O.B. Nechaeva, O.K. Biragova
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow

Summary. The regulatory and procedural framework for TB care delivery has recently undergone significant changes. Target indicators that are quality indicators of TB care delivery have been approved.

The aim of the study was to implement objective monitoring of epidemiological indicators of tuberculosis in the Russian Federation.

Methods. TB care indicators were calculated according to forms of the state statistical monitoring.

Results. The monitoring results showed that in Russia the level of tuberculosis morbidity is objective and reflects the true decrease in TB morbidity. At the same time, organization of preventive examinations for tuberculosis improved and the share of advanced forms of TB among new cases decreased. The TB death rate declines faster than TB morbidity rate.

Increased number of patients with HIV-TB co-infection and patients with multi-drug resistance can potentially reduce rates of decline in key indicators of tuberculosis.

In terms of importance and volume of care, inpatient TB services significantly prevail over the outpatient services, which contradicts to the modern approaches towards care organization. Lack of relevant experience of TB care facilities in care delivery according to standards and lack of experience of insurance companies in external quality audit of care delivery to patients with tuberculosis further increases the gap.

There was not registered any significant positive dynamics of TB cure rates in 2010-2012. Indicators of the State Program for Healthcare Development for 2020 cannot be attained without a major restructuring of TB care facilities.

This work is intended for health care authorities of the Russian Federation, health managers, physicians, and TB specialists.

Keywords: tuberculosis, HIV-infection; multi-drug resistance; TB care facilities.

References

1. The order of providing medical care to tuberculosis patients in the Russian Federation approved by the Regulation of the Ministry of Health of the Russian Federation of 2012 November 15 № 932н (registered in the Ministry of Justice of the RF on 2013 Mar 07 № 27557) [Internet] [cited 2013 Apr 29]. Available from: http://www.kptd.ru/?op=con&mid=56¶m=2,491,1,1 (In Russian).
2. On the program on state guarantees to deliver free medical care to the citizens in 2013 and 2014-2015 planned period: regulation of the Government of the Russian Federation of 2012 October 22. № 1074 [Internet] [cited 2012 Oct 25]. Available from: http://www.government.ru/gov/results/21208 (In Russian).
3. Regulation of the Government of the Russian Federation of 2012 Dec 24 № 2511-р, which approved the Government Program of healthcare development in the Russian Federation. [Internet] [cited 2013 Apr 30]. Available from: http://base.consultant.ru/cons/cgi/online.cgi?req=doc;base=LAW;n=139821 (In Russian).
4. On improving the government healthcare policy: the Decree of the President of the Russian Federation of 2012 May 7 № 598 [Internet] [cited 2012 Oct 13]. Available from: http://www.rg.ru/printable/2012/05/09/zdorovje-dok.html (In Russian).
5. On the basis for population health protection in the Russian Federation: the Federal Law of the Russian Federation of 2011 Nov 21. № 323-FZ [Internet] [cited 2012 Sep 6]. Available from: http://www.rg.ru/2011/11/23/zdorovie-dok.html (In Russian).

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