O.B. Nechayeva, I.M.Son, N.V. Eismont
Federal Research Institute for Health Organization and Informatics of Ministry of Health and Social Development of the Russian Federation, Moscow

Summary. Recently there has emerged significant changes in the normative and methodical grounds that regulate the activities of anti-tuberculosis service in Russia: the Order No.1224í of the Ministry of Public Health and Social Welfare from Dec.29, 2010 (Jan.31, 2011 it was registered at the Ministry of Justice by the No.19640) made provisions for the Procedure of rendering medical aid to patients with tuberculosis in the Russian Federation. This Procedure implied drastic organizational reforming of establishments charged with anti-tuberculosis care to the population of the Russian Federation.

However, as far as in Oct.21, 2011 by the Resolution No.856 of the Government of the Russian Federation a Program of state guarantees for rendering gratuitous medical aid to the citizens of the Russian Federation was adopted, and this Program contradicted with the requirements of the aforementioned Procedure inasmuch as in the Program the volume of rendering inpatient medical aid along the “phthisiology” item significantly exceeded the values of the Procedure.

What’s more, this Program had put the inpatient anti-TB facilities much more above the outpatient ones as far as their importance and volume of services were concerned, and such a perception does not apply to modern approaches to the organization of therapeutic process in this field. A confusion was further aggravated with anti-TB facilities lacking the experience of working along medical standards and with medical insurance companies being perfectly naïve as to the implementation of external control for medical establishments for healthcare ends.

It was the Federal Law No.323-FL from Nov.21, 2011 (“On the foundations of protection of health of citizens of the Russian Federation”) that committed medical establishments to render medical aid along medical standards. Federal standards of rendering medical assistance to patients with tuberculosis, however, are not applicable in full scale in the routine work of medical establishments charged with anti-tuberculosis assistance to the population, just because these establishments are mainly of low technical capability and usually do not possess sufficient materiel and technical logistics. These drawbacks of the establishments most probably will retain prospectively.

Material technical logistics of anti-tuberculosis medical facilities of regional-level is obviously worse than that of all other levels of them. Only but 49% of buildings would be suitable for further use, while the rest of them need to be repaired and reconstructed. Diagnostic and therapeutic equipment of most anti-tuberculosis facilities is technically and morally obsolete despite various measures taken for its modernization.

Keywords. Program of state guarantees; procedure of rendering medical aid; tuberculosis; HIV-infection.

References

1. Mikhaylova Yu.V., Skachkova Ye.I., Matinyan N.S., Shestakov M.G. Natsionalnaya strategiya borby s tuberkulezom v Rossii [National strategy for TB control in Russia]. Problemy sotsialnoy gigiyeny, zdravookhraneniya i istorii meditsiny 2009;(4):33-35.
2. Mikhaylova Yu.V., Nechayeva O.B., Skachkova Ye.I., Nazarov V.I. Effektivnost raboty zdravookhraneniya Rossiyskoy Federatsii [Efficiency of healthcare in the Russian Federation]. Zdravookhraneniye Rossiyskoy Federatsii 2011;(6):3-7.
3. Nechayeva O.B., Antonova N.V. VICh-infektsiya i tuberkulez [HIV-infection and tuberculosis]. Zdravookhraneniye Rossiyskoy Federatsii 2003;(2):33-35.
4. Nechayeva O.B. Statsionarzameshchayushchiye tekhnologii v lechenii i reabilitatsii bolnykh tuberkulezom legkikh [Alternatives to hospital admission in treatment and rehabilitation of pulmonary tuberculosis patients]. Problemy tuberkuleza i bolezney legkikh 2007;(6):34-37.
5. Nechayeva O.B., Skachkova Ye.I., Mikhaylova L.A. Normativy protivotuberkuleznoy sluzhby [Standards of TB control service]. Zdravookhranenie Rossiyskoy Federatsii 2011;(2):12-17.
6. Nechaeva O.B., Sterlikov S.A., Son I.M., Mikhaylova L.A., Skachkova Ye.I., Yablonskiy P.K., Punga V.V. Gordina A.V. Set uchrezhdeniy ftiziatricheskoy sluzhby. Resursy [The net of phthisiology service facilities. Resources]. In: Tuberkulez v Rossiyskoy Federatsii 2010 g. Analiticheskiy obzor statisticheskikh pokazateley, ispolzuyemykh v Rossiyskoy Federatsii. Moscow. 2011. P. 210-225.
7. Skachkova Ye.I., Nechayeva O.B. O programme gosudarstvennykh garantiy okazaniya grazhdanam Rossii besplatnoy meditsinskoy pomoshchi v protivotuberkuleznykh uchrezhdeniyakh [On the Program on State Guarantees to Deliver Free Medical Care to the Citizens of the Russian Federation in TB control facilities]. Problemy tuberkuleza i bolezney legkikh 2008;(7):14-18.
8. Son I.M., Leonov S.A., Flek V.O., Matveyev E.N., Bantyeva M.N., Kurayeva V.M., Mirskov Yu.A., Rugol L.V., Kucheryavaya D.A., Kondratyev I.N. Sovershenstvovaniye normativnoy bazy zdravookhraneniya kak usloviye formirovaniya strukturno effektivnykh territorialnykh programm gosudarstvennykh garantiy okazaniya naseleniyu subyektov RF besplatnoy statsionarnoy meditsinskoy pomoshchi v usloviyakh modernizatsii regiona [Improving healthcare regulations as a condition to form structurally efficient regional programs on state guarantees to deliver free inpatient medical care to the population of the RF subjects in conditions of modernization of the region]. Sotsialnyye aspekty zdorovya naseleniya [Online Scientific Journal]. 2011 [cited 2012 Jan 18]; 5(21). Available from: http: //vestnik.mednet.ru/content/view/351/30/lang,ru/
9. Eysmont N.V. Opyt organizatsii statsionarnoy pomoshchi bolnym tuberkulezom na pozdnikh stadiyakh VICh-infektsii v Sverdlovskoy oblasti [Experience in organization of inpatient care to TB patients with advanced HIV in Sverdlovsk region]. Problemy tuberkuleza u bolnykh VICh-infektsiyey 2007;(3):21-23.

Write Comment

Please keep the topic of messages relevant to the subject of the article. Personal verbal attacks will be deleted. Please don't use comments to plug your web site. Such material will be removed. Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button. Keep in mind that the above process only applies if you simply entered the wrong security code.
Name:
E-mail
Comment:
Code:*