Schipova V M, Bakunts S A, Shchepin V O
N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia.
N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia,
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2022 May;30(3):448-454. doi: 10.32687/0869-866X-2022-30-3-448-454.
The article presents the results of analysis of normative legal documents and their changes related to planning of volume of medical care in "medical rehabilitation" profile. The calculation of planned normative number of beds of this profile from 2014 to 2021 is presented according to the number of bed-days and planned beds turnover. The number of arithmetic errors in planned indices of specialized medical care in hospital conditions for medical rehabilitation is demonstrated in the letters of the Minzdrav of Russia related to formation and economic validation of territorial program of state guarantees. So, significant decrease (by 44%) in recommended volumes in 2021 contradicts data presented in the Decree of the Government the Russian Federation. The violations of nomenclatures of positions of medical workers, double standard of the number of positions for day-and-night work are defects of vast majority of Orders about Procedures of provision of medical care that may testify severe problems in actual health planning. At the same time, such changes in Orders on Procedures of organizing medical rehabilitation as division into adults and children, alterations of set of units, staging in provision of medical care and corresponding staff standards, increasing of standard number of positions should result in improvement of quality of medical rehabilitation, including its implementation at early stages and expanding possibilities of rehabilitation without hospitalization related to organization of day hospital.
本文介绍了规范性法律文件的分析结果及其与“医疗康复”领域医疗服务量规划相关的变化。根据床日数和计划床位周转率，给出了2014年至2021年该领域计划规范床位数的计算结果。俄罗斯卫生部关于国家保障领土计划的形成和经济验证的信函中显示了医院条件下医疗康复专业医疗服务计划指标中的算术错误数量。因此，2021年推荐量大幅下降（44%）与俄罗斯联邦政府法令中的数据相矛盾。违反医务人员职位命名法、昼夜工作职位数量的双重标准是绝大多数医疗服务提供程序命令的缺陷，这可能证明实际卫生规划中存在严重问题。同时，医疗康复组织程序命令中的此类变化，如分为成人和儿童、单位设置的改变、医疗服务提供的阶段划分和相应的人员标准、职位标准数量的增加，应会提高医疗康复质量，包括在早期阶段的实施以及扩大与日间医院组织相关的非住院康复可能性。
