (Interquartile range 28-61), the female:male ratio was 3:2, 57% had completed a college or graduate degree and 85% were Caucasian vs. 15% ethnic minorities. The majority of participants (76%) were able to correctly estimate complication rates when a single surgeon and his or her complication rates were shown, but when respondents were asked to compare/rank multiple surgeons, respondents overestimated complication rates by 5-7 fold, on average, for the lower ranking surgeons and only 15% of respondents could correctly identify the complication rate of the lowest performing surgeon. College graduates and those with a graduate degree were more likely to correctly estimate complication rates compared to participants with less education (odds ratio 1.98 95% CI 1.04-3.75, p = 0.035). Conclusions: Online surgeon rating websites that compare and rank surgeons may lead the general public to drastically overestimate the risk of postoperative complications. These errors in estimating complication rates appear to be reduced amongst those who are college educated and when viewing single surgeon outcomes in the absence of a comparison.
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Petrashko, L. P., i O. V. Martyniuk. "Ethical compass for medical solutions in the COVID-19 pandemic". Ukrainian Society 77, nr 2 (15.07.2021): 9–25. http://dx.doi.org/10.15407/socium2021.02.009.
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The article actualizes and structures significant problems of the medical sphere that arise in the context of the COVID-19 pandemic, in terms of the relations vectors: global world – state – person, state – clinic – society, clinic – doctor (medical staff), clinic – patient, doctor (medical staff) – the patient. The authors presented the evolutionary context of the norming process of medical resources and emphasized the hierarchical scheme of the regulation process of scarce resources norming in the health care system under the pandemic crisis conditions. The paper substantiates approaches to making medical decisions on “sorting” and applying a number of its forms depending on various regional, national, religious, and local models of the ethical values system formation. Emphasis is placed on American and European models of bioethics. The authors consider the utilitarian approach to preparing medical solutions of “clinical sorting” to level ethical catastrophes in a pandemic based on Catholic ethics. The issues of regulated norming of scarce medical resources and the “clinical triage” of patients during the COVID-19 pandemic in Ukraine have been investigated. The main bioethical dilemma of the COVID-19 pandemic is outlined. The authors actualize criteria and models of ethical medical solutions for equitable allocation of scarce medical resources in the context of the COVID-19 pandemic. These criteria and models are defined in the Ethical Guidelines for Responding to COVID-19 of the Bioethics Committee at the Council of Europe, the US Department of Health and Human Services; in normative documents in the field of ethics of medical decisions during the COVID-19 pandemic of the National Medical Associations, chambers, centres of bioethics of Italy, Hungary, USA, Great Britain; in the guidelines of national, religious and local institutions for the preparation of medical decisions for the levelling ethical catastrophes during the pandemic and the studies of international bioethics experts. The paper identified the need to formalize the fair distribution of scarce resources during the COVID-19 pandemic in Ukraine. The authors suggested recommendations for the implementation of ethical values and priorities for their application in critical conditions of shortage of medical resources and personnel in the COVID-19 pandemic in the health care system of Ukraine.
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Jacob, Sabrina Anne, Ailsa Power, Jane Portlock, Tesnime Jebara, Scott Cunningham i Anne C. Boyter. "Competency-Based Assessment in Experiential Learning in Undergraduate Pharmacy Programmes: Qualitative Exploration of Facilitators’ Views and Needs (ACTp Study)". Pharmacy 10, nr 4 (26.07.2022): 90. http://dx.doi.org/10.3390/pharmacy10040090.
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Newly registered pharmacists will need to possess higher-level competencies and, in Great Britain, there is an expectation that assessments are undertaken during experiential learning (EL). The aim of this study was to explore the perceptions and educational needs of practice-based EL facilitators of student pharmacists, undertaking competency-based assessments during EL. Semi-structured one-on-one interviews were conducted with EL facilitators working in the community, hospital, and primary-care pharmacies. Data were thematically analysed. Fifteen facilitators were interviewed, and there were five from each site. There was general support for this role, but also anxiety due to the lack of knowledge about assessments and the repercussions on students. Benefits were that students would receive real-time feedback from workplace-based practitioners and facilitators would benefit from self-development. Challenges included additional workload and lack of consistency in marking. The majority agreed that clinical, professional, and communication skills could be assessed; however, a consensus was not reached regarding the tools, methods, and grading of assessments. The need for training and support were highlighted. A co-design method was proposed to ensure that the assessment methods and processes are accepted by all stakeholders. Training and resources should be tailored to the needs of facilitators.
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Davies, Andrew Neil, Frank Elsner, Marilène Jeanne Filbet, Josep Porta-Sales, Carla Ripamonti, Daniele Santini i Kath Webber. "Breakthrough cancer pain (BTcP) management: a review of international and national guidelines". BMJ Supportive & Palliative Care 8, nr 3 (6.06.2018): 241–49. http://dx.doi.org/10.1136/bmjspcare-2017-001467.
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ObjectiveBreakthrough cancer pain (BTcP) is common and has a significant impact on the quality of life of patients with cancer. This review compares current national/international BTcP guidelines in order to identify disparities and priorities for further research.MethodsRelevant guidelines were identified using searches of PubMed, the National Guideline Clearinghouse, the internet (commercial search engines), and correspondence with key opinion leaders and relevant pharmaceutical companies. Identified guidelines were compared, using the Association for Palliative Medicine of Great Britain and Ireland recommendations as the ‘reference’ guideline.ResultsTen specific BTcP guidelines were identified/reviewed, as well as major international generic cancer pain guidelines. In general, there was good agreement between the specific BTcP guidelines, although there remain some differences in terms of definition, diagnostic criteria and treatment of BTcP. Disparities between the different BTcP guidelines invariably reflect personal opinion rather than research evidence. Generic cancer pain guidelines continue to support the use of oral opioids as rescue medication, while specific BTcP guidelines invariably endorse the use of transmucosal opioids as rescue medication.ConclusionCurrent guidelines agree on many aspects of the management of BTcP. However, the evidence to support current guidelines remains low grade, and so more research is needed in this area of care. Moreover, there needs to be an international consensus on the definition and diagnosis criteria of BTcP.
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Pham, Dem Van, Hai Hoang Do, Anh Viet Nguyen, Nam Thanh Nguyen, Ngoc Van Hoang i Ngoc-Anh Hoang. "The first newborn patient with SARS-CoV-2 variant B.1.1.7 identified in Viet Nam: treatment and care practices". Western Pacific Surveillance and Response Journal 12, nr 3 (30.09.2021): 77–81. http://dx.doi.org/10.5365/wpsar.2021.12.2.008.
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SARS-CoV-2 variant B.1.1.7, first detected in September 2020 in the United Kingdom of Great Britain and Northern Ireland, has spread quickly to many countries around the world. While some publications have described the clinical features of adult patients with the B.1.1.7 variant, little information is available on newborn patients. We report the clinical characteristics, treatment and care practices for a 21-day-old newborn patient who was confirmed to be infected with SARS-CoV-2 variant B.1.1.7 in Viet Nam during contact tracing after her father was confirmed to be infected with SARS-CoV-2. The patient displayed no symptoms of COVID-19 on admission but 3 days later developed diarrhoea, vomiting, a runny nose and a productive cough. These symptoms lasted for 3 days before becoming milder for 1 day and then stopping until discharge. During treatment, the patient received Vietnamese traditional herbal peppermint extracts for cough and digestive probiotics for diarrhoeal symptoms. A saltwater solution (Sterimar 0.9%) was used to clean the patient’s sinuses. The patient was cared for and fed breastmilk by her mother, who was provided with personal protective equipment, including sterilized infant equipment, medical masks and hand sanitizer, during hospitalization. The patient’s mother tested negative for SARS-CoV-2 throughout hospitalization. In conclusion, we found no severely abnormal clinical symptoms in a newborn infected with SARS-CoV-2 variant B.1.1.7 during treatment. Our case suggests that newborn patients with the B.1.1.7 variant can receive exclusive breastmilk feeding if sufficient preventive measures are provided for both mother and child.
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Zakieva, L. "DOMESTIC AND FOREIGN EXPERIENCE OF TERRITORIAL PLACEMENT AND FUNCTIONING OF HEALTHCARE FACILITIES". Bulletin of Belgorod State Technological University named after. V. G. Shukhov 7, nr 3 (16.12.2021): 42–51. http://dx.doi.org/10.34031/2071-7318-2021-7-3-42-51.
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The primary task of our work is to determine the distribution and functioning of healthcare facilities in the planning structure of large cities in domestic and foreign practice. Domestic experience is present in cities which are characterized by introducing reforms in the health system: Moscow, St. Petersburg, Kazan, Tomsk, Perm. We studied the features of the distribution of healthcare facilities in cities which are characterized by an active policy of reforming the health care system: Singapore, Hong Kong, Great Britain, Germany, Israel. The research have been conducted on the basis of general scientific methods: analysis, synthesis and systematization of data identified from literary, graphic and Internet resources. As a result of analysis the spatial placement of the components the healthcare facilities we have been compiled the heat maps, which demonstrating the features of placement in the planning structure of cities. We have been analyzing a land plots of healthcare facilities to identify the compliance to the current regulatory documents and to determine the density of development depending on the location in the structure of the city. We have been carrying out a comparative analysis of the domestic and foreign experience of the spatial distribution of healthcare facilities. As a result, we have been identified two forms of spatial organization of healthcare facilities: point-based «network» and interconnected and functionally dependent organizations concentrated on a local territory the «medical clusters» – one of the most important trends of health care system
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Iakovlieva, L. V., T. O. Bahlai i O. V. KHOMENKO. "Comparative analysis of antimicrobial drugs recommended by medical and technological documents for the treatment of patients with community-acquired pneumonia". Farmatsevtychnyi zhurnal, nr 2 (10.05.2019): 38–44. http://dx.doi.org/10.32352/0367-3057.2.19.04.
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Today community-acquired pneumonia remains one of the leading causes of death as a result of infectious diseases. For effective treatment must be guided by such guidelines which would take into account not only recent world experience in the field of antimicrobial therapy but also regional peculiarities of the microbial spectrum and the resistance to pathogens of this nosology.
The aim of the work was to conduct a comparative analysis of antimicrobial drugs recommended for the treatment for patients with community-acquired pneumonia.
The assortment of major antimicrobial drugs was studied according to the «Pharmstandard» system of the «Morion» company. Also, the research used data of medical and technological documentation of Ukraine, Great Britain, USA.
Current the Unified Protocol for the provision of medical care to adult patients with community-acquired pneumonia and the State Medicines Directive offer almost identical antimicrobial drugs and differ only in those that do not have a proof-based basis. Leading international sources recommend a smaller number of drugs whose trade names are sufficient in the domestic market, and pharmacological properties suggest a rational pharmacotherapy of patients with community-acquired pneumonia when using them.
Medical and technological documents offer for pharmacotherapy of patients with community-acquired pneumonia more than 20 preparations with more than 500 product names mainly present on the domestic market; in foreign directions a number of drugs (cefaclor, flucloxacillin, temocylin, piperacillin, colistin) are recommended, which are not in the domestic documentation, whose pharmacological properties and price range are rational to have for treatment of patients with community-acquired pneumonia.
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Moroz, G. Z., I. A. Holovanova, S. A. Bychkova i O. O. Dzyzinska. "CURRENT ASPECTS OF ENGAGING PATIENTS TO SHARED DECISION-MAKING AND PARTNER PARTICIPATION IN THE TREATMENT PROCESS (review)". Клінічна та профілактична медицина 2, nr 24 (5.06.2023): 89–98. http://dx.doi.org/10.31612/2616-4868.2(24).2023.13.
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The aim of the research: to conduct an analysis and generalization of scientific publications on the engaging patients to shared decision-making and partner participation in the treatment process.
Materials and methods. The analysis and generalization of scientific publications on the implementation of shared decision-making strategy and the engaging of patients to self-management and participation in the treatment process were carried out. Methods were used: systematic approach, bibliosemantic, analytical.
Results. In modern conditions, partner participation of patients in the treatment process has become a mandatory component of the development of a patient- centered model of medical care and is recommended by the WHO. A necessary component of this process is the implementation of shared decision-making strategy by the doctor and the patient. Organizational approaches to the implementation of the shared decision-making strategy in clinical practice are being improved and generalized, in particular, in 2021 NICE (Great Britain) experts published guideline NG197 «Shared decision-making». One of the most important factors of the shared decision-making strategy implementation in clinical practice is the training of medical staff on improving communication skills and empathy, engaging the patient to independent control of the disease, etc. WHO pays considerable attention to the engaging of patients self-management of health status and treatment results, as a component of patient partnership in the organization of medical care. It has been proven that self-management programs reduce the number of unplanned hospitalizations of patients with chronic obstructive pulmonary disease and bronchial asthma, heart failure, etc. A wide range of approaches have been proposed to support patient engagement in self-management and partnership in treatment, including information leaflets, online peer support, individual counselling, group educational sessions, telephone coaching, symptom monitoring technologies and change interventions psychological behavior.
Conclusions: The implementation of a patient-centered model of medical care requires engaging patients in the treatment process as partners, which involves joint decision-making by the doctor and patient and self-management. It is essential to improve the communication skills of physicians and educate patients about participating in shared decision-making and self-management.
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Witt, Claudia M., i Christine Holmberg. "Changing Academic Medicine: Strategies Used by Academic Leaders of Integrative Medicine—A Qualitative Study". Evidence-Based Complementary and Alternative Medicine 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/652546.
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In Western countries, complementary and alternative medicine (CAM) is more and more provided by practitioners and family doctors. To base this reality of health care provision on an evidence-base, academic medicine needs to be included in the development. In the study we aimed to gain information on a structured approach to include CAM in academic health centers. We conducted a semistructured interview study with leading experts of integrative medicine to analyze strategies of existing academic institutions of integrative medicine. The study sample consisted of a purposive sample of ten leaders that have successfully integrated CAM into medical schools in the USA, Great Britain, and Germany and the Director of the National Center for Alternative and Complementary Medicine. Analysis was based on content analysis. The prerequisite to foster change in academic medicine was a strong educational and professional background in academic medicine and research methodologies. With such a skill set, the interviewees identified a series of strategies to align themselves with colleagues from conventional medicine, such as creating common goals, networking, and establishing well-functioning research teams. In addition, there must be a vision of what should be needed to be at the center of all efforts in order to implement successful change.
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Rogalski, David, Nina Barnett, Amanda Bueno de Mesquita i Barry Jubraj. "The Pharmacist Prescriber: A Psychological Perspective on Complex Conversations about Medicines: Introducing Relational Prescribing and Open Dialogue in Physical Health". Pharmacy 11, nr 2 (22.03.2023): 62. http://dx.doi.org/10.3390/pharmacy11020062.
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Pharmacists have traditionally supported the prescribing process, arguably in reactive or corrective roles. The advent of pharmacist prescribing in 2004 represented a major shift in practice, leading to greater responsibility for making clinical decisions with and for patients. Prescribing rights require pharmacists to take a more prescriptive role that will allow them to contribute to long-standing prescribing challenges such as poor medication adherence, overprescribing, and the need for shared decision-making and person-centered care. Central to these endeavors are the development and possession of effective consultation skills. University schools of pharmacists in the UK now routinely include consultation skills training, which is also provided by national education bodies. These challenges remain difficult to overcome, even though it is understood, for example, that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments. More recently, a concerted effort has been made to tackle overprescribing and the harm that may occur through the inappropriate use of medication. In routine pharmacy work, these priorities may linger at the bottom of the list due to the busy and complex nature of the work. Solutions to these problems of adherence, optimizing benefits of medication, and overprescribing have typically been pragmatic and structured. However, an arguably reductionist approach to implementation fails to address the complex patient interactions around prescribing and taking medication, and the heterogeneity of the patient’s experience, leaving the answers elusive. We suggest that it is essential to explore how person-centered care is perceived and to emphasize the relational aspects of clinical consultations. The development of routine pharmacist prescribing demands building on the core values of person-centered care and shared decision making by introducing the concepts of “relational prescribing” and “open dialogue” to cultivate an essential pharmacotherapeutic alliance to deliver concrete positive patient outcomes. We provide a vignette of how a clinical case can be approached using principles of relational prescribing and open dialogue. We believe these are solutions that are not additional tasks but must be embedded into pharmacy practice. This will improve professional satisfaction and resilience, and encourage curiosity and creativity, particularly with the advent of all pharmacists in Great Britain becoming prescribers at graduation from 2026.
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Sergoventsev, Alexander A., i Andrey E. Zobov. "Comparative analysis of the features of organizing measures to combat the COVID-19 pandemic in the health systems of the Russian Federation and foreign countries". Bulletin of the Russian Military Medical Academy 24, nr 4 (4.01.2023): 775–88. http://dx.doi.org/10.17816/brmma114757.
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The study analyzed available literatures covering the organization of measures to combat the COVID-19 pandemic in the healthcare systems of the Russian Federation and several foreign countries. For the comprehensive assessment of the specifics of organizing measures to combat the COVID-19 pandemic, countries were chosen based on geographical distances from China (the closest is Korea, and the most remote are the Great Britain and Haiti), maximum population on their continent (the United States is in North America, and Brazil in South America), and significant differences in the functioning of the healthcare systems. The peculiarities of organizing measures to combat the COVID-19 pandemic in the considered countries were associated with a complex of political, financial, economic, demographic, and organizational factors, the individual combination of which determined the peculiarities of the development of the epidemic process in each specific case. Moreover, as a priority manifestation of the severity of these factors, the capabilities of the healthcare system, including the availability of services of medical workers, sufficient number of testing equipment, medical protection equipment, hospital beds, and other parameters, should be considered. The main role was played by global state strategies implemented in the healthcare systems of the analyzed countries at the pre-epidemic stage and, in most cases, aimed at optimizing the financial and economic provisions of state guarantees of medical care. The general criteria for the differential diagnosis of COVID-19 in the national recommendations of all the states considered were respiratory symptoms and general infectious intoxication. In addition, fever and respiratory symptoms were accepted as priority criteria for COVID-19 screening.
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Склярова, Е. К. "LIVERPOOL IN VICTORIAN DOMESTIC POLITICS". Британские исследования, nr VII(VII) (1.06.2022): 227–43. http://dx.doi.org/10.21267/aquilo.2022.vii.vii.001.
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В статье рассматриваются особенности социального развития Ливерпуля в контексте его роли во внутренней политике Великобритании в эпоху королевы Виктории. Крупнейший город и порт Соединённого Королевства Великобритании и Ирландии одним из первых ощутил на себе все негативные последствия промышленного переворота, урбанизации и миграции населения. Как и многие другие города Великобритании, Ливерпуль фигурировал в прессе, медицинских, статистических и парламентских отчётах, как город подвалов, центр массовой миграции, трущоб, высокой смертности населения, отсутствия санитарно-технических норм и антисанитарии. Парламентские расследования и пресса указали на Ливерпуль, а также Вулверхемптон, Глазго, Дублин, Лидс, Лондон, Манчестер, Шеффилд, как города, где необходимо первоочередное проведение социальных реформ. В середине XIX в. в эпоху королевы Виктории Ливерпуль израсходовал значительные суммы денег на решение проблемы антисанитарии, уборки и мощения города, водоснабжения и освещения, жилищную реформу, организацию прачечных, общественных бань, библиотек, парков. Пионерами муниципализации и здравоохранения Ливерпуля стали — доктор Уильям Данкен, С. Хольм, Дж. Тинн. До введения общегосударственного Закона об обеспечении общественного здравоохранения 1848 г., Ливерпуль инициировал институт инспекции и санитарных врачей, жилищную реформу, систематическое вмешательство государства в решение социальных проблем. The article examines the features of Liverpool's social development in the context of its role in the domestic politics of Great Britain in the era of Queen Victoria. The largest city and port of the United Kingdom of Great Britain and Ireland was one of the first to feel all the negative consequences of the industrial revolution, urbanization and population migration. Like many other cities in the UK, Liverpool appeared in the press, medical, statistical and parliamentary reports as a city of basements, a center of mass migration, slums, high mortality, lack of sanitary standards and unsanitary conditions. Parliamentary investigations and the press have pointed to Liverpool, as well as WolverHampton, Glasgow, Dublin, Leeds, London, Manchester, Sheffield, as cities where social reforms are needed as a priority. In the middle of the XIX century in the era of Queen Victoria, Liverpool spent significant amounts of money on solving the problem of unsanitary conditions, cleaning and paving the city, water supply and lighting, housing reform, the organization of laundries, public baths, libraries, and parks. The pioneers of municipalization and health care in Liverpool were Dr. William Duncan, S. Holm, J. Thinn. Prior to the introduction of the National Public Health Law of 1848, Liverpool initiated the Institute of inspection and sanitary doctors, housing reform, and systematic state intervention in solving social problems.
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Bozhenko, Victoria. "Tackling corruption in the health sector". Health Economics and Management Review 3, nr 3 (2022): 32–39. http://dx.doi.org/10.21272/hem.2022.3-03.
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Corruption in the health sector is unique because it includes abuse by public officials and unscrupulous behavior by other actors (drug manufacturers, health professionals, patients, etc.). The urgency of solving the scientific problem lies in the fact that financial relations in the medical field arise between a wide range of persons who can act as initiators of corruption decisions and/or their executors. The study’s main goal is to analyze the forms of corruption in the healthcare system and their consequences for society, as well as to assess the degree of interrelationship between the level of corruption and indicators of financial support in the healthcare sector. The methods of structural and comparative bibliometric analysis and correlation analysis became the methodical tools of the conducted research. The object of research is 140 countries in the world. The conducted bibliometric analysis testified to the permanent growth of the study of the issue of corruption in medicine in the scientific environment. Scientists from the United States, United Kingdom, and Germany have implemented the largest number of works on a certain topic. The conducted correlation analysis also empirically confirmed that an increase in the level of corruption in the country leads to an increase in the share of household expenses for financing their own medical needs. The article founds that the population in countries with a low level of corruption (the corruption promotion index is closer to 100) has a higher level of provision of vital medical services (reproductive health, health of women, newborns, and children, infectious diseases, non-infectious diseases and opportunities provision of services and access to them). Countries with a high level of anti-corruption and coverage of medical services include Finland, Sweden, Germany, and Great Britain. The results of the research can be useful for state regulatory bodies, specialized organizations in the field of health care, as well as public organizations.