[An analysis of the activities of hospital institutions on the territorial level by using the system of diagnosis-related groups]. / Analiz deiatel'nosti bol'nichnykh uchrezhdenii na territorial'nom urovne s ispol'zovaniem sistemy diagnosticheski sviazannykh grupp.

The authors present the results of analysis of the activity of hospitals at one territory of Russia making use of a system of Diagnosis Related Groups (DRG). Factographic analysis of database for inpatients, based on the DRG typology of patients, helped determine the profile of each hospital, group of hospitals, and the entire territorial hospital network. The results of analysis permit us to define the main profiles of each hospital (or hospital type) and assess its actual and potential resources. Such method of analysis, based on the DRG typology of patients, may be used for rapid assessment of the activities of hospitals in order to determine the trends in possible changes of the hospital profile.

[Diagnosis-related groups: a comparative analysis of hospital activity in different countries]. / Diagnosticheski sviazannye gruppy v sravnitel'nom analize deiatel'nosti statsionarov raznykh stran.

Comparative study of hospital activities in the Novgorod district and nine countries of the European Community, carried out within the framework of the International Project CAMISE (Case Mix and Severity) of the European Community on the basis of the classification system for diagnosis-related groups, showed a lower Case Mix Index, a longer hospital stay for all major disease, and a lower surgical activity in the hospitals of the Novgorod district in comparison with other European countries. The detected differences are largely due to specific features in the organization of hospital service in Russia (no special hospitals for acute and chronic patients, no nursing homes) and insufficiently intensive therapeutic and diagnostic process.

[Health insurance and use of diagnostic related groups]. / Meditsinskoe strakhovanie i ispol'zovanie diagnosticheski sviazannykh grupp.

One of the ways to improve measures aimed at population health protection may be the development of insurance medicine in our country. This is a system of curative and preventive measures realized through insurance payments made by citizens and on the basis of target payments by employers, employees and state grants. The international experience of insurance medicine indicates that the existing principle of grouping diseases according to the basic diagnosis no longer provides the effective use of resources and not precisely enough assess to the outcomes of hospital performance. The search of ways to solve this problem led to the necessity of using the method of assessing financial and economic activities of curative and preventive institutions on the basis of diagnosis related groups of diseases (DRG) which unite the cases of similar diseases having approximately the same technology of examination and treatment of patients and consequently the same cost of treatment. This system originated in the USA and is widely used in many countries of Western Europe. With the help of DRG system health institutions can acquire more full information on the results of treatment, costs of treatment and prospects for development. The introduction of DRG system permits to improve the financial and economic performance of institutions and to collaborate with organizations realizing health insurance programmes.

[Diagnosis of hemorrhages in the brain with rupturing of blood into the ventricular system]. / Diagnostika krovoizliianii v mozg s proryvom krovi v zheludochkovuiu sistemu.

Clinical observations of 424 patients with intracerebral hemorrhages (314 with parenchymatous-ventricular and 110 with parenchymatous) verified at autopsy are reviewed. An analysis of the observations allowed the differentiation of the very acute, acute and subacute forms of parenchymatous-ventricular hemorrhages. The incidence of some "classical" symptoms of parenchymatous-ventricular bleeding was shown to change. The erroneous diagnosis of the ischemic nature of the stroke in 7.7% of observations was analyzed. The accuracy of computing differential diagnosis (using Bies's procedure in postulating the independence of the signs) was 75-79% depending on the type and localization of cerebral hemorrhages.

[Method of processing past records for evaluating methods of treating breast cancer]. / Metodika razrabotki dokumentov proshlykh let dlia otsenki metodov lecheniia raka molochnoi zhelezy.

The work includes the form, containing 380 properties for evaluation of the breast cancer treatment. The form embraces practically all clinical signs, which may influence the breast cancer prognosis, i.e. the results of its clinical treatment.

[Methods of evaluating the results of treatment of breast cancer]. / O metodakh otsenki rezul'tatov lecheniia raka molochnoi zhelezy.

The following limitations of the available prospective cooperated methods of evaluation of the results of breast cancer treatment are identified: the attention of the researcher often appears to be focused on only one and, inevitably, a rather narrow aspect of the problem. The studies are time-consuming and involve organizational difficulties. It is suggested that assessment of treatment results may be carried out faster and more effectively, if the advantages of the Soviet state system of health protection are used to the full. Such measures as life-time registration and dispensary-sponsored follow-up of all cancer patients, particularly, in large cities where cancer incidence is relatively high application of traditional therapeutic procedures developed at oncological dispensaries of the city of Moscow, computerized retrospective randomization and integration of rational methods of breast cancer treatment with practice may serve the purpose.