The article considers issues of organizational and legal progress of social protection of workers involved in medical care during period of COVID-19. The purpose of the study is to analyze regulatory legal documents that define state guarantees that provide social protection for persons involved in the provision of medical care during COVID-19. The attempt was made to analyze international and national information on relevant morbidity, mortality and disability of health care workers, but respective data was not readily available in open admission. The analysis of international documents (the WHO, CDC, JHU reports), public documents of the Russian Federation, information from official websites of the President of the Russian Federation and the executive authorities of the Russian Federation (state reports on sanitary and epidemiological well-being of the population in the Russian Federation in 2020-2022) demonstrated the following. The whole world faced with the problem of protecting health care workers from contamination with new corona-virus infection. In the Russian Federation, unprecedented measures were taken to ensure social protection for this category of workers, including provision of additional social benefits.

Bringing to disciplinary responsibility of medical workers in the context of reforming the system of personnel training for the medical field, the introduction of digital technologies into the daily activities of a doctor, acquires pronounced specific features. The purpose of the study is to review the current labor legislation regulating labor discipline and identify the grounds for bringing medical workers to disciplinary responsibility in medical organizations.

OBJECTIVE: Investigation of the clinical and economic advisability of using self-adhesive wound bandages of plaster type (on the example of Cosmopor E steril) compared to gauze bandages in the conditions of medical organization.
METHODS: Study design - a retrospective analysis of literature data. Methods of pharmacoeconomic analysis - cost minimization analysis, «impact on budget» analysis. The Unified Information System in Procurement was the information source of the self-adhesive bandages cost. The charges of gauze bandages production were calculated on the basis of data provided by structural subdivisions of SamSMU Clinics.
RESULTS: It was determined that the use of self-adhesive bandages of plaster type is economically feasible as a result of the analysis of cost minimization and impact on the budget. Saving during 1 year can be from 259 466 to 532 603 rubles (in total for three departments - 1.1 million rubles). Sensitivity analysis showed the stability of the obtained results to the variation of entry conditions (costs for gauze bandages and bandages of plaster type) in a wide range of values.
CONCLUSIONS: The data obtained from the study showed that the use of bandages of plaster type for different types of surgical treatment is more justified in terms of cost saving.
UNASSIGNED: Изучение клинико-экономической целесообразности использования самоклеящихся раневых повязок пластырного типа (на примере Cosmopor E steril) по сравнению с марлевыми повязками в условиях медицинской организации.
UNASSIGNED: Дизайн исследования — ретроспективный анализ данных литературы. Методы фармакоэкономического анализа — анализ минимизации затрат, анализ влияния на бюджет. Источником информации о стоимости самоклеящихся повязок была Единая информационная система в сфере закупок. Затраты на изготовление марлевых повязок рассчитывались на основании данных, предоставленных структурными подразделениями Клиник ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России.
UNASSIGNED: В результате анализа минимизации затрат и влияния на бюджет определено, что использование самоклеящихся повязок пластырного типа экономически целесообразно. Экономия в течение 1 года может составлять от 259 466 до 532 603 руб. (суммарно по трем отделениям — 1,1 млн руб.). Анализ чувствительности показал устойчивость полученных результатов к колебанию входных условий (затраты на марлевые повязки и повязки пластырного типа) в широком диапазоне значений.
UNASSIGNED: Полученные в результате исследования данные продемонстрировали, что использование повязок пластырного типа при различных типах хирургических вмешательств является более обоснованным с позиции экономии затрат.

The state health care policy in Russia is directed at improving medical care quality and population satisfaction with it. The functioning of medical organizations beloning to national health care system has determinative impact on population health. The increasing of level of organization of their functioning is imposible without target manpower policy, upgrading qualification and professionalism of health care workers. The purpose of the study was to analyze personnel potential of Oblast clinical hospital, as one of leading health care institutiond of the Astrakhan Oblast. The methodologies of statistical, logical and system analysis were applied. The study used method of continuous sampling and was carried out in 2012-2021. The information sources included forms of the Federal statistical monitoring № 30 \"Information on the medical organization\" and № 17 \"Information on medical and pharmaceutical workers\". The absolute and mean values, extensive parameters modeling structure and methods of dynamic series construction were applied. The study revealed positive dynamics of increasing of number of established posts on 33.7%. The number of physical persons of hospital medical personnel (the basic increase made up to 40%) increased. It resulted in decreasing of combining jobs coefficient and in increasing of staff efficiency employment. The women consisted 65.2% of all working physicians. The mean age made 43.2 years among phycians and 41.7 years among paramedical personnel. The ratio 1.5:1 of paramedical personnel to physicians in staff list is negative factor. Alongside, ratio of physical persons of paramedical personnel and physicians decreases. It testifies necessity of increasing both established posts and involvement of more physical persons to work on paramedical personnel rates.

The purpose of the study is to identify relationship between value orientations and safety culture of workers of medical organization. The sampling consisted of 284 workers (66 men, 218 women) of medical clinic. To identify system of personal values the \"Value Orientations\" questionnaire by Sch. Schwartz was applied. The mean values and ranks were calculated for each value indicator. To assess safety culture the \"Safety Attitudes Questionnaire\" by K. N. Tsaranov et al. was applied. The data statistical processing of the data was carried out using variance analysis and correlation analysis (Pearson coefficient). The largest differences in the indicators in the group with a low level of value-intentional coherence indicator were observed in relation to values \"conformity\" (rank difference 2.16), \"stimulation\" (1.73), \"universalism\" (0.9), \"achievement\" (0.83), \"independence\" (0.77), \"traditions\" (0.61) For other values difference was less than 0.5. The largest differences in indicators in the group with high level of value-intentional coherence indicator (IVC) were observed for values \"universalism\" (1.01), \"stimulation\" (0.64), \"achievement\" (0.5). For the remaining values difference was less than 0.5. Assessment of safety culture revealed that below threshold of agreement (75%) were results on the scale \"Recognition (understanding) of stress\" in all groups of respondents. On indicator \"Working conditions\" below level of agreement were results of groups with low and high levels of value-intentional consistency indicator. Below threshold of agreement (75%) were results of responses to the question about the relationship with clinical pharmacologists in all groups of respondents. The value-intentional coherence index can be applied only concerning each single worker. The qualitative analysis of IVC indicator should both include its comparison at the level of normative ideals and behavioral priorities of values and to consider the spread between ranks. The values \"stimulation\" and \"achievement\" have no effect on manifestation of attitude to safety culture of medical organization. The key personal values associated with manifestations of safety culture are \"power\", \"autonomy\" and \"conformality\".

The article considers draft of new edition of the International Health Regulations. The possible risks associated with changing of the document are evaluated from perspective of member countries, in whose territories occur or supposedly occur emergency situations in field of public health having international importance.
В статье рассмотрен проект новой редакции международных медико-санитарных правил. Оценены возможные риски, связанные с изменением документа, с позиции государств-участников, на территории которых происходят или предположительно происходят чрезвычайные ситуации в области общественного здравоохранения, имеющие международное значение.

OBJECTIVE: The purpose of this research is to study the quantitative indicators of the provision of medical care using telemedicine technologies (TMT) with the remote interaction of medical workers with each other to obtain an objective assessment of the level of activity and involvement of medical organizations (MO) of different constituent entities of the Russian Federation (RF) in this process.
METHODS: The study was carried out according to the reporting forms of the Federal State Budgetary Institution National Medical Research Center «Central Research Institute of Dental and Maxillofacial Surgery» (FSBI NMRC «CRID&MFS») of the Ministry of Health of Russia based on the results of councils of doctors using TMT. A total of 648 indicators were studied, reflecting the purpose of the consultation, the number of medical organizations that requested consultation in the specialty «maxillofacial surgery», the number of patients and requests. There were 685 applications for consultations in FSBI NMRC «CRID&MFS» of the Ministry of Health of Russia of 577 patients from 138 medical organizations of 72 constituent entities of the Russian Federation in 8 Federal Districts (FD) for 2021 processed.
RESULTS: The most involved MO in the process of providing medical care using TMT with remote interaction of medical workers with each other are of the Ural, Central, and Volga Federal Districts, of which the most active are the Khanty-Mansky and Yamalo-Nenets Autonomous Districts (AD). The demand for clarification of the tactics of treatment by doctors of MO of the constituent entities of the Russian Federation is 1.8 times higher than in determining the possibility of hospitalization and 3.5 times higher than in clarification of the diagnosis.
CONCLUSIONS: The indicators obtained as a result of the study can be included in the predictive analysis to determine the volume of TMT for the next calendar year, allowing in advance to rationally allocate personnel, time, information, material, and technical resources to ensure the process of providing medical care using TMT with remote interaction of workers with each other.
UNASSIGNED: Методом анализа изучить количественные показатели оказания медицинской помощи с применением телемедицинских технологий (ТМТ) при дистанционном взаимодействии медицинских работников между собой с целью получения объективной оценки уровня активности и вовлеченности медицинских организаций (МО) разных субъектов РФ в данный процесс.
UNASSIGNED: Исследование проводили по данным отчетных форм ФГБУ НМИЦ «ЦНИИСиЧЛХ» Минздрава России по результатам консилиумов врачей с применением ТМТ. Всего изучено 648 показателей, отражающих цель консультации, число МО, запросивших консультацию по специальности «челюстно-лицевая хирургия», число пациентов и обращений. Обработано 685 заявок на проведение консилиумов врачами ФГБУ НМИЦ «ЦНИИСиЧЛХ» Минздрава России 577 пациентов из 138 МО 72 субъектов РФ в 8 федеральных округах (ФО) за 2021 г.
UNASSIGNED: Наиболее вовлеченными в процесс оказания медицинской помощи с применением ТМТ при дистанционном взаимодействии медицинских работников между собой являются МО Уральского, Центрального и Приволжского ФО, из которых наиболее активные — МО Ханты-Мансийского и Ямало-Ненецкого АО. Востребованность в уточнении тактики лечения врачами МО субъектов РФ в 1,8 раза выше, чем в определении возможности госпитализации и в 3,5 раза выше, чем в уточнении диагноза.
UNASSIGNED: Полученные в результате исследования показатели могут быть включены в прогностический анализ с целью определения объема телемедицинских услуг на следующий календарный год, позволив заранее рационально распределить кадровые, временные, информационные, материально-технические ресурсы для обеспечения процесса оказания медицинской помощи с применением ТМТ при дистанционном взаимодействии медицинских работников между собой.

The article considers possible risks according analysis of comprehension by workers of necessary competencies ensuring quality and safety of medical activities at performing their duties as well as assessment of factors affecting completeness of choice. It is proposed to apply corporate training as component targeted to improving quality and safety of medical activities by addressed training of necessary competencies within the framework of continuous medical education, supplementing existing self-education.
Представлен анализ возможных рисков по результатам анализа понимания сотрудниками необходимых компетенций по обеспечению качества и безопасности медицинской деятельности при выполнении ими своих обязанностей, а также оценка факторов, влияющих на полноту выбора. Предлагается использование корпоративного обучения как компонента, направленного на повышение качества и безопасности медицинской деятельности, через адресное формирование необходимых компетенций в рамках непрерывного медицинского образования, в дополнении к существующему самообразованию.

Further reforming of the rural health care should be proceeded with special attention to availability of medical care in countryside.The purpose of the study is to develop on the basis of analysis of accounting data and research results recommendations for improving organizational forms of medical care to country dwellers. The exploration of peopleware and main performance indicators of medical organizations in rural areas was implemented.The statistical, analytical and sociological methods were applied. The reporting forms 47, 30, 12 of Federal statistical monitoring are analyzed.Results. The provision of population with medical personnel in rural municipalities in 2010-2018 increased from 12.5 to 14.5 per 10 thousand of rural population. The provision with paramedical personnel made up to 52.3%oo and during the same years indicator decreased from 55.4 to 52.3%oo. During the analysis period, 4241 feldsher obstetric posts were reduced and in 2018 their number made up to 33,350. The number of feldshers in rural areas decreased on 18.5%. In 2005-2018 number of central district hospitals and district hospitals decreased in 2.5 times. At that, provision of beds in municipalities of rural areas decreased from 49.6 to 38.8%oo. There significant winding up of district hospitals and their restructuring into branches of central district hospitals occurred. In 2018, remained only 47 out of them equipped with 1549 beds. Unfortunately, the reporting forms of the Ministry of Health of the Russian Federation do not account branches of central district hospitals. This information is to be included in accountability of the Ministry of Health.It is necessary to expand scope of authority of local government bodies in resolving medical and social problems in rural territories.
Реформирование системы здравоохранения села следует продолжать, уделив особое внимание проблеме медицинского обеспечения - доступности медицинской помощи на селе.На основе анализа учетных данных и результатов исследовательских работ разработаны рекомендации по совершенствованию организационных форм оказания медицинской помощи сельским жителям.Проанализированы кадровое обеспечение села и основные показатели деятельности медицинских организаций, расположенных в сельской местности. Использованы методы: статистический, аналитический, социологический. Проанализированы отчетные формы федерального статистического наблюдения 47, 30, 12.Исследование показало, что обеспеченность населения врачебными кадрами в медицинских организациях, расположенных в селе, за 2010-2018 гг. увеличилась с 12,5 до 14,5 на 10 тыс. сельского населения. Обеспеченность средним медицинским персоналом составила 52,3%oo, за те же годы показатель снизился с 55,4 до 52,3%oo. За анализируемый период сокращен 4241 фельдшерско-акушерский пункт, их число в 2018 г. составило 33 350. Число фельдшеров на селе уменьшилось на 18,5%. За период 2005-2018 гг. число центральных районных больниц и районных больниц сократилось в 2,5 раза, при этом обеспеченность койками медицинских организаций, расположенных в сельской местности, снизилось с 49,6 до 38,8%oo. Произошли значительное сокращение участковых больниц и реструктуризация их в филиалы центральных районных больниц. В 2018 г. их осталось всего 47 с числом коек в них 1549. К сожалению, в отчетных формах Минздрава России не ведется учет филиалов центральных районных больниц. Эту информацию следует заложить в отчетность Минздрава.Необходимо расширять сферу полномочий местных органов власти в решении медико-социальных проблем на селе.

There is an ongoing debate among researchers and policy-makers on how to make transparency a powerful tool of healthcare systems. This study addresses how the availability and accessibility of information about medical services to the general population affects healthcare outcomes in Russia. A systematic review was conducted and reported according to the Preferred Reporting Items for Systematic Reviewing and Meta-Analysis (PRISMA) guidelines. Transparency indicators of health facilities used in the world\'s most efficient healthcare systems are also reviewed. Although the increase of transparency in the Russian healthcare system is considered as a tool for improving its efficiency, very little has been done to improve the actual level of transparency. The existing institutional specifics of the Russian healthcare system impose serious restrictions on acceptable levels of transparency. In the reviewed empirical Russian studies, transparency is often viewed simplistically as either information available on the websites of medical organizations or issues related to the amount of accessible indicators of compulsory medical statistical reporting. The novelty of this study consists in (a) reviewing the most recent studies on the topic and (b) including studies in Russian in the analysis. We elaborate on general and specific policy implications for improving transparency-driven outcomes in the Russian healthcare system.