Vol 24, No 4 (2025)

The article is devoted to the evolution of the definition of patient orientation and the factors influencing its formation. The review analyzes approaches to the relationship between concepts used to characterize the orientation of the health care system toward patients’ interests, primarily patient orientation and patient-centeredness; a summary of existing definitions of patient orientation is provided, taking into account the mechanisms of its achievement.

Considering the scale of the impact of digital transformation of health care on medical care delivery, the author concludes that it is necessary to reconsider the format of physician–patient relationships when formulating the definition of patient orientation at the present stage. In this regard, based on analysis of the published evidence and regulatory documents, an integral definition of patient orientation in the context of digital transformation of health care is proposed—as an organizational principle of medical care delivery based on social empathy and harmonization of classical physician–patient relationships with the digital ecosystem of the health care sector, aimed at ensuring an optimal level of satisfaction with medical services.

In conclusion, the article emphasizes the evolving nature of the definition of patient orientation, determined by changes in patients’ goals and expectations when receiving medical care depending on the socioeconomic situation and the level of development of medicine.

BACKGROUND: With age, the burden of accumulated morbidity increases and is largely determined by behavioral factors. Under conditions of a threat to life and health caused by a pandemic, the choice of a behavioral model for seeking medical care becomes especially evident.

AIM: This work aimed to determine behavioral models of the elderly population of the Grodno region when seeking medical care during the COVID-19 pandemic.

METHODS: Based on data from a survey of 1270 individuals aged 60 years and older living in the Grodno region (the sample is representative by sex and type of residence), respondents’ answers regarding prior COVID-19 infection and the influence of sociodemographic factors on the choice of behavioral model in relation to the disease were analyzed.

RESULTS: A history of COVID-19 infection was reported by 71.26% of respondents, regardless of sex, type of residence, employment, marital status, and age. Most respondents (95% CI, 36.91–43.98) received outpatient treatment (rank 1), whereas inpatient care was required for approximately every fifth to sixth participant (rank 3). The second most frequent behavioral model (every fourth respondent) was not seeking medical care: respondents indicated that they had “recovered while continuing their usual activities” or were unable to confirm illness (response option “do not know” to the question “Have you had COVID-19?”). A tendency toward a higher prevalence of this model among men was identified, which may have contributed to later seeking of medical care and, consequently, more frequent hospitalization compared with women [21.3% (95% CI, 16.81–26.61) vs 15.56% (95% CI, 12.56–19.11); p = 0.043].

CONCLUSION: A high prevalence of not seeking medical care among elderly individuals was identified. The absence of an association between place of residence (urban/rural), age, employment, presence of children, and marital status and the choice of this behavioral model indicates its stability with respect to sociodemographic factors and highlights the need to develop additional mechanisms to stimulate medical care–seeking behavior in the population.

BACKGROUND: The incidence of diseases of the ear and mastoid process (International Classification of Diseases, 10th Revision: H60–H95) represents a significant medical and social problem due to its substantial contribution to the structure of hearing loss, chronicity, disability, and economic burden. Regional features, including population aging, infectious factors, and occupational risks, emphasize the need for epidemiological monitoring to optimize preventive measures and resource planning in the health care system.

AIM: This study aimed to analyze the prevalence and incidence of diseases of the ear and mastoid process in the Ryazan region for the period 2019–2023.

METHODS: The study was based on analysis of data on prevalence, incidence, and the chronicity index of diseases of the ear and mastoid process for 2019–2023, with calculation of rates per 100,000 population. Stratification was performed by age groups (total population, adults, working-age population, individuals older than working age, children aged 0–14 and 15–17 years). The analysis considered seasonal and demographic factors, as well as access to medical care.

RESULTS: The prevalence per 100,000 population decreased from 3421.3 in 2019 to 3241.5 in 2023, with the greatest decline observed in 2020–2021 (−5.2% over the period). Incidence decreased by 4.9%. The chronicity index remained relatively stable (1.44–1.53). In the disease structure, middle ear diseases predominated (40%–45%; chronicity index, 1.29), followed by diseases of the external ear (30%–35%) and hearing loss (15%–20%; index, 5.39). In children, acute forms predominated (overall incidence, 4042.6), whereas in older individuals, chronic forms were more common (chronicity index, 1.89).

CONCLUSION: The predominance of chronic forms in older individuals and acute forms in children requires differentiated approaches to prevention, vaccination, and rehabilitation. Further studies on the role of exogenous factors in morbidity formation are warranted.

BACKGROUND: Sociological aspects of relationships between patients and medical organizations in situations involving harm to life and health remain insufficiently studied despite the availability of official judicial statistics. Existing studies of legal language rarely focus on judicial acts as a source for analyzing social relationships. The present study aims to address this gap.

AIM: This study aimed to explore social relationships between patients and medical organizations regarding compensation for harm to life and health using content analysis of judicial acts.

METHODS: A cross-sectional study was conducted using content analysis. The sample included 112 judicial acts in cases on compensation for harm to life and health, selected from the ConsultantPlus database for 2021–2025. The texts of the acts were combined into a single corpus and processed using the NLTK library in the Python 3.11 environment, including tokenization, lemmatization, and frequency analysis. Common and standard legal terms were excluded from the analysis.

RESULTS: Based on the analysis of the 200 most frequent words, four semantic groups describing the problem field were identified: “Core of Legal Violation” (care, defect, violation), “Consequences for the Patient” (harm, health, suffering), “Standards of Proof” (expert examination, causation, conclusion), and “Judicial Process and Claims” (compensation, reimbursement, hospital). Three key contradictions were identified: 1) a conflict between formalized procedures and the patient’s personal experience; 2) bureaucratization of suffering; and 3) the dual nature of medicine as both a sphere of care and a domain of market relations.

CONCLUSION: Content analysis of judicial acts confirmed its effectiveness as a method for sociological interpretation of legal conflicts. The results revealed a complex interplay of meanings and motivations among the participants in the process. The main limitation of the study is the sample size; more detailed conclusions require analysis of a larger number of judicial acts, taking into account regional and court-level characteristics.

BACKGROUND: Interest in the use of telemedicine technologies is characteristic of healthcare systems worldwide. Studying physicians’ attitudes in different countries toward the prospects and risks associated with telemedicine allows healthcare administrators to make timely decisions aimed at increasing its positive perception among medical professionals and minimizing negative factors.

AIM: To assess the perceived prospects and risks of using telemedicine technologies in the Russian Federation and the Republic of Uzbekistan according to physicians’ opinions.

METHODS: The study was conducted in medical institutions of the Republic of Uzbekistan (Tashkent) and the Russian Federation (Nizhny Novgorod) using a questionnaire-based survey of physicians (focus groups) based on author-designed questionnaires. A total of 60 physicians participated in the study.

RESULTS: The findings demonstrated that physicians in both the Russian Federation and the Republic of Uzbekistan generally have a positive perception of telemedicine in improving accessibility and continuity of medical care. In both countries, physicians noted a favorable public attitude toward remote consultations, associated with time and financial savings for patients. At the same time, persistent technical limitations, communication difficulties during remote interactions, and a perceived decrease in empathy between physician and patient were identified as negative factors.

CONCLUSIONS: Telemedicine technologies have become part of routine clinical practice in both countries; however, the physician–patient interaction format continues to raise certain concerns among clinicians. Nevertheless, the accumulated positive experience in overcoming technical and communication challenges improves physicians’ perception of telemedicine and facilitates its further implementation and sustainable development.