Federal Healthcare Development Program of the Year. On the state program of the Russian Federation "Development of healthcare
Conservative scenario (option 1) characterized by moderate long-term economic growth on the basis of active modernization of fuel and energy and commodity sectors while maintaining a relative lag in the civilian high- and medium-tech sectors.
Average annual GDP growth rate estimated at 3.2% in 2012-2030. The economy will double by 2030, and Russia's share in world GDP will decrease slightly - from 3.8% in 2012 to 3.6% in 2030.
Modernization of the economy focuses more on imported technologies and knowledge.
Expenses for Scientific research and development will increase by 2030 to a level not higher than 1.3% of GDP.
Education expenses throughout the entire period, they stabilize at the level of 4.8-6.0% of GDP (including the budgetary system - 4.0-5.1% of GDP).
Health care costs until 2030 will be in the range of 4.6-6.2%, including 3.6-4.9% of GDP due to the budgetary system.
Private and public level investment in human capital will be significantly inferior to the parameters of developed countries.
Innovative scenario (option 2) characterized by an increase investment focus economic growth ... The scenario is based on the creation of a modern transport infrastructure and competitive the high-tech manufacturing sector and knowledge economy along with the modernization of the energy and raw materials complex.
The scenario involves transformation innovative factors into a leading source of economic growth and a breakthrough in improving the efficiency of human capital at the turn of 2020-2022, which also makes it possible to improve the social parameters of development.
Private and public expenses for health care growing from 4.6% of GDP in 2010 to 6.1% of GDP in 2020 and 7.1% of GDP in 2030, education expenses- up to 6.0 and 6.5% of GDP, respectively (in 2010 - 5.2% of GDP). Science spending increase from 1.2% of GDP in 2010 to 2.5% of GDP in 2030, which is comparable to the parameters of developed countries.
At the same time, a significant increase in economic efficiency parameters in relation to 2010: GDP energy intensity will decrease in 2020 by 24%, in 2030 by 43%, labor productivity will increase in 2020 by 1.5 times and in 2030, respectively, by 2.4 times.
Average annual growth rate Russian economy estimated at 4.1% in 2013-2030, which will exceed the growth of the world economy. The script assumes saving zero balance current account, which is achieved through a significant increase in exports of a high degree of processing. At the same time, the trend towards a moderate weakening of the ruble exchange rate prevails.
The implementation of the innovative scenario can significantly reduce the gap with developed countries in terms of the level of well-being of Russian citizens and to raise the status of Russia in the world economy. Russia will strengthen its position as one of the leaders of scientific, technological and educational development in the world.
Economic growth will be supported by active social changes... The share of the middle class will rise from 22% in 2010 to 37% in 2020 and 48% in 2030.
In the forecast as the main criteria for classifying citizens as middle class determined the level of income over six living wages.
Based on this in 2010 year representatives of the middle class had an average per capita income of more than 34 thousand rubles a month.
V 2030 year the level of income, allowing to relate to this category of the population, will be about 100 thousand rubles. However, the income criterion is not exhaustive.
It is assumed that the middle class should have property, savings, competitive professional qualifications and participation in the formation of civil society.
Target (forced) scenario (option 3) developed on the basis of an innovative scenario, while it is characterized by accelerated growth rates, an increased rate of private savings and the creation of a powerful export sector for products with high added value.
The scenario is in line with the benchmarks of the long-term state economic policy and characterized intensification of all available factors of economic growth... This implies acceleration of reforms to improve the business climate and intensify the inflow of foreign capital, as well as to intensify the use of national savings and growth government spending on the development of social and transport infrastructures.
The scenario provides for the implementation of the tasks set in the decrees of the President Russian Federation dated May 7, 2012 No. 596-606, creating and modernizing 25 million high-performing jobs by 2020, increase in volume investment to at least 25% of GDP by 2015 and up to 27% by 2018, an increase relative to the 2011 level share of products of high-tech and knowledge-intensive sectors of the economy in GDP by 2018 by 1.3 times, productivity labor in 2018 by 1.5 times, as well as activities within the framework of the state social policy, including an increase by 2018 real wages 1.6-1.7 times, including an increase salaries of public sector employees and researchers by 2018 up to 200% of the average salary in the corresponding region.
WHO has determined that the main goal of creating and developing health systems is to improve the health of the population. In the Russian Federation, thanks to targeted measures taken in the industry from 2005 to 2012, some improvement in the health indicators of the population was achieved. However, in many of these indicators, Russia continues to lag significantly behind developed countries. In particular. mortality from preventable causes in the Russian Federation is almost 2 times higher than in the EU countries on average, and life expectancy (LE) is 8 years lower.
The goal of significantly improving the health of the population of the Russian Federation through the modernization of health care is set in the decrees of the President of the Russian Federation of May 7, 2012: “On improving public policy in the field of health care "(No. 598) and" On measures to implement demographic policy Russian Federation "(No. 606). In these documents, it is planned that by 2018 the life expectancy of Russian citizens should increase from the current 70.3 to 74 years, and the population - from 143 to 145 million people.
However, in the healthcare of the Russian Federation, serious problems remain that will impede the achievement of the above goals. The main ones are:
The shortage of medical personnel (especially expressed in primary health care and in rural areas) and imbalances in their structure, including the suboptimal ratio of doctors and nurses (1: 2.5);
Unsatisfactory qualifications of medical personnel, which is associated with problems in basic medical education, lack of continuity of postgraduate education and insufficient implementation of modern educational technologies:
Insufficient volumes provided medical care under the program of state guarantees, compared with the "new" EU countries. including insufficient provision of the population with medicines (drugs) in
outpatient conditions (4.8 times less) and low volumes of high-tech medical care (5-7 times less than in these countries);
Inconsistency of the system of organizing medical care with modern technologies for its provision, including the suboptimal structure of the bed fund - an excess and poor equipment of medical beds for intensive and urgent treatment of patients; lack of rehabilitation and long-term care beds;
Non-systemic management, including the absence of a health development strategy. responsibility and accountability of managers at all levels for the achievement of results according to established indicators, as well as an insufficient and contradictory regulatory framework for health protection.
It should be noted that in order to improve the situation in healthcare, the Russian Ministry of Health has developed Government program"Development of healthcare until 2020" (Order of the Government of the Russian Federation of December 24, 2012 No. 2511-r). This program contains provisions important for the development of the industry, among them: early detection of diseases and the development of primary health care; elimination of the shortage of medical personnel and improvement of their qualifications; the development of medical rehabilitation and sanatorium-resort treatment, an increase in the volume of palliative care; introduction of innovative treatment methods. In the Program, a reasonable emphasis is placed on improving the health of the population as a whole, preventing diseases and the health of children and adolescents. However, the Program does not reflect all areas of health care development. For example, it is necessary to include a set of measures to initiate and coordinate interdepartmental programs to protect the health of citizens: to substantiate the amount of funding required to achieve the target health indicators; develop detailed implementation mechanisms for each of the subprograms.
The main risk in the implementation of the Program is the lack of sufficient funding from state (public) sources, So. costs federal budget for health care from 2012 to 2015 are reduced by 1.7 times, the budgets of most constituent entities of the Russian Federation are in deficit (according to the Accounts Chamber of the Russian Federation, 60% of them have a high state debt, with which they will not be able to settle). A further increase in the rates of insurance premiums for compulsory medical insurance is highly undesirable due to the increased tax burden on the payroll fund. especially for small and medium businesses. Paid services the population of the Russian Federation also cannot become a source additional income health care systems, since today the share of population spending on health care exceeds that in OECD countries (33 and 27% of total expenditures, respectively). Moreover, today 50% of the population of the Russian Federation lives on incomes of less than 15 thousand rubles. per month and in conditions of significant growth in expenses for other top-priority items family budget: housing and communal services, food, transport, education of children, etc.
All this dictates the need to develop and promptly approve a health development strategy for the medium term (2018-2020) with justification of appropriate funding from public funds. In this strategy, priority areas should be highlighted, tasks should be defined covering the full range of measures to protect the health of citizens. implementation mechanisms and indicators for monitoring have been developed. And most importantly, the volumes and sources of additional financing of health care have been determined.
When developing a strategy, in addition to solving the internal problems of the industry, it will be necessary to take into account external demographic, socio-economic and technological challenges. Among them are demographic ones - high mortality from non-communicable diseases, a decrease in the number of working-age citizens by 1 million annually, an increase in the proportion of the elderly population to 26%, and
reduction in the number of women of childbearing age by 22%. Taking into account these challenges in the health development strategy, emphasis should be placed on maintaining and strengthening the health of citizens of working age, women of childbearing age and children, increasing the volume of medical and social assistance to citizens of the older age group and children.
Serious economic challenges should also be taken into account - an increase in the gap in the amount of income of various groups of the population and the need to extend the retirement age by at least 5 years (which can only be realized if the life expectancy of men is extended by 5 years, in which case they will live up to 65 years already almost 60% of men); and social challenges - an increase in poverty as a result of the impact of a possible global economic crisis and abbreviations budget expenditures and others. Socio-economic challenges confirm the need to increase the volume of free medical care for the population at the expense of public funds.
The main technological challenge to healthcare will be the rapid development of information electronic technology... It should be used in medical education, data collection and analysis in health care. organization of medical care for patients.
To achieve the target indicators of public health and based on the need to resolve the problems that have developed in the health care system as soon as possible, as well as taking into account the tasks set in the presidential decrees of May 7, 2012 and the Health Development Program until 2020, the editorial board of the National Leadership proposes the following goals and priority directions for the development of healthcare in the Russian Federation for the medium term.
GOALS BY 2018-2020
1. To increase the share of the population satisfied with the quality and availability of medical care - 2 times(from 34 to 70%).
2. To achieve an improvement in the health status of the population:
Increase LE for 5.3 years(from 70.3 to 75.6 years);
Reduce the overall mortality rate by 19% - from 13.5 to 11.0 cases per 1,000 population:
Reduce the mortality rate of men of working age by 33% - from 10.0 to 6.7 cases per 1,000 men;
Reduce the share of working-age citizens among the total number of people who are first recognized as disabled from 47 before 35%.
3. To form a healthy lifestyle among the citizens of the Russian Federation, namely:
Reduce the proportion of adults who smoke daily from 40 before 25%;
Reduce alcohol consumption by 33% - from 15 to 10 liters per year in terms of pure alcohol per capita over 15 years old;
To increase the proportion of the population regularly engaged in physical culture. from 20 before 30%:
Stabilize the number of faces. suffering from drug addiction, at the level of 2 million.
4. Promote an increase in the birth rate and better health of children, including:
To increase by 20% the number of children born to one woman (total fertility rate or fertility rate) - from 1.5 to 1.75;
Reduce infant mortality by 22% - from 8.8 to 6.4 cases in children under 1 year of age per 1,000 live births;
Reduce the proportion of children born sick or sick during the neonatal period. - from 40 before 30% to the total live births:
To reduce on the 25% child mortality (from the moment of birth to 5 years) - from 10.2 to 7.6 cases per 1,000 live births;
To reduce on the 30% the number of abortions (from 73.7 to 57 cases per 100 births);
to reduce on the 6% maternal mortality - from 16.5 to 15.5 cases per 100 thousand live births.
5. Increase the availability of medical care, including:
Reduce the waiting time for a doctor's appointment at the clinic before 20 min, consultations by specialist doctors of the polyclinic (in case of a mild illness) - up to 3 days;
Reduce the time of arrival of ambulance teams in urban settings up to less than 20 minutes;
Reduce the waiting time for scheduled operations before 1 month high-tech medical interventions - up to 2 months
PRIORITY DIRECTIONS
1. Increase in the volume of state financing of health care by 1.5 times(from 2 to 3 trillion rubles in 2011 prices) or up to 6% of GDP, as is the case today in all developed countries... Solving other problems will not be possible without increased funding for health care. This will require identifying additional sources of health financing, including considering the introduction of a progressive scale income tax, as is customary in EU countries. USA. Japan, etc.
2. Ensuring the optimal number and structure of medical personnel. For this, along with an increase in the salary of medical personnel provided for in the decree of the President of the Russian Federation (doctors - 2 times in relation to the average salary in the regional economy, nursing staff - at the level of the average salary in the economy), additional measures must be envisaged. Among them: to optimize the range of medical specialties; develop "professional" standards; to substantiate the standards for the provision of medical personnel in the context of specialties, taking into account the changing needs of the population in medical care and modern technologies for its provision, and also to develop indicators for assessing the quality and results of the work of medical workers to conclude an "effective" contract.
3. Professional development of medical personnel. To implement this direction, it will be necessary to significantly improve the quality of basic medical education, for which to increase the remuneration of the teaching staff by at least 2.5-3 times; introduce modern technologies for improving the qualifications of doctors, including developing a system of continuing medical education (CME). The most important directions in the development of CME should be: increasing the hours of advanced training of medical workers from 144 to 250 hours in 5 years with a distribution of at least 50 hours per year; control of knowledge as you learn; accounting of educational activity in credits or credit units; expanding the range of educational events (conferences, internships, scientific activities, etc.) and their mandatory accreditation (assessment for compliance with established requirements); the complexity of training (health economics, ILC management, etc.); introduction of innovative educational technologies (electronic, distance learning, training on simulators and simulators), as well as more active participation in this process of professional non-profit associations of medical workers.
4. Increase in the volume and quality of free drug provision (FP) of the population on an outpatient basis at the expense of the state
donated (public) sources. These volumes should be gradually increased by at least 5 times - to the level of 1% of GDP, i.e. to the level of the “new” EU countries today (or from 132 billion rubles to 600 billion rubles per year in 2012 prices). For the implementation of state programs of drug provision of the population, it is necessary to formulate unified approaches - a single the legislative framework, a single list of medicinal products (MP). combining all existing state programs of the Leningrad Region into one, single Information system in medical organizations. It is also necessary at the federal level to organize a strict system of control over the sale of pharmaceuticals in the constituent entities of the Russian Federation. Considering the experience of implementing the DLO program. the insurance principle must be observed, i.e. impossibility of monetizing the cost of drugs for patients. To level the risks from the population and medical workers (misunderstanding of the transformations in the field of drug therapy, irrational discharge and consumption of drugs), it is necessary to carry out continuous information and educational work. It is also advisable to establish reference prices for medicinal products and consider the possibility of minor co-payments from the population. To work out the mechanisms of PL programs, it is urgently necessary to carry out pilot projects in the constituent entities of the Russian Federation.
5. Ensuring the availability of primary health care with the preservation and development of the system of organization of medical care that existed in the Soviet Union, namely: a preventive focus, the territorial principle of attaching the population, coordination and integration of medical care to patients by a primary care physician (including a system of referrals to other levels of medical care), preservation of polyclinics and separate provision of medical care for adults and children. Together with the concerned departments and employers, it is necessary to restore and develop, taking into account modern conditions school and industrial medicine. Special emphasis should be placed on the availability of this type of care in rural conditions, which can be ensured, among other things, through the use of mobile diagnostic systems, the introduction of technologies for remote monitoring of patients and telemedicine.
6. Reorganization of medical care in stationary conditions-allocation of its three levels (for the provision of specialized, specialized high-tech and innovative medical care); restructuring of the bed fund - division of the bed fund into beds for emergency and intensive treatment and into beds for rehabilitation and follow-up care. It will also require the development of a network of institutions and services for the provision of palliative care and long-term patient care (including an increase in the number of medical and social beds for citizens of the older age group and the disabled). To do this, it is necessary to develop standards for the provision of bed resources of various profiles for each level of medical care, standards for the provision of medical care for all the above types of medical care and standards for equipping the relevant units, as well as train medical personnel.
7. Development of a health care quality management system. This requires the development of a national policy for the management of the ILC. create special departments for managing the quality of medical care in healthcare management bodies of all levels, introduce a system of compulsory accreditation medical organizations(based on ISO standards and international system accreditation of medical
organizations), as well as unified methods for assessing the quality of medical care by developing indicators of the quality and safety of medical care (target values of these indicators must be set for each level of healthcare management in accordance with the best indicators in the constituent entities of the Russian Federation and abroad). Particular emphasis should be placed on achieving high ethical principles in the relationship of doctors with patients and on monitoring their observance.
8. Improving management efficiency, including improving legislative and regulatory framework health care. This will require the development of a health development strategy, increased responsibility and accountability of managers at all levels for achieving results and efficient use of resources, as well as continuous improvement of the qualifications of management personnel. It is also necessary to introduce such elements market relations, as competition between doctors and medical organizations in terms of the quality of medical care. compilation of ratings medical institutions, payment for the result. This will require the development of a system of indicators for assessing the work of medical personnel and the activities of medical organizations. In order to introduce innovative approaches in the provision of medical care, it is necessary to actively promote the development of medical science, for which purpose it is necessary to significantly increase the volume of its funding, to select research and development projects on a competitive basis, taking into account the priorities of practical health care, to increase the innovativeness and quality of scientific developments, admission and expertise. scientific works... Improvement of the sectoral statistical reporting and bringing it to international standards.
9. Creating conditions for the citizens of the Russian Federation to lead a healthy lifestyle(in solving this problem, the Ministry of Health of Russia acts as the initiator and coordinator of the programs). Priority programs to be developed under the patronage of the Ministry of Health of Russia: monitoring the implementation of the Federal Law of the Russian Federation of February 23, 2013 N 15-FZ "On protecting the health of citizens from the effects of second hand tobacco smoke and the consequences of tobacco consumption": developing programs to combat the prevalence of alcoholism and drug addiction, including patient rehabilitation measures. suffering from alcohol and drug addiction. It is also necessary to develop programs aimed at improving working conditions in production. the quality of food and living conditions of the population, as well as to ensure an increase in its commitment to a healthy lifestyle.
Increasing public funding for health care and the successful implementation of the above priority directions will allow by 2018 to increase the life expectancy of Russian citizens to 75-76 years. Moreover, an increase in the availability of free medical care for the majority of the population in the context of a serious stratification of the country's population in terms of income will play an important role in achieving social and political stability in the country.
Resolution of April 15, 2014 No. 294. The state program is aimed at improving the health of the population and the performance indicators of healthcare organizations on the basis of constant modernization of the technological base of the industry, the development of medical science and education, the improvement of the staff, the introduction information technologies and modern management standards.
reference
The state program was developed by the Russian Ministry of Health.
The state program "Development of health care" (hereinafter referred to as the state program) is aimed at improving the health of the population and the performance indicators of the health care organizations on the basis of constant modernization of the technological base of the industry, the development of medical science and education, the improvement of the workforce, the introduction of information technologies and modern management standards.
The responsible executor of the state program is the Ministry of Health of Russia, the co-executor is the FMBA of Russia, the participants are the Ministry of Foreign Affairs of Russia, the Ministry of Defense of the Russian Federation, the Ministry of Industry and Trade of the Russian Federation, the Ministry of Agriculture of the Russian Federation, the Ministry of Labor of the Russian Federation, the Ministry of Energy of the Russian Federation, the Ministry of Finance of Russia, the Ministry of Economic Development of Russia, the Federal Tax Service of Russia, the Federal Penitentiary Service of Russia, Roszdravnadzor, Rospotrebnadzor, FSSP of Russia , Rosaviatsia, Rosimushchestvo, Rosavtodor, Rosmorrechflot, FANO Russia, FOMS.
The state program includes the following subprograms:
- “Prevention of diseases and the formation of a healthy lifestyle. Development of primary health care ";
- "Improving the provision of specialized, including high-tech, medical care, ambulance, including emergency specialized medical care, medical evacuation";
- "Development and implementation of innovative methods of diagnosis, prevention and treatment, as well as the basics of personalized medicine";
- "Protection of the health of mothers and children";
- "Development of medical rehabilitation and spa treatment, including children";
- "Provision of palliative care, including for children";
- "Staffing of the health care system";
- "Development of international relations in the field of health protection";
- "Expertise and control and supervisory functions in the field of health protection";
- "Medical and sanitary provision selected categories citizens ";
- "Management of the development of the industry."
The goal of the state program is to ensure the availability of medical care and improve efficiency. medical services, the volumes, types and quality of which should correspond to the level of morbidity and the needs of the population, the advanced achievements of medical science.
As part of the implementation of the state program, the following tasks are being solved:
Ensuring the priority of prevention in the field of health protection and the development of primary health care;
Improving the efficiency of the provision of specialized medical care, including high-tech, as well as emergency medical care;
Development and implementation of innovative methods of diagnosis, prevention and treatment, as well as technologies of personalized medicine;
Improving the efficiency of obstetric and childhood services;
Development of medical rehabilitation of the population and improvement of the system of sanatorium-resort treatment;
Provision of palliative care for patients suffering from incurable diseases;
Providing the health care system with highly qualified and motivated personnel;
Improving the efficiency and transparency of control and supervisory functions in the field of health protection.
The state program defines the development of healthcare in Russia until 2020 and is implemented in two stages: the first stage (2013–2015) - structural transformations; the second stage (2016–2020) is the development of innovative potential in healthcare.
Resource support of the state program at the expense of the federal budget is determined taking into account the need to achieve the indicators provided for by the Decrees of the President of Russia dated May 7, 2012 No. 597, No. 598, No. 606, and the Concept of the demographic policy of the Russian Federation for the period up to 2025.
Volume financial security the state program for 2013–2020 from all levels of the budget system is 26 620.8 billion rubles, including funds from the federal budget - 2451.2 billion rubles, funds consolidated budgets constituent entities of the Federation - 11,079.4 billion rubles, funds Federal Fund obligatory health insurance- 13,090.2 billion rubles.
The amount of funding for the state program will be specified when drafting budgets for the corresponding year and planning period.
As part of the implementation of the state program, it is planned to achieve the following main results:
Creation of sustainable motivation of the population to maintain a healthy lifestyle;
Increasing the satisfaction of the population with the quality of medical care;
Creation of conditions for any citizen of the country, regardless of his place of residence, to receive a guaranteed volume of medical care that satisfies uniform requirements for availability and quality;
Formation of scientific and educational clusters based on the best medical universities;
Establishment of uniform state priorities in the field of biomedicine, creation of new scientific schools;
Increasing social attractiveness, the level of qualifications of medical personnel and the prestige of the profession, including on the basis of a significant increase in wages;
Creation of conditions for population growth and increase in life expectancy.
The effectiveness of the implementation of the state program is determined by the achievement of the following indicators by 2020:
Reduction of mortality from all causes to 11.4 cases per 1000 population; reduction of infant mortality to 6.4 cases per 1000 live births;
Reduction of mortality (per 100 thousand population) from diseases of the circulatory system to 622.4 cases, from road traffic accidents - up to 10 cases, from neoplasms (including malignant ones) - up to 190 cases, from tuberculosis - up to 11.2 ;
Reducing the consumption of alcoholic products (in terms of absolute alcohol, liters per capita per year) to 10 and the prevalence of tobacco consumption among the adult population up to 25%, among children and adolescents - up to 15%;
Reducing the incidence of tuberculosis to 35 cases per 100 thousand population;
Increase in life expectancy at birth to 74.3 years;
Increase by 2018 of the average salary of doctors and employees of medical organizations with a higher medical (pharmaceutical) or other higher education providing medical services (ensuring the provision of medical services), from the average salary in the relevant region to 200%, as well as an increase in the average salary of nursing (pharmaceutical) personnel and nursing staff (personnel providing conditions for the provision of medical services) from the average wages in the relevant region up to 100%.
Lecture questions 1. The goal of the State Program "Healthcare Development".
2. Objectives of the program.
3. Target indicators and indicators of the program.
4. Stages and terms of the program implementation.
5. Structural reforms in the area legal regulation
the sphere of health protection.
6. Strategic goal of the program and target indicators by 2020
year.
7. Ensuring the priority of prevention in the field of protection
health.
8. Reforming the PHC system for the population.
9. Improving the efficiency of providing specialized
help.
10. Improving the efficiency of the obstetric service and
childhood.
The state program of the Russian Federation "Development of health care" was developed in accordance with the List of state programs of the Russian Federation, approved
State program of the Russian Federation "Developmenthealth care "is developed in accordance
with the List of state programs of the Russian Federation,
approved by the Government
RF dated November 11, 2010 No. 1950-r
The program defines the goals, objectives, main
measures for the development of healthcare in the Russian Federation,
financial support and implementation mechanisms
envisaged activities, their indicators
effectiveness
Purpose of the program:
ensuring accessibilitymedical care and raising
effectiveness of medical
services, volumes, types and quality
which should
match the level
population, advanced
advances in medical science
Objectives of the program:
--
-
-
Ensuring the priority of prevention in the field of protection
health and development of primary health care;
Improving delivery efficiency
specialized, including high-tech,
medical assistance, ambulance, incl. Ambulance
specialized, medical care, medical
evacuation;
Development and implementation of innovative methods
diagnostics, prevention and treatment;
Improving the efficiency of the obstetric service and
childhood;
Development of medical rehabilitation of the population and
improvement of the system of sanitary-resort treatment;
Providing medical care for the incurable
sick;
Objectives of the program:
--
-
Provision of the health care system
highly qualified and motivated
personnel;
Enhancing the role of Russia in global health care;
Improving efficiency and transparency
control and supervisory functions in the field of protection
health;
Biomedical health protection
population;
And etc.
All-cause mortality;
Maternal mortality;
Infant mortality;
Mortality from diseases of the system
blood circulation;
Deaths from road accidents;
Mortality from neoplasms (incl.
malignant);
Mortality from tuberculosis;
Consumption of alcoholic beverages (in
recalculated to absolute alcohol);
Prevalence of tobacco use;
Target indicators and indicators of the program:
Tuberculosis incidence;The ratio of doctors and nurses
staff;
Average wage middle
medical (pharmaceutical) personnel
from average salary in the corresponding
region;
Average salary of doctors - "- from
average salary in the corresponding
region;
Life expectancy at
birth.
Stages and terms of the program implementation:
State program of the Russian Federation"Health care development"
implemented in 2 stages:
the first stage - 2013 - 2015;
second stage - 2016 - 2020.
Amount of budgetary appropriations of the Program
TOTAL: 6,067,519,580.1 thousand rublesIn the field of legal regulation of the health sector, a number of structural reforms have been carried out
For the period 2006-2011. adopted normative documents, the main of which are:
ФЗ dated November 21, 2011 No. 323-ФЗ "On the basics of protectionhealth of citizens in the Russian Federation ";
ФЗ dated November 22, 2010 No. 326-ФЗ "On compulsory
medical insurance in the Russian Federation ";
ФЗ dated April 24, 2008 No. 51-ФЗ "On accession
Of the Russian Federation to the WHO Framework Convection for
tobacco control ”;
The concept of the demographic policy of the Russian Federation for the period up to
2025, approved By the Decree of the President of the Russian Federation of October 9, 2007 No.
№1351;
Fundamentals of the state policy of the Russian Federation in the field
healthy nutrition of the population for the period up to 2020
The effectiveness of the functioning of the health care system:
Overcome negative tendencies in the state of the systemdiagnostics and treatment of the main socially significant
diseases;
There have been significant positive changes in
demographic situation;
Foundations laid for further performance improvement
health of the population, their gradual approximation to
European level.
Causes of mortality of the population of the Russian Federation
The strategic goal of the Program is
The strategic goal of the Program Formation of a system that ensuresavailability of medical care and
improving the efficiency of medical
services, volumes, types and quality of which
must match the level
morbidity and needs
population, advanced achievements
medical science
Achievement of the strategic goal of the Program in 2020 will be characterized by a decrease in the values of the following target indicators:
* Mortality from all causes - up to 11.4 cases per1000 population;
* Infant mortality - up to 6.4 cases per 1000
born alive;
* Maternal mortality - up to 15.5 cases per 100 thousand.
US.
* Consumption of alcoholic
products - up to 10 liters per
capita per year;
* Prevalence
Tobacco consumption among
Adult population - up to 25%
* Among children and adolescents -
Up to 15%;
Making prevention a priority
Improving the efficiency of primary health care;Optimization of the total bed capacity;
Improving the efficiency of inpatient care;
Provision of the population with preventive care
walking distance;
Development and implementation of incentive mechanisms
polyclinic link at the earliest possible
detection of diseases before the stage leading to
hospitalizations
The main tasks of the Program in the field of prevention of infectious diseases
- Vaccination coverage of at least 95% of the contingents subject tovaccination;
- Inclusion in the vaccination calendar:
vaccination against pneumococcal infection in 2014,
Against varicella in 2015,
Against human papillomavirus in 2016;
- Reducing the prevalence of infectious
diseases, the prevention of which is carried out by
immunization;
- Reducing the rate of spread of HIV infection and viral
hepatitis B and C among the population;
- Formation among the population of a responsible attitude to their
health, a change in behavior model from risky to less
risky.
Reforming the PHC system for the population
–changing the system of rendering assistance to the rural population;
–
modernization of existing institutions and their divisions;
–
alignment of patient flows with the formation of uniform
routing principles;
–
development of new forms of medical care -
hospital for replacement and field work methods;
–
development of emergency care on the basis of polyclinic
divisions;
- improving the principles of interaction with stationary
institutions and departments of emergency medical care.
Improving the efficiency of providing specialized care
- introduction of innovative methods into practicetreatment,
- development of infrastructure and resource
health care, including
financial, logistical and
technological equipment of medical and preventive institutions based on
innovative approaches and principles
standardization,
Federal Law "On compulsory medical
insurance "it is envisaged to include from 2015
high-tech medical care into the system
compulsory health insurance.
Improving the efficiency of obstetric and childhood services:
* Development of the "Generic Certificate" program;* Development of a network of perinatal centers;
* Prenatal diagnosis
developmental disorders
child;
* Early detection of hereditary and congenital
diseases immediately after
birth of a child;
* Development of specialized medical care for
children.
In order to coordinate the development of the Concept for Healthcare Development until 2020, I order:
1. Create a Commission of the Ministry of Health and social development Of the Russian Federation on the development of the concept of health care development until 2020 (hereinafter - the Commission).
2. Approve:
Regulation on the Commission in accordance with Appendix No. 1;
The composition of the Commission is in accordance with Appendix No. 2.
3. I reserve control over the execution of this order.
Appendix N 1
and social development of the Russian Federation
dated February 5, 2008 N 48
Position
on the Commission of the Ministry of Health and Social Development of the Russian Federation on the development of a concept for health development until 2020
1. The Commission for the Development of the Concept for Healthcare Development until 2020 (hereinafter referred to as the Commission) is created by the Ministry of Health and Social Development of the Russian Federation (hereinafter referred to as the Ministry) in order to develop a concept for the development of healthcare until 2020 (hereinafter referred to as the Concept) and is an advisory body.
2. In its activities, the Commission is guided by the Constitution of the Russian Federation, federal constitutional laws, federal laws, decrees and orders of the President of the Russian Federation, regulatory legal acts The Government of the Russian Federation, the Ministry, as well as these Regulations.
3. The Commission includes representatives of the Ministry, heads of healthcare institutions, representatives of the Expert Directorate of the President of the Russian Federation, the Public Council under the Ministry, the Public Chamber of the Russian Federation and interested federal bodies executive power, executive bodies of the constituent entities of the Russian Federation.
4. The tasks of the Commission are:
approval of the Terms of Reference for the Concept;
ensuring public discussion of the Concept, including by members of the collegium of the Ministry and the Public Chamber of the Russian Federation, as well as by all interested parties on a specially created website on the Internet;
coordination and submission of the draft Concept for approval to the Chairman of the Commission.
5. In accordance with the tasks, the Commission performs the following functions:
creates and coordinates the activities of working groups in the main areas of the Concept;
ensures discussion and approval of proposals on the main directions of the Concept in accordance with the requirements of the Technical Building;
asks for expert opinion on the issues discussed.
6. The operational management of the Commission's activities is carried out by the chairman or, on his behalf, by the deputy chairman of the Commission. Organizational and technical issues of the Commission's work are carried out by the executive secretary of the Commission.
7. The heads of the working groups of the Commission and the work plan of the Commission are approved by the Chairman of the Commission.
8. The personal composition of the working groups of the Commission is approved by the chairman of the Commission and the head of the working group.
9. The plan of meetings of the working group is approved by the head of the working group. The minutes of the meeting of the working group are signed by the head of the working group and the executive secretary of the Commission.
10. Sessions of the Commission are held in accordance with the work plan approved by the chairman of the Commission. The decision to hold meetings is taken by the Chairman of the Commission or, in his absence, the Deputy Chairman of the Commission.
11. A meeting is considered competent for decision-making if more than half of the members of the Commission are present at it.
12. Decisions of the meetings of the Commission are taken by a majority of the members present and are drawn up in minutes signed by the chairman of the Commission and all members of the Commission. A written dissenting opinion of the Commission members is attached to the minutes.
13. Organizational and technical support for the activities of the Commission is carried out by the Ministry. Documentation related to the activities of the Commission is kept in the Department for Analysis and Forecast of Healthcare and Social and Labor Sphere of the Ministry.
Appendix N 2
to the order of the Ministry of Health
and social development of the Russian Federation
dated February 5, 2008 N 48
Composition of the Commission of the Ministry of Healthcare and Social Development of the Russian Federation on the development of a concept for health care development until 2020
Golikova Tatiana Alekseevna | - | Minister of Health and Social Development of the Russian Federation (Chairman of the Commission) |
---|---|---|
Starodubov Vladimir Ivanovich | - | Deputy Minister of Health and Social Development of the Russian Federation (Deputy Chairman of the Commission) |
Belov Vladimir Sergeevich | - | |
Bokeria Leo Antonovich | - | Chairman of the Commission of the Public Chamber of the Russian Federation on the formation of a healthy lifestyle (as agreed) |
Borzova Olga Georgievna | - | Chairman of the State Duma Committee on Health Protection (as agreed) |
Glebova Lyubov Nikolaevna | - | State Secretary-Deputy Minister of Health and Social Development of the Russian Federation |
Davydov Mikhail Ivanovich | - | President of the Russian Academy of Medical Sciences, Head of the Blokhin State Scientific Oncological Center (as agreed) |
Zelensky Vladimir Anatolyevich | - | |
Olga Krivonos | - | Assistant to the Minister of Health and Social Development of the Russian Federation |
Lyadov Konstantin Viktorovich | - | Director of the Medical and Rehabilitation Center of Roszdrav (as agreed) |
Malyavina Sofia Andreevna | - | Assistant to the Minister of Health and Social Development of the Russian Federation |
Naygovzina Nelly Borisovna | - | Deputy Head of the Expert Directorate of the President of the Russian Federation (as agreed) |
Nikitina Irina Viktorovna | - | Assistant to the Minister of Health and Social Development of the Russian Federation |
Onishchenko Gennady Grigorievich | - | supervisor Federal Service on supervision in the field of consumer protection and human well-being |
Paltsev Mikhail Alexandrovich | - | Rector of the Moscow Medical Academy named after I.M. Sechenov of Roszdrav |
Roshal Leonid Mikhailovich | - | Chairman of the Commission of the Public Chamber of the Russian Federation on health issues (as agreed) |
Ulumbekova Guzel Ernestovna | - | Advisor to the Governor of the Samara Region (Executive Secretary of the Commission) (as agreed) |
Khalfin Ruslan Albertovich | - | Deputy Minister of Health and Social Development of the Russian Federation |
Denis Manturov | - | Deputy Minister of Industry and Energy of the Russian Federation (as agreed) |
Order of the Ministry of Health and Social Development of the Russian Federation of February 5, 2008 N 48 "On the Commission of the Ministry of Health and Social Development of the Russian Federation on the development of a concept for the development of health care until 2020"