Government program Russian Federation“Health 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 “Health Development”.

Decree of the Government of the Russian Federation of March 29, 2019 No. 380 “On Amendments to the State Program of the Russian Federation “Health Development” approved changes to the State Program regarding 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 the provision and distribution subsidies from federal budget budgets of subjects of the Russian Federation.

The State Program was developed in accordance with the Rules for the Development, Implementation and Evaluation of the Effectiveness of Certain 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 Certain State Programs of the Russian Federation”.

The state program has been prepared taking into account the provisions of:

• Messages of the President of the Russian Federation to the Federal Assembly of the Russian Federation dated March 1, 2018; 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 up to 2024”;
• The main areas of activity of the Government of the Russian Federation for the period up to 2024, approved by the Chairman of the Government of the Russian Federation D.A. Medvedev September 29, 2018 No. 8028p-P13;
• Guidelines on 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 the Government Decree
  Russian Federation dated October 31, 2018 No. 1288;

• documents strategic planning Russian Federation
  in the health sector;
• decisions (orders) of the President of the Russian Federation
  and the Government of the Russian Federation; and etc.

Taking into account the 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 up to 2024” (hereinafter - Decree No. 204), the goals of the State Program have been adjusted.

Goals of the State Program:

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

2) reduction by 2024 of mortality from diseases of the circulatory system to 450 cases per 100,000 population;

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

4) reduction by 2024 of infant mortality to 4.5 cases per 1,000 live births.

Values ​​of target indicators by years of implementation are indicated
in the passport of the State program.

The deadline for the implementation of the State Program has been changed from 2025
for 2024 in accordance with the deadline for completing the implementation of the national project "Healthcare". This change was approved by Decree 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 project part of the pilot State Program includes the national project "Healthcare" (hereinafter referred to as the National Project).

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

“Development of the primary health care system”;

"The fight against cardiovascular diseases";

"Fight against oncological diseases";

"Development of children's healthcare, including the creation of a modern infrastructure for the provision of medical care to children"

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

"Development of a network of national medical research centers
and introduction of innovative medical technologies”;

"Creation of a single digital contour in healthcare based on a unified state health information system (EGISZ)";

"Development of export of medical services";

Passports of federal projects 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 design part of the State Program includes 2 federal projects 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 (TSP) developed on the basis of separate measures.

The development and approval of the projects of the TDC 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 of 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 accelerated development of priority territories of the Russian Federation. The list of priority territories has been brought into line with paragraph 1 of Decree of the President of the Russian Federation dated November 3, 2018 No. 632 “On Amendments to the List federal districts, approved by Decree of the President of the Russian Federation dated May 13, 2000 No. 849”.

Aleksandrov M.A. Center for the Study of Health Problems

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

The State Program of the Russian Federation "Health 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 was 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 certain 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 objectives of the Program are:

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

2) reduction by 2025 of the mortality rate of the working-age population to 380 per 100,000 population;

3) reduction of mortality from diseases of the circulatory system to 500 per 100,000 population by 2025;

4) reduction by 2025 of mortality from neoplasms (including malignant ones) to 185 per 100,000 population;

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

The effectiveness of the Program depends on the achievement of quantifiable indicators of the planned goals. As you can see, the planned indicators of life expectancy and mortality are very optimistic. However, it is not entirely clear what Russians will die from closer to 2025, because it is with an increase in life expectancy that the share of diseases of the circulatory system and neoplasms, the main causes of death, increases in the structure of morbidity. If people continue to live up to the same oncology, then the death rate from cancer will only increase. This trend is observed in all developed countries with aging populations. All indicators of the goals of the Program are calculated per 100,000 population, and not by age and sex groups. In this regard, there are questions to the calculation of the real effectiveness of the Program.

Increasing satisfaction of the population with the quality of medical care

Quantitative indicators of goal No. 5 “Improving the satisfaction of the population with the quality of medical care” with a detailed breakdown by years also raise questions. We all know about the quality of sociological surveys conducted in healthcare, including through compulsory health insurance. The existing methods of collecting and processing information do not fully meet the modern requirements for conducting sociological research. The biggest 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 questionnaires is not explained. The representativeness of the sample by sex and age composition, reasons for contacting a medical institution, nosologies, etc. is not determined.

The quality of ongoing sociological research in the health care system can be judged by the results of surveys already conducted. We can recall the case when in 2013 the website of the Ministry of Health of Russia published the results of a study of population satisfaction with medical care in 2011-2012 in the context of the constituent entities of the Russian Federation. 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 studies, the unavailability of some specialist doctors, satisfaction with the work of doctors, the level of technical equipment of medical institutions and the length of waiting time for hospitalization.

It also reported that independent surveys conducted by insurance medical organizations in 3537 hospitals and 6459 institutions providing medical care on an outpatient basis showed that during the implementation period regional programs The modernization of health care significantly increased the satisfaction of the population with the medical care provided to them from 53% in 2011 to 72% by the beginning of 2013.

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

In general, the reliability of primary sociological data depends on many factors: the professional training of organizers and performers of a 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 influenced by the fact that the satisfaction of the population with medical care is included in the system of indicators for evaluating the activities of regional authorities.

At that time, the Novgorod Region (an increase of 2.22 times, an increase of 121.9%), the Republic of Sakha (Yakutia) (an increase of 2.07 times, an increase of 107.3%) and the Vologda Oblast became the champions in terms of increasing the indicators of satisfaction with medical care. region (an increase of 1.93 times, an increase of 92.7%). The best indicators of population satisfaction with medical care in 2012 were in the Khabarovsk Territory (96%) and Moscow (95%). Not much behind with their 94% Altai Territory, Primorsky Territory and Novosibirsk region. There is no point in commenting on these indicators.

It turns out that we have already achieved and even exceeded all indicators of public satisfaction with the quality of medical care planned in the Program. It should be noted that the methodology for conducting sociological research in health care, approved by the Russian Ministry of Health and the Federal Compulsory Medical Insurance Fund, has not changed much since that time. Interestingly, the Special Communications and Information Service also deals with issues of satisfaction with the quality of medical care. Federal Service protection (FSO) of Russia, whose data is posted on the website of the Ministry of Health of Russia. However, we do not know anything about the methodology for conducting these studies. By the way, the results of the research conducted by the FSO are more consistent with the indicators of public satisfaction with the quality of medical care planned in the Program - population satisfaction with medical care according to the FSO in March-July 2015 was 40.4% (the sample was 90 thousand respondents).

Financing of the Program

The total amount of financing of the Program will be 34910398190.4 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 in 9 main areas (subprograms):

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

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

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

4. Development of human resources in health care.

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

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

7. Medical and sanitary provision of certain categories of citizens.

8. Information technology and industry development management.

9. Organization of compulsory health insurance citizens of the Russian Federation.

The State Program for the Development of Healthcare for 2018-2025 was approved by the Decree of the Government of the Russian Federation of December 26, 2017 No. 1640 “On Approval of the State Program of the Russian Federation “Health Development””.

The State Health Development Program for 2018-2025 will be financed in the amount of more than 34.9 trillion. rubles.

Among the goals of the program:

• increasing life expectancy at birth to 76 by 2025;
• reduction by 2025 of the mortality rate of the working-age population to 380 per 100,000 population;
• reduction by 2025 of mortality from diseases of the circulatory system to 500 per 100 thousand of the population;
• reduction by 2025 of mortality from neoplasms to 185 per 100,000 population;
• increase the share of the population satisfied with the quality of medical care to 54 percent by 2025.

The state program provides for the development of the following areas (subprograms):

• improving the provision of medical care, including the prevention of diseases and the formation of a healthy lifestyle;
• development and implementation of innovative methods of diagnostics, prevention and treatment, as well as the basics of personalized medicine;
• development of medical rehabilitation and sanatorium treatment;
• development of human resources in health care;
• development of international relations in the field of health protection;
• expertise and control and supervisory functions in the field of health protection;
• medical and sanitary provision of certain categories of citizens;
• information technology and industry development management;
• organization of compulsory medical insurance for citizens of the Russian Federation.

The Decree invalidated the Decree of the Government of the Russian Federation of April 15, 2014 N 294 “On Approval of the State Program of the Russian Federation “Health Development””

GOVERNMENT OF THE RUSSIAN FEDERATION

RESOLUTION

ON THE APPROVAL OF THE STATE PROGRAM

OF THE RUSSIAN FEDERATION "HEALTH DEVELOPMENT"

The Government of the Russian Federation decides:

1. Approve the attached state program of the Russian Federation "Health Development".

2. To the Ministry of Health of the Russian Federation:

place the state program of the Russian Federation "Health Development", approved by this resolution, on the official website of the Ministry, as well as on the portal of state programs of the Russian Federation in the information and telecommunications network "Internet" within 2 weeks from the date of the official publication of this resolution;

take measures to implement the activities of the state program of the Russian Federation "Health Development".

3. To recommend that the executive authorities of the constituent entities of the Russian Federation, when making changes to the state programs of the constituent entities of the Russian Federation aimed at developing health care, take into account the provisions of the state program of the Russian Federation "Health Development", approved by this resolution.

4. Recognize as invalid:

Decree of the Government of the Russian Federation of April 15, 2014 N 294 “On approval of the state program of the Russian Federation “Health Development”” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2014, N 17, Art. 2057);

paragraphs 2 and 3 of the Decree of the Government of the Russian Federation of March 31, 2017 N 394 “On Amendments and Recognition as Invalid of Certain Acts of the Government of the Russian Federation” and paragraph 1 of the amendments that are made to the acts of the Government of the Russian Federation approved by the specified resolution (Collection of Legislation of the Russian Federation, 2017, N 15, article 2225);

Decree of the Government of the Russian Federation of May 7, 2017 N 539 “On Amendments to the State Program of the Russian Federation “Health Development”” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2017, N 20, Art. 2924);

Decree of the Government of the Russian Federation of August 12, 2017 N 964 “On Amendments to Appendix N 9 to the State Program of the Russian Federation “Health Development”” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2017, N 34, Art. 5288).

Prime Minister

Russian Federation

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The strategic goal of the Program is: improving the system of protecting the health of citizens in order to prevent diseases, preserve and strengthen the physical and mental health of each person, maintain his long-term active life, and provide him with medical care. The strategic goal of the Program is achieved by 2020 through decrease in the values ​​of the following indicators:

• mortality from all causes - up to 10.3 cases per 1000 population;
• infant mortality - up to 6.4 cases per 1000 live births;
• maternal mortality - up to 15.5 cases per 100 thousand population;
• mortality from diseases of the circulatory system - up to 551.4 cases per 100 thousand population;
• mortality from road traffic injuries - up to 10 cases per 100 thousand of the population;
• mortality from neoplasms - up to 189.5 cases per 100 thousand population;
• mortality from tuberculosis - up to 8.2 cases per 100 thousand population;
• consumption of alcoholic products (in terms of absolute alcohol) - up to 10 liters per capita per year;
• the prevalence of tobacco use among the adult population is up to 25%;
• the prevalence of tobacco use among children and adolescents is up to 15%;
• incidence of tuberculosis - up to 35.0 cases per 100 thousand population;

increasing by 2020 the values ​​of the following indicators:

• life expectancy at birth up to 75.7 years;

achievement by 2018 of the values ​​of the following indicators:

• the ratio of salaries of doctors and employees of medical organizations with higher medical (pharmaceutical) or other higher education, to the average wages in the corresponding region - 200%;
• the ratio of the salary of the average medical (pharmaceutical) personnel to the average salary in the corresponding region - 100%;
• the ratio of the salary of junior medical personnel (personnel providing conditions for the provision of medical services) to the average salary in the corresponding region is 100%.

Program objectives

The tasks of turning Russia into global leader world economy, reaching the level of developed countries in terms of social well-being dictate new requirements for the healthcare system.

Ensuring the priority of prevention in the field of health protection and the development of primary health care

In the direction of solving this problem, it is necessary to increase the efficiency of primary health care, optimize the total number of beds, and increase the efficiency of inpatient care. The practical implementation of the transition to a healthy lifestyle is impossible without bringing preventive medicine closer to the person. In this regard, the priority is to provide the population, primarily healthy people and people with chronic diseases without exacerbation, with preventive care within walking distance. It is necessary to develop and implement mechanisms to stimulate the polyclinic level for the earliest possible detection of diseases and to prevent the development of diseases to the stage leading to hospitalization. The implementation of these measures is aimed at improving the indicators of temporary disability of the working population.

Formation of a responsible attitude towards their health among the population, refusal of smoking, alcohol and drug abuse, provision of conditions for a healthy lifestyle, correction and regular monitoring of behavioral and biological risk factors for non-communicable diseases at the population, group and individual levels should become the most important direction of policy in the field of health protection.

Non-communicable diseases (diseases of the circulatory system, oncological diseases, respiratory diseases and diabetes mellitus) cause more than 80% of all deaths in the population of the Russian Federation, with 56% of all deaths due to cardiovascular diseases. The development of non-communicable diseases is based on a single group of risk factors associated with an unhealthy lifestyle (smoking, physical inactivity, poor diet, alcohol abuse).

The World Health Organization has identified 7 leading risk factors that make the main contribution to premature mortality in Russia, including:

• high blood pressure (35.5%), hypercholesterolemia (23%),
• smoking (17.1%),
• unhealthy diet, insufficient consumption of fruits and vegetables (12.9%),
• obesity (12.5%),
• alcohol abuse (11.9%), low physical activity (9%).

Risk factors can accumulate in individuals and interact with each other, creating a multiple effect: the presence of several risk factors in one person increases the risk of death from diseases of the circulatory system by 5-7 times.

Based on the experience of many countries (Finland, USA, UK, New Zealand and others) have shown that lifestyle modification and reduction of risk factors can slow down the development of circulatory system diseases both before and after the onset of clinical symptoms.

Systematic analysis shows that lifestyle and nutritional changes can reduce the risk of death from coronary heart disease both in the population and among patients with this disease. Thus, stopping smoking reduces the risk by 35% and 50%, respectively, increasing physical activity by 25% and 20–30%, moderate alcohol consumption by 25% and 15%, changing at least 2 factors in nutrition by 45%. % and 15–40%.

Another systematic analysis shows that the treatment of patients with coronary heart disease and other diseases of the circulatory system with drugs from the group of antiplatelet agents reduces the risk of complications in such patients by 20-30%, beta-blockers - by 20-35%, ACE inhibitors - by 22-30%. 25%, statins - by 25-42%.

An analysis of the reasons for the significant reduction in mortality from diseases of the circulatory system in many countries showed that the contribution of recovery (lifestyle changes) and the reduction of risk factors in reducing such mortality ranges from 44% to 60%.

Factor analysis of the causes leading to high rates of cancer incidence and mortality showed that the influence of group A factors (tobacco smoking, excessive alcohol consumption, overweight, nutritional imbalance, other factors (production, natural environment, housing, the impact of infectious carcinogenic factors, etc.) .) is 65%, and group B factors (delayed detection and treatment of precancerous diseases, late diagnosis of cancer, lack of screening, lack of formation and monitoring of risk groups, irregular preventive examinations of the population, lack of medical examination of risk groups, lack of oncological alertness of doctors in the primary network, lack of educational work among the population, insufficient work to motivate the population for active and conscious participation in screening activities, the absence of unified screening programs at the federal level, the absence of a register of persons included in screening programs) is 35%.

The basis for promoting a healthy lifestyle, along with informing the population about the dangers of tobacco consumption, irrational and unbalanced nutrition, low physical activity, abuse of alcohol, drugs and toxic substances, should be training in hygiene, work and study rules. At the same time, increasing the motivation of the population to maintain a healthy lifestyle should be accompanied by the creation of appropriate conditions for this. In addition, priority should be given to measures not only for the timely detection of risk factors and non-communicable diseases, but also for their timely correction.

When reforming the system of primary health care for the population, the tasks of changing the system of providing assistance to the rural population come to the fore; modernization of existing institutions and their divisions; alignment of patient flows with the formation of uniform routing principles; development of new forms of medical care - hospital replacement and outreach methods of work; development of emergency care on the basis of outpatient departments; improving the principles of interaction with hospitals and ambulance units.

lining up modern system provision of primary health care to the population should include both the smallest settlements and large cities.

Improving the efficiency of providing specialized, including high-tech, medical care, ambulance, including emergency specialized, medical care, medical evacuation

High-tech medical care is part of specialized medical care and includes the use of new, complex and (or) unique, as well as resource-intensive methods of treatment with scientifically proven effectiveness, including cellular technologies, robotic technology, information technology and genetic engineering methods developed on the basis of achievements medical science and related branches of science and technology.

To improve the availability and quality of medical care, measures will be taken to improve the organizational system for providing specialized, including high-tech, medical care, to improve the provision of medical care for socially significant diseases, including patients with diseases of the circulatory system, tuberculosis, oncological, endocrine and some other diseases, the introduction of innovative methods of treatment into practice, the development of infrastructure and resource support for healthcare, including financial, material, technical and technological equipment of medical institutions based on innovative approaches and the principle of standardization.

The Federal Law "On Compulsory Medical Insurance" provides for the inclusion of high-tech medical care in the system of compulsory medical insurance from 2015. One of the conditions for such inclusion is the development of the possibility of providing high-tech medical care in medical institutions of the constituent entities of the Russian Federation.

The main tasks of providing emergency, including emergency specialized, medical care, medical evacuation at the present stage should be to provide patients and injured with pre-hospital medical care aimed at preserving and maintaining the vital functions of the body, and delivering them as soon as possible to a hospital to provide qualified specialized medical care. This work should be carried out mainly by feldsher teams.

It is necessary to increase the role and effectiveness of the use of emergency medical teams as intensive care teams and, if necessary, highly specialized teams.

A successful solution to the problems of organizing and providing emergency medical care to the population is possible only in close connection with the improvement of the work of the outpatient service, including the transition to the organization of primary medical care on the principle of a general practitioner (family doctor), day hospitals, hospitals for home.

Development and implementation of innovative diagnostic and treatment methods

In the next decade, developed countries will move to the formation of a new technological base economic systems based on the use of the latest advances in biotechnology, informatics and nanotechnology, including in healthcare. Development information technologies and the advent of advanced technologies for computing and processing information will allow the use of predictive approaches based on modeling in the field of health care. First of all, interest is the possibility of creating epidemiological models that will allow us to analyze and predict the prevalence of various diseases in the population, thereby increasing the effectiveness of preventive measures.

There is an obvious need to form targeted scientific programs for priority areas in order to maintain the health of the population and the formation of a healthy lifestyle, the development and implementation of new effective technologies for early diagnosis in the practice of the healthcare system.

Taking into account the forecasts of the intensive introduction of biomedical technologies into the advanced healthcare practices of developed countries, an important task is to create the necessary conditions for the development and implementation of such products and technologies in the domestic healthcare system.

Improving the efficiency of obstetrics and childhood services

The issues of protecting the health of mother and child are named as priorities in all fundamental documents on the development of health care, the goals of reducing maternal, infant and child mortality are proclaimed among the UN Millennium Development Goals. Reducing maternal, infant and child mortality is very difficult due to the presence of numerous factors, mostly difficult to manage, that affect these indicators. Index maternal mortality depends on the socio-economic condition of the country, geographical features, development of medical care, cultural and educational level of the population.

In Russia in 2011, the maternal mortality rate was 16.2 per 100,000 live births. At this level of the indicator, 320-350 working-age women die every year, which places a heavy burden on families, reduces the number of children that could be born in the future, and increases the underproduced contribution to GDP. According to the WHO, the average European maternal mortality rate in 2010 was 20 per 100,000 live births and decreased by only 9.1% between 2005 and 2010. The lowest maternal mortality is in countries with developed economies, high population density, and developed transport infrastructure. For example, in Germany in 2010 the maternal mortality rate was 7.0 per 100 thousand live births, in France - 8.0, in the UK - 12.0. At the same time, maternal mortality is much higher in Eastern European countries. In particular, in the Republic of Moldova, the maternal mortality rate in 2010 was 41.0 per 100 thousand live births, in Latvia - 34.0, in Ukraine - 32.0, in Romania - 27.0, in Hungary - 21, 0.

In countries with a larger area, with other equal conditions, it is usually higher than in smaller countries - in the USA, the maternal mortality rate was 21.0 in 2010, in Canada -12.

Infant mortality has similar patterns - low infant mortality rates are typical for countries with high level life of the population, a small area of ​​​​the territory and a high population density. For example, in Germany in 2010 the infant mortality rate was 3.5 per 1,000 live births, in France - 4.1, in the UK - 5.0, in Belgium - 3.5, in Austria - 3.9. In countries with a high standard of living of the population, but a large extent of the territory, the presence of regions with a low population density, the infant mortality rate is slightly higher. For example, in the United States, the infant mortality rate in 2010 was 6.0 per 1,000 live births, in Canada it was 5.0, and in Australia it was 5.0.

At the same time, in some European countries, the infant mortality rate is higher than in the Russian Federation. In particular, in the Republic of Moldova, the infant mortality rate in 2010 was 11.8 per 1,000 live births, in Ukraine - 9.1, in Romania - 9.8, in Montenegro - 10.0, in Macedonia - 7.7 .

Low rates of maternal and infant mortality correlate to some extent with health care costs (in % of GDP), which are - in the USA - 15.2%, in Germany - 11.1%, in France - 10.1%. In Russia, the growth in health spending from 3.1% to 3.7% of GDP was accompanied by a decline in maternal and infant mortality rates. Infant mortality is influenced by a number of factors that require a multidisciplinary approach.

First of all, this is the state of the material and technical base of obstetric and childhood institutions. Until now, most regions are not fully provided with resuscitation and intensive care beds for newborns, which have modern high-tech equipment. There is no network of perinatal centers that provide medical assistance to the most severe contingent of pregnant women, women in childbirth, puerperas and newborns. In developed countries, perinatal centers are organized at the rate of 1 center per 1 million population in countries with high population density, and per 500 thousand population in countries with low density. With this calculation, the number of perinatal centers in Russia requires a significant increase.

The presence of highly qualified specialists in maternity and childhood institutions plays a huge role in reducing the infant mortality rate. Russia has a huge staff shortage both neonatologists and nurses, which is associated primarily with low salary. As a rule, in the Russian Federation, there are 4 to 10 critically ill newborns per 1 nurse in the intensive care unit for newborns. In the US and Europe, there is 1 extremely sick newborn, or 2 seriously ill newborns, or 3 stable children per 1 nurse.

The level of financing of medical organizations has a great influence on the quality of medical care for newborns born with pathology and the result of their treatment. In the Russian Federation, the cost of treating one child in the intensive care unit is about 200–300 US dollars per day. In the UK, the cost of treatment per day is 1600-2000 pounds. In the USA, depending on the severity of the condition of the newborn, it ranges from 2,000 to 5,000 US dollars, in Europe - from 1,500 to 4,000 euros per day. At the same time, a significant share of the funds falls on the salaries of medical workers.

Other factors also have a significant impact on the level of maternal and infant mortality - the quality of road connections, the sufficient availability of road and air ambulance transport, healthy lifestyle life of the population, control of migration processes.

Reducing infant and child mortality from injuries, violent actions, neglect by parents from socially disadvantaged families of the health and well-being of their children is the responsibility of not only and not so much medical workers, but social protection authorities, the Ministry of Internal Affairs of Russia, the Ministry of Emergency Situations of Russia, etc.

Thus, by improving the availability, quality and organization of medical care for mothers and children, reducing the number of abortions, it is possible to reduce maternal and infant mortality by 2020 to the level of 6.5–6.0%, maternal mortality to the level of 15.5–15, 0 per 100,000 live births. Reducing infant mortality to 3–4%, and maternal mortality to 5–8% is possible only with the development of the economy, transport infrastructure, and a responsible attitude of the population towards their health, comparable to the level of the most developed countries of Western Europe.

Reducing the infant mortality rate from 8.5% (taking into account the new registration criteria) to 6.4% will save at least 4,000 children's lives annually. Since each death of a child causes an underproduced contribution to GDP of 6 million rubles, the total loss of GDP, if the indicator remains at the current level, will be 24 billion rubles. Even if we take into account the possible payment of disability pensions to a maximum of 5% of saved children, this amount will amount to 100 million rubles, and the total increase in GDP due to saved lives will be 23.9 billion rubles. But these calculations, of course, cannot take into account the full benefits of the implementation of the program - improving the quality of care will lead to a decrease in the mortality of children under 5 and under 17 years of age, which will further increase the expected increase in the contribution to GDP, increase the satisfaction of the population with the healthcare system in the country which, indirectly, can contribute to an increase in the birth rate.

Since the mortality of newborns is 55–70% of infant mortality and 40% of the mortality of children under 5 years old, an important direction in reducing the mortality of the child population is to improve care for newborns, an extremely significant aspect of which is the development of a network of perinatal centers. The perinatal center is not only a clear and vivid evidence of the state's care for mothers and children, it is inherently high-tech centers that allow you to provide effective care for the most severe pathology, develop innovative methods of treatment (as well as fetal and neonatal surgery, resuscitation-intensive care for mothers and children in critical conditions). The creation of a network of perinatal centers will make it possible to move throughout the country to a full-fledged and effectively functioning three-level system for providing medical care to women during pregnancy and childbirth and newborns, which will improve the qualifications of medical personnel and the quality of medical care in all obstetric institutions without exception. In fact, within the framework of the Program, it is planned to create a coherent system not only to provide assistance differentiated by levels, but also a system of interaction, monitoring, and training of personnel using simulation centers. It is envisaged to create a completely new system of relationships between obstetric and pediatric institutions in the territory, tightening requirements and creating opportunities for full and adequate patient routing, changing reporting forms, and creating new approaches to staff motivation.

After the mass commissioning of perinatal centers in 2010–2011, maternal mortality in the country decreased from 22.0 per 100,000 live births in 2009 to 16.2 in 2011, i.e. by 26.4%, infant mortality - from 8.1 per 1000 live births to 7.4, respectively, i.e. by 8.6%. Moreover, in the constituent entities of the Russian Federation, where perinatal centers operate, the decline in indicators was more significant.

In fact, thanks to the perinatal centers, conditions were created for the transition of the Russian Federation in 2012 to the international birth registration criteria recommended by WHO, starting from a body weight of 500.0 g, which, although formally will lead to a certain increase in infant mortality, but at the same time time, will save more than a thousand children's lives every year. To solve the problem of improving the nursing of children with extremely low body weight and reducing the level of disability in this contingent, the section of the program related to improving the equipment of intensive care units and pathology of newborns is also aimed, since the process of life support for these children requires the most modern high-tech equipment. This section is inextricably linked with the development of a network of perinatal centers.

A well-functioning system of early detection and correction of developmental disorders is extremely important to reduce child mortality. The most effective tool for the prevention of congenital and hereditary diseases is a comprehensive prenatal (prenatal) diagnosis, including ultrasound and biochemical screening for maternal serum markers, an individual risk program, and invasive diagnostic methods (molecular genetic, cytogenetic studies, sequencing). The effectiveness of prenatal diagnosis can only be ensured by a mass examination of pregnant women in deadlines, to ensure which this section of the Program is aimed. The development of neonatal surgery is aimed at ensuring effective correction of disorders detected during prenatal diagnosis, and early correction of metabolic changes detected during neonatal screening will allow in the future to create opportunities and conditions for a sick child for normal development, education, professional training, subsequent employment and a fulfilling life. Further development of prenatal diagnostics will make it possible to reduce the number of children born with congenital developmental anomalies by 50% and reduce the death rate of children from severe malformations by 50–70%.

Until now, there is a high need for the development of specialized medical care for children. In 14 regions of the Russian Federation, there are no regional, republican, regional multidisciplinary children's hospitals. In a number of regions, the existing pediatric medical organizations do not meet modern requirements that allow nursing children with severe pathologies, including children of the first year of life and, first of all, those born with low and extremely low body weight. This situation requires resolution, as it does not allow to ensure the full availability and quality of medical care for children. Children with oncological diseases are not fully provided with high-quality medical care, a system for providing medical care to children with autoimmune diseases and diseases of immune genesis has not been created, neurosurgical and traumatological and orthopedic care for children remains inaccessible, and psychiatric, narcological and TB care requires serious modernization.

The key to improving the quality of medical care for children will be the development of multidisciplinary and specialized pediatric hospitals in the constituent entities of the Russian Federation, taking into account regional needs for specific types of medical care.

Solving the issue of state support for the construction and reconstruction of regional (regional, republican) children's multidisciplinary hospitals, the structure of which must fully comply with modern requirements, will ensure the real achievement of the goals and objectives of the Program. Moreover, this section is inextricably linked with the development of a network of perinatal centers. Since on the basis of perinatal centers medical care is provided to children only in the first days and months of life, children's hospitals should be the most important part of a functional network that provides the entire cycle of care for a child.

The problem of preventing vertical transmission of HIV from mother to child remains topical. Despite the high numbers of chemoprophylaxis for HIV-infected pregnant women, the transmission of infection through perinatal contacts remains high, in the whole country at a level of about 6%, which probably indicates an insufficiently high effectiveness of chemoprophylaxis of vertical transmission of HIV from mother to child, and dictates the need to improve systems for providing this type of assistance and its monitoring.

Development of the provision of medical rehabilitation to the population and improvement of the system of sanatorium and resort treatment, including for children

An important component of solving the problem of improving the quality and accessibility of medical care is the development of a system of medical rehabilitation, sanatorium and resort treatment. An analysis of the provision of medical rehabilitation in the Russian Federation showed that it requires serious reorganization and bringing it into a coherent system of comprehensive rehabilitation.

At present, difficulties in the accessibility of medical rehabilitation are associated with a shortage of rehabilitation beds, the slow introduction of modern, certified in Russia, integrated rehabilitation technologies, an insufficient number of professionally trained medical personnel, and a weak material and technical base of rehabilitation institutions.

The shortage of beds to provide assistance in the medical rehabilitation of children, both at the federal level and at the level of the constituent entities of the Russian Federation, as well as the shortage of trained medical personnel (doctors and paramedical workers) does not fully satisfy the need for these medical services. Currently, only 50% of the children who need it receive medical rehabilitation.

The problem of increasing the availability and quality of medical rehabilitation and sanatorium treatment is also relevant in pediatrics and is due to an increase in the number of children suffering from severe chronic (disabling) diseases and children with disabilities. As of January 1, 2012, more than 500,000 disabled children were registered in the Russian Federation, of which more than 340,000 are in need of medical rehabilitation. The need for rehabilitation assistance to other contingents of children is much higher. Currently, only 50% of the children who need it receive medical rehabilitation.

Solving the problems of health protection and social protection of children suffering from severe chronic (disabled) diseases, children with disabilities and their families is possible while ensuring the availability and quality of medical rehabilitation by further development a network of specialized rehabilitation institutions for children (regional, inter-district), as well as complexes for the implementation of high-tech methods of treatment with beds (branches of hospitals) for aftercare and rehabilitation. Solving this problem will reduce the load on "expensive" beds in hospitals and increase their throughput.

The current level of development of world medicine requires an objective assessment (according to the criteria of evidence-based medicine) of the effectiveness of spa treatment, as well as the improvement of existing and the development of new health and treatment methods.

At the moment, there is an urgent need for a set of measures aimed at maintaining the potential of the resort sector and the formation of a modern resort complex, capable of solving both the medical and social problems of providing affordable, effective sanatorium treatment for the population, and the economic problems of forming the sphere of resort business. At the same time, it should be borne in mind that the decline of the resort business in Russia, of course, has become one of the important factors deteriorating health indicators of the nation. Under these conditions, the restoration of the system of sanatorium treatment and rehabilitation, its accessibility for the bulk of the population, the revival of Russian resorts is an important national task that can make a great contribution to improving the level of public health of the people.

Providing medical care to terminally ill patients, including children

Against the background of the demographic aging of the population in the Russian Federation, the number of patients in need of palliative care is increasing every year.

Extremely important are not only medical, but also social, spiritual and psychological aspects of providing palliative care to incurable patients.

The main directions in the provision of palliative care to incurable patients should be not only the reduction of patients' suffering, but also adequate psychological assistance, social support, and communication with relatives, which make it possible to prepare family members for the inevitable end.

In order to create optimal conditions for children suffering from incurable, life-limiting diseases, as well as to help family members in conditions of an incurable illness of a child, it is planned to develop a network of medical and social institutions specializing in providing palliative care to children in the Russian Federation (opening departments of palliative care for children in multidisciplinary hospitals and independent hospice institutions), based on an approximate calculation of 2-3 beds per 100 thousand children.

The concept of palliative care is that the fight against pain, the solution of the psychological, social or spiritual problems of patients is of paramount importance. Thus, the main task of providing medical care to a dying patient is to ensure, as far as possible, a decent quality of life for a person at its final stage.

Creation of palliative care departments will reduce the load on expensive beds, where resuscitation and intensive care is provided, by at least 15%.

It should be noted that at present, in educational medical institutions at the undergraduate level, at the departments of public health and health care, the organizational and socio-medical aspects of palliative care are not presented.

This indicates the need to introduce teaching the basics of palliative care not only to university students, but also at the postgraduate stage, both for doctors of all specialties and for healthcare organizers.

Providing the healthcare system with highly qualified and motivated personnel

In this direction, the task of creating a system of continuous vocational education in order to train highly qualified specialists focused on continuous improvement of their own knowledge, skills and abilities necessary to achieve and maintain a high quality of professional activity.

It is planned to carry out measures to improve the system of practical training of medical and pharmaceutical workers in order to improve the quality of professional training, expand the list of skills and abilities acquired by a specialist during the training period.

Training programs for medical and pharmaceutical specialists at the stages of postgraduate and additional professional education will be formed and implemented, as well as advanced training programs for scientific and pedagogical workers of educational and scientific organizations implementing medical and pharmaceutical education programs, developed taking into account changes in the training of medical and pharmaceutical specialists in connection with the introduction of federal state educational standards for secondary and higher professional education of the third generation.

Until 2020 development is planned professional standards medical and pharmaceutical workers, which will allow the formation of unified approaches to determining the level of qualification and set of competencies of medical and pharmaceutical workers necessary for professional activities.

A system of accreditation of medical and pharmaceutical specialists will be created and implemented, which will allow for personal admission of specialists to a specific type of professional activity, taking into account the competencies acquired during the training.

Together with the constituent entities of the Russian Federation, it is planned to take measures to improve the quality of life of medical and pharmaceutical workers and their families, reduce the outflow of personnel from the industry, including by providing specialists with residential premises, land plots, housing subsidies, subsidizing interest rate on a loan for the purchase of housing by medical and pharmaceutical workers, granting children of certain categories of medical and pharmaceutical workers the right to extraordinary enrollment in preschool educational institutions.

Educational events will also be organized to increase the prestige of the profession.

Together, the solution of these tasks will improve the quality of training of medical and pharmaceutical specialists, reduce the shortage of medical personnel and, as a result, improve the quality of medical care and pharmaceutical services provided to citizens of the Russian Federation.

In pursuance of Decree of the President of the Russian Federation dated May 7, 2012 No. 598 “On improving public policy in the field of healthcare” in the constituent entities of the Russian Federation, it is planned to adopt programs aimed at improving the skills of medical personnel, assessing the level of their qualifications, gradually eliminating the shortage of medical personnel, as well as developing differentiated measures social support medical workers, especially the most scarce specialties.

Increasing the role of Russia in global health

The main directions of international relations in the field of health care should be to ensure a strong and authoritative position of Russia in the world community, to the greatest extent meeting the interests of the Russian Federation as one of the influential centers of the modern world; creation of favorable external conditions for the modernization of Russia; formation of good neighborly relations with neighboring states; search for agreement and concurring interests with other states and interstate associations in the process of solving problems determined by Russia's national priorities in the field of health protection, creating on this basis a system of bilateral and multilateral partnerships; comprehensive protection of the rights and legitimate interests of Russian citizens and compatriots living abroad; promoting an objective perception of the Russian Federation in the world; support and popularization of domestic healthcare in foreign countries.

Priority area foreign policy In healthcare, Russia remains to cooperate with the member states of the Commonwealth of Independent States, the Eurasian Economic Community. The development of health issues within the framework of the Asia-Pacific Economic Cooperation should also be considered important.

Improvement of control and supervisory functions

The main task of the functioning of the quality and safety control system of medical activities will be to control the process of providing medical care, its compliance with approved standards and procedures for providing medical care, and the interaction of medical personnel with patients.

The interaction of the subjects of the system of quality control and safety of medical activities, their activities, powers and responsibilities are regulated by regulatory legal acts approved in the prescribed manner.

Main task state control(supervision) in the sphere of circulation medicines will be control over the circulation of medicines and compliance with its current legislation Russian Federation.

The main objective of the functioning of the system of state control over the circulation of medical devices is to identify and withdraw from circulation low-quality medical devices, as well as falsified and counterfeit medical devices with subsequent disposal and destruction, identify and prevent possible negative consequences of the use and use of medical devices in circulation on the territory Russian Federation, warnings about the facts of this kind of potential users, as well as medical personnel.

An important task in the development of health care is the modernization of state forensic activities in the Russian Federation. Forensic medical and forensic psychiatric examinations in the Russian Federation are a special medical and legal type of activity aimed at providing bodies of inquiry, investigation and court with the results of special studies obtained in compliance with legal norms, carried out by experts or doctors involved in the production of an examination, licensed as a separate type of medical activity.

In addition, state forensic medical institutions perform an important function in determining the causes and nature of defects in the provision of medical care.

In this regard, the task is to determine unified approaches to expert activities in the Russian Federation, to create a unified methodological basis production of forensic psychiatric and forensic medical examinations, providing a modern material and technical base for all public institutions carrying out forensic psychiatric and forensic medical examinations.

The effectiveness of the implementation of federal state sanitary and epidemiological supervision and the organization of ensuring the sanitary and epidemiological well-being of the population is achieved by the combined activities of the territorial bodies of Rospotrebnadzor, which directly carry out control and supervision activities, as well as Rospotrebnadzor institutions that provide control and supervision, through a wide range of laboratory studies, the implementation of scientific and research and scientific and methodological developments, implementation of anti-plague measures.

Reducing the harmful effects of environmental factors on the population will be ensured by measures to ensure a safe environment for the population - atmospheric air, water bodies, soil; improving food quality and safety; ensuring radiation safety of the population.

Medico-biological provision of public health protection

An important factor in ensuring the radiation, chemical and biological safety of the population and territories served by the Federal Medical and Biological Agency is the system of medical and sanitary support of the FMBA of Russia, one of the main tasks of which is to take measures to identify and eliminate the influence of especially dangerous factors of physical, chemical and biological nature on the health of employees of serviced organizations and the population of serviced territories.

The system of medical support for such enterprises and facilities includes conducting preliminary medical examinations, pre- and post-shift medical examinations, periodic medical examinations, carrying out medical and preventive and rehabilitation and rehabilitation measures, monitoring the health of employees of enterprises and the population.

The goal of health care in the field of medical and sanitary and biomedical support of elite sport is to prevent the incidence and disability of athletes and to consistently increase the level of their provision with biomedical technologies for effective adaptation to intense sports loads.

The main tasks in the field of medical and biomedical support for athletes of the national teams of the Russian Federation: the formation of an infrastructure for medical and preventive purposes, territorially integrated with the training bases for the sports teams of the Russian Federation, which makes it possible to ensure 100% coverage of candidates for the sports teams of the Russian Federation by type sports with all kinds of medical care during training and competitive activities; providing qualified medical personnel for sports teams of the Russian Federation; implementation of biomedical technologies that provide the training and competitive level of training of candidates for the sports teams of the Russian Federation in sports.

Prevention and mitigation activities emergencies FMBA of Russia carries out directly or through its territorial bodies, subordinate organizations in cooperation with other federal executive authorities, executive authorities of the constituent entities of the Russian Federation, local governments.

The objectives of the sphere of protection of certain categories of citizens from the effects of especially dangerous factors of a physical, chemical and biological nature are to ensure breakthrough results in medical research that can give rise to new drugs, technologies and products, the development of innovative infrastructure for the provision of health care to certain categories of citizens.

Ensuring the systemic organization of health care

In modern conditions, the creation and functioning of distributed information systems and analytical tools for data processing are the "gold standard" of the organization of sectoral management. The introduction of new medical technologies is impossible without the parallel implementation of information systems that optimize the process of providing services. The creation of such systems is required to solve issues related to the calculation full cost medical service, forecasting the required volume and cost of medical care and drug provision, assessing staffing needs in the healthcare sector, assessing and forecasting the epidemiological situation. Thus, the task of introducing and using modern information and telecommunication technologies in healthcare is a key enabling task, the solution of which determines the effectiveness of most of the activities of the State Program "Health Development".

Ministry of Health and Social Development of Russia

State budget educational institution
higher professional education

"Siberian State Medical University"

Ministry of Health and Social Development of the Russian Federation

(GBOU VPO Siberian State Medical University of the Ministry of Health and Social Development of Russia)

Faculty of Economics and Management in Health Care

Department of Health Organization and Public Health

Course work

in the discipline "Medical and social foundations of health"

FEDERAL TARGET PROGRAMS AIMED AT POPULATION HEALTH PROTECTION

Completed by: 2nd year student of group 7001

Baldandorzhieva N.A.

Checked by: Dr. med. sciences, professor

CM. Khlynin,

cand. honey. Sciences, Associate Professor O.V. Kudelina

Tomsk 2011

Introduction

At present, society and healthcare are faced with a very big problem - this is a decline in the health of the population, primarily the working-age population. In connection with this health care, a number of federal targeted programs have been developed aimed at reducing morbidity, improving the standard of living of patients suffering from socially significant diseases, as well as developing the medical literacy of the population.

So my theme term paper"Federal targeted programs aimed at protecting the health of the population" is relevant today, since federal targeted programs are designed to help in solving strategic problems of healthcare development and social sphere, especially in cases where it is necessary to concentrate resources to achieve specific goals within a given time frame.

The aim of the course work is:

study of federal targeted programs, its directions, activities.

implementation analysis, implementation activities, program financing

To achieve this goal, it is necessary to solve the following tasks:

To reveal the essence of the federal target program.

To study financing, formation, approval of the target program.

Conduct an analysis of the implementation of federal target programs in the Russian Federation and their role in financing budget investments.

Chapter 1. Characteristics of federal target programs

1. Basic concepts of a targeted program aimed at protecting public health

In modern civilization, the human right to health protection ceases to be a purely individual property, it becomes the most important value for the state and civil society. The peculiarities of the right to health protection lie in the fact that it belongs to an inalienable right, belongs to a person even before his birth, is an indispensable condition for the life of society and is associated not only with the need to take care of his health of every citizen, but also with the responsibility of the state for the preservation and promotion of health. their citizens. Human life and health are the highest values ​​for society, taking into account which all other values ​​and benefits should be determined.

Public health protection is a set of political, economic, legal, social, scientific, medical, sanitary-hygienic and anti-epidemic measures aimed at preserving and strengthening the physical and mental health of each person, maintaining his long-term active life, providing him with medical and medicinal assistance. . At present, it is generally accepted that the program-target method serves as the most important tool for the implementation of the state social and economic development country and its individual regions along with methods of forecasting and indicative planning.,

The federal target program is a complex of research, development, production, socio-economic, organizational, economic and other measures linked by tasks, resources and deadlines that provide an effective solution to systemic problems in the field of state, economic, environmental, social and cultural development of the Russian Federation.

Targeted programs are one of the most important means of implementing the structural policy of the state, actively influencing its socio-economic development and should be focused on the implementation of large-scale, most important investment and scientific and technical projects for the state, aimed at solving systemic problems that fall within the competence of federal executive authorities.

The target program may include several subprograms aimed at solving specific problems within the program. The division of the target program into subprograms is carried out on the basis of the scale and complexity of the problems being solved, as well as the need for a rational organization of their solution.

Budget financing can be divided into two parts - financing the volume of services and specific targeted programs. In the first case, the funds go to a specific subject budget spending, in the second, funding can go to a number of industries. In this case, funding is sent either directly to the contractor or through the department.

The role of a customer of a long-term target program can be a state authority or a local government for municipal target programs. It is this body that acts on behalf of the state or municipality when developing a long-term target program and its implementation.

Federal targeted programs are an effective tool for implementing state economic and social policy, especially when addressing long-term goals and implementation of major infrastructure projects. It is this program-project approach that is used in the countries of the European Union, in the USA, Canada, Japan and others to solve strategic problems of economic and social development, in cases where it is necessary to concentrate resources to achieve specific goals within a given time frame.

1.3. List of federal targeted programs aimed at protecting public health

 Federal target program "Prevention and control of socially significant diseases (2007-2011)"

1) Subprogram "Diabetes mellitus"

2) Subprogram "Tuberculosis"

) Subprogram "Vaccinal prophylaxis"

) Subprogram "HIV-infection"

) Subprogram "Oncology"

) Subprogram "Sexually transmitted infections"

) Subprogram "Viral hepatitis"

) Sub-program "Mental disorders"

) Subprogram "Arterial hypertension"

 Federal target program "Children of Russia" for 2007-2010

Subprogram "Healthy Generation"

Subprogram "Children and family"

 Federal target program "Improvement of traffic safety in 2006-2012".

3.1.
Program "Prevention and control of socially significant diseases (2007 - 2012)"

The federal target program "Prevention and control of socially significant diseases (2007 - 2011)" (hereinafter - the Program) was developed in accordance with the order<#"663364.files/image001.gif">

Rice. 1 Source of funding for program activities

Financing of the Program at the expense of the federal budget is carried out in the following areas:

· capital investments- 23064.9064 million rubles;

· research and development work - 1238.7268 million rubles;

· other needs - 21149.8245 million rubles, including subsidies from the federal budget - 1593.716 million rubles.

Rice. 2 Directions for spending funds from the federal target program "Prevention and control of socially significant diseases 2007-2011"

Fulfillment at the expense of the federal budget of obligations for construction projects and facilities that are state-owned by the constituent entities of the Russian Federation and municipal property is carried out in the manner of inter-budgetary relations in accordance with the provisions of the Budget Code<#"663364.files/image003.gif">

Rice. 3 Funding for subprograms

Evaluation of the effectiveness of the Program implementation is carried out on the basis of comparison with the data for 2005 and taking into account the need to achieve the following indicators:

increase in the average life expectancy of men with type 1 diabetes up to 55.4 years, women - up to 59.2 years;

increase in the average life expectancy of men with type II diabetes mellitus, up to 71.4 years, women - up to 73.2 years;

increase in the rate of abacillation of tuberculosis patients registered at the end of the year to 36.1 percent;

reduction in the number of newly registered cases of HIV infection during the year in correctional institutions of the Federal Penitentiary Service to 1.67 thousand cases;

an increase in the proportion of HIV-infected pregnant women included in the program for the prevention of HIV infection in newborns, up to 95 percent;

reduction in the proportion of patients who died from malignant neoplasms within a year from the date of diagnosis, in total strength patients registered for the first time in previous year, to 27.5 percent;

reduction in mortality from malignant neoplasms in men to 231.2 cases per 100 thousand population, in women - up to 170 cases per 100 thousand population;

reduction in the incidence of syphilis in children to 7.1 cases per 100,000 children;

reduction in the incidence of gonorrhea in children to 7.7 cases per 100 thousand of the child population;

increase in the share of specialized medical institutions that monitor the variability of sexually transmitted infections in the total number of institutions of the dermatovenerological profile up to 62 percent;

increase in the number of specialized centers for the prevention and treatment of sexually transmitted infections for adolescents, up to 60 units;

reduction in the incidence of acute viral hepatitis B to 2.6 cases per 100,000 population;

reduction in the incidence of acute viral hepatitis C to 3.7 cases per 100,000 population;

an increase in the proportion of patients covered by brigade forms of mental health care in the total number of observed patients up to 30 percent;

exclusion of cases of poliomyelitis;

reduction in the incidence of measles to 0.99 cases per 1 million population.

2.2 Program "Children of Russia for 2007-2010"

The implementation of the Program activities will allow:

improve the quality of life and health of children;

improve the quality and accessibility of social services for families with children, especially for families with disabled children;

to improve the state system of social protection and support for minors in order to ensure the provision of emergency and prompt assistance to children in difficult life situations, as well as the implementation of long-term consistent work to support children in need of special state care.

The implementation of the activities of the subprogram "Healthy Generation" will allow to continue improving state support for the service of motherhood and childhood, to increase the availability and quality of medical care for women and children, to achieve by 2011:

During the implementation of the Gifted Children subprogram, a state system will be created for identifying, developing and targeted support for gifted children, covering up to 40 percent of the school-age child population, aimed at preserving the country's national gene pool, forming a future highly professional elite in various fields of intellectual and creative activity.

The number of winners of all-Russian contests, competitions, olympiads, tournaments held within the framework of the subprogram will increase by 8 percent by 2011 compared to 2006 data.

Evaluation of the implementation of the direction "Prevention of neglect and juvenile delinquency" by 2011 will be carried out according to the following indicators:

· the proportion of street children in the total number of child population - 2.17 percent;

· The proportion of children who received social rehabilitation in specialized institutions for minors in the total number of neglected and homeless children is 83.3 percent.

Evaluation of the implementation of the direction "Family with disabled children" by 2011 will be carried out according to the following indicators:

the share of disabled children who received rehabilitation services in specialized institutions for children with disabilities in the total number of disabled children - 43.1 percent;

the proportion of families with disabled children who received services in specialized institutions for children with disabilities in the total number of families with disabled children in need of services is 25.2 percent.

The implementation of the activities of this subprogram will reduce the number of orphans and children left without parental care transferred to institutions for full state support, increase the number of orphans and children left without parental care transferred to the upbringing of families of citizens, ensure effective socialization of children who found themselves in a difficult life situation, and their integration with society.

The evaluation of the implementation of the direction "Orphans" by 2011 will be carried out according to the indicator reflecting the share of orphans and children left without parental care, transferred to the families of citizens, in the total number of orphans and children left without parental care, which should reach 72 percent.

Financing

The total amount of financing of the Program is 47,845.9 million rubles (in the prices of the corresponding years), including:

at the expense of the federal budget - 10101.7 million rubles;

at the expense of the budgets of the constituent entities of the Russian Federation - 36315.1 million rubles;

at the expense of extrabudgetary sources - 1429.1 million rubles.

Table 3. Source of funding for the activities of the FTP "Children of Russia 2007-2010"

The allocation of funds to spending areas is as follows:

capital investments - 25899.3 million rubles, including:

at the expense of the federal budget - 6917 million rubles;

at the expense of the budgets of the constituent entities of the Russian Federation - 18812.3 million rubles;

at the expense of extrabudgetary sources - 170 million rubles;

research and development work - 37.7 million rubles at the expense of the federal budget;

other needs -21908.9 million rubles, including:

at the expense of the federal budget - 3147 million rubles;

at the expense of the budgets of the constituent entities of the Russian Federation -17502.8 million rubles;

at the expense of extrabudgetary sources - 1259.1 million rubles.

Rice. 4 Program funding sources

health population targeted investment

The executors of the Program activities are determined in accordance with the procedure established by the legislation of the Russian Federation.

The Program is supposed to be implemented within 7 years (2006-2012) in 2 stages.

At the first stage (2006 - 2007), the main activities were identified for implementation:

· creation of a system of propaganda influence on the population in order to form a negative attitude towards offenses in the field of traffic;

· Ensuring the involvement of civil society institutions in preventive work;

· Improving the licensing system in the field of driver training, developing a legal framework for monitoring the implementation of self-training by citizens to obtain the right to drive vehicles of categories "A" and "B";

· preparation of proposals for the introduction of mechanisms in relation to driving schools to improve the quality of driver training;

Strengthening control over the availability, serviceability and use of security equipment;

· increasing the prevention of child road traffic injuries, the active introduction of child restraints;

· Implementation of pilot projects to replace traffic police posts with technical automatic systems for monitoring road users' compliance with the Rules of the Russian Federation Road Traffic and the use of helicopters to speed up the arrival at the scene of a traffic accident;

Prevention of traffic congestion, optimization of high-speed traffic on sections of the road network;

· Monitoring the dynamics of road traffic injuries, public opinion on road safety issues and the implementation of the Program activities.

Stage II (2008-2012) provides for the implementation of the following activities:

· further increase in the volume of work on the organization of traffic and pedestrians, including the introduction of integrated schemes and projects for the organization of traffic, traffic management of main, district and citywide significance;

· Expansion of the scope of work on the construction of underground and elevated pedestrian crossings;

· increasing the role of public associations and organizations in carrying out preventive measures;

Improving work on the prevention of children's road traffic injuries;

· improvement of forms and methods of control and supervision over the observance by road users of the established norms and rules;

· improvement of forms and methods of international cooperation in the field of road safety;

· continued monitoring of the dynamics of road traffic injuries, public opinion on road safety issues and the implementation of the Program activities.

Transfer to the subjects of the Russian Federation of material and technical resources (equipment that does not require installation, special Vehicle) purchased at the expense of the federal budget, is carried out by the state customers of the Program in the manner established by the Government of the Russian Federation.

Financing

The total amount of financing of the Program is 47,755.51 million rubles, including:

at the expense of the federal budget - 21049.01 million rubles (of which - for research and development work - 2446.23 million rubles, capital investments - 15247.58 million rubles and other needs - 3355.21 million . rubles);

at the expense of the budgets of the subjects of the Russian Federation - 26245.4 million rubles (of which for capital investments - 21805.9 million rubles and other needs - 4439.5 million rubles);

at the expense of extrabudgetary sources - 461.1 million rubles (of which for capital investments - 359.9 million rubles and other needs - 101.2 million rubles) (as amended by Decrees of the Government of the Russian Federation of 18.08. dated 15.07.2008 N 538, dated 14.02.2009 N 132, dated 02.08.2011 N 642) reduction by 2012 in the number of people who died as a result of traffic accidents,

Table 4. Funding sources of the FTP "Improving road safety in 2006-2012"

Rice. 5 Program funding sources

Conclusion

Upon completion of the work, it can be concluded that today federal targeted programs aimed at protecting public health are one of the most important means of implementing social policy state and active influence on socio-economic development.

Evaluation of the effectiveness of the implementation of the programs under consideration is carried out on the basis of a comparison with the data for 2005.

The results of the effectiveness of the program "Prevention and control of socially significant diseases for 2007-2011"

reduction in the proportion of complications in diabetes mellitus to 28.5 percent;

reduction in the incidence of tuberculosis in correctional institutions of the Federal Penitentiary Service to 1,490 cases per 100,000 people;

reduction in mortality from tuberculosis to 15.2 cases per 100 thousand people, including in correctional institutions of the Federal Penitentiary Service - up to 104.9 cases per 100 thousand people;

reduction in the incidence of syphilis to 49.2 cases per 100 thousand people, including in correctional institutions of the Federal Penitentiary Service - up to 148 cases per 100 thousand people;

reduction in the incidence of chronic viral hepatitis B and C to 54 cases per 100,000 population;

improvement of indicators characterizing the early detection of malignant neoplasms, including an increase in the proportion of patients with visual tumor localizations detected at stages I and II of the disease, up to 72 percent;

FTP "Children of Russia 2007-2010"

reducing the infant mortality rate to 9.8 per 1,000 live births;

reducing the maternal mortality rate to 21 per 100,000 live births;

reducing the mortality rate of children aged 0 to 4 years (inclusive) to 10.9 per 1000 newborns of the corresponding year of birth;

increasing the proportion of children in the 1st health group to 37.5 percent of the total number of children;

reducing the rate of primary disability for children aged 0 to 17 (inclusive) to 21.4 per 10,000 children.

FTP "Improving road safety in 2007-2012"

When implementing the program, the number of deaths in road traffic accidents compared to 2005 will be reduced by 1.5 times by 2012, and the number of road traffic accidents with victims - by 10 percent. At the same time, the implementation of the activities of the Program takes into account the implementation by the constituent entities of the Russian Federation of the activities of regional programs aimed at improving road safety.

Thus, a number of federal targeted programs aimed at protecting the health of the population have significantly improved the health of citizens, but some results are to be expected.

List of used literature

1. Vyalkov, A.I. Modern problems of the state of health of the population of the Russian Federation / A.I. Vyalkov // Probl. healthcare management. 2009. - No. 3.

2. Vyalkov, A.I. Healthcare Management and Economics: tutorial/ ed. A.I. Vyalkova; A.I. Vyalkov, V.Z. Kucherenko, B.A. Raizberg and others - M.: GEOTAR-Media, 2009. - 664 p.

Medkov, V.M. Health Management / Under. ed. V.Z. Kucherenko. M.: TEIS, 2007. - 448 p.

Trushkina L.Yu., Tleptserishev R.A., Trushkin A.G. etc. Economics and health management. M. 2002

Federal Target Programs of Russia, Department of State Target Programs and Capital Investments: - electronic resource [access mode ]

Federal target programs of Russia: electronic resource [access mode ]

FTP "Improving road safety in 2007-2012" - electr. resource [access mode ]

Federal Law of July 22, 1993 N 5487-1 Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens (as amended on December 1, 29, 2004, March 7, 2005)

Central Research Institute of Organization and Informatization of Healthcare: - electr. resource [access mode ]

Shilenko Yu.V., Raizberg B.A., Vyalkov A.I. Health Management and Economics . M., 2002