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 This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
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.

References

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