DOI: 10.21045/2071-5021-2018-62-4-6
Obuhova O.V., Brutova A.S., Dergachev A.V., Bazarova I.N., Starodubov V.I.
Federal Research institute for Health organization and informatics of Ministry of Health of the Russian Federation, Moscow
Contacts: Obuhova Olga, e-mail
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Information about authors:
Starodubov V.I., https://orcid.org/0000-0002-3625-4278
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.
Abstract
Increased access to high-tech medical care has been one of the
important objectives of the State in the recent years. To fulfill these
objectives, methods of high-tech care, which are characterized by high
replication, are being gradually immersed into the basic program of
compulsory health insurance every year. This approach allows delivery of
high-tech care by medical organizations of different levels and forms
of ownership in the volumes demanded by population.
The purpose of the study is to assess prospects to
transfer high-tech care within the «traumatology and orthopedics»
profile into specialized medical care covered by the compulsory health
insurance by clinical and statistical disease groups.
Material and methods. The study includes data from the
Federal Compulsory Health Insurance Fund on methods of high-tech care
included in the basic program of the compulsory health insurance for
2015-2016.
Methods of scientific knowledge included: bibliographic, statistical, mathematical.
Results.
By level of replication, three out of 16 methods have a value of less
than 500 cases per year, 2 methods are annually performed in the
volumes exceeding 15 thousand cases. Delivery of high-tech medical care
within the "traumatology and orthopedics" profile was implemented by
virtually all subjects of the Russian Federation, the minimum coverage
of the number of subjects participating in the method equaled to 20%.
The analysis showed that methods of high-tech care within the
“traumatology and orthopedics” profile are hardly supported by normative
documents that determine the scope and structure of medical care
(standards of medical care, clinical recommendations); treatment methods
do not correspond to the positions of the Nomenclature of Medical
Services - this fact reduces possibility of transferring methods into
clinical and statistical groups of diseases.
Conclusions. The study of the high-tech medical care
within the «traumatology and orthopedics» profile made it possible to
evaluate prospects of transferring methods of high-tech medical care
into clinical and statistical groups of diseases. According to the
results of the study, all 16 methods of high-tech medical care within
the «traumatology and orthopedics» profile included in the basic program
of compulsory health insurance can be gradually transferred to clinical
and statistical groups of diseases.
Key words: high-tech medical care; compulsory health insurance; clinical and statistical groups of diseases.
Abstract
One of the important tasks of the state in recent years is to
increase the accessibility of the country's population to receive
high-tech medical care. To this end, the methods of this type of medical
care, which are characterized by high replication, are gradually
immersed every year in the basic program of compulsory medical
insurance. This approach allows us to provide high-tech medical care by
medical organizations of different levels and forms of ownership in the
volumes necessary for the population.
The purpose of the study is to assess the prospects for the
transfer of high-tech medical assistance in the field of «traumatology
and orthopedics» into specialized medical care paid for by clinical and
statistical disease groups from mandatory medical insurance.
Material and methods. The study includes data from the Federal
Compulsory Medical Insurance Fund on methods of high-tech medical care
included in the basic program of compulsory health insurance for
2015-2016.
As methods of scientific knowledge used: bibliographic, statistical, mathematical.
Results. According to the results of the study, all 16 methods
of high-tech medical care on the profile of «traumatology and
orthopedics», included in the basic program of compulsory medical
insurance, can be gradually transferred to clinical and statistical
groups of diseases.
By level of replication, 3 methods out of 16 have a value of less
than 500 cases per year, 2 methods are annually performed in a volume
exceeding 15 thousand cases. Provision of high-tech medical assistance
in the field of "traumatology and orthopedics" was carried out by
virtually all subjects of the Russian Federation, the minimum coverage
of the number of subjects participating in the method was 20%.
The analysis showed low availability of methods of high-tech medical
assistance in the field of traumatology and orthopedics with normative
documents determining the scope and structure of medical care (standards
of medical care, clinical recommendations), the lack of conformity of
treatment methods to positions in the Nomenclature of Medical Services,
which reduces the possibility of translating methods into clinical and
statistical groups of diseases.
Conclusions. The study of the high-tech medical care on the
profile of «traumatology and orthopedics» made it possible to evaluate
the methods of high-tech medical care for their readiness for transfer
to clinical and statistical groups of diseases.
Key words: high-tech medical care; compulsory medical insurance; clinical and statistical groups of diseases.
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