A.A.Kalininskaya¹, P.B.Abdurashidova², L.M.Aliyeva^1
1 Federal Research Institute for Health Organization and Informatics of Ministry of Health and Social Development of the Russian Federation, Moscow
² Republican pediatric medical advisory clinic of the Republic of Dagestan

Summary. Organization and provision of the service of medical advice and diagnosis for children and adolescent population is a delicate problem in the healthcare system far from being solved as yet. It is most topical for the Republic of Dagestan as there exist certain features of national specificity in this field: large-sized families having many children, varying lifestyles within one family due to highly mixed population of the Republic, women insufficiently cultivated as mothers, especially in rural environment. The mean proportion of infants upon a medical district reaches 15%, while in the Russian Federation on a whole it does not exceed 3%.

To outline certain measures for solving the problems identified in organization and provision of the service of medical advice and diagnosis for children and adolescent population in the Republic of Dagestan.

Locally varying features of children and adolescent morbidity were investigated into in all territories of this Republic. Rate of response through involvement in medical activity of the citizens was estimated along statistical techniques. Districts of the Republic differing in accessibility of medical care for children and adolescents were compared for the volume and main stream of provision of medical advice and diagnosis-making for them.

Rural dwellers are not rarely in a position to take access to medical care in a needed volume due to low transport accessibility of central district hospitals. As a result, central district hospitals have switched - under the pressure of limited funding - to provision of medical care mainly to the population of administrative centers of rural and urban municipalities. Experimental approaches to organization of one day hospital based in the Republican children’s clinic were developed and approved. Its medical and social efficiency and economic role were appreciated, as well. The current condition of outpatient medical care for children and adolescents was assessed for the structure of its primary and referral components and comprehensive measures and ways for its improvement were outlined.

Conclusions:

1. Extension of rights of heads of rural settlements aimed at increasing their responsibility for the health condition of the inhabitants was considered feasible in this trial.
2. Adoption of the law (or a package of laws) - for Constituent Territories of the Russian Federation - on healthcare in localities with low density of the population was considered essential in funding general practitioners in the countryside context.
3. Development of the National Project entitled “Health” is considered to enter this framework also.

Key words. Children;, adolescents; consultation and diagnostic care; areas of accessibility of medical care, organizational model of diagnosis.

References

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