Koshkina E.A.¹, Kirzhanova V.V.¹, Guseva O.I.², Miroshnikova Yu.V.^3
1National Research Center for Addiction Medicine, Moscow
²Ministry of Health of the Russian Federation, Moscow
³Federal Medical and Biological Agency, Moscow

Abstract. Background. The ongoing modernization and reforming of drug rehabilitation service in Russia conditions the necessity to monitor its current state: structural changes, major performance indicators, development of rehabilitation capacities.

The aim was to analyze structural changes, to evaluate current state and development of human resources, to analyze major performance indicators and rehabilitation capacities of drug rehabilitation service in the context of its modernization.

Methods: time series analysis, growth rates of absolute and relative indicators.

Results. Performance monitoring of drug rehabilitation service in 2009-2013 shows further changes in its structure during reforming. Decrease in the number of drug rehabilitation facilities, departments and beds is observed; capacity of outpatient facilities reduces against the background of decreased number of beds resulting in lower access to outpatient drug rehabilitation services. At the same time the number of rehabilitation departments as well as inpatient and outpatient rehabilitation programs is growing. A number of organizational problems were identified in the work of addiction psychiatrists related to insufficient number of such specialists and their high work load. Shortage of rehabilitation specialists was also identified, including addiction psychiatrists, psychotherapists, psychologists, social workers and outreach specialists.

Conclusions. The authors made suggestions on development of outpatient facilities of the drug rehabilitation service in the context of beds reduction, development of hospital replacing technologies, enhanced availability of addiction psychiatrists, rehabilitation specialists as well as their work regulation. The study also revealed issues for further analysis.

Keywords: drug rehabilitation service; structure; staff; rehabilitation.

References

1. Babushkina E.I., Chernova T.V. New organization forms of health care to alcohol abuse patients in Sverdlovsk region. Sovremennaya meditsina: aktual'nye voprosy. 2013; (20): 58-63 (in Russian).
2. Babushkina E.I., Gaydarova A.Kh., Dolgova I.G., Kimpaev I.A., Malishevskaya T.N., Razumova T.O., et al. Modernization of health care: integration of national and foreign experiences. Moscow. 2014. 164 p. (in Russian).
3. Vlasovskikh R.V., Gasper I.B., Davletov L.A., Koporov S.G., Agibalova T.V., Val'chuk D.S. Efficiency assessment of the program for rehabilitation of psychoactive substance abuse patients in outpatient rehabilitation department of narcological dispensary. Voprosy narkologii. 2013; (3): 60‒69 (in Russian).
4. Gurovich I.Ya., Storozhakova Ya.A., Fursov B.B. International experience in reforms of mental health care and future development of mental health service in Russia. Sotsial'naya i klinicheskaya psikhiatriya. 2012; 22 (1): 5-19 (in Russian).
5. Kalininskaya A.A., Stukalov A.F., Alikova T.T. Hospital-replacing forms of medical care: organization and activity efficiency. Zdravookhranenie Rossiyskoy Federatsii. 2008; (6): 5-8 (in Russian).
6. Kanarskiy I.A. The history of creation and activity of mental health and narcological services for children in Yekaterinburg. Ural'skiy meditsinskiy zhurnal. 2009; (6): 94-99 (in Russian).
7. Koshkina E.A., Kirzhanova V.V., Babicheva L.P., Mugantseva L.A. Activity of narcological service in the Russian Federation: assessment of statistical indicators and result analysis. Zhurnal nevrologii i psikhiatrii im. S.S.Korsakova. 2013; 113 (6-2): 3-8 (in Russian).
8. On approval of the procedure of providing health care by the profile of “drug abuse’: the Order of the MoH of Russia of 2012, November 15 ¹ 929n. [Internet]. 2012 [cited 2014 Oct 08]. Available from: http://www.rg.ru/2013/04/25/narkologiya-dok.html (in Russian).
9. On approval of the standard for specialized health care to patients with abuse syndrome caused by psychoactive substances use: the Order of the MoH of Russia of 2013 September 4 ¹133n. [Internet]. 2013 [cited 2014 Oct 08]. Available from: http://www.consultant.ru/document/cons_doc_LAW_140433/ (in Russian).
10. On approval of the List of harmful and/or dangerous working conditions and works in which mandatory preliminary and periodic medical examinations are provided and the Procedure for providing mandatory preliminary and periodic medical examinations for employees engaged at heavy works and harmful and/or dangerous working conditions: the Order of MoH&SD of Russia of 2011 April 12 ¹ 302n. [Internet] 2011 [cited 2014 Oct 08]. Available from: http://www.consultant.ru/document/cons_doc_LAW_149116/ (in Russian).
11. Pushkarev O.V. Criteria and quantitative assessment of efficiency of health care management. Obshchestvennoe zdorov'e i zdravookhranenie. 2008; (2): 23-27 (in Russian).
12. Tsarev S.A. Integration of preventive programs for drug abuse patients in the work of narcological service. Voprosy narkologii. 2012; (1): 41-42 (in Russian).

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