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Main arrow Archive of previous Issues arrow ╣1 2012 (23) arrow The prospects and capabilities of anti-tuberculosis service in the Russian Federation: discussion
The prospects and capabilities of anti-tuberculosis service in the Russian Federation: discussion Print
Tuesday, 20 March 2012

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.1224Ý 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 ôphthisiologyö item significantly exceeded the values of the Procedure.

Whatĺs 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 (ôOn the foundations of protection of health of citizens of the Russian Federationö) 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.


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