Department of Sociology and Social Work
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Item The Attitude of the Orthodox Parishioners Toward Euthanasia: Evidence From Georgia(SAGE Publications, 2019) Verulava, Tengiz; Mamulashvili, Mariam; Kachkachishvili, Iago; Jorbenadze, RevazItem Cardiac Implantable Electronic Device Infections - Prevention, Diagnosis, Treatment and Impact on Quality of Life(Georgian Medical News, 2021) Kuridze, Nika; Rukhadze, B; Bakashvili, N; Verulava, Tengiz; Aladashvili, AFor several decades, highly refined cardiac implantable elec-tronic devices (CIED) are used to prevent and manage various types of cardiac pathology, which have saved the lives of many patients. Cardiac implantable electronic devices help maintain and improve the quality of life by regulating the heart rate, ter-minating life-threatening arrhythmias, and improving systolic function, including pacemakers, implantable cardioverter defi-brillators, and cardiac resynchronization therapy devices. Re-gardless of the benefits received after its implantation, in some cases, serious complication has appeared, such as CIED infec-tions, associated with severe morbidity, mortality, financial ex-penses and changes in the quality of life. Exactly, in this article will be addressed the issues of prevention, diagnosis, and treat-ment of this condition, which will help specialists to properly assess the problem and to find a way to effectively solve itItem Challenges of the COVID-19 pandemic: German strategy(Ivane Javakhishvili Tbilisi State University, 2020-06-20) Verulava, TengizStrategies to combat global pandemics around the world include more or less strict quarantine or other restrictions. Nevertheless, the results achieved in the fight against coronavirus infection are different for all countries. The number of people infected with COVID-19 in Germany is one of the highest in the world, however, the mortality rate (1.6%) is lower than in Italy (12%), Spain, France and the United Kingdom (10%), China (4%) and the United Kingdom. In the States (3%). Germany works best among European countries in the crisis caused by the COVID-19 pandemic. This is evidenced by the results of a study conducted by experts from the Deep Knowledge Group. Germany ranks second in the world in terms of world security among countries that operate effectively in the context of the coronavirus pandemic. In the list of 40 countries published on the official page of Deep Knowledge Group, Germany lags behind only Israel. Reconstruction credit bank has a special role in the history of Germany in critical situations. During the pandemic, the Reconstruction Credit Bank will issue any loans to entrepreneurs so that companies do not stop working due to lack of funds. In order to save the economy, the government is ready to take over the management of strategically important companies. Despite the adoption of restrictive measures, most of the country's factories continue to operate. The main factor in the smooth operation of German production in the face of the pandemic is the introduction of digital technology in production systems long before. They created the "Industrial 4.0 Strategy", which involves training German companies for the fourth industrial revolution, or digital age. Germany has more ability and opportunity to protect the industry from the devastating effects of a pandemic. Germanyโs success is linked to an efficient healthcare system. Germany spends $ 5,033.45 per capita per year on health care, which is significantly higher than in other countries. Another important factor in success is the sufficient number of hospitals and medical staff, hospital equipment. In Germany, the number of beds per 100,000 population is the highest in the European region. Germany is better equipped with artificial lung ventilation devices than other countries. Also, Germany has the opportunity to produce medical equipment and medicines inside the country. From the beginning of the spread of the infection in Germany, the laboratories already had a supply of diagnostic tests and, as a result, soon began mass testing. Early and mass testing has made it possible to identify patients with asymptomatic infections and mild severity in order to isolate them immediately, which has dramatically slowed the spread of the virus. The testing was particularly effective for medical personnel who had direct contact with those infected. The Robert Koch Institute has developed a control app that allows to collect data on the geographical distribution of Coronavirus. Experts attribute the success to the public's confidence in the government. Merkel's plan is based on the recommendations of the Robert Koch Research Institute. It may be too early to draw a conclusion from the global pandemic, but one thing is clear: the pursuit of technological innovation allows Germany to relatively reduce the negative consequences of a pandemic.Item Context and issues of social health insurance introduction in Georgia(Archives of the Balkan Medical Union, 2021) Verulava, Tengiz; Jorbenadze, AvtandilThe social health insurance system, unlike general tax financing system is more focused on market mechanisms. Despite the achievements, the introduction of social health insurance in Georgia turned out to be way too difficult. Due to ongoing economic crises, the state failed to finance its promised commitments, resulting in a chronic shortage of funding for health care system. The new government abandoned the idea of building a social insurance system and switched to a general tax financing model, where the state takes a dominant lead, and the healthcare is financed from state budget. Given that the social insurance system is the best way of mobilizing additional funds and therefore providing sustainable funding for health sector, it is advisable to promote social insurance development. The healthcare sector needs consistent, continued and successive reforms. Despite the change of governments, the strategic course should not change drastically in the long run and the achievement should not be denied due to the political climate change.Item Factors that influence tobacco use in Georgian youth(Malta Medical Journal, 2020-11-13) Verulava, Tengiz; Nemsadze, Davit; Jorbenadze, Revaz; Dangadze, BekaObjective: Social environment, especially education, levels of awareness, friends and parental behavior greatly affects the use of tobacco among teenagers. The research aims to identify various factors that promote tobacco use in youth. Method: Qualitative and analytic cross-sectional descriptive research method was carried in among students from Tbilisi State University. Results: Most respondents have started tobacco consumption at juvenile age. The community played a decisive role in starting tobacco use. Respondents started using tobacco with their classmates and close friends. The survey has shown that tobacco consumption was perceived as a positive social behavior among teenagers. Introducing the tobacco control laws that prohibit tobacco consumption and advertising in public places, particularly near schools are of paramount importance. Conclusion: Interventions that focus particularly on multiple risk factors may have an impact on the use of tobacco by adolescents. Where possible, such programs should be personalized to ensure that they address the specific set of risk factors that has a bearing on each individual's tobacco use.Item Family Support Policy in Georgia: Challenges and Reform Options(Bulletin of the Georgian National Academy of Sciences, 2020) Verulava, Tengiz; Jorbenadze, RevazGeorgia experienced demographic crisis in recent decades. The severe demographic situation is caused by low birth rate, increased mortality, aging and is also contributed by poor economic conditions, unemployment and high rate of migration. The study aims to document the drastic loss of population in Georgia and to asses which model best describes the current family support policy in Georgia according to the Gauthierโs typology (1996), which includes four models of family policies: pro-natalist, pro-traditional, pro-egalitarian and non-interventionist. The study argues that the overall outcome puts Georgia in the non-interventionist model of family support policies. The family support policy in Georgia does not create adequate conditions for settling demographic problems. The financial assistance measures, such as: one-time financial aid for a childbirth, help in covering childcare costs and tax benefits are not even available. It is recommended that the state develop a family support policy program that will target low and middle income families across the country to improve the demographic condition. The selective approach is more appropriate for a low-income countries to achieve a maximum efficacy. Targeted state program for improving demographic conditions, as a minimum basic package must be a standard for the whole country.Item Food products labeling in Georgia: problems and solutions(Science Publishing Corporation, 2018) Verulava, Tengiz; Gurchiani, Tamuna; Jorbenadze, RevazThe Georgian legislation is a very clear regarding food labeling and completely shares the regulations and fundamental principles of all EU member states at formal level, but there are no effective mechanisms and institutions in place to react to the violation of the established regulations of the law, as well as to be responsible on the increase of public awareness, raising the food purchase and consumption culture. The aim of the thesis is to show problems in the Georgian food market in terms of fulfillment of fundamental norms envisaged under the EU Association Agreement. Qualitative research methodology - Observation method was used for data gathering. Observation was conducted in agricultural hypermarkets of Tbilisi. The situation in Georgia in terms of food labeling norms is quite complicated. The fundamental rules are met in no object of food sales, the information printed on food products creates the obscure presentation for customers regarding its content and suitability, the level of awareness of consumers is very low, consumers are not interested in details about the label information. The consumers focus on the price of products not on the information about its characteristics. Despite regulations that exists on formal level and existence of National Food Agency and also several active projects within partnership with European Union, situation in Georgia is complicated with lack of information from consumers and spurning food safety norms from their side. It is important to increase consumers awareness and actively turning them into those processesItem The Gatekeeper Model: patientโs view on the role of the family physician(Family Medicine & Primary Care Review, 2020) Verulava, Tengiz; Dangadze, Beka; Jorbenadze, Revaz; Lordkipanidze, Ana; Karimi, Leila; Eliava, Ekaterine; Maglakelidze, TamarBackground. An adequate primary healthcare system substantially determines quality of population health and effective spending of healthcare resources. The family physician serving as a โgatekeeperโ can make judicious decisions about the appropriate use of medical services. Objectives. The goal of this study was to find out patientsโ characteristics, preferences and behavior in regards to the role of the family physician as the gatekeeper in The Republic of Georgia. Materials and Methods. As part of a cross-sectional quantitative study, respondents were interviewed using a structured questionnaire. Results. Majority of the respondents (53.7%, n=245) had a permanent family physician, but were not satisfied with a level of family physicianโs professionalism (56.6%, n=258) and preferred self-referral to specialists (55%, n=253). Only 19.5% (n=89) referred to specialists upon family physicianโs advice who would coordinate all services and 23% (n=103) have used both family physicians and self-referral. Private health insurance companies were more interested in implementing cost reducing mechanisms rather than the Social Service Agency (which is responsible for Universal Health Care Program). Conclusions. It is appropriate to share private health insurance experiences for developing a model of gatekeeper in the UHCP. In order to improve a family physician institute and increase confidence in it, it is recommended to raise the level of family physiciansโ skills of relations with patients as it has a significant effect on the patient preferences. It is advisable to develop a flexible and voluntary gatekeeper model which will better suit the needs of both patients and physicians.Item Health Capital, Primary Health Care and Economic Growth: Evidence from Georgia(2021) Verulava, TengizIntroduction: Health care system orientation to the primary care has a positive effect on the continuity and coordination of medical services, which improves the health of the population. Investments in healthcare are important in terms of formation of the health capital. The research aims to find out the role of the health capital in economic growth of a Georgia (country). Methods: This study is based on the secondary sources of data. The study data were obtained from Human Development Report, Ministry of Labor, Health and Social Protection of Georgia. As a proxy indicator for measuring the health capital we used the life expectancy, the morbidity prevalence and Incidence rate, maternal and childrenโs mortality rate, outpatient referral rate, the state expenses on healthcare. Results: The average life expectancy has increased in recent 25 years. The maternal and childrenโs mortality rate has decreased, healthcare expenses have become higher and outpatient referral rate has also become more constant character. All these have a positive influence on the peopleโs health and countryโs economic growth. However, the state expenses on health and primary healthcare referral rate is far below the European level. Patients are less motivated to go to a primary healthcare for prevention and decide to receive medical service only when they are in critical condition. All this shows that the primary healthcare system cannot fulfill the role of the so called โgatekeeperโ. In general, the primary healthcare system has not developed in Georgia. Conclusion: As the health capital fulfills significant role in terms of the countryโs economic growth in a long-run perspective, it is advisable to promote the development of the primary healthcare system.Item Health Problems of Professional Ballet Dancers(Shota Rustaveli Theater and Film State University of Georgia, 2021) Verulava, Tengiz; Tvalavadze, KetevanBallet is a professional activity that places risky physical and psycho-emotional demands on the human body. The goal of this study was to evaluate health-related problems among ballet dancers. Within the qualitative study, in-depth interviews were conducted with ballet dancers at the State Ballet of Georgia.Item Introduction of Mandatory Vehicle Inspection and its impact on Health: Case of Georgia(Taylor & Francis Group, 2019) Lordkipanidze, Ana; Bigvava, Nana; Verulava, TengizTo fight atmospheric air pollution, the Georgian government has implemented a law about vehicle inspection. The aim of this survey is to determine under which conditions are owners of technically faulty vehicles ready to give up using technically faulty cars. Within the qualitative study the in-depth interviews were conducted. Taxi drivers think that this law is harmful to them though they appreciate the efficacy of vehicle inspections. Controls should be placed on the quality of fuel as part of the development of public transport while increasing awareness about the harmful effects of atmospheric air pollution.Item Left Ventricular Systolic Dysfunction After Myocardial Infarction(Gazi Medical Journal, 2021-01) Verulava, Tengiz; Shakinov, Giorgi; Jorbenadze, Revaz; Bakashvili, Naniko; Beka, DangadzeThe left ventricular systolic dysfunction is one of the most common complications after myocardial infarction. The damage of the large area of the cardiac muscle leads to a significant decrease in cardiac contractility. Our study presents a very unusual case of the left ventricular systolic dysfunction after myocardial infarction. A 76-year-old female was hospitalized at Chapidze Emergency Cardiology Center (Tbilisi, Georgia) with the diagnoses of ischemic heart disease and acute subendocardial myocardial infarction. Due to cardiac muscle ischemia, sinus bradycardia and diastole prolongation was revealed, which increased left ventricular end-diastolic volume and eventually caused left ventricular overload. It seemed to be a main predictor of developing compensatory ventricular premature contractions, followed by ventricular fibrillations. This argument was later supported by the stable medical condition reached by transcutaneous cardiac pacing. According to this result, the decision was made to implant a dual-chamber cardioverter - defibrillator as a non-standard treatment option, which turned out to be very successful. According to recent data, implanting permanent dual-chamber cardioverter-defibrillators as a preventive step for ventricular fibrillation has not been reported yet.Item Obstacles in the Development of Nonprofit Hospitals in Georgia(Taylor & Francis Group, 2019) Verulava, Tengiz; Lordkipanidze, Ana; Besiashvili, Nino; Todria, Mirian; Lobjanidze, Zviad; Jorbenadze, Revaz; Eliava, EkaterineThe most common form of ownership of medical establishments worldwide is a nonprofit organization. In contrast, the number of nonprofit medical institutions in Georgia is very scarce, while private profit organizations hold about 90% of the medical market. The goal of the research is to study the factors that affect the development of nonprofit hospitals in Georgia. Since there are very few nonprofit medial institutions in Georgia, we hypothesize that there is not enough motivation for functioning of such institutions. For the purposes of this research, six in-depth interviews were conducted with managers and experts of nonprofit organizations. As the research demonstrated, there is no sufficient motivation for functioning of the nonprofit form of medical organizations. Although the Tax Code provides tax benefits, they exist only in a token way and do not support the development of nonprofit medical organizations. It is necessary to improve the tax benefits provided for nonprofit hospitals in the Tax Code and share the world experience in order to increase number of nonprofit organizations in Georgia. It is recommended for Government to give more support to nonprofit organizations, in order to increase their functioning efficiency and bring incentive for development of new nonprofit medical institutions.Item Patientsโ perceptions about access to health care and referrals to family physicians in Georgia(Balkan Medical Union, 2020) Verulava, Tengiz; Jorbenadze, Revaz; Karimi, LeilaIntroduction: Adequate utilization of primary health care directly reflects the health status of a population. In the Republic of Georgia many patients seek care without a referral by a primary-care provider; as a result, patientโs referral rate to a family physician is low. The tendency of patientโs self-referral behavior may reduce the effectiveness of the healthcare system. The objective of the study. The research aims to study the cause of low referral rate to a family physician in Georgia. Material and methods. An analytic cross-sectional study was conducted. Within the quantitative survey 300 patients and within the qualitative research 20 family physicians from different cities and regions of Georgia were interviewed. Results: Patientโs referral rate to a family physician was low. 55% of family physicians revealed that patients had often addressed them only for the referral to specialists. 42% of patients visited the family physician once or did not visit at all and 57% did not consult with a family physician for preventive purpose. Conclusion: The result suggested that patientโs low referral rate was due to distrust towards family physicians, which was related to the lack of qualification of physicians and the low public awareness of the family doctorโs competence. Due to an inadequate reimbursement, family physicians do not have enough motivation to provide adequate service and lack of continuous education negatively affects their professional development. It is recommended to raise public awareness about the primary care, to introduce effective methods for payment of family doctors, to increase the role and affordability of continuous professional education.Item Readmission after hospitalization for heart failure in elderly patients in Chapidze Emergency Cardiology Center, Georgia(Emerald Publishing, 2021) Verulava, Tengiz; Jorbenadze, Revaz; Lordkipanidze, Ana; Ghonghadze, Ana; Tsverava, Michael; Donjashvili, MananaPurpose: Heart Failure (HF) is one of the leading mortality causes in elderly people. The goal of our study is the assessment of readmission in elderly patients with HF. Methodology: We explored medical records of elderly patients with HF (75 years and more) at Chapidze Emergency Cardiology Center (Georgia) within 2015-2019 years. We analyzed the structure of the cardiovascular diseases and readmission rates of hospitalized patients with HF (I50, I50.0 I50.1). A multivariate logistic regression model was used to identify factors, associated with readmission for any reason during 6-9 months after the initial hospitalization for HF. Findigs: The major complication of cardiovascular diseases in elderly patients is Heart Failure (68.6%). Hospitalization rates due to the HF in elderly patients were increased during the past years, which is associated with the population aging process. This trend will be most likely continued during the next years. Despite significant improvements in the HF treatment, readmission rates are still high. HF is the most commonly revealed cause of readmission (48% of all readmissions). 6-9 months after the primary hospitalization due to HF, readmission for any reason was 60%. Patients had concomitant diseases including hypertension (43%), myocardial infarction (14%), diabetes (36%), and stroke (8%), affecting the readmission rate. Originality/value: HF remains an important problem in Public Health. During HF associated hospitalization both cardiac and non-cardiac conditions should be addressed, which has the potential for health problems and disease progression. Some readmissions may be prevented by the proper selection of medicines and monitoring.Item The Role of Social Workers in Pediatric Oncology(Archives of the Balkan Medical Union, 2019) Verulava, Tengiz; Asatiani, Tinatin; Jorbenadze, Revaz; Dangadze, BekaIntroduction. In the past years, the role of social workers in the oncological disease treatment processes has significantly increased. The role implies supporting patientโs psychosocial conditions. This study aims at studying psycho-social challenges of oncological children and their families and defining a role of social work in this area. Methods. As part of a qualitative study, five interviews were conducted with pediatric oncologists, also 15 in-depth interviews with family members of oncological patients and a focus group with 8 members. For the quantitative study, 62 beneficiaries and 12 medical specialists were interviewed. Results. The children with oncology conditions and their families faced psycho-social challenges and were in need of social workersโ support in overcoming those challenges. The study demonstrated a low level of public awareness. There is a lack of information among both doctors and beneficiaries. Both psychologists and social workers are involved in re-socialization of oncological children and they care for the improvement of childrenโs quality of life and support their families. However, there are only a few of such organizations. Therefore, many people who need their support have no chance to take such services. Conclusion. Implementing the social work in the pediatric oncology will be a major step toward the medical quality standards.Item Socialization among the rural-to-urban migrant students in Georgia(Youth Voice Journal, 2019) Verulava, Tengiz; Kapanadze, Nino; Chilingarashvili, Sophiko; Panchulidze, Tamar; Kachkachishvili, Iago; Jorbenadze, Revaz; Dangadze, BekaPurpose. Difficulties and stress associated with cultural adjustment are significant issues affecting the life experience of the rural-to-urban migrant students. They may experience problems such as culture shock, psycho-social difficulties and interpersonal conflicts, which may negatively affect migrant studentsโ socialization. The goal of this research was to identify socialization and adaptation related problems that migrant students encounter. Design/methodology/approach. In the framework of qualitative research method, the focus groups were identified and studied. Findings. Majority of students had difficulties adapting to the urban environment. They felt uncomfortable in urban noise, traffic jams and crowded streets. For the majority of students living conditions worsened after arriving to the capital city. Because of the lack of free time, most of the migrant students could visit their families only on holidays. Some of them felt discriminated because of their language accent, taste and style. Most students plan to return to their home region and use experience and knowledge gained in urban places. However, some students do not plan to return because they donโt see any career prospects back home. Recommendations. It is recommended to develop specific types of interventions that will target the unique needs of rural-to-urban migrant students. Training and educational programs can be done to increase studentsโ awareness of available services. In addition, creating a more flexible and tailored environment, where students can actively engage in various activities in order to increase the quality of their socialization, will be beneficial.Item แแฃแแแก แฃแแแแ แแกแแแแก แแแแแแแแแแแแแฃแ แ แแแแแกแแแฃแ แแแแแ แฎแแแแแแแฃแ แแแชแแแแขแแแจแ(แฏแแแแแชแแแก แแแแแขแแแ, แแแแแแแแแ แแ แกแแชแแแแแแแ, 2020) แแแ แฃแแแแ, แแแแแแ; แฆแแแฆแแซแ, แแแ; แฏแแ แแแแแซแ, แ แแแแ; แฌแแแ แแแ, แแแฎแแแ; แแแแฏแแจแแแแ, แแแแแแแจแแกแแแแแ: แแฃแแแก แฃแแแแ แแกแแแ แกแแแแแแแแแแแแแก แแ แ-แแ แแ แฌแแแงแแแแ แแแแแแแ แฎแแแแแแแฃแแแแจแ. แแฃแแแก แฃแแแแ แแกแแแแก แแฅแแแ แฎแแแแแแแฃแ แแแชแแแแขแแ แแแแแแแ แแแแแ แฃแคแ แ แแแแแ แแแแ แแแชแแแแขแแ แกแแชแแชแฎแแแก แฎแแแแ แซแแแแแแแก แจแแแแแแแ แแ แแแก แแแแ. แแแแแแแก แแแแแแแ แแฃแแแก แฃแแแแ แแกแแแแก แแแแแแแแแแแแแฃแ แ แขแแแแแแชแแแแแก แจแแกแฌแแแแ แฎแแแแแแแฃแ แแแชแแแแขแแแจแ. แแแแแแแแแแแ: แแแแแแแก แคแแ แแแแแจแ แจแแแแกแฌแแแแแ แฉแแคแแซแแก แแแแแฃแแแแแแ แแแ แแแแแแแแแก แชแแแขแ แแก แกแแกแฎแแแก แแแแแฅแชแแแแก แกแแกแขแแแแก แแแแแแแแแแแแ แแ แแแ แจแแ แแก, แแฃแแแก แฃแแแแ แแกแแแแ แฎแแแแแแแฃแแ แแแชแแแแขแแแแก (75 แฌแแแก แแ แแแขแ แแกแแแแก) แกแแแแแแชแแแ แแกแขแแ แแแแ (2015-2019 แฌแฌ.). แแแแแแแแแแแฃแ แแฅแแ แกแแกแฎแแแก แแแแแฅแชแแแแก แกแแกแขแแแแก แแแแแแแแแแแแก แกแขแ แฃแฅแขแฃแ แ แแ แแฃแแแก แฃแแแแ แแกแแแแ แแแแแฎแแแแ แแแแแแแแแแก (I50, I50.0 I50.1) แแฅแแแ แฐแแกแแแขแแแแแแแฃแ แแแชแแแแขแแ แ แแแแแแกแแแก แแแฉแแแแแแแแแ. แจแแแแแแแ, แแแกแแฃแกแแ: แฎแแแแแแแฃแ แแแชแแแแขแแแจแ แกแแกแฎแแแก แแแแแฅแชแแแแก แกแแกแขแแแแก แแแแแแแแแแแแก แฃแแแแแ แแกแ แแแ แแฃแแแแแ แแฃแแแก แฃแแแแ แแกแแแ (68.6%), แฎแแแ แแ แแแแแแแแแแแแแแ แแฃแแแก แฃแแแแ แแกแแแแก แกแแแแ แแแ แงแแแแแแ แแแขแแ แแฆแแแแจแแแแ แแแ แชแฎแแแ แแแ แแฃแญแแแแแ แฃแแแแ แแกแแแแก แแ แแก (65%). แแแแ แฌแแแแจแ แแแแแแ แแ แแฃแแแก แฃแแแแ แแกแแแแก แแฅแแแ แฎแแแแแแแฃแแ แแกแแแแก แแแชแแแแขแแ แฐแแกแแแขแแแแแแชแแแก แ แแแแแแแแ, แ แแช แแแแแแจแแ แแแฃแแแ แแแกแแฎแแแแแแก แแแแแ แแแแก แแ แแชแแกแแแ. แแฆแแแจแแฃแแ แขแแแแแแชแแ, แกแแแแ แแฃแแแ, แจแแแแแแ แฌแแแแจแแช แแแแ แซแแแแแแ. แแแฃแฎแแแแแแ แแฃแแแก แฃแแแแ แแกแแแแก แแแฃแ แแแแแแแจแ แแแแจแแแแแแแแแ แแแฆแฌแแแแแแกแ, แแกแแ แแแฆแแแแ แ แแแแแแกแแแก แแแฉแแแแแแแแ. แ แแแแแแกแแแก แงแแแแแแ แฎแจแแ แแแแแแแ แแฃแแแก แฃแแแแ แแกแแแ (แงแแแแ แ แแแแแแกแแแก 48%). แแฃแแแก แฃแแแแ แแกแแแแ แแแ แแแแแแ แฐแแกแแแขแแแแแแชแแแแแ 6-9 แแแแก แจแแแแแ แแแแแกแแแแ แ แแแแแแแก แแแแ แ แแแแแแกแแ แจแแแแแแแแ 60%-แก. แแแชแแแแขแแแก แแฆแแแแจแแแแแแแ แแกแแแ แแแแแฎแแแแ แแแแแแแแแแแ, แ แแแแ แแแแชแแ แฐแแแแ แขแแแแแ (43%), แแแแแแ แแแฃแแแก แแแคแแ แฅแขแ (14%), แแแแแแขแ (36%), แแแ แแคแแ แแฃแแ แกแแกแฎแแซแแ แฆแแแแแก แแแแแแแแแ (7%) แแ แแแกแฃแแขแ (8%), แ แแช แแแแแแแแก แแฎแแแแก แ แแแแแแกแแแก แแแฉแแแแแแแแแ. แแฆแแแจแแฃแแ แแแฃแแแแแแก, แ แแ แแฃแแแก แฃแแแแ แแกแแแแก แแแ แแ, แ แแแแแแกแแแก แแแแแแฌแแแแ แแแแแแแแ แจแแแซแแแแ แแงแแก แแกแแแ แแ แแแแ แแแแแฃแ แ แแแแแแแ แแแแแแ, แ แแแแ แแแแชแแ: แแแแแแแแแ, แแแ แแแแแก แฃแแแแ แแกแแแ แแ แคแแแขแแแแแก แฅแ แแแแแฃแแ แแแกแขแ แฃแฅแชแแฃแแ แแแแแแแแแแแ. แแแแแแแแแแขแแแแก แกแแแแแแแ แจแแ แฉแแแแแ แแ แแแแแขแแ แแแแแ แจแแกแแซแแแแแแแ แแแ แแแแฃแแ แแ แแแแ แแแแแฃแ แ แแแแแแแ แแแแแฌแแแฃแแ แ แแแแแแกแแแก แแ แแแแแชแแ. แแแแแแแ แแฉแแแแ, แ แแ แแแชแแแแขแแแก, แ แแแแแแกแแช แแ แฐแฅแแแแแ แแแแแแแแฃแแ แแแแแแแขแแ แแแฃแแ แแแ แแแแแแฌแงแแแแแแแแแ แแฃแแแก แฃแแแแ แแกแแแแก แแแ แแแแแแ แฐแแกแแแขแแแแแแชแแแก แแ แแก, แแฆแแแแจแแแแแแแ แ แแแแแแกแแแก แแ แกแแแแแแแแแแแแแก แฃแคแ แ แแแฆแแแ แแแฉแแแแแแแแ. แแแกแแแแ, แ แแแแแแแแแชแแแแ: แแแฃแฎแแแแแแ แแแแกแ, แ แแ แแแแ แฌแแแแจแ แฎแแแแแแแฃแแ แแกแแแแก แแแชแแแแขแแแจแ แกแแกแฎแแแก แแแแแฅแชแแแแก แกแแกแขแแแแก แแแแแแแแแแแแก แแ แแฃแแแก แฃแแแแ แแกแแแแก แแแแแแแฃแ แ แแแแแกแแแแแแ แแแฃแแฏแแแแกแแ, แ แแแแแแกแแแก แแแฉแแแแแแแแ แแแแแช แแแฆแแแ แ แฉแแแ. แแฆแแแจแแฃแแ แแแแแแแแแแแก, แ แแ แแฃแแแก แฃแแแแ แแกแแแ แฏแแ แแแแแ แ แฉแแแ แฏแแแแแชแแแก แแแแจแแแแแแแแ แแ แแแแแแแ. แแฃแชแแแแแแแแ แแฃแแแก แฃแแแแ แแกแแแแ แแแแแฌแแแฃแแ แฐแแกแแแขแแแแแแชแแแกแแก แงแฃแ แแแฆแแแ แแแแฅแชแแก แ แแแแ แช แแแ แแแฃแ, แแกแแแ แแ แแแแ แแแแแฃแ แแแแแแแ แแแแแแก. แฉแแแแก แแแแ แฉแแขแแ แแแฃแแ แแแแแแแ แแแแแแแแแแ แแ แฆแแแแกแซแแแแแแ แแแแแแแแก แแฃแชแแแแแแแแ, แ แแแแแแแช แจแแแแชแแ แแแแ แแฃแแแก แฃแแแแ แแกแแแแ แแแแแฌแแแฃแ แ แแแแแแกแแแก. แแแแแแ แแแแฌแแแแก แแฎแแ แแแคแแ แแแชแแแก แแฃแแแก แฃแแแแ แแกแแแแก แแฅแแแ แฎแแแแแแแฃแ แแแชแแแแขแแ แแแฎแแกแแแแแแแแแกแ แแ แแแแแกแแแแแแแ แกแแฅแแ แแแแแแจแ. แแแแแแ แกแแจแฃแแแแแแก แแแแซแแแแก แแแแแกแแแฆแแ แแ แแฃแแแก แฃแแแแ แแกแแแแก แแฅแแแ แฎแแแแแแแฃแ แแแชแแแแขแแ แแแแแ แ แแแแแแแแ แแแแแแแแแก แกแคแแ แแแแ.Item แแแแฆแแแแแก แแกแขแแ แแ(แฏแแแแแชแแแก แแแแแขแแแแก แแ แแแแแแแแแแก แชแแแขแ แ, 2018) แแแ แฃแแแแ, แแแแแแItem แแแแแแแแแแ แจแแญแแแฃแแ แฏแแฃแคแแแแ (DRG) แกแแแแแแแงแแคแแก แแแคแแแแแกแแแแก แแแแแแ แแ 1995 แฌแแแก แฏแแแแแชแแแก แ แแคแแ แแแแ(Forbes Georgia, 2021-07) แแแแแแ, แแแ แฃแแแแ; แแแแแแแแ, แฏแแ แแแแแซแแแฆแแก แแแแ แก แกแแฃแแ แแแแ แแแแแแแแแแ แจแแญแแแฃแแ แฏแแฃแคแแแแ (Diagnosis-Related Groups โ DRG) แกแแแแแแแงแแคแแก แแแคแแแแแกแแแแก แแแแแแแ. แแแแแแแแแแ แจแแญแแแฃแแ แฏแแฃแคแแแแ (DRG) แแแคแแแแแกแแแแก แแแแแแแก แฌแแแแแซแฆแแ แแแ, แกแแแแแแชแแแ แแแแแแแแแฃแ แ แกแขแแแแแ แขแแแ แกแแฅแแ แแแแแแจแ แฏแแ แแแแแ 1996 แฌแแแก แฏแแแแแชแแแก แกแแกแขแแแแจแ แแแแแแแแ แ แ แแคแแ แแแแแก แจแแแแแแ แแแแแแ แแ. แแ แแฎแ แแ, แกแแแแแแแแแแแกแแแแแก แกแแแแขแแ แแกแ แแฅแแแแ แกแแแแแแชแแแ แแแแแแแแแฃแ แ แกแขแแแแแ แขแแแแก, แ แแแแ แช แกแแแแแแแงแแคแแก แแแคแแแแแกแแแแก แฎแแ แฏ-แแคแแฅแขแฃแ แ แแแแแแแก, แกแแฅแแ แแแแแแก แแแแแชแแแแแแแก แแแชแแแแ.