Healthcare development. About the state program of the Russian Federation “Development of healthcare Economic components of the state program for development of healthcare

Tatarnikov M.A. Research Institute of Public Health and Health Management MMA named after. I.M Sechenova

The program-target method is the most important tool for implementing state socio-economic policy, incl. and in the field of health. Federal targeted programs(FTP) are a complex of research, development, production, socio-economic, organizational, economic and other activities linked by resources, implementers and timing of implementation, ensuring the effective solution of problems in the field of state, economic, environmental, social and cultural development Russian Federation(RF). Their the most important feature is to identify priority problems and ways to solve them, taking into account the possibilities of financing program activities at the federal, regional or local levels. Thus, program-targeted management allows not only to concentrate resources on priority areas, but also to implement an integrated approach to solving the most current problems healthcare based on intersectoral interaction.

Federal targeted programs in the field of public health stimulate the participation of constituent entities of the Russian Federation in solving health problems in their territories on the basis of co-financing or the adoption and implementation of their own similar programs.

Currently, a regulatory, legal and methodological framework has been created that defines the rules for the consideration, approval and financing of federal targeted programs. When working with target programs, the following stages are distinguished:

selection of problems for software development;
making a decision on the development of a target program and its formation;
examination and evaluation of the target program;
approval of the target program;
management of the implementation of the target program and monitoring the progress of its implementation.

According to current legislation any legal and individuals. However, as a rule, the Ministry of Health and Social Development of Russia and its subordinate institutions act in this capacity.

The selection of problems for their software development and solution at the federal level is determined by the following factors:

significance of the problem;
the inability to comprehensively solve the problem within an acceptable time frame and the need state support to solve it;
fundamental novelty and high efficiency of technical, organizational and other measures necessary for the large-scale dissemination of progressive achievements;
the need to coordinate intersectoral connections to solve this problem.

When justifying the need to solve problems using programmatic methods at the federal level, the priorities and goals of the socio-economic development of the Russian Federation and the results of an analysis of the economic and social state of the country are taken into account. In accordance with the approved procedure, proposals must contain:

name of the problem and analysis of the reasons for its occurrence;
possible ways problem solving;
the need for financial resources and possible sources of their provision (federal budget, budgets of constituent entities of the Russian Federation, extra-budgetary funds);
preliminary assessment of the socio-economic effectiveness and consequences of the program;
government customers and developers of the target program, the time and cost of preparing the target program.

The Ministry of Economic Development (MED), together with the Ministry of Finance of Russia and other interested federal executive authorities and executive authorities of the constituent entities of the Russian Federation, based on forecasts of the socio-economic development of the country, prepares proposals for solving this problem using program methods at the federal level and sends them to the Government of the Russian Federation. Based on the submitted proposals, the Government of the Russian Federation makes a decision on the preparation of an appropriate target program, the timing and cost of its development, and determines the state customer.

The state customer is responsible for the timely and high-quality preparation and implementation of the target program, prepares the initial task for its formation, manages the actions of the developers, manages the program implementers after its approval, and ensures the effective use of funds allocated for the implementation of the program. The state customer of the federal target program in the field of public health protection is, as a rule, the Ministry of Health and Social Development of Russia.

The target program consists of the following sections:

the content of the problem and the rationale for solving it using software methods;
main goals and objectives, timing and stages of program implementation;
system of program events;
resource support for the program (from funds federal budget and extra-budgetary sources, budgets of constituent entities of the Russian Federation and with the distribution of expenses by region of the country);
program implementation mechanism;
organizing program management and monitoring the progress of its implementation;
evaluation of program effectiveness;
passport of the target program.

Attached to the draft target program are: explanatory note, a business plan with socio-economic and feasibility studies, a preliminary budget request for allocations from the federal budget to finance the program for the next year, a sheet of agreement with the interested federal executive authorities and, if necessary, agreements (agreements) of intent between the state the customer of the program with enterprises, organizations, government bodies of the constituent entities of the Russian Federation, confirming the financing of the program from extra-budgetary sources, budgets of the constituent entities of the Russian Federation.

The Ministry of Economic Development and the Ministry of Finance of the Russian Federation evaluate the presented draft target program, paying attention to Special attention on the:

the priority nature of the problem proposed for a software solution;
validity and complexity of program activities, timing of their implementation;
need to attract outside budget funds, funds from the budgets of the constituent entities of the Russian Federation for the implementation of the program in conjunction with the possibilities of its state support at the expense of centralized resources;
effectiveness of the program implementation mechanism;
socio-economic effectiveness of the program as a whole, expected final results of the program.

The Ministry of Economic Development, with the participation of the Ministry of Finance, prepares a conclusion on the draft target program and preliminary budget request. Taking into account comments and suggestions, the state customer of the target program, together with its developers, finalizes the draft program. The revised draft target program is re-sent to the Ministry of Economic Development.

In case of a positive assessment, the Ministry of Economic Development, in agreement with the Ministry of Finance of Russia, submits a draft target program for approval to the Government of the Russian Federation.

Target programs and government customers are approved by the Government of the Russian Federation. Government customers are provided financial resources in the amount established by the federal budget, and are responsible for the implementation of federal target programs. The interaction of several state customers under one program is carried out by the state customer - coordinator, determined by the Government of the Russian Federation.

Forms and methods of organizing management of the implementation of the target program are determined by the state customer. The current management of the Federal Targeted Program for the protection of public health is carried out by a directorate formed by the state customer, headed by one of the Deputy Ministers of Health of the Russian Federation, responsible for the implementation of the target program.

The implementation of the target program is carried out on the basis government contracts(agreements) concluded by the state customer of the program with all performers of program activities. The selection of objects and projects of program activities and their performers is carried out on a competitive basis.

The Ministry of Economic Development, with the participation of interested government bodies, organizes expert inspections of the progress of implementation of individual target programs. At the same time, attention is paid to meeting the deadlines for the implementation of program activities, to the targeted and effective use of financial resources and the final results of the program.

Currently, the main current federal target program in the field of healthcare is the program “Prevention and Control of Socially Significant Diseases (2007-2011)”, which includes the subprograms “Diabetes Mellitus”, “Tuberculosis”, “HIV Infection”, “Oncology”, “Sexually transmitted infections”, “Viral hepatitis”, “Mental disorders”, “Arterial hypertension” and “Vaccine prevention”, approved by Decree of the Government of the Russian Federation of May 10, 2007 N 280 (as amended by Decree of the Government of the Russian Federation of February 18, 2008 N 95 , dated 06/02/2008 N 423, dated 04/09/2009 N 319). The program is an essential component of the national priority project"Health".

Characteristics of the problem the program is aimed at solving

The federal target program "Prevention and control of socially significant diseases (2007-2011)" (hereinafter referred to as the Program) was developed in accordance with the order of the Government of the Russian Federation dated December 11, 2006 N 1706-r, the list of socially significant diseases approved by the Decree of the Government of the Russian Federation dated 01.12.2004 N 715, the procedure for the development and implementation of federal target programs and interstate target programs in the implementation of which the Russian Federation participates, approved by Decree of the Government of the Russian Federation dated 06.26.1995 N 594.

The need to prepare and implement the Program is caused by a number of socio-economic factors influencing the decline in the quality of life of the population, including excessive stress loads, a decrease in the level of sanitary and hygienic culture, as well as still high rates of morbidity, disability and mortality, despite the implementation of the federal target program "Prevention and control of diseases of a social nature (2002-2006)".

The rate of complications in diabetes mellitus is currently 35 percent. Limb amputations were performed in 1 percent of patients. In total, for the first time during the year, 38.6 thousand people were recognized as disabled due to diabetes.

Tuberculosis incidence in correctional institutions Federal service execution of punishments is currently 1515 cases per 100 thousand people, mortality is 153.4 cases per 100 thousand people, the proportion of cases of cessation of bacterial excretion is 73.5 percent, mortality from tuberculosis is 22.6 cases per 100 thousand population.

The number of newly registered cases of HIV infection reached 37.7 thousand cases, in correctional institutions of the Federal Penitentiary Service - 2 thousand cases, the share of HIV-infected pregnant women included in the program for the prevention of HIV infection in newborns was 75 percent.

The proportion of patients with visual localizations of malignant neoplasms detected at stages I and II of the disease in the total number of patients with visual localizations of the tumor is 67.6 percent, the proportion of those who died from malignant neoplasms within a year from the date of diagnosis among patients registered for the first time V previous year, - 31.6 percent, mortality from malignant neoplasms per 100 thousand population is 186.8 cases for men, 93.5 cases for women.

The incidence of syphilis is 72 cases per 100 thousand population, in correctional institutions of the Federal Penitentiary Service - 176.6 cases per 100 thousand people, the incidence of syphilis in children is 21.2 cases, gonorrhea - 23.4 cases per 100 thousand children. . At the same time, the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions is 15 percent. The total number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections does not exceed 12 in the country as a whole.

The incidence of acute viral hepatitis B and C is currently 8.6 and 4.5 cases per 100 thousand population, respectively, chronic viral hepatitis B and C - 51.4 cases per 100 thousand population.

The share of patients covered by team forms of psychiatric care in the total number of observed patients is 5 percent, the share of patients in need of inpatient psychiatric care in the total number of observed patients is 16 percent. At the same time, the average duration of treatment of a patient in a psychiatric hospital is 75.6 days, and the proportion of repeated hospitalizations in a psychiatric hospital during the year is 20 percent.

The incidence of vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 5776 cases per 100 thousand population, and mortality from vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 325 cases per 100 thousand population.

95% coverage of children with preventive vaccinations is maintained. The incidence of diphtheria and measles is currently 0.25 and 1.6 cases per 100 thousand population, respectively.

The main goals and objectives of the program, the period of its implementation, as well as target indicators and indicators

The goals of the Program are to reduce morbidity, disability and mortality of the population due to socially significant diseases, increase the duration and improve the quality of life of patients suffering from these diseases.

The objectives of the Program are:

improving methods of prevention, diagnosis, treatment and rehabilitation for socially significant diseases;
development and implementation modern methods prevention, diagnosis, treatment and rehabilitation for socially significant diseases based on advanced technologies;
construction and reconstruction of specialized medical institutions.

The Program provides for the implementation of a set of interrelated measures for the prevention, diagnosis, treatment and rehabilitation of socially significant diseases throughout the entire period of the Program implementation.

Program implementation mechanism

The state customer - coordinator of the Program is the Ministry of Health and Social Development of Russia, the state customers of the Program are the Ministry of Health and Social Development of Russia, the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, the Federal Penitentiary Service and the Russian Academy of Medical Sciences.

The Program is implemented on the basis of government contracts concluded by government customers with implementers of Program activities in accordance with Federal law"On placing orders for the supply of goods, performance of work, provision of services for state and municipal needs", as well as co-financing of expenditure obligations of a constituent entity of the Russian Federation under the relevant regional (municipal) programs (plans).

Interaction between government customers and executive authorities of the constituent entities of the Russian Federation is carried out on the basis of agreements.

The implementation of the Program in the constituent entities of the Russian Federation is carried out through a set of measures aimed at reducing the incidence of socially significant diseases, improving methods of their prevention and early diagnosis, ensuring the quality of treatment and rehabilitation.

To manage the implementation of the Program activities, a coordinating council (hereinafter referred to as the council) is created, formed from officials state customer - Program coordinator, state customers of the Program and interested federal bodies executive power.

The Council performs the following functions:

develops proposals on the topics and volumes of financing of orders for the supply of goods, performance of work and provision of services within the framework of the Program;
reviews materials on the progress of implementation of Program activities;
organizes inspections of the implementation of Program activities, the targeted and effective use of funds allocated for their implementation;
prepares recommendations for the effective implementation of Program activities, taking into account the progress of the Program implementation and trends in the socio-economic development of the Russian Federation;
identifies scientific, technical and organizational problems during the implementation of the Program;
considers the results of the examination of projects and activities proposed for implementation in the next financial year, in terms of their content and cost.

The Council approves the following developed by government customers:

Detailed organizational and financial plans for the implementation of Program activities;

Indicators for monitoring the implementation of Program activities.

The Council is headed by the Deputy Ministry of Health and Social Development of Russia. The regulations on the council and its composition are approved by the Minister of Health and social development Russian Federation.

Ministry of Health and Social Development of Russia:

exercises control over the activities of government customers of the Program;
prepares draft regulatory legal acts of the Government of the Russian Federation necessary for the implementation of the Program;
annually, if necessary, clarifies the mechanism for implementing the Program, target indicators and indicators, costs for the implementation of Program activities;
prepares taking into account the progress of the Program implementation in this year and submits, in accordance with the established procedure, to the Ministry of Economic Development a consolidated budget request for financing the activities of the Program in the next financial year;
quarterly submits to the Ministry of Economic Development statistical, reference and analytical information on the progress of implementation of the Program as a whole, monitoring data on the implementation of Program activities;
submits annually, before February 1, to the Ministry of Economic Development and the Ministry of Finance of Russia on in the prescribed form a report on the progress of work under the Program, results achieved and the effectiveness of the use of financial resources;
initiates, if necessary, expert reviews of the progress of implementation of individual Program activities;
submits to the Ministry of Economic Development and the Ministry of Finance of Russia proposals to adjust measures for the implementation of the Program or to terminate its implementation;
upon completion of the Program, submits a report to the Ministry of Economic Development and the Ministry of Finance of Russia on the implementation of the Program and on the effectiveness of the use of financial resources for the entire period of its implementation.
Government customers of the Program:
carry out ongoing management of the implementation of the Program;
draw up a detailed organizational and financial plan for the implementation of Program activities;
in the event of a reduction in the volume of funding for Program activities from the federal budget, additional measures are developed to attract funds from extra-budgetary sources to achieve results characterized by target indicators of the Program, and also, if necessary, developed in deadlines proposals for their adjustment;
make proposals to clarify target indicators and indicators, costs for the implementation of Program activities and subprograms, as well as to improve the mechanism for its implementation;
ensure the effective use of funds allocated for the implementation of the Program;
organize quarterly reporting on the implementation of the Program and subprograms, as well as monitoring the implementation of program activities;
organize expert inspections of the implementation of individual activities of the Program and subprograms;
carry out management of the activities of the implementers of the Program activities as part of the implementation of program activities;
carry out the selection on a competitive basis of performers of works (services), suppliers of products for each event of the Program and subprograms, as well as the conclusion of government contracts (agreements);
organize the application information technologies for the purpose of managing and monitoring the implementation of the Program, ensure the placement on the Internet of the text of the Program, regulatory legal acts, methodological materials regarding the management of the implementation of the Program and monitoring the implementation of its activities, as well as materials on the progress and results of the Program implementation;
agreed with the state customer - the Program coordinator and the main interested participants of the Program possible timing implementation of activities, volumes and sources of financing;
quarterly provide the state customer - the Program coordinator with statistical, reference and analytical information on the progress of implementation of the Program activities;
if necessary, submit proposals to the state customer - coordinator of the Program to extend the period or to terminate the implementation of the Program;
submit annually, before January 25, to the state customer - the Program coordinator, in the prescribed form, a report on the progress of the Program, the results achieved and the effectiveness of the use of financial resources.

Assessment of the socio-economic effectiveness of the program

The effectiveness of the Program is assessed based on comparison with data for 2005 and taking into account the need to achieve the following indicators:

reduction in the proportion of complications in diabetes mellitus to 28 percent;

increase average duration life of men with type I diabetes mellitus up to 55.3 years, women - up to 59.1 years;

an increase in the average life expectancy of men with type II diabetes mellitus to 71.5 years, women - to 73.5 years;

reduction in the incidence of tuberculosis in correctional institutions of the Federal Penitentiary Service to 1,495 cases per 100 thousand people;

an increase in the abacillation rate of tuberculosis patients registered at the end of the year to 35.9 percent;

reduction in mortality from tuberculosis to 17.8 cases per 100 thousand population, including in correctional institutions of the Federal Penitentiary Service - up to 140 cases per 100 thousand people;

reduction in the number of newly registered cases of HIV infection during the year to 31 thousand cases, in correctional institutions of the Federal Penitentiary Service - to 1.6 thousand cases;

increasing the proportion of HIV-infected pregnant women included in the program to prevent HIV infection in newborns to 98 percent;

improvement of indicators characterizing the early detection of malignant neoplasms, including an increase in the proportion of patients with visual tumor localizations identified at stages I and II of the disease, up to 73.1 percent;

reduction in the proportion of patients who died from malignant neoplasms within a year from the moment of diagnosis, among patients first registered in the previous year, to 27.8 percent;

reduction in mortality from malignant neoplasms in men to 171.6 cases per 100 thousand population, in women - to 90.1 cases per 100 thousand population;

reducing the incidence of syphilis to 50.1 cases per 100 thousand people, including in correctional institutions of the Federal Penitentiary Service - up to 150 cases per 100 thousand people;

reducing the incidence of syphilis in children to 7.2 cases per 100 thousand children;

reducing the incidence of gonorrhea in children to 10.2 cases per 100 thousand children;

increasing the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions to 60 percent;

increasing the number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections to 55;

reduction in the incidence of acute viral hepatitis B to 2.7 cases per 100 thousand population;

reduction in the incidence of acute viral hepatitis C to 3.8 cases per 100 thousand population;

reducing the incidence of chronic viral hepatitis B and C to 36 cases per 100 thousand population;

increasing the proportion of patients covered by team forms of mental health care in the total number of observed patients to 41 percent;

reducing the proportion of patients in need of inpatient psychiatric care in the total number of observed patients to 14.5 percent;

reduction in the average duration of treatment of a patient in a psychiatric hospital to 73.9 days;

reducing the share of repeated hospitalizations to a psychiatric hospital during the year to 17.5 percent;

reducing the incidence of cerebrovascular diseases in the population to 4680 cases per 100 thousand population;

reducing population mortality from cerebrovascular diseases to 270 cases per 100 thousand population;

increasing the number of newly diagnosed patients with arterial hypertension to 1000 thousand people per year;

increasing the number of people trained in health schools for patients with arterial hypertension to 1,400 thousand people per year;

maintaining a 95 percent level of coverage of children with preventive vaccinations;

reducing the incidence of diphtheria to 0.16 cases per 100 thousand population;

eliminating cases of polio;

reducing the incidence of measles to 0.8 cases per 100 thousand population.

It is assumed that the overall economic effect from the implementation of the Program’s activities will be achieved by reducing morbidity, disability and mortality of the population due to socially significant diseases.

The social effectiveness of the implementation of the Program’s activities will be expressed in improving the quality and increasing the life expectancy of patients, preserving labor potential, forming the foundations of a healthy lifestyle, reducing social and psychological tension in society due to the threat of the spread of socially significant diseases.

The State Program of the 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 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 completion date of the 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 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 budgetary healthcare institution 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 health care reform is the preservation and development of the state municipal health care system, the organization of their activities, as well as the activities of the private health care system 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 the population with 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 healthy image life. 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 wages 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 health care institutions.

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.

Measures to solve major health problems require effective spending of budget funds, focused on the end result, a shift in the emphasis of medical care to primary care (pre-hospital stage), and a preventive focus on 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 of a healthy lifestyle among 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.

Ministry of Health and Social Development of Russia

State budgetary educational institution
higher professional education

"Siberian State Medical University"

Ministry of Health and Social Development of the Russian Federation

(GBOU VPO SibSMU Ministry of Health and Social Development of Russia)

Faculty of Economics and Healthcare Management

Department of Health Organization and Public Health

Course work

in the discipline "Medical and social foundations of health"

FEDERAL TARGETED PROGRAMS AIMED AT PROTECTING POPULATION HEALTH

Completed by: 2nd year student of group 7001

Baldandorzhieva N.A.

Checked: dr med. sciences, professor

CM. Khlynin,

Ph.D. honey. Sciences, Associate Professor O.V. Kudelina

Tomsk 2011

Introduction

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

So, the topic of my course work “Federal target programs aimed at protecting public health” is relevant today, since federal target programs are designed to help in solving strategic problems of health care development and social sphere, especially in cases where it is necessary to concentrate resources to achieve specific goals within a given time frame.

The purpose of the course work is:

study of federal target programs, their directions, activities.

implementation analysis, implementation activities, program financing

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

Reveal the essence of the federal target program.

Study the 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 target program aimed at protecting public health

In modern civilization, the human right to health care 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 care are that it is an inalienable right, belongs to a person even before his birth, is an integral condition of the life of society and is associated not only with the need to take care of the 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.

Protecting public health is a set of political, economic, legal, social, scientific, medical, sanitary and hygienic and anti-epidemic measures aimed at preserving and strengthening the physical and mental health of each person, maintaining his long active life, providing him with medical and medicinal care . Currently, it is generally accepted that the program-target method serves as the most important tool for the implementation of state social and economic development of the 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 and economic and other activities linked by tasks, resources and implementation deadlines, providing an effective solution to systemic problems in the field of government, economic, environmental, social and cultural development of the Russian Federation.

Targeted programs are one of the most important means of implementing the state's structural policy, 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.

A 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 based on 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, funds go to a specific subject of budget expenditures; 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 customer of a long-term target program can be a state authority or a local government body for municipal target programs. It is such a body that acts on behalf of the state or municipality when developing a long-term target program and its implementation.

Federal target programs are an effective tool for implementing state economic and social policy, especially when solving long-term goals and implementation of large infrastructure projects. It is this program-project approach that is used in the countries of the European Union, 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 target 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 "Vaccine prevention"

) Subprogram "HIV infection"

) Subprogram "Oncology"

) Subprogram "Sexually transmitted infections"

) Subprogram "Viral hepatitis"

) Subprogram "Mental disorders"

) Subprogram "Arterial hypertension"

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

· Subprogram "Healthy Generation"

· Subprogram "Children and Family"

 Federal target program "Increasing security traffic 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 referred to as the Program) was developed in accordance with the order<#"663364.files/image001.gif">

Rice. 1 Source of financing for program activities

The Program is financed from the federal budget in the following areas:

· capital investments- 23064.9064 million rubles;

· research and development work - 1238.7268 million rubles;

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

Rice. 2 Directions for spending funds from the Federal Target Program “Prevention and Combating Socially Significant Diseases 2007-2011”

Fulfillment, at the expense of federal budget funds, of obligations on construction projects and objects that are in state ownership of constituent entities of the Russian Federation and in municipal ownership is carried out in the manner of interbudgetary relations in accordance with the provisions of the Budget Code<#"663364.files/image003.gif">

Rice. 3 Amount of funding for subprograms

The effectiveness of the Program is assessed based on comparison with data for 2005 and taking into account the need to achieve the following indicators:

an increase in the average life expectancy of men with type I diabetes mellitus to 55.4 years, women - to 59.2 years;

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

an increase in the abacillation rate 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;

increasing the proportion of HIV-infected pregnant women included in the program to prevent HIV infection in newborns to 95 percent;

reducing the proportion of patients who died from malignant neoplasms within a year from the moment of diagnosis, in the total number of patients first registered in the 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;

reducing the incidence of syphilis in children to 7.1 cases per 100 thousand children;

reducing the incidence of gonorrhea in children to 7.7 cases per 100 thousand children;

increasing the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions to 62 percent;

increasing the number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections to 60 units;

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

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

increasing the proportion of patients covered by team forms of mental health care in the total number of observed patients to 30 percent;

eliminating cases of polio;

reduction in measles incidence 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, primarily for families with disabled children;

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 long-term consistent work to support children in need of special care from the state.

The implementation of the activities of the “Healthy Generation” subprogram will allow us to continue to improve state support for maternity and childhood services, increase the availability and quality of medical care for women and children, and achieve by 2011:

During the implementation of the "Gifted Children" subprogram, it will be created government system identification, development and targeted support of 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 areas intellectual and creative activity.

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

The assessment of the implementation of the direction “Prevention of neglect and juvenile delinquency” by 2011 will be carried out according to the following indicators:

· the share of street children in the total child population is 2.17 percent;

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

The assessment 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 is 43.1 percent;

the share 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 foster families of citizens, and ensure effective socialization of children who find themselves in difficult life situations, and their integration with society.

The assessment of the implementation of the “Orphans” direction 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 funding for the Program is 47,845.9 million rubles (in prices of the corresponding years), including:

at the expense of the federal budget - 10,101.7 million rubles;

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

at the expense of extra-budgetary sources - 1429.1 million rubles.

Table 3. Source of financing for the activities of the Federal Target Program “Children of Russia 2007-2010”

The funds are distributed according to areas of expenditure 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 extra-budgetary 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 extra-budgetary sources - 1259.1 million rubles.

Rice. 4 Sources of funding for the program

health population target investment

Performers of the Program activities are determined in the manner established by the legislation of the Russian Federation.

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

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

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

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

· improvement of the licensing system in the field of driver training, development legal basis control over 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 for driving schools to improve the quality of driver training;

· strengthening control over the availability, serviceability and use of safety equipment;

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

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

· preventing traffic congestion, optimizing speed limits on sections of the road network;

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

At stage II (2008 - 2012), the following activities are envisaged:

· further increase in the volume of work on organizing the movement of transport and pedestrians, including the introduction of comprehensive schemes and projects for organizing road traffic, managing traffic of highway, district and citywide importance;

· expansion of the scope of work on the construction of underground and overground pedestrian crossings;

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

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

· improving the forms and methods of control and supervision of compliance by road users with established standards and rules;

· improving the forms and methods of international interaction 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 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 government customers of the Program in the manner established by the Government of the Russian Federation.

Financing

The total amount of funding for 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 constituent entities 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 extra-budgetary sources - 461.1 million rubles (of which for capital investments - 359.9 million rubles and other needs - 101.2 million rubles) (as amended by Resolutions of the Government of the Russian Federation dated August 18, 2007 N 528, 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 killed as a result of road accidents,

Table 4. Sources of financing for the Federal Targeted Program “Improving road safety in 2006 - 2012”

Rice. 5 Sources of funding for the program

Conclusion

Upon completion of the work, we can conclude that today federal target programs aimed at protecting public health are one of the most important means of implementation social policy state and active influence on socio-economic development.

The effectiveness of the implementation of the programs under consideration is assessed based on comparison with data for 2005.

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 thousand people;

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

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

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

Federal Target Program “Children of Russia 2007-2010”

reducing the infant mortality rate to 9.8 per 1000 live births;

reduction of the indicator maternal mortality up to 21 per 100 thousand 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 of 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 years (inclusive) to 21.4 per 10 thousand children.

Federal Target Program “Increasing road safety in 2007-2012”

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

Thus, a number of federal target programs aimed at protecting public health have significantly improved the health of citizens, but some results can be expected to be better.

List of used literature

1. Vyalkov, A.I. Contemporary issues state of health of the population of the Russian Federation / A.I. Vyalkov // Problem. healthcare management. 2009. - No. 3.

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

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

Trushkina L.Yu., Tleptserishev R.A., Trushkin A.G. and others. Economics and healthcare 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 ]

Federal Targeted Program “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 Health Care: - electr. resource [access mode ]

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

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Ministry of Health and Social Development of Russia

State budgetary educational institution
higher professional education

"Siberian State Medical University"

Ministry of Health and Social Development of the Russian Federation

(GBOU VPO SibSMU Ministry of Health and Social Development of Russia)

Faculty of Economics and Healthcare Management

Department of Health Organization and Public Health

Course work

in the discipline "Medical and social foundations of health"

FEDERAL TARGETED PROGRAMS AIMED AT PROTECTING POPULATION HEALTH

Completed by: 2nd year student of group 7001

Baldandorzhieva N.A.

Checked by: Dr. med. sciences, professor

CM. Khlynin,

Ph.D. honey. Sciences, Associate Professor O.V. Kudelina

Tomsk 2011

Introduction

So, the topic of my course work, “Federal target programs aimed at protecting public health,” is relevant today, since federal target programs are designed to help in solving strategic problems in the development of healthcare and the social sphere, especially in cases where it is necessary to concentrate resources to achieve specific goals within a given time frame.

The purpose of the course work is:

Study of federal target programs, their directions, activities.

Analysis of implementation, implementation activities, program financing

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

1. Reveal the essence of the federal target program.

2. Study the financing, formation, approval of the target program.

3. 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

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

Federal target programs are an effective tool for implementing state economic and social policies, especially when solving long-term problems and implementing large infrastructure projects. It is this program-project approach that is used in the countries of the European Union, 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 target 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"

3) Subprogram "Vaccine prevention"

4) Subprogram "HIV infection"

5) Subprogram "Oncology"

6) Subprogram "Sexually transmitted infections"

7) Subprogram "Viral hepatitis"

8) Subprogram "Mental disorders"

9) Subprogram "Arterial hypertension"

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

· Subprogram "Healthy Generation"

· Subprogram "Children and Family"

Federal target program "Improving road safety in 2006 - 2012".

1.3.1. 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 of the Government of the Russian Federation of December 11, 2006 N 1706-r, the list of socially significant diseases approved by the Government Resolution of the Russian Federation of December 1, 2004 N 715, the procedure for the development and implementation of federal target programs and interstate target programs in the implementation of which the Russian Federation participates, approved by Decree of the Government of the Russian Federation of June 26, 1995 N 594.

The proportion of patients with visual localizations of malignant neoplasms detected at stages I and II of the disease in the total number of patients with visual localizations of the tumor is 67.6 percent, the proportion of those who died from malignant neoplasms within a year from the date of diagnosis among patients registered for the first time in the previous year - 31.6 percent, mortality from malignant neoplasms per 100 thousand population is 233.1 cases for men, 170.3 cases for women. (as amended by Decree of the Government of the Russian Federation dated 04/06/2011 N 254)

The incidence of syphilis is 72 cases per 100 thousand population, in correctional institutions of the Federal Penitentiary Service 176.6 cases per 100 thousand people, the incidence of syphilis in children is 21.2 cases, gonorrhea is 23.4 cases per 100 thousand children. At the same time, the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions is 15 percent. The total number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections does not exceed 12 in the country as a whole.

The incidence of acute viral hepatitis B and C is currently 8.6 and 4.5 cases per 100 thousand population, respectively, chronic viral hepatitis B and C - 51.4 cases per 100 thousand population. The share of patients covered by team forms of psychiatric care in the total number of observed patients is 5 percent, the share of patients in need of inpatient psychiatric care in the total number of observed patients is 16 percent. At the same time, the average duration of treatment of a patient in a psychiatric hospital is 75.6 days, and the proportion of repeated hospitalizations in a psychiatric hospital during the year is 20 percent.

95% coverage of children with preventive vaccinations is maintained. The incidence of diphtheria and measles is currently 0.25 and 1.6 cases per 100 thousand population, respectively.

Main goals and objectives

The objectives of the Program are:

Ш improvement of methods of prevention, diagnosis, treatment and rehabilitation for socially significant diseases;

Ш development and implementation of modern methods of prevention, diagnosis, treatment and rehabilitation for socially significant diseases based on advanced technologies;

Ш construction and reconstruction of specialized medical institutions.

The program is being implemented in 2007 - 2012. (as amended by Decree of the Government of the Russian Federation dated 04/06/2011 N 254)

The program includes subroutines:

v "Diabetes mellitus",

v "Tuberculosis",

v "HIV infection",

v "Oncology",

v "Sexually transmitted infections",

v "Viral hepatitis",

v "Mental disorders",

v "Arterial hypertension",

v "Vaccine prevention"

Subprogram “Diabetes mellitus” (as amended by Resolutions of the Government of the Russian Federation dated 06/02/2008 N 423, dated 04/06/2011 N 254)

For patients with diabetes, the need for medical care increases as their condition worsens and complications arise. The prevalence of life-threatening and disabling vascular complications of diabetes remains high, including diabetic retinopathy, diabetic nephropathy and cardiovascular complications.

The goals of the “Diabetes Mellitus” subprogram are:

Reducing the incidence of diabetes mellitus;

Improving measures to prevent its complications;

increase in the average life expectancy of patients with diabetes.

1) improvement of methods for the prevention and diagnosis of diabetes mellitus;

2) treatment and rehabilitation of patients with diabetes mellitus;

3) development and implementation of high-tech methods for treating the disease and its complications;

4) development and implementation of training programs for patients with diabetes mellitus on the prevention and treatment of diabetes mellitus.

Subprogram "Tuberculosis"

In patients suffering from tuberculosis, the decisive socio-economic factor is a decrease in the level and quality of life.

Not all groups of the population are covered by preventive medical examinations carried out for the purpose of early detection of tuberculosis. It is necessary to take additional measures to ensure a reduction in the level of morbidity, disability and mortality due to tuberculosis, to optimize the treatment of patients with tuberculosis, to ensure early diagnosis and prevention of the development of severe complications due to tuberculosis, to increase the duration and improve the quality of life of patients suffering from this disease, including by strengthening the financial -technical base of healthcare institutions.

The goals of the Tuberculosis subprogram are to reduce the incidence of tuberculosis and reduce the mortality rate from tuberculosis.

The tasks of the subprogram are:

1) improving methods of preventing tuberculosis, including

2) development of information programs for the population, educational

3) programs for tuberculosis patients and persons in contact with them;

4) improving tuberculosis infection control measures;

5) improvement of diagnostic methods, treatment and comprehensive programs medical and social rehabilitation;

6) construction and reconstruction of anti-tuberculosis medical institutions.

The incidence of tuberculosis in correctional institutions of the Federal Penitentiary Service is currently 1515 cases per 100 thousand people, mortality is 153.4 cases per 100 thousand people, the proportion of cases of cessation of bacterial excretion is 73.5 percent, mortality from tuberculosis is 22.6 cases per 100 thousand population.

Subprogram "HIV infection"

The continuing increase in the number of registered HIV-infected persons is largely due to socio-economic factors, the spread of drug addiction, and insufficient awareness of the population. It is necessary to increase the proportion of HIV-infected pregnant women included in the program for the prevention of HIV infection in newborns. A study of drug resistance of the human immunodeficiency virus to antiretroviral drugs is required. Further development of safe technologies for collecting blood and its components is necessary in order to reduce the risk of HIV transmission when using donor blood and its products.

The goals of the HIV subprogram are:

Reducing the number of newly registered cases of HIV infection;

Introduction of methods to prevent HIV infection in newborns;

Ensuring availability of antiretroviral drugs;

Reducing the mortality rate of patients with HIV infection.

The tasks of the subprogram are:

1) improving methods for preventing the spread of HIV infection;

2) improving methods of diagnosis, treatment and rehabilitation for HIV infection;

3) development and implementation of modern antiretroviral drugs;

4) construction and reconstruction of specialized medical institutions and equipping them with modern medical and technological equipment.

Subprogram “Oncology”

Disability rates due to malignant neoplasms remain extremely high. The proportion of patients who died from malignant neoplasms within a year from the date of diagnosis is high. The organization of preventive medical examinations for the purpose of early detection of cancer is insufficient. It is necessary to continue the study of substances, products, production processes, household and natural factors that are carcinogenic to humans.

The goals of the Oncology subprogram are:

Providing diagnostics in the early stages of diseases;

Reducing disability and mortality due to malignant neoplasms.

The tasks of the subprogram are:

1) improving methods for the prevention of cancer, early detection of tumor and precancerous diseases;

2) assessment of carcinogenic environmental factors;

3) monitoring of carcinogenic production factors and industries;

4) ensuring the diagnosis of tumor diseases of visual localization in the early stages;

Subprogram "Sexually transmitted infections"

The number of sexually transmitted infectious diseases (including cases of neurosyphilis) identified among adolescents increases every year. Resistance of pathogens of sexually transmitted infections to the drugs used is developing. In this regard, it is necessary to carry out sanitary educational activities and promote a healthy lifestyle. In addition, it is necessary to increase the number of specialized medical institutions studying the variability of pathogens of sexually transmitted infections, organize research aimed at overcoming the therapeutic resistance of pathogens of sexually transmitted infections, and improve their diagnosis, taking into account the molecular characteristics of the pathogens.

The goal of the “Sexually Transmitted Infections” subprogram is to reduce the incidence of sexually transmitted infections.

1) improving methods for preventing sexually transmitted infections, including the development of information materials and educational programs for the population;

2) development and implementation of modern methods of diagnosis, treatment and rehabilitation for sexually transmitted infections;

3) improving the system for monitoring the resistance of sexually transmitted pathogens to the drugs used;

Subprogram "Viral hepatitis"

The incidence of chronic forms of viral hepatitis B and C, acute forms of viral hepatitis C, as well as disability and mortality due to these diseases increases every year.

It is necessary to improve methods for investigating cases of epidemic outbreaks of viral hepatitis, molecular diagnostic methods, methods for preventing viral hepatitis, further development specialized medical care.

The tasks of the subprogram are:

1) improving methods for the prevention of viral hepatitis and epidemiological surveillance;

2) ensuring the quality of diagnosis, treatment and rehabilitation of acute and chronic viral hepatitis;

3) development and implementation of modern medicines and diagnostic kits;

4) construction and reconstruction of specialized medical institutions, equipping them with modern medical and technological equipment.

Subprogram "Mental disorders"

The incidence of mental and behavioral disorders in the population is growing. About 60 thousand people die from suicide every year.

The goal of the subprogram “Mental Disorders” (hereinafter referred to as the subprogram) is to develop a comprehensive system of prevention, diagnosis, treatment and rehabilitation for mental disorders.

The tasks of the subprogram are:

1) improvement of methods for the prevention of mental disorders, development and implementation advisory assistance, educational programs for the population on mental health and suicide prevention;

2) improving methods of diagnosis and treatment of mental disorders, introducing team forms of work in a psychiatric hospital, day hospital, psychoneurological dispensary and rehabilitation dormitory;

3) introduction of modern methods of psychosocial therapy and psychosocial rehabilitation;

Subprogram "Arterial hypertension"

The level of morbidity, disability and mortality of the population due to diseases of the circulatory system, among which hypertension occupies a leading place, remains high. In this regard, it is necessary to take into account and prevent factors that contribute to a decrease in the quality of life of the population, including those caused by excessive stress loads.

It is necessary to develop and implement measures for the prevention of cardiovascular diseases, and implement programs to organize rehabilitation treatment for patients with stroke and acute myocardial infarction.

The goals of the "Arterial Hypertension" subprogram are to reduce the number of diseases of vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension and reduce mortality from its complications.

The objectives of this subprogram are:

1) creation of an effective system for the prevention of arterial hypertension in risk groups;

2) development and implementation of modern methods for early diagnosis, treatment of arterial hypertension and rehabilitation of patients with its complications.

Subprogram "Vaccine prevention"

While the level of coverage of children with preventive vaccinations remains high, cases of diphtheria, measles and whooping cough, as well as outbreaks of mumps, continue to occur. It is necessary to create new vaccines for mass use and introduce modern technologies their production. It is necessary to develop a system of informing the population about measures to prevent the spread of infections controlled by means of specific prevention.

The goal of the “Vaccine Prevention” subprogram is to reduce the incidence of infections controlled by specific prevention means.

The tasks of the subprogram are:

1) improvement of methods for preventing infections controlled by means of specific prevention;

2) improving methods for monitoring the implementation of preventive and anti-epidemic measures;

3) improving the vaccine transportation system.

1.3.2. Program "Children of Russia" for 2007 - 2010

There are 29 million children living in the Russian Federation. The most vulnerable categories of children include orphans and children without parental care (731 thousand children), disabled children (587 thousand children), children in a socially dangerous situation (676 thousand children). Specified groups Children need, first of all, social rehabilitation and adaptation, integration with society.

According to forecasts, by 2010 the number of children will decrease by 3.73 million people compared to 2003, which determines a further downward trend in the country's population. The birth rate does not ensure simple reproduction of the population. Maternal and infant mortality rates remain at high level, only 30 percent of newborns can be considered healthy. Over the past 10 years, the morbidity rate among children as a whole has increased by more than 1.4 times.

Family dysfunction, antisocial behavior of parents and lack of control over the behavior of children leads the latter to early criminalization.

Statistics show a steady increase in juvenile crime (145.4 thousand crimes were committed in 2003, 154.4 thousand crimes in 2004, 154.7 thousand crimes in 2005).

The goals of the Program are to create favorable conditions for integrated development and life activities of children, state support for children in difficult life situations.

The objectives of the Program are:

Ensuring safe motherhood and the birth of healthy children, protecting the health of children and adolescents, including reproductive health;

Prevention and reduction of child and adolescent morbidity, disability and mortality;

Creation of a state system for identifying, developing and targeted support for gifted children, preserving the country’s national gene pool, developing the intellectual and creative potential of Russia;

Prevention of social ill-being of families with children, protection of the rights and interests of children;

As a result of the implementation of the federal target program "Children of Russia" for 2003 - 2006, a decrease in infant mortality was achieved (from 12.4 per 1000 live births in 2003 to 11 per 1000 live births in 2005), maternal mortality (from 31.9 to 100 thousand live births in 2003 to 30.5 per 100 thousand live births in 2005), reducing disability among children with chronic pathologies, strengthening the health of children and adolescents at all stages of development. Compared to 2003, in 2005 the number of street children decreased by 3.2 thousand people (4.27 thousand versus 7.5 thousand), children in difficult life situations - by 274 thousand people (676 thousand). against 950 thousand). In 2005, more than 440 thousand families with disabled children received assistance from social service institutions for families and children, which is 26 percent more than in 2003.

Within the framework of this federal target program, the construction and reconstruction of 42 maternity and childhood institutions, 77 institutions for orphans and children left without parental care, 60 orphanages for disabled children and rehabilitation centers for children with disabilities were carried out.

The implementation of the program made it possible to strengthen the material and technical base of more than 600 maternity and childhood institutions, 1,200 specialized institutions for minors in need of social rehabilitation, including centers to help families with children and crisis centers to help women, more than 500 educational institutions, 92 temporary detention centers for juvenile offenders of internal affairs bodies, more than 50 educational colonies of the penal system of the Federal Penitentiary Service, more than 300 specialized institutions for disabled children, more than 400 institutions for orphans and children without parental care (equipped with vehicles , agricultural machinery, modern medical and preventive, rehabilitation, computer, technological and household equipment).

It is proposed to highlight the subprograms “Healthy Generation”, “Gifted Children”, “Children and Family” within the Program.

The goal of the “Healthy Generation” subprogram is to preserve, restore and strengthen the health of children and adolescents, instilling in them healthy lifestyle skills.

The objectives of this subprogram are:

Ensuring safe motherhood, creating conditions for the birth of healthy children;

Introduction of high-tech methods for diagnosing and preventing hereditary diseases and congenital malformations in children;

Protecting the health of children and adolescents, including reproductive health;

Promotion of healthy lifestyles;

Prevention of morbidity, disability and mortality in childhood and adolescence;

The goal of the "Gifted Children" subprogram is to provide favorable conditions for the creation of a unified state system for identifying, developing and targeted support for gifted children in various areas of intellectual and creative activity.

The tasks of the subprogram are:

Creation of a state system for identifying, developing and targeted support for gifted children, including on the basis of innovative technologies for identifying and supporting gifted children living in rural areas, settlements remote from large centers of culture, education, science;

Coordination of the activities of basic centers for working with gifted children and their support;

Providing consulting assistance to parents and teachers working with gifted children;

The goals of the “Children and Family” subprogram are to protect and improve the situation of children in difficult life situations, prevent social orphanhood and family dysfunction, comprehensive solution problems of families with disabled children, ensuring their full functioning and integration with society, development family forms devices for orphans.

Due to the specifics of the problems various categories children within the framework of this subprogram, such areas as “Prevention of neglect and juvenile delinquency”, “Family with disabled children”, “Orphans” are provided.

1.3.3. Program "Improving road safety in 2006 - 2012"

The problem of accidents associated with road transport (hereinafter referred to as accident rates) has become particularly acute in the last decade due to the inconsistency of the road transport infrastructure with the needs of society and the state for safe road traffic, the insufficient efficiency of the road safety system and the extremely low discipline of participants traffic.

In 2004, there were over 208 thousand road accidents, in which 34.5 thousand people died. Compared to 1997, the death toll increased by 27.8 percent. In total, over the past 10 years, 312.5 thousand people have died as a result of road accidents, more than a quarter of whom are people of the most active working age (26 - 40 years).

A radical change in the accident rate occurred after 2000. The increase in the main accident rates in 2001-2004 in relation to 1 percent growth in the number of vehicles was:

· for road traffic accidents - 3.6 percent;

· by the number of people killed as a result of road accidents - 2.7 percent;

· by the number of people injured as a result of road accidents - 4.5 percent.

Since 2000, such relative indicators accident rate, as the number of people killed as a result of road accidents per 10 thousand units of transport (transport risk) and the number of people killed as a result of road accidents per 100 thousand population (social risk). In 2004, they reached their maximum (more than 10 and over 24 people died as a result of road accidents, respectively).

Road traffic accidents cause significant damage to the Russian economy, amounting to 2.2 - 2.6 percent of the country's gross domestic product in the last 4 years (in 2004, the damage amounted to 369 billion rubles, including as a result of deaths and injuries of people - 227.7 billion rubles).

The goal of the Program is to reduce the number of people killed in road accidents by 1.5 times in 2012 compared to 2004. This will allow the Russian Federation to approach the level of road safety characteristic of countries with developed motorization of the population, reduce accident rates and, consequently, reduce the social severity of the problem.

The conditions for achieving the goals of the Program are the solution of the following tasks:

· preventing dangerous behavior of road users;

· development of a system for training drivers and their admission to participation in road traffic;

· reduction of child road traffic injuries;

· improving the organization of transport and pedestrian traffic in cities.

Chapter 2. Implementation Analysis

2.1. "Prevention and control of socially significant diseases (2007 - 2011)"

Solving the problem of reducing morbidity, increasing the duration and improving the quality of life for socially significant diseases by software means will be carried out through a reasonable selection of activities in all areas of the implementation of the federal target program "Prevention and Control of Socially Significant Diseases (2007 - 2011)".

Activities for implementation

When solving the problem of the incidence of socially significant diseases using a program-targeted method, 3 options for implementing the Program are possible, differing in the amount of funding.

First option - financial support implementation of the Program in the declared volumes.

Approval of the Program according to the first option will allow achieving the set goal.

In this option, the implementation of the Program is associated with macroeconomic risks associated with the possibility of a decrease in economic growth rates and the level of investment activity, and the emergence of a budget deficit.

The second option is the adoption of the Program with a funding volume of 50 to 80 percent of the declared volume.

Under this option, funding for the Program will be focused on the most effective activities that ensure stabilization of the main indicators of the incidence of socially significant diseases, as well as on activities that require relatively small amounts of funding.

The third option is the adoption of the Program with a funding volume of less than 50 percent. Under this option, Program funding is concentrated on the least costly priority activities.

Financing

Financing for the preparation of target program projects and concepts for implementing program problems, the development of which is carried out by decision of the Government of the Russian Federation, is carried out from the funds provided in the “Other Articles” section of the federal budget. Approved target programs are implemented at the expense of federal budget funds, extra-budgetary sources attracted for the implementation of these programs, and funds from the budgets of constituent entities of the Russian Federation.

Federation cannot be set below 5 percent in the current financial year with the condition that financing for the construction of facilities by a constituent entity of the Russian Federation remains at least 50 percent estimated cost work during the period of the Program.

The Program's activities are financed from the federal budget, the budgets of the constituent entities of the Russian Federation and extra-budgetary sources.

The total costs for the implementation of the Program activities amount to 95820.8577 million rubles (in prices of the corresponding years), of which from the federal budget - 45453.4577 million rubles, budgets of the constituent entities of the Russian Federation - 48763.2 million rubles, extra-budgetary sources - 1604.2 million rubles. (as amended by Decree of the Government of the Russian Federation dated 04/06/2011 N 254)

Table 1.

Source of financing for the activities of the Federal Targeted Program “Prevention and Control of Socially Significant Diseases 2007-2011”

Rice. 1 Source of financing for program activities

The Program is financed from the federal budget in the following areas:

· capital investments - 23064.9064 million rubles;

· research and development work - 1238.7268 million rubles;

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

Rice. 2 Directions for spending funds from the Federal Target Program “Prevention and Combating Socially Significant Diseases 2007-2011”

Fulfillment, at the expense of federal budget funds, of obligations on construction sites and objects that are in state ownership of constituent entities of the Russian Federation and in municipal ownership is carried out in the manner of interbudgetary relations in accordance with the provisions of the Budget Code of the Russian Federation.

Table 2. Financing of subprograms

Subroutines	Million rub (plan)
Diabetes
Tuberculosis
Oncology
Sexually transmitted infections
Arterial hypertension
Vaccinal prevention
Viral hepatitis
HIV infection
Mental disorders

Rice. 3 Amount of funding for subprograms

The effectiveness of the Program is assessed based on comparison with data for 2005 and taking into account the need to achieve the following indicators:

An increase in the average life expectancy of men with type I diabetes mellitus to 55.4 years, women - to 59.2 years;

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

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

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

Increasing the number of newly registered cases of HIV infection during the year to 65 thousand cases;

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;

Increasing the proportion of HIV-infected pregnant women included in the program for the prevention of HIV infection in newborns to 95 percent;

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

Reducing the proportion of patients who died from malignant neoplasms within a year from the moment of diagnosis, in the total number of patients first registered in the previous year, to 27.5 percent;

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

Reducing the incidence of syphilis in children to 7.1 cases per 100 thousand children;

Reducing the incidence of gonorrhea in children to 7.7 cases per 100 thousand children;

Increasing the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions to 62 percent;

Increasing the number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections to 60 units;

Reducing the incidence of acute viral hepatitis B to 2.6 cases per 100 thousand population;

Reducing the incidence of acute viral hepatitis C to 3.7 cases per 100 thousand population;

Increasing the proportion of patients covered by team forms of mental health care in the total number of observed patients to 30 percent;

Elimination of cases of polio;

Reducing 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;

Increase the quality and accessibility of social services for families with children, primarily for families with disabled children;

Improve the government system 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 care from the state.

Reducing the infant mortality rate to 9.8 per 1000 live births;

Reducing the maternal mortality rate to 21 per 100 thousand 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 of 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 years (inclusive) to 21.4 per 10 thousand children.

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

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

The assessment of the implementation of the direction “Prevention of neglect and juvenile delinquency” by 2011 will be carried out according to the following indicators:

· the share of street children in the total child population is 2.17 percent;

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

The assessment 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 is 43.1 percent;

The share 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.

Financing

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

At the expense of the federal budget - 10,101.7 million rubles;

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

At the expense of extra-budgetary sources - 1429.1 million rubles.

Table 3. Source of financing for the activities of the Federal Target Program “Children of Russia 2007-2010”

The funds are distributed according to areas of expenditure 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 extra-budgetary 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 extra-budgetary sources - 1259.1 million rubles.

Rice. 4 Sources of funding for the program

2.3 Program "Improving road safety in 2006 - 2012"

health population target investment

Performers of the Program activities are determined in the manner established by the legislation of the Russian Federation.

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

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

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

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

· improving the licensing system in the field of driver training, developing a legal basis for monitoring citizens’ self-training to obtain the right to drive vehicles of categories “A” and “B”;