Clinical Solutions: Factors and Problematic Situations from the Perspective of Doctors in a Large Russian City

<p>This article focuses on the main results of a quantitative empirical study of clinical decisions made by doctors in medical institutions of various profiles in a large Russian city. The study was conducted in 2019 and is based on the results of the previous qualitative analysis stage — with...

Full description

Bibliographic Details
Main Authors: Anna S. Gotlib, Vitaly L. Lekhtsier
Format: Article
Language:Russian
Published: Russian Academy of Sciences, Federal Center of Theoretical and Applied Sociology 2020-09-01
Series:Социологический журнал
Subjects:
Online Access:http://jour.fnisc.ru/upload/journals/1/articles/7398/submission/proof/7398-61-13552-1-10-20200923.pdf
_version_ 1828490096508141568
author Anna S. Gotlib
Vitaly L. Lekhtsier
author_facet Anna S. Gotlib
Vitaly L. Lekhtsier
author_sort Anna S. Gotlib
collection DOAJ
description <p>This article focuses on the main results of a quantitative empirical study of clinical decisions made by doctors in medical institutions of various profiles in a large Russian city. The study was conducted in 2019 and is based on the results of the previous qualitative analysis stage — within the research “mix-strategy”. The main point of analytical interest is the factors which influence the doctors’ clinical decisions in two basic clinical situations — in the situation of disease diagnosis and in the situation of treatment prescription. The object of the research was doctors from Samara medical clinics. Factors and decisions made by doctors were studied from the point of view of doctors themselves. The degree of influence of each factor on the decisions made by doctors was assessed with the help of the Influence Index, an integral index on a fully ordered scale. The article presents a hierarchy of factors influencing medical decision-making in diagnosis and treatment situations; the top group of factors in both situations is identified and interpreted. At the same time, additional problematic situations were studied in the research. In particular, the range of clinical decisions and factors determining them, in case of it being necessary to conduct an examination not provided by standard state medical care, in a situation when this examination is provided, but the limit of prescriptions is exhausted, in a situation when the medical institution (hospital) does not have the best quality medication for the patient in the quantities needed, in a situation when the state standard on a specific nosology is ineffective for a specific patient, as well as other problematic situations.</p>
first_indexed 2024-12-11T10:37:35Z
format Article
id doaj.art-135b0d4f11af46c7a71059567296b94d
institution Directory Open Access Journal
issn 1562-2495
language Russian
last_indexed 2024-12-11T10:37:35Z
publishDate 2020-09-01
publisher Russian Academy of Sciences, Federal Center of Theoretical and Applied Sociology
record_format Article
series Социологический журнал
spelling doaj.art-135b0d4f11af46c7a71059567296b94d2022-12-22T01:10:40ZrusRussian Academy of Sciences, Federal Center of Theoretical and Applied SociologyСоциологический журнал1562-24952020-09-0126311414710.19181/socjour.2020.26.3.73987398Clinical Solutions: Factors and Problematic Situations from the Perspective of Doctors in a Large Russian CityAnna S. Gotlib0Vitaly L. Lekhtsier1Russian FederationRussian Federation<p>This article focuses on the main results of a quantitative empirical study of clinical decisions made by doctors in medical institutions of various profiles in a large Russian city. The study was conducted in 2019 and is based on the results of the previous qualitative analysis stage — within the research “mix-strategy”. The main point of analytical interest is the factors which influence the doctors’ clinical decisions in two basic clinical situations — in the situation of disease diagnosis and in the situation of treatment prescription. The object of the research was doctors from Samara medical clinics. Factors and decisions made by doctors were studied from the point of view of doctors themselves. The degree of influence of each factor on the decisions made by doctors was assessed with the help of the Influence Index, an integral index on a fully ordered scale. The article presents a hierarchy of factors influencing medical decision-making in diagnosis and treatment situations; the top group of factors in both situations is identified and interpreted. At the same time, additional problematic situations were studied in the research. In particular, the range of clinical decisions and factors determining them, in case of it being necessary to conduct an examination not provided by standard state medical care, in a situation when this examination is provided, but the limit of prescriptions is exhausted, in a situation when the medical institution (hospital) does not have the best quality medication for the patient in the quantities needed, in a situation when the state standard on a specific nosology is ineffective for a specific patient, as well as other problematic situations.</p>http://jour.fnisc.ru/upload/journals/1/articles/7398/submission/proof/7398-61-13552-1-10-20200923.pdfsociology of medicineclinical decisionsdiagnosticstreatment prescriptioninfluence factorsproblem situations
spellingShingle Anna S. Gotlib
Vitaly L. Lekhtsier
Clinical Solutions: Factors and Problematic Situations from the Perspective of Doctors in a Large Russian City
Социологический журнал
sociology of medicine
clinical decisions
diagnostics
treatment prescription
influence factors
problem situations
title Clinical Solutions: Factors and Problematic Situations from the Perspective of Doctors in a Large Russian City
title_full Clinical Solutions: Factors and Problematic Situations from the Perspective of Doctors in a Large Russian City
title_fullStr Clinical Solutions: Factors and Problematic Situations from the Perspective of Doctors in a Large Russian City
title_full_unstemmed Clinical Solutions: Factors and Problematic Situations from the Perspective of Doctors in a Large Russian City
title_short Clinical Solutions: Factors and Problematic Situations from the Perspective of Doctors in a Large Russian City
title_sort clinical solutions factors and problematic situations from the perspective of doctors in a large russian city
topic sociology of medicine
clinical decisions
diagnostics
treatment prescription
influence factors
problem situations
url http://jour.fnisc.ru/upload/journals/1/articles/7398/submission/proof/7398-61-13552-1-10-20200923.pdf
work_keys_str_mv AT annasgotlib clinicalsolutionsfactorsandproblematicsituationsfromtheperspectiveofdoctorsinalargerussiancity
AT vitalyllekhtsier clinicalsolutionsfactorsandproblematicsituationsfromtheperspectiveofdoctorsinalargerussiancity