Economy and management of public health systems

The Federal Agency in Public Health Protection
and Social Development
The Stavropol State Medical Academy




The Public Health and Public Health Service Department








L. L. Maksimenko








ORGANISATION OF THE TREATMENT-AND-PROPHYLACTIC AID IN RUSSIA






For the Students of General Medicine
of the English-speaking Medium














Stavropol 2010

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L.L. Maksimenko


Organisation of the treatment-and-prophylactic aid in Russia. The
manual. Stavropol, 2010. 107 p.

Reviewers:
V.N. Muravyova, D.M.S., Professor, Rector of the Stavropol State
Medical Academy, the Head of the Public Health and Public Health Service
Department.
S.V. Znamenskaya, C.P.S., Associate Professor, Dean of the Foreign
Students' Department of the Stavropol State Medical Academy, the Head of
Latin and Foreign Languages Department.



Translated from Russian by T.N. Finenko, the Senior Teacher of Latin
and Foreign Languages Department of the Stavropol State Medical Academy.




??? 51.1 (2)

??? 614.2






Recommended for publication by the Cycle Methodical Committee for
Education of the English-speaking Medium students
of the Stavropol State Medical Academy





© Stavropol State Medical Academy, 2010
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INTRODUCTION


In the modern world the condition of public health is defined by the
level of economic development of the state, its steadiness and stability on
geopolitical space and it is an important factor of the national safety.
Traditional components of strategic power of the state - the quantity of
the population, the size of the territory and stocks of natural resources -
were added now with the new ones: quality of health of the population, the
ability to develop, to make and to apply widely high technologies in the
economic, defense and socially-focused systems, including medicine. Health
protection becomes a priority direction of the national policy and means,
besides medical aid rendering, health supervision, improvement of
environment, working conditions and a life, nutrition improvement,
assistance to development of mass physical training and sports. The public
health services are a part of the health protection system, one of branches
of the social sphere providing realization of the rights of citizens on
receiving of adequate medical aid (medical prophylaxis, treatment, medical
rehabilitation).
«The public health services system is a set of the interconnected
actions which promote strengthening of health and are carried out in-home,
in educational institutions, at workplaces, in communities, in a physical
and psychosocial environment, and also in sector of public health services
and the sectors connected with it» (definition of the WHO).
By public health services system in Russia a set of the state and
public measures of social and economic character on the medical aid
organization, the prevention of diseases and increase of level of health of
the population is understood. In Russia there are state, municipal and
private systems of public health services. The state system of public
health services concerns the Ministry of Health and Social Development of
the Russian Federation (Ministry of Public Health and Social Development of
the republics component of the Russian Federation, regions, territories),
and also treatment-and-prophylactic, research, educational, and other
establishments which are in a state ownership and subordinated to controls
of the state system of public health services. Public health authorities,
treatment-and-prophylactic, research, educational, pharmaceutical, and
other establishments in the municipal property are referred to municipal
system. The private medical commercial and noncommercial organizations
which property is in a private ownership are private system of public
health services. For example: republican, regional, territorial hospitals
are the establishments concerning the state system of public health
services; city polyclinics and hospitals are referred to municipal system,
and private dental offices, firms belong to private system. The state and
municipal systems of public health services are united by the term - public
health services.
Main principles of public health services:
1. Observance of human and citizen rights in the field of health protection
and maintenance of the state guarantees connected with them.
2. A priority of preventive measures in the field of health protection of
citizens.
3. Availability of the medico-social aid.
4. Social security of citizens in case of health loss.
5. Responsibility of state governing bodies of the enterprises,
establishments and the organizations, irrespective of ownership patterns,
officials for maintenance of the rights of citizens in the field of health
protection.
Medical aid is subdivided into the primary health care, medical aid to
women in pregnancy, during and after labor, emergency, specialized, expert
care (sanitary-aviation), hi-tech (expensive) medical aid.
The primary health care (PHC) - is the first level of contact of the
population with public health services system; it is approached to a
residence and work place of people as much as possible and represents the
first stage of continuous process of protection of their health.
Territorial availability of PHC is provided with rational placing of
medical institutions taking into account the developed and perspective
systems of the population settlement, and also of some other factors.
The primary health care includes out-patient-polyclinic, urgent, in-
patient medical aid of the general profile and urged to satisfy
requirements of the population in health strengthening, treatment,
rehabilitation, sanitary education. The basic establishment rendering the
primary health care is the polyclinic.





THEME 11
ORGANIZATION OF AMBULATORY CARE. THE CITY POLYCLINIC. ITS LEADING
SIGNIFICANCE IN ORGANIZATION OF PRIMARY HEALTH CARE FOR ADULT POPULATION
Objectives of the lesson: to learn the system of public health
services in Russia, the main principles of primary health care (PHC)
organization to urban population. To analyze structure, problems and
organization of work of a city polyclinic, to master a technique of
calculation and estimation of the polyclinic activity general indicators,
to use the received information for the analysis and planning of public
health service establishments' activity. To know the forms of succession
and interrelation between treatment-and-prophylactic establishments.
Technique of lesson conduction: Students prepare for practical class
independently by the recommended literature and carry out individual
homework. The teacher checks their homework for 10 minutes and specifies
the introduced errors, checks preparation degree using testing and oral
interrogation. Then the students independently calculate the polyclinic
activity basic indicators according to the annual report of a treatment-and-
prophylactic establishment. They analyze the obtained data and formulate
the conclusion. At the end of the lesson the teacher checks independent
work of students.
CONTROL QUESTIONS:
1. What systems of public health services function in Russia?
2. What is public health service?
3. Name the main principles of public health services in our country.
4. What are the tasks, structure and organization of work of a city
polyclinic?
5. What is the organization of work of a polyclinic registry?
6. What is maintenance and organization of work of a polyclinic therapeutic
department?
7. What are functional duties of a district doctor and a district nurse?
8. How is regular medical check-up organized in adult patients of a city
polyclinic?
9. What does anti-epidemic and sanitary-educational work in a polyclinic
consist of?
10. What are the main kinds of documentation the district doctors use?
11. Name the general indicators of polyclinic activity. What is a technique
of their calculation and estimation?
THE THEME SUMMARY:
The primary health care (PHC) is the first stage of the population's
contact with public health services system; it is approached to a residence
and work of people as much as possible and represents the first stage of
continuous process of