Public authorities and management effectiveness estimation in the RF regional level

The article discusses the problems of state civil and municipal services effectiveness estimation at the regional level. Comparing the main indicators of the socio-economic development of the Republic of Tatarstan and other regions of the Privolzhsky Federal District and using the proposed estimated indicators, the authors try to trace the relationship between these indicators and the efficiency and effectiveness of public authorities and management in these regions. Formed versions of the ratings of the regions of the Privolzhsky Federal District, according to the authors, will allow identifying the relationship between the quality of public authorities and management and the state of the environment in the regions. A number of calculated indicators proposed by the authors can be applied within the region (at the level of municipalities) in the development of measures provided for by national projects for many areas of strategic development. In addition, the work focuses on increasing the professionalism of government and municipal employee.

Minister – Coordinator of Special Services in Poland (1997 – 2020). Civil Democratic Control or Political Influence?

The aim of the article is to present the tranformation of the function of the minister – coordinator of special services in Poland between 1997 and 2020. Espiecially the elements of civil democratic control and the examples of political influence towards special services are taken into consideration. It is very important to establish the institution that can provide suitable coordination in the specific area of the state security that can lead to the special services effectiveness. The analysis of the regulations connected with the minister-coordinator creation and activity shows rather the political involvment and influence towards special services activity than the positive aspects of impoving their coordination and cooperation for the state security and civil democratic control.

What Does the Public Know About Varying Depression Severity?–Results of a Population Survey

Objectives: In this study, we examine the public’s knowledge about different levels of depression severity in Germany.Methods: Data stem from a national telephone survey in Germany. A total of 1,009 persons participated, response rate was 46.8%. A vignette was presented with signs of mild, moderate or severe depression. Participants were asked what they think the person has, which persons and services are helpful and how effective different treatment options are. Differences between the three vignettes were tested with 95% confidence intervals and χ2-tests.Results: 55.3% of the respondents identified depression as the health problem in question. Participants who heard the vignette with moderate symptomatology recognized depression more often. Across groups, a general practitioner was named most frequently concerning helpful persons/services. Effectiveness of psychotherapy received high levels of approval, online therapy and books were less often rated as effective. There were only few significant differences between the three vignettes.Conclusions: This is the first study examining public depression literacy for different severity levels. Small differences between severity levels indicate a lack of knowledge, which may have adverse consequences for adherence to treatment, especially for mild depression.

Challenges for palliative care day services: a focus group study

Background Palliative care day services provide a safe environment for people with palliative care needs, enabling them to access a range of services while acting as a respite services for family caregivers. Viewed as marginal services, they are often under resourced and under researched. The aim of this study was to understand how palliative day care services contribute to client care from the perspective of management and hospice multidisciplinary teams. Methods A descriptive qualitative study, using six focus groups conducted with staff at three United Kingdom hospices in England, Scotland and Northern Ireland. Thirty-five participants were recruited, including management and staff. Discussions were transcribed and analysed thematically. Results Four key themes emerged: (1) variations of care, beyond heterogeneity of patients; (2) unclear referrals and inconsistent patient population; (3) recognising strengths and challenges and (4) an uncertain future. A major focus of group discussions was the model of care and the benefits of the service, however the importance of demonstrating services’ effectiveness and value for money was highlighted. Conclusions Management and hospice staff believed day-services to be a helpful introduction to palliative care, providing both social and medical support. Economic pressures and patient demand were influencing them to move from a social model to a hybrid model. Further research is needed to understand the effectiveness of the service.

Analysis of the telemedical services application results in the Novosibirsk region

В статье приведены результаты исследования динамики применения телемедицины на базе государственных лечебно-профилактических учреждений Новосибирска и Новосибирской области в период с 2004 по 2019 годы. Для оценки экономической эффективности оказания телемедицинских услуг был использован системный подход, основанный на сопоставлении стоимости, качества и объемов телемедицинских услуг с экономическим эффектом, получаемым в результате. В ходе исследования была построена множественная регрессионная модель, которую можно применять для прогнозирования эффективности оказываемых телемедицинских услуг в Новосибирской области. The article includes the results of the study of the use of telemedicine dynamics on the basis of state medical institutions in Novosibirsk and the Novosibirsk region in the period from 2004 to 2019. To assess the economic efficiency of telemedicine services provision, a systematic approach was used. It was based on a comparison of the cost, quality and volume of telemedicine services with the economic effect obtained as a result. During the study, a multiple regression model was constructed that can be used to predict the telemedicine services effectiveness provided in the Novosibirsk Region.

Hepatitis C Among High-Risk Alabamians: Disease Burden and Screening Effectiveness

Background The effectiveness of hepatitis C testing and linkage-to-care (LTC) is poorly characterized in low-resource jurisdictions facing gaps in harm reduction, including illegality of syringe exchange services. Effectiveness of a community-based test/LTC program was evaluated in Alabama. Methods In 2016–2018, shelters, drug treatment centers (DTCs), AIDS organizations, and Federally Qualified Health Centers (FQHCs) engaged in screening/LTC. A coordinator navigated individuals to confirm viremia and link to substance use treatment or primary care with hepatitis C prescribers. Results Point-of-care (POC) tested 4293 individuals (10% [427] antibody-positive, 71% [299/419] RNA performed, 80% [241/299] viremia confirmed) and 93% linked to care (225/241). Electronic medical record (EMR)-based reflex strategy screened 4654 (15% [679] antibody positive, 99% [670/679] RNA performed, 64% [433/679] viremia confirmed) and 85% linked to care (368/433). We observed higher odds of RNA confirmation in EMR-based reflex versus POC (OR, 2.07; P < .0001) and higher odds of LTC in EMR-based reflex versus POC (OR, 1.51; P < .0001). Overall, 53% individuals tested were nonbaby boomers. Conclusions In Alabama, screening at high-risk settings identified significant hepatitis C burden and reflex testing outperformed point-of-care linkage indicators. Colocating testing in DTCs and treatment in FQHCs provided key LTC venues to at-risk younger groups.

Life Expectancy of Population of the Country: The Role of Health Services Effectiveness

The impact of health care on life expectancy of population in different countries has been studied. The subject of the study was analysis of efficiency of public health expenditures and their percentage of Gross Domestic Product. The authors employed a relatively new method of comparative analysis, Data Envelopment Analysis (DEA), which involves to measure technical efficiency of activity of an economic entity. DEA method allowed identifying the effectiveness of economic measures in healthcare system, as well as provision of the necessary volume of medical services in different countries. A study was conducted to compare the actual effectiveness of the country's medical services to the maximum possible effectiveness. As factor indicators, the summary of health expenditure and its percentage of GDP were considered. The average life expectancy of countries was taken as an average resulting indicator. According to the results, all the surveyed indicators proved to be the most effective measures in providing population with medical services in such countries as Andorra and San Marino, Monaco. It was determined that in order to increase the average life expectancy for one year, an average annual increase in the expenditure on the health care system by 0.48% of GDP is required.