Evaluation of Continuity of Care: What Can Physician Survey Add?

Background: The evaluation of continuity of care is usually based on the indicators of the frequency of patients' contacts with specific providers. There are some first attempts to use physician survey for the evaluation.

Objective: Is to get additional information on the continuity of care in Russia by a newly developed physician questionnaire with detailed questions related to the specific areas of providers' interaction in the health system.

The hard way from the Beveridge to the Bismarck model of health finance: Expectations and reality in Russia.

Most post-Soviet countries have introduced mandatory health insurance (MHI) systems which completely or partially replaced national health systems known as budgetary models. In Russia, an attempt was made to introduce a competitive MHI model with multiple health insurers. The current MHI system has, however, acquired an increasing number of features inherent in the previous budgetary model.

Health workforce policy in the Russian Federation: How to overcome a shortage of physicians?

Russia looks for ways to overcome a shortage of physicians. Health workforce policy is focused on training an additional number of physicians. The current efforts have reduced some areas of the shortage but failed to solve the problem due to many factors that reproduce the deficit.

What next for the polyclinic? New models of primary health care are required in many former Soviet Union countries.

Background: There is unfinished reform in primary care in Russia and other former Soviet Union (FSU) countries. The traditional 'Semashko' multi-specialty polyclinic model has been retained, while its major characteristics are increasingly questioned. The search for a new model is on a health policy agenda.

Structural changes in the Russian health care system: do they match European trends?

Unlabelled: ВACKGROUND: In the last two decades, health care systems (HCS) in the European countries have faced global challenges and have undergone structural changes with the focus on early disease prevention, strengthening primary care, changing the role of hospitals, etc. Russia has inherited the Semashko model from the USSR with dominance of inpatient care, and has been looking for the ways to improve the structure of service delivery. This paper compares the complex of structural changes in the Russian and the European HCS.

Vertical program of screenings and check-ups in the Russian Federation: design, implementation and lessons learnt.

Background: The Russian Federation has introduced a vertical large-scale program of 'dispensarization' (Program) that includes health check-ups and screenings for the entire adult population. It is expected to improve the results of medical interventions and ensure health gains at a relatively low cost. The major research question: Does the design and implementation of the program meet the expectations?

Methods: We analyze regulatory acts and the literature on the design and the outcomes of the Program.

Using Targets to Reduce Waiting Times for Elective Care: What Can We Learn from the Russian Experience?

This article explores the potential for maximum waiting times targets to improve access to healthcare in a country with limited financial resources. The study combines policy analysis, off-the-record communications, face-to-face interviews, public opinion surveys and open access patient complaints to create a rich picture of how waiting time targets are monitored and implemented in theory and practice. The study found that most waiting time targets in the Russian Federation are unrealistically low, while institutional and operational arrangements for their implementation have not been built in most regions.

Concentration of health care providers: does it contribute to integration of service delivery?

Background: The concentration of health care providers is a growing process in many countries, including Russia. There is a general expectation that larger medical entities can better promote the process of service integration.

Purpose: This paper explores the impact of health provider concentration on service delivery integration through the indicators of teamwork, coordination and continuity of care in outpatient and inpatient medical facilities.

The evolving Semashko model of primary health care: the case of the Russian Federation.

This paper addresses the major developments in primary care in the Russian Federation under the evolving Semashko model. The overview of the original model and its current version indicates some positive characteristics, including the financial accessibility of care, focus on prevention, patient lists, and gatekeeping by primary-care providers. However, in practice these characteristics do not work according to expectations.

Too many and too few: The paradoxical case of physicians in the Russian Federation.

There is a paradox characterising the Russian health workforce. By international standards, Russia has a very high number of physicians per capita but at the same time is confronted by chronic real shortages of qualified physicians. This paper explores the reasons for this paradox by examining the structural characteristics of health workforce development in the context of the Soviet legacy and the comparative performance of other European countries.

[Regeneration of planarians: experimental object].

We discuss the expediency of using invertebrates, such as flatworms and planarians, as experimental objects. Free-living planarian flatworms (phylum Platyhelminthes, class Turbellaria) are invertebrate animals in which a bilateral symmetry appears for the first time in evolution and organs and tissues form. As the highest ecological link of the food chain--predators--these animals are characterized by a set of behavioral reactions controlled by a differentiated central nervous system.

[Modulating effect of weak combined magnetic fields on duration of mealworm beetle Tenebrio molitor metamorphosis stage].

It is shown that an exposure of pupae of the mealworm beetle Tenebrio molitor to the combined static (42 μT) and very weak alternating (250 nT) magnetic fields exerts different influence, depending on the frequency of the alternating magnetic field, on duration of metamorphosis processes in these insects. For instance, an exposure of pupae to weak combined magnetic fields, adjusted to the frequency of ion cyclotron resonance for glutaminic acid (4,4 Hz), stimulates metamorphosis process--a transitional stage from pupae to imago lasts shorter. An inhibiting effect was observed when adjusted to the frequency of ion cyclotron resonance for Ca2 (32,2 Hz).

Evaluation of health care delivery integration: the case of the Russian Federation.

Fragmentation in organization and discontinuities in the provision of medical care are problems in all health systems, whether it is the mixed public-private one in the USA, national health services in the UK, or insurance based one in Western Europe and Russia. In all of these countries a major challenge is to strengthen integration in order to enhance efficiency and health outcomes. This article assesses issues related to fragmentation and integration in conceptual terms and argues that key attributes of integration are teamwork, coordination and continuity of care.

Rocky road from the Semashko to a new health model. Interview by Fiona Fleck.

Health care is receiving much higher priority and more funds than ever before in the Russian Federation. Russian health economist Igor Sheiman talks to Fiona Fleck.

Opportunities and limitations of patient choice: the case of the Russian Federation.

While many countries have increased the opportunities for patient choice of provider, there is debate to what extent this has had positive effects on efficiency and quality of healthcare provision. First, some conditions should be met to exercise such choice, of which the most important is the provision of reliable data on providers' performance to both patients and physicians as their agents, as well as increasing primary health care (PHC) providers' involvement in realization of patient choice. Second, expanding patient choice does not always lead to efficient allocation of resources in a healthcare system.

[The effect of combined magnetic fields, adjusted to ion-cyclotron resonance for Ca ions, on intensity of division in planaria].

The combination of a constant (42 mkT1) and parallel to it a changing magnetic field on a frequency of 32 Hz (it corresponds to cyclotron frequency for Ca2+ ions) is shown to have a changing magnetic field amplitude-dependent effect on intensity of division in planaria. A stimulating effect has been observed at the magnitude of a changing component equal to 100 nT, but the amount of division significantly decreased at 250 nT and no impact of the magnetic field was registered at 500 nT1.

[Formation of the photosensing system function in early development].

The function of simple prototypic eyes in two planarian species, the two ocular Girardia tigrina and the multiocular Polycelis tenuis, has been studied. When exposed to light, planarians display the light avoidance reaction known as negative phototaxis. This reaction has been investigated in intact animals and in head and tail fragments after their section in the course of eye regeneration.

Prospects for regulated competition in the health care system: what can China learn from Russia's experience?

As China explores new directions to reform its health care system, regulated competition among both insurers and providers of care might be one potential model. The Russian Federation in 1993 implemented legislation intended to stimulate such regulated competition in the health care sector. The subsequent progress and lessons learned over these 17 years can shed light on and inform the future evolution of the Chinese system.

Effects of weak electromagnetic irradiation on various types of behavior in the mealworm Tenebrio molitor.

The effects of weak electromagnetic irradiation on simple forms of behavior were studied using adult Tenebrio molitor mealworms. The beetles' motor behavior was studied in conditions of different motivations, i.e.

[Regeneration processes in various species of planarians].

Blastema growth and functional maturation of the pharynx during regeneration in various planarian species were compared. The intensity of blastema growth was highest in Polycelis tenuis; the lowest, in Schmidtea mediterranea. In the sexual and asexual races of Girardia tigrina blastema growth differed inconsiderably.

[Effects of weak physical and chemical factors on morphogenetic processes in invertebrates].

Numerous data of long-term investigations of weak agents on morphogenetic processes in invertebrates (regeneration of planarians, Dugesia (Girardia) tigrina and postembryonic development of insects, the grain beetle Tenebrio molitor) have been analyzed. Weak physical and chemical factors were used: electromagnetic radiation, static, alternating, and combined magnetic fields, and low concentrations of solutions of neuropeptides. Some common features of the influence of weak factors on morphogenesis were found, namely, the instability and the opposite direction of the effect.

[Influence of weak electromagnetic field on different forms of behavior in grain beetle, Tenebrio molitor].

The influence of weak electromagnetic radiation on simple forms of behavior was studied on the model of the motor behavior of the imago grain beetle (Tenebrio molitor). Positive (feeding) and negative (illumination) motivations were created in the same experimental conditions. Beetles in a Petri dish were put to the starting point of a special container.

Effect of weak static and low-frequency alternating magnetic fields on the fission and regeneration of the planarian dugesia (Girardia) tigrina.

The effect of weak static (DC) and alternating (AC) magnetic fields (MFs), as well as combined (AC/DC) collinear MFs on the intensity of morphogenesis processes in the planarian Dugesia (Girardia) tigrina has been studied. It was found that combined MFs produce a stimulating effect on the fission and regeneration of planarians. Both components of the combined MFs, the direct (DC) and the alternating (AC), are important in the realization of the effects of weak MFs.

Effects of neuropeptide F on regeneration in Girardia tigrina (Platyhelminthes).

The effects of neuropeptide F (NPF; from Moniezia expansa) on the regeneration of Girardia tigrina were studied. The animals were decapitated and incubated in water (control) or NPF. The dynamics of the proliferation of the neoblasts in the developing tissue were studied during the course of regeneration by monitoring the mitotic index (MI).

[Effect of weak and ultraweak static magnetic fields on the intensity of fission of the planarian Dugesia tigrina].

It has been shown that, in the range of 03000 nT, a biological system differently responds to the treatment with a weak static magnetic field. Thus, at a practically complete compensation of the field (induction 5 nT), the intensity of fission of planarian does not differ from control values. As the field intensity is successively increased to 300 nT, a marked and statistically significant stimulating effect is observed (SC 1.