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The purpose and objectives of the program. State program of the Russian Federation "health development" State program for health care development

(as amended by Resolutions of the Government of the Russian Federation dated March 31, 2017 N 394,

dated 05/07/2017 N 539, dated 08/12/2017 N 964)

  • Passport of the state program of the Russian Federation "Health Development"
  • Passport of subprogram 1 "Prevention of diseases and promotion of a healthy lifestyle. Development of primary health care" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram 2 "Improving the provision of specialized, including high-tech, medical care" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram 4 "Maternal and Child Health Protection" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram 5 "Development of medical rehabilitation and sanatorium-resort treatment, including children" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram 6 "Providing palliative medical care, including to children" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram 7 "Staffing of the healthcare system" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram 8 "Development of international relations in the field of health care" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram 9 "Expertise and control and supervisory functions in the field of health protection" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram B "Health care provision for certain categories of citizens" of the state program of the Russian Federation "Health Development"
  • Passport of the subprogram G "Industry Development Management" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram D "Organization of compulsory health insurance for citizens of the Russian Federation" of the state program of the Russian Federation "Health Development"
  • Passport of subprogram I "Development of emergency medical care" of the state program of the Russian Federation "Health Development"
  • I. Priorities and goals of state policy, including general requirements for state policy of the constituent entities of the Russian Federation
  • III. General characteristics of the participation of constituent entities of the Russian Federation in the implementation of the Program
  • Appendix No. 1. Information on the indicators (indicators) of the state program of the Russian Federation "Healthcare Development", subprograms of the state program of the Russian Federation "Healthcare Development" and their meanings
  • Appendix No. 2. List of main activities of the state program of the Russian Federation "Health Development"
  • Appendix No. 3. Information on the main measures of legal regulation in the implementation of the state program of the Russian Federation "Health Development"
  • Appendix No. 4. Resource support for the implementation of the state program of the Russian Federation "Healthcare Development" at the expense of the federal budget and the budgets of state extra-budgetary funds of the Russian Federation
  • Appendix No. 5. Implementation plan of the state program of the Russian Federation "Healthcare Development" for 2017 and for the planning period of 2018 and 2019
  • Appendix No. 6. Rules for the provision and distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation and the city of Baikonur for the implementation of certain activities of the state program of the Russian Federation "Health Development"
  • Appendix No. 7. Rules for providing subsidies from federal budget within the framework of the state program Russian Federation"Development of healthcare" to the budgets of the constituent entities of the Russian Federation for co-financing capital investments into state-owned objects of the constituent entities of the Russian Federation, which are carried out from the budgets of the constituent entities of the Russian Federation, or for the purpose of providing appropriate subsidies from the budgets of the constituent entities of the Russian Federation to local budgets for co-financing capital investments in municipal property objects, which are carried out from local budgets
  • Appendix No. 8. Rules for the provision of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation for the purchase of aviation services by public authorities of the constituent entities of the Russian Federation for the provision of medical care using aviation
  • Appendix No. 9. Rules for the provision and distribution of subsidies from the federal budget to the budgets of constituent entities of the Russian Federation for co-financing expenses arising when providing high-tech technology to citizens of the Russian Federation medical care, not included in basic program mandatory health insurance
  • Appendix No. 10. Information on the need for capital construction of healthcare facilities in the Far East for 2017 - 2020
  • Appendix No. 11. Information on target indicators (indicators) of the state program of the Russian Federation "Health Development" in the Far East
  • Appendix No. 12. Information on resource support for the implementation of activities of the state program of the Russian Federation "Health Development" in the Far East at the expense of the federal budget
  • Appendix No. 13. Information on resource provision and forecast (reference) assessment of federal budget expenditures, consolidated budgets constituent entities of the Russian Federation and other extra-budgetary sources for the implementation of activities of the state program "Health Development" in the Far East

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Government program The Russian Federation “Healthcare Development” (hereinafter referred to as the State Program) was approved by Decree of the Government of the Russian Federation dated December 26, 2017 No. 1640 “On approval of the state program of the Russian Federation “Healthcare Development”.

Decree of the Government of the Russian Federation dated March 29, 2019 No. 380 “On Amendments to the State Program of the Russian Federation “Health Development” approved changes to the State Program concerning the adjustment of goals, the composition of co-executors and participants, the structure and timing of the implementation of the pilot State Program, the rules for provision and distribution subsidies from the federal budget to the budgets of constituent entities of the Russian Federation.

The state program was developed in accordance with the Rules for the development, implementation and evaluation of the effectiveness of individual state programs of the Russian Federation, approved by Decree of the Government of the Russian Federation of October 12, 2017 No. 1242 “On the development, implementation and evaluation of the effectiveness of individual state programs of the Russian Federation.”

The state program was prepared taking into account the provisions:

  • Messages of the President of the Russian Federation to the Federal Assembly of the Russian Federation dated March 1, 2018; dated February 20, 2019;
  • Decree of the President of the Russian Federation of May 7, 2018 No. 204
    “On the national goals and strategic objectives of the development of the Russian Federation
    for the period until 2024";
  • The main directions of activity of the Government of the Russian Federation for the period until 2024, approved by the Chairman of the Government of the Russian Federation D.A. Medvedev September 29, 2018 No. 8028p-P13;
  • Guidelines for the development of national projects (programs) approved by the Chairman of the Government of the Russian Federation D.A. Medvedev June 4, 2018 No. 4072p-P6;
  • Regulations on the organization of project activities in the Government of the Russian Federation, approved by Government Decree
    Russian Federation dated October 31, 2018 No. 1288;
  • documents strategic planning Russian Federation
    in the healthcare sector;
  • decisions (instructions) of the President of the Russian Federation
    and the Government of the Russian Federation; and etc.

Taking into account Decree of the President of the Russian Federation dated May 7, 2018 No. 204 “On national goals and strategic objectives of the development of the Russian Federation for the period until 2024” (hereinafter referred to as Decree No. 204), the goals of the State Program were adjusted.

Goals of the State Program:

1) reducing the mortality rate of the working-age population by 2024
up to 350 cases per 100 thousand population;

2) reducing mortality from diseases of the circulatory system to 450 cases per 100 thousand population by 2024;

3) reduction by 2024 in mortality from neoplasms, including
from malignant, up to 185 cases per 100 thousand population;

4) reduction by 2024 infant mortality up to 4.5 cases per 1 thousand live births.

The values ​​of target indicators by year of implementation are indicated
in the State Program passport.

The deadline for the implementation of the State Program has been changed from 2025
for 2024 in accordance with the implementation completion date national project"Healthcare". This change was approved by Order of the Government of the Russian Federation dated October 13, 2018 No. 2211-r “On Amendments to the List of State Programs of the Russian Federation.”

The design part of the pilot State program includes the national project “Healthcare” (hereinafter referred to as the National Project).

The National Project reflects in the form of structural elements
8 federal projects:

“Development of the primary health care system”;

“Combating Cardiovascular Diseases”;

“Fighting cancer”;

“Development of children's healthcare, including the creation of a modern infrastructure for providing medical care to children”

“Providing medical organizations of the healthcare system with qualified personnel”;

“Development of a network of national medical research centers
and implementation of innovative medical technologies";

“Creation of a single digital circuit in healthcare based on a single state information system health care (Unified State Health Information System)";

"Export Development medical services»;

Passports of federal projects were approved by the minutes of the meeting of the project committee for the national project “Healthcare”
dated December 14, 2018 No. 3.

In addition, the structure of the project part of the State Program includes 2 federal project implemented within the framework of the national project “Demography”:

“Strengthening public health”;

"Older generation".

The process part of the State Program includes 24 departmental target programs (DTPs), developed on the basis of individual events.

Development and approval of VDC projects was carried out in accordance with
with the Regulations on the development, approval and implementation of departmental
target programs approved by Decree of the Government of the Russian Federation dated April 19, 2005 No. 239 (as amended on February 23, 2018 No. 196).

The State Program includes in the form of annexes the Rules for the distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation, as well as summary information on the rapid development of priority territories of the Russian Federation. The list of priority territories is brought into compliance with paragraph 1 of the Decree of the President of the Russian Federation of November 3, 2018 No. 632 “On amendments to the list federal districts, approved by Decree of the President of the Russian Federation of May 13, 2000 No. 849.”

I approve

Chief physician of the State Budgetary Healthcare Institution of the Republic of Belarus

G. Kumertau

___________ O.A. Astakhov

REPORT

FOR 2015

Afonina Evgenia Valerievna

NURSE'S ROOM

PEDIATRIC DEPARTMENT

State state-financed organization Healthcare of the Republic of Bashkortostan City Hospital of Kumertau

To assign a second qualification category in a specialty

"Nursing in Pediatrics"

Kumertau


I. Introductory part

1. Healthcare reform 3

2.Main federal health programs

population 7

3.Biographical information 8

II. Main part

4. City healthcare 9

5. Characteristics of the pediatric department 11

6. Performance indicators of the pediatric department 13

7. Basic orders regulating the work of a nurse 16

pediatric department

8.Organization of the work of the pediatric ward nurse 19

departments

9. Sanitary and anti-epidemic work of ward nurse 27 of the pediatric department

10. Sanitary education work 32

III. Final part.

11. Conclusions 34

12. Sentences 35

13. References 36

Healthcare reform.

Healthcare is a series of socio-economic and medical reforms aimed at maintaining and improving the level of health of each individual and the population as a whole. The goal of healthcare reform is the preservation and development of the state municipal healthcare system, the organization of their activities, as well as the activities of private system health care to maximize the rights of citizens in the field of health care.

Healthcare reform offers solutions to the following priority tasks:

1. From inpatient medical care to outpatient care - this is an increase in the volume of medical care in the clinic, the introduction of hospital-replacing technologies: day hospitals in the clinic, at home;

2. From specialized care to general medical practice, family medicine, when medical care is as close as possible to the place of residence and is a long process;

3. From increasing the amount of resources in the industry to their effective use;

4.From the volume of medical services to their quality;

5. From increasing the number of beds, to their rational use, repurposing and phasing of inpatient care;

6. From an increase in the number of doctors and paramedical workers to the quality of their work - improving the quality of professional training, the practical healthcare system providing primary medical care.

7.From government funding- to financing from various sources: paid services.

8.Providing for the population medicines accessible to all segments of the population.

9. From partial to full provision of the rights and responsibilities of the patient. This is the provision to the population of free, accessible and qualified assistance from a doctor and a medical institution, and the right to receive a medical insurance policy.

10. From treating diseases to preventing them and strengthening public health. This is ensuring the priority of disease prevention, creating psycho-preventive support centers. Publication of articles promoting a healthy lifestyle. Supply of good quality food products, water supply, protection of maternal and child health; immunization against major infectious diseases; prevention of endemic diseases.

In order to strengthen the health of the population of Russia, reduce the level of morbidity, disability, mortality, increase the accessibility and quality of medical care, strengthen primary health care, develop the preventive orientation of health care, and meet the population’s need for high-tech types of medical care, the national project “Health” was developed, which successfully is being implemented.

National project "Health"

The main goals of the priority national project in the field of healthcare:

1. Strengthening the health of the Russian population, reducing the level of morbidity, disability, and mortality.

2.Increasing the availability and quality of medical care.

3.Strengthening primary health care, creating conditions for the provision of effective medical care at the prehospital stage:

Training and retraining of general (family) practitioners, local therapists and pediatricians;

Increase in wages for primary care medical workers, paramedics and midwives and ambulances;

Strengthening the material and technical base of the diagnostic service for primary medical care and emergency medical care.

4.Development of preventive healthcare:

Prevention of HIV infection, hepatitis B and C , identification and treatment of HIV patients;

Additional immunization of the population within the framework of the national vaccination calendar;

Introduction of new screening programs for newborn children;

Additional medical examination of the working population;

Providing medical care to women during pregnancy and childbirth in state and municipal institutions healthcare.

5. Meeting the population’s need for high-tech medical care:

Increasing the volume of high-tech medical care;

Construction of new high medical technology centers;

Training of highly qualified doctors and paramedical personnel for these centers.

Interventions to address major health problems require efficient spending budget funds oriented towards the final result, shifting the emphasis of medical care to primary care (pre-hospital stage), preventive focus of healthcare.

Federal target programs

for the protection of the health of the population of the Russian Federation.

1. Construction of medical centers to provide specialized medical care in the field of obstetrics, gynecology and neonatology (perinatal centers).

2. Republican target program"Formation healthy image life of the population of the Republic of Bashkortostan, including reducing the consumption of alcohol, tobacco and the fight against drug addiction, for 2011-2015."

3. Republican target program “Prevention and control of socially significant diseases in the Republic of Bashkortostan (2011-2015)” The program includes the subprograms “Oncology”, “Sexually transmitted infections”, “Vaccine prevention”, “Diabetes mellitus”.

4. Program of state guarantees of free medical care to citizens in the Republic of Belarus for 2014-2016.

5. Departmental target program of the Ministry of Health of the Republic of Bashkortostan "Safe blood for 2012-2014"

6. Departmental target program of the Ministry of Health of the Republic of Bashkortostan "Treatment of viral hepatitis in the Republic of Bashkortostan for 2013-2015"

7. Departmental target program of the Ministry of Health of the Republic of Bashkortostan "Tuberculosis" for 2013-2015"

Biographical information.

I, Afonina Evgenia Valerievna, was born in 1988.

In 2008, she graduated from the Sterlitamak Medical School, Kumertau Branch, with a degree in Nursing.

I have been working at the State Budgetary Healthcare Institution of the Republic of Belarus in the city of Kumertau since 2008.

Alexandrov M.A. Center for Health Research

The article discusses the goals, structure, directions and timing of the implementation of the state program of the Russian Federation “Healthcare Development”, approved by Decree of the Government of the Russian Federation of December 26, 2017 N 1640.

The State Program of the Russian Federation “Healthcare Development” (hereinafter referred to as the Program) is a strategic document for the development of the industry. It defines the goals and main directions Russian healthcare until 2025. The Ministry of Health of Russia has been approved as the responsible executor of the Program.

First federal program in the field of healthcare was developed in accordance with the new “Rules for the development, implementation and evaluation of the effectiveness of individual state programs of the Russian Federation”, approved by Decree of the Government of the Russian Federation of October 12, 2017 N 1242.

Program Goals

The main goals of the Program are:

1) increasing life expectancy at birth to 76 years by 2025;

2) reducing the mortality rate of the population of working age to 380 per 100 thousand population by 2025;

3) reducing mortality from diseases of the circulatory system to 500 per 100 thousand population by 2025;

4) reducing mortality from neoplasms (including malignant ones) to 185 per 100 thousand population by 2025;

5) increasing population satisfaction with the quality of medical care to 54 percent by 2025.

The effectiveness of the Program depends on the achievement of quantifiable indicators of planned goals. As can be seen, the planned life expectancy and mortality rates are very optimistic. However, it is not entirely clear why Russians will die closer to 2025, because it is with increasing life expectancy that the share of circulatory system diseases and neoplasms, the main causes of mortality, in the morbidity structure is growing. If people live to see cancer, the mortality rate from cancer will only increase. This trend is observed in all developed countries with an aging population. All indicators of the Program’s goals are calculated per 100 thousand population, and not by age and sex groups. In this regard, there are questions about calculating the real effectiveness of the Program.

Increasing public satisfaction with the quality of medical care

Quantitative indicators of goal No. 5 “Increasing public satisfaction with the quality of medical care” with detailed breakdown by year also raise questions. We all know about the quality of sociological surveys conducted in healthcare, including compulsory medical insurance. Existing methods for collecting and processing information do not fully meet modern requirements for conducting sociological research. The greatest problems arise with the collection of primary data. When organizing surveys, the requirements of anonymity are often not observed, the goals and objectives of the survey are not explained, an inconvenient time and place for conducting the survey is chosen, and the procedure for filling out the questionnaires is not explained. The representativeness of the sample in terms of age and gender composition, reasons for visiting a medical institution, nosologies, etc. is not determined.

The quality of ongoing sociological research in the healthcare system can be judged by the results of already conducted surveys. You can recall the case when in 2013, the results of a study of population satisfaction with medical care in 2011-2012 in the context of constituent entities of the Russian Federation were published on the website of the Russian Ministry of Health. The total number of respondents was more than 1.5 million people. Satisfaction was assessed by such indicators as: waiting time at the reception desk, for an appointment with a doctor, when making an appointment for laboratory and instrumental tests, the unavailability of some medical specialists, satisfaction with the work of doctors, the level of technical equipment medical institutions and length of wait for hospitalization.

It was also reported that independent surveys conducted by insurance medical organizations in 3,537 hospitals and 6,459 institutions providing medical care on an outpatient basis showed that during the implementation period regional programs modernization of healthcare, the population's satisfaction with the medical care provided to them has significantly increased from 53% in 2011 to 72% by the beginning of 2013.

It is known that public opinion is inert, therefore, for such a significant change in such a short period of time, serious changes in the health care system were needed, which was not the case.

In general, the reliability of primary sociological data depends on many factors: the professional training of the organizers and performers of the sociological survey, the quality of methodological support, including the preparation of a research program, determining the representativeness of the sample, developing questionnaires and instructions for filling them out, ensuring the anonymity of the survey, etc. The reliability of the data may also be affected by the fact that the population's satisfaction medical care is included in the system of indicators for assessing the activities of regional authorities.

Then the Novgorod region (2.22 times increase, an increase of 121.9%), the Republic of Sakha (Yakutia) (2.07 times increase, an increase of 107.3%) and Vologda Region(an increase of 1.93 times, an increase of 92.7%). Best performance population satisfaction with medical care in 2012 were Khabarovsk Territory(96%) and Moscow (95%). Not far behind with their 94% Altai region, Primorsky Krai and Novosibirsk region. There is no point in commenting on these indicators.

It turns out that we have already achieved and even exceeded all the indicators of population satisfaction with the quality of medical care planned in the Program. It should be noted that the methods of conducting sociological research in healthcare, approved by the Russian Ministry of Health and the Federal Compulsory Medical Insurance Fund, have remained virtually unchanged since that time. It is interesting that the Special Communications and Information Service of the Federal Security Service (FSO) of Russia also deals with issues of satisfaction with the quality of medical care, whose data is posted on the website of the Russian Ministry of Health. However, we know nothing about the methodology for conducting these studies. By the way, the results of the FSO studies are more consistent with the indicators of population satisfaction with the quality of medical care planned in the Program - population satisfaction with medical care, according to the FSO data, in March-July 2015 was 40.4% (sample was 90 thousand respondents).

Program Financing

The total amount of funding for the Program will be 349,103,98,190.4 thousand rubles, including:

for 2018 - 3875167871.3 thousand rubles;

for 2019 - 3958918478.1 thousand rubles;

for 2020 - 4142170871 thousand rubles;

for 2021 - 4300148194 thousand rubles;

for 2022 - 4434248194 thousand rubles;

for 2023 - 4577248194 thousand rubles;

for 2024 - 4729248194 thousand rubles;

for 2025 - 4893248194 thousand rubles.

The money will go to 9 main areas (subprograms):

1. Improving the provision of medical care, including disease prevention and the formation of a healthy lifestyle.

2. Development and implementation of innovative methods of diagnosis, prevention and treatment, as well as the fundamentals of personalized medicine.

3. Development of medical rehabilitation and sanatorium-resort treatment, including for children.

4. Development of human resources in healthcare.

5. Development international relations in the field of health care.

6. Expertise and control and supervisory functions in the field of health care."

7. Health care individual categories citizens.

8. Information Technology and management of industry development.

9. Organization of compulsory medical insurance for citizens of the Russian Federation.

Approved Decree of the Government of the Russian Federation of April 15, 2014 No. 294. This resolution recognizes that the order of the Government of the Russian Federation of December 24, 2012 No. 2511-r has become invalid.

Responsible executor: Ministry of Health of the Russian Federation(). Co-executor: Federal Medical and Biological Agency ().

Program participants: Ministry of Foreign Affairs of the Russian Federation, Ministry of Defense of the Russian Federation, Ministry of Industry and Trade of the Russian Federation, Ministry Agriculture Russian Federation, Ministry of Labor and social protection Russian Federation, Ministry of Finance of the Russian Federation, Ministry of Economic Development of the Russian Federation, Ministry of Energy of the Russian Federation, Federal tax service, federal Service execution of punishments, Federal Service for Surveillance in Healthcare, Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Federal Service bailiffs, Federal agency air transport, Federal Agency for Sea and River Transport, Federal Agency scientific organizations, Federal Agency for Management state property, Federal Road Agency, Federal Compulsory Health Insurance Fund.

  • first stage: 2013 – 2015
  • second stage: 2016 – 2020

Volumes of budgetary allocations, thousand rubles

2013 2014 2015 2016 2017 2018 2019 2020
Federal budget funds (according to preliminary estimates 2451185163.2 thousand rubles) 413096449,8 357154180,6 260503600,8 262867673,8 263304352,2 286879826,8 299241851,9 308137227,3
Funds from the consolidated budgets of the constituent entities of the Russian Federation (according to preliminary estimates, 11079448074.3 thousand rubles) 855100000 1278914456 1336464817,5 1396605734,3 1459452992,4 1525128377 1586133512,1 1641648185
Facilities Federal Fund compulsory medical insurance (according to preliminary estimates 13090239782 thousand rubles) 1059200000 1240116074,5 1452032467,1 1521253067,1 1684669055,1 1857824179,3 2042263268,1 2232881670,8
TOTAL:
The total amount of funds is: 26 620 873 019,5

Expected results of the Program implementation

  • reduction in mortality from all causes to 11.4 cases per 1000 population;
  • reduction in infant mortality to 6.4 cases per 1000 live births;
  • reducing mortality from diseases of the circulatory system to 622.4 cases per 100 thousand population;
  • reducing mortality from road accidents to 10 cases per 100 thousand population;
  • reduction in mortality from neoplasms (including malignant ones) to 190 cases per 100 thousand population;
  • reduction in mortality from tuberculosis to 11.2 cases per 100 thousand population;
  • reducing the consumption of alcoholic products (in terms of absolute alcohol) to 10 liters per capita per year;
  • reducing the prevalence of tobacco use among adults to 26 percent;
  • reduction in the number of registered patients diagnosed with active tuberculosis for the first time in life (per 100 thousand population) to 61.6 cases per 100 thousand population;
  • the supply of doctors will be 40.2 people per 10 thousand population;
  • the number of nursing staff per 1 doctor will be 3 people;
  • increasing the ratio of average wages of doctors and employees of medical organizations with higher medical (pharmaceutical) or other degrees higher education providing medical services (ensuring the provision of medical services), to average wages for a constituent entity of the Russian Federation up to 200 percent;
  • increasing the ratio of the average salary of paramedical (pharmaceutical) personnel (personnel providing conditions for the provision of medical services) to the average salary in the constituent entity of the Russian Federation to 100 percent;
  • increasing the ratio of the average salary of junior medical personnel (personnel providing conditions for the provision of medical services) to the average salary in the constituent entity of the Russian Federation to 100 percent;
  • increasing the ratio of the average salary of paramedical (pharmaceutical) and junior medical personnel (personnel providing conditions for the provision of medical services) to the average salary in the constituent entity of the Russian Federation to 100 percent;
  • increase in life expectancy at birth to 74.3 years
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