Ponkin Igor V., Ponkina Alexandra A.
Pediatric Palliative Care
pp. 1-17 (Research)
The article investigates the nature and legal basis of pediatric palliative care. Investigated the key features of child-patients, defining features of pediatric palliative care.
Key words: palliative medical care, pediatric palliative medical care, terminal illness, death, life, medical law, bioethics, medical care, medicine
Danishevskiy K. D.
Types of studies in evidence-based medicine
pp. 18-30 (Reviews)
The article describes different study designs used today in medical science, the hierarchy of their reliability is considered, the validity of the obtained data is compared.
Key words: study design, case, case series, prospective cohort study, randomized study, systematic review
Plavinski S. L.
Economic evaluation of medicines for rare diseases. Should it be carried out and, if so, what are its features?
pp. 31-43 (Discussion)
Orphan drug laws that were enacted firstly in the USA and then in some other countries led to the creation of functioning market of drugs for rare diseases and increased number of such drugs. In the same time price tag for innovative drugs is frequently high which lead to the debates about their cost effectiveness and that effectiveness of rare diseases drug is frequently difficult to test because of disease rarity. The article discussed some types of the designs of clinical trials that could increase effectiveness and examples are given with standard design. It is mentioned that for majority of the diseases there is a possibility to get point estimates for the effectiveness, but with small sample size they will not be precise which will contribute to the difficulties with cost-effectiveness analysis. Some mechanisms are discussed that were proposed to solve the situation.
Key words: rare diseases, clinical trial design, cost-effectiveness analysis, quality-adjusted life years, reimbursement schemes
Vasquez Abanto J.E., Vasquez Abanto A.Å., Arellano Vasquez S.B.
Bioethics of the health care professional in the 21st century
pp. 44-62 (Discussion)
In this article, based on in-depth analysis of health care, analyzes the modern principles and trends of ethics and morality of a medical professional, lists the basic aspects, from the point of view of the authors, of his medical practice in the modern world. Also draws attention to the key, according to the authors, the issues of formation of personal qualities in order to improve medical bioethical approach during of his medical work.
On the basis of their medical practice by the authors highlighted the main components in the relationship, «the patient-physician-society», concluding that in the course of employment physician should focus on compliance with ethics and deontology, guided primarily by international instruments in the field of health, in a clear relationship with the realities of society and the scientific and technological progress.
Medicine does not belong to the category of the exact sciences and quite acceptable different ways to achieve the same goal. Ethics and collegiality allow the medical community to unite and speak with one voice for the benefit of the patient, to the best solution, consider the situation from different perspectives.
Education of future physicians has the features. Medical activity is a not only special profession, but also the calling demanding special qualities of the personality. Formation of demanded spiritual and moral culture is cornerstone of educational activity training of specialists of a medical profile. In modern medicine value a moral factor amplifies. It is connected with that in turn medical technologies put the expert before need to make a moral choice at the solution of the professional tasks affecting the personality or health of the patient which has asked for the help.
Key words: medicine, bioethics, collegiality, ethics, medical relationships
Protsenko R. V., Akinshin B. I., Popova V. S.
Medico-environmental monitoring of Belgorod region pediatric health state in districts affected by Chernobyl industrial disaster
pp. 63-69 (Research)
Article deals with statistic information on pediatric morbidity in the environmentally unfavorable districts of Belgorod Region.
Key words: children, dynamics, morbidity
Nesterova A. V.
Financial, organizational and legal aspects of free high-tech medical care in Russia
pp. 70-81 (Research)
The article discusses the changes in the financial, organizational and legal bases of free high-tech medical care (hereinafter – HMC) provision in Russia during its incorporation in the general health insurance (hereinafter – GHI).
The data base for the study consists of federal and regional legal acts, materials of the Government of the Russian Federation and the Russian Ministry of Health, statistical data on the planned HMC volumes in the medical institutions, the works of local authors on the issues of the HMC in Russia. In the course of in-depth interviews views of different target groups were obtained (doctors, representatives of NGOs, former employees of the Ministry of Health) on the imperfections of the HMC provision by means of the quota system and the GHI.
The results suggest a reduction of spendings on HMC and less transparency of distribution services within the HMC, that can in the future adversely affect the quality and accessibility of health care in Russia.
Key words: high-tech medical care, reforms in high-tech medical care, quotes, cancer patients, general health insurance
