Implementation of the state social program for healthcare development. Fundamentals of health care. Medical and biological support for public health protection

Rules
provision and distribution of subsidies from the federal budget to the budgets of constituent entities of the Russian Federation for one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand . Human

With changes and additions from:

1. These Rules establish the goals, conditions and procedure for the provision and distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation in order to co-finance the expenditure obligations of the constituent entities of the Russian Federation to make one-time compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural areas settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people (hereinafter referred to as subsidies).

2. Subsidies are provided within the limits of budgetary obligations communicated to the Ministry of Health of the Russian Federation as the recipient of federal budget funds for the provision of subsidies for the purposes specified in paragraph 1 of these Rules.

3. The selection criteria for a constituent entity of the Russian Federation to provide a subsidy are:

a) the presence of a list of vacant positions of medical workers in medical organizations and their structural divisions approved by the authorized executive body of the constituent entity of the Russian Federation in the field of healthcare (hereinafter referred to as the authorized body), upon replacement of which one-time compensation payments are made for the next financial year (program register of positions), developed on the basis of an approximate list of positions of medical workers in medical organizations and their structural divisions providing primary health care, upon replacement of which one-time compensation payments are made for the next financial year (program register of positions), approved by the Ministry of Health of the Russian Federation;

b) the presence of an application from the highest executive body of state power of a constituent entity of the Russian Federation for participation in the event, containing information about the planned number of participants in the event (doctors, paramedics).

4. The subsidy is provided on the basis of an agreement on the provision of a subsidy concluded between the Ministry of Health of the Russian Federation and the highest executive body of state power of the constituent entity of the Russian Federation, prepared (formed) using the state integrated information system for public finance management "Electronic Budget" in accordance with the standard form, approved by the Ministry of Finance of the Russian Federation (hereinafter referred to as the agreement).

5. The conditions for providing a subsidy are:

a) the procedure for providing one-time compensation payments to medical workers (doctors, paramedics) who are citizens of the Russian Federation and who do not have outstanding financial obligations under an agreement on targeted training, approved by a regulatory legal act of a constituent entity of the Russian Federation (with the exception of medical organizations with a staffing level of less than 60 percent), who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people and entered into an employment contract with a medical organization subordinate to the executive body of a constituent entity of the Russian Federation or a local government body, for full-time working conditions with the duration of working hours established in accordance with Article 350 of the Labor Code of the Russian Federation, with the performance of labor functions in a position included in the program register of positions provided for in paragraph 3 of these Rules, in the amount of:

2 million rubles for doctors and 1 million rubles for paramedics who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements located on the territory of the Far Eastern Federal District, in the regions of the Far North and equivalent areas , Arctic zone of the Russian Federation;

1.5 million rubles for doctors and 0.75 million rubles for paramedics who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements located in remote and hard-to-reach areas. The list of remote and hard-to-reach territories is approved by the highest executive body of state power of the constituent entity of the Russian Federation;

1 million rubles for doctors and 0.5 million rubles for paramedics who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements (except for those indicated in paragraphs two and three of this subclause), or cities with a population of up to 50 thousand people;

b) the presence in the budget of the constituent entity of the Russian Federation of budgetary allocations provided for the financial support of the expenditure obligations of the constituent entity of the Russian Federation, for the purpose of co-financing which a subsidy is provided, in the amount necessary to fulfill these obligations, including the amount of the subsidy planned to be provided;

c) conclusion of an agreement in accordance with paragraph 10 of the Rules for the formation, provision and distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation, approved by Decree of the Government of the Russian Federation of September 30, 2014 N 999 “On the formation, provision and distribution of subsidies from the federal budget to the budgets of the constituent entities Russian Federation" (hereinafter referred to as the Rules for the formation, provision and distribution of subsidies).

6. A one-time compensation payment is provided by the authorized body to a medical worker from among the medical workers specified in paragraph 1 of these Rules (hereinafter referred to as medical workers), once on one of the grounds specified in subparagraph “a” of paragraph 5 of these Rules. The authorized body has the right to decide to provide a medical worker with a one-time compensation payment:

a) if he has obligations related to targeted training (targeted training), subject to his concluding an employment contract with a medical organization whose staffing level is less than 60 percent;

b) provided that the medical worker who has fulfilled the obligations related to targeted training (targeted training) continues to work in the same medical organization located in a rural locality, or a workers’ village, or an urban-type village, or a city with a population of up to 50 thousand. Human.

7. A medical worker who has entered into an agreement with a medical organization on the provision of a one-time compensation payment (hereinafter referred to as the agreement) accepts the obligations:

a) perform labor duties for 5 years from the date of conclusion of the contract for positions in accordance with the employment contract, subject to the extension of the contract for the period of non-fulfillment of the labor function in full (except for the rest period provided for by the Labor Code of the Russian Federation);

b) return to the budget of the constituent entity of the Russian Federation part of the one-time compensation payment, calculated in proportion to the unworked period from the date of termination of the employment contract until the expiration of the 5-year period (except for cases of termination of the employment contract on the grounds provided for in paragraph 8 of part one of Article 77 and paragraphs 5 - 7 part one of Article 83 of the Labor Code of the Russian Federation), as well as in case of transfer to another position or enrollment in additional professional programs;

c) return to the budget of a constituent entity of the Russian Federation part of the one-time compensation payment, calculated in proportion to the unworked period from the date of termination of the employment contract, in the event of dismissal due to conscription for military service (in accordance with paragraph 1 of part one of Article 83 of the Labor Code of the Russian Federation) or extend the duration of the contract for the period of non-fulfillment of functional duties (at the choice of the medical worker).

8. The total amount of the subsidy (S total) is determined by the formula:

S total = S 1i + S 2i + S 3i,

S li - the amount of the subsidy to the budget of the i-th subject of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules, insofar as they relate to medical workers who arrived (moved) to work in rural settlements or workers' settlements , or urban-type settlements (with the exception of medical workers specified in paragraphs 10 and these Rules), or cities with a population of up to 50 thousand people;

S 2i - the amount of the subsidy to the budget of the i-th subject of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules, insofar as they relate to medical workers who arrived (moved) to work in rural settlements or workers' settlements , or urban-type settlements located on the territory of the Far Eastern Federal District, in the regions of the Far North and equivalent areas, in the Arctic zone of the Russian Federation;

S 3i - the amount of the subsidy to the budget of the i-th subject of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules, insofar as they relate to medical workers who arrived (moved) to work in rural settlements or workers' settlements , or urban-type settlements located in remote and hard-to-reach areas.

9. The amount of the subsidy to the budget of the i-th subject of the Russian Federation, participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules (S 1i), insofar as they relate to medical workers who arrived (moved) to work in rural settlements, either workers' settlements, or urban-type settlements (with the exception of medical workers specified in paragraphs 10 and these Rules), or cities with a population of up to 50 thousand people, is determined by the formula:

S 1i = (V 1plani 1 + F 1plani 0.5) L i ,

V 1plani - the number of doctors who are planned to receive one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

1 - the amount of a one-time compensation payment provided to the doctor, equal to 1 million rubles;

F 1plani - the number of paramedics who are planned to receive one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

0.5 - the amount of a one-time compensation payment provided to a paramedic, equal to 0.5 million rubles;

paragraph 13

10. The amount of the subsidy to the budget of the i-th subject of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules (S 2i), insofar as they relate to medical workers who arrived (moved) to work in rural settlements, either workers' settlements or urban-type settlements located on the territory of the Far Eastern Federal District, in the regions of the Far North and equivalent areas, in the Arctic zone of the Russian Federation, is determined by the formula:

S 2i = (V 2plani 2 + F 2plani 1) L i ,

V 2plani - the number of doctors who are planned to receive one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

2 - the amount of a one-time compensation payment provided to the doctor, equal to 2 million rubles;

F 2plani - the number of paramedics who are planned to receive one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

1 - the amount of a one-time compensation payment provided to a paramedic, equal to 1 million rubles;

L i is the maximum level of co-financing of the expenditure obligation of the i-th subject of the Russian Federation from the federal budget, determined in accordance with paragraph 13 of the Rules for the formation, provision and distribution of subsidies.

11. The amount of the subsidy to the budget of the i-th subject of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules (S 3i), insofar as they relate to medical workers who arrived (moved) to work in rural areas, either workers' settlements or urban-type settlements located in remote and hard-to-reach areas, is determined by the formula:

S 3i = (V 3plani 1.5 + F 3plani 0.75) L i ,

V 3plani - the number of doctors who are planned to receive one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

1.5 - the amount of a one-time compensation payment provided to the doctor, equal to 1.5 million rubles;

F 3plani - the number of paramedics who are planned to receive one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

0.75 - the amount of a one-time compensation payment provided to a paramedic, equal to 0.75 million rubles;

L i is the maximum level of co-financing of the expenditure obligation of the i-th subject of the Russian Federation from the federal budget, determined in accordance with paragraph 13 of the Rules for the formation, provision and distribution of subsidies.

12. The volume of budgetary allocations for financial support of the expenditure obligations of a constituent entity of the Russian Federation for the implementation of one-time compensation payments to medical workers, for the purpose of co-financing of which a subsidy is provided, is approved by the law of the constituent entity of the Russian Federation on the budget of the constituent entity of the Russian Federation (determined by the consolidated budget breakdown of the budget of the constituent entity of the Russian Federation) based on the need to achieve the values ​​of the result of using the subsidy established in the agreement - the share of medical workers who are actually provided with one-time compensation payments in the total number of medical workers who are planned to receive these payments.

The amount of the subsidy to the budget of a constituent entity of the Russian Federation in a financial year cannot exceed the amount of funds for the fulfillment in the financial year of the expenditure obligations of the constituent entity of the Russian Federation related to the implementation of the measures provided for in paragraph 1 of these Rules, taking into account the maximum level of co-financing of the expenditure obligation of the constituent entity of the Russian Federation from the federal budget, determined in accordance with paragraph 13 of the Rules for the formation, provision and distribution of subsidies.

13. The subsidy is transferred in the prescribed manner to an account opened by the territorial body of the Federal Treasury in the institution of the Central Bank of the Russian Federation to record transactions with budget funds of the constituent entity of the Russian Federation.

14. To assess the results of using the subsidy, an indicator is used - the share of medical workers who are actually provided with one-time compensation payments in the total number of medical workers who are planned to receive the specified payments (percentage) (I i), calculated by the formula:

V facti - the number of doctors who were actually provided with one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

F facti - the number of paramedics who were actually provided with one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

V plani - the number of doctors who are planned to receive one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

F plani - the number of paramedics who are planned to receive one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year.

15. The assessment of the effectiveness of the use of the subsidy is carried out by the Ministry of Health of the Russian Federation based on a comparison of the value of the results of the use of the subsidy established in the agreement and the value of the results of the use of the subsidy actually achieved at the end of the reporting year, provided for in paragraph 14 of these Rules.

16. The procedure and conditions for the return of funds from the budgets of the constituent entities of the Russian Federation to the federal budget in the event of a violation of the obligations stipulated by the agreement, as well as the grounds for exempting the constituent entities of the Russian Federation from the application of financial liability measures are established in paragraphs 16 - 18 and the Rules for the formation, provision and distribution of subsidies.

17. Control over the implementation by constituent entities of the Russian Federation of the measures provided for in paragraph 1 of these Rules is carried out by the Federal Service for Surveillance in Healthcare.

18. Monitoring of compliance by constituent entities of the Russian Federation with the conditions for the provision of subsidies is carried out by the Ministry of Health of the Russian Federation and authorized bodies of state financial control.

REPORT

About the work done

For 2012

Nurse

Urological office

MBUZ Polyclinics No. 2

Patraeva Lidia Vladimirovna

Specializing in nursing

Introduction.

Introductory part:

Priority areas for healthcare reform in the Russian Federation,

The main federal target programs for protecting public health.

Main part:

1. Characteristics of the area of ​​clinic No. 2, its organizational structure.

2. Population grid.

3. Urological service.

4. Organization of the work of a nurse in the urological office.

5. Qualitative indicators.

6. Dispensary work.

7. Anti-epidemic work of a nurse in a urological office.

8. Sanitary educational work.

Final part:

NOTES in the work of a clinic nurse.

General conclusions and prospects for the near future.

I Introduction

It was decided to carry out the modern healthcare reform in the form of modernization, which makes it possible to solve a number of problems within a short period of time (2–3 years), such as: finding internal resources for financing healthcare, increasing the efficiency of the healthcare system, strengthening the technical base of medical institutions. The goal of the ongoing reform is to increase the accessibility and quality of medical care for the general population. The main direction of healthcare reform is to preserve the health of the population. In this regard, the resolution developed priority areas for healthcare reform.

Basic principles:

Priority of disease prevention measures.

Ensuring sanitary well-being.

Public health education.

Promotion of healthy lifestyles.

Ensuring the guarantee and accessibility of free medical and pharmaceutical care for citizens.

Ensuring state policy in the field of protecting the health of women and children.

Development of technologies that ensure the birth of viable children.

Reducing healthcare costs for hospital services and increasing the volume and quality of outpatient services:

a) day hospitals;

b) improving the provision of medicines to the population;

c) creation of a unified information support system in the healthcare system;

d) development of diagnostic services.

Improving the compulsory health insurance system and ensuring the completeness and timeliness of receipt of insurance premiums.

The reform provides for the development of a new model of a polyclinic - economical, maximally focused on the specific patient: the development of outpatient surgery centers, day care departments, and home hospitals on the basis of polyclinics. A gradual transition to providing medical care based on the principle of a family doctor is being intensified. According to these priority areas, territorial and federal programs are being developed at the level of the Ministry of Health of the Republic of Belarus.

Protecting the health of the population in the Republic of Belarus is one of the priority areas of social policy.

II Introductory part

Priority areas of reform in the Russian Federation.

1) Development of a set of measures to ensure accessibility and improve the quality of medical care for the population.

2) Development of preventive healthcare.

3) An investment project to create a network of federal medical centers providing high-tech types of medical care.

4) Measures to improve the provision of medicines to certain categories of citizens entitled to receive state social assistance.

5) Proposals for attracting non-state investments in healthcare.

6) Carrying out measures to provide primary health care facilities with medical personnel.

7) Carrying out measures aimed at preventing the introduction and spread of especially dangerous and widespread infectious diseases, toxic substances and hazardous products on the territory of the Russian Federation, eliminating measles and maintaining the status of the country free of polio, programs for the prevention of HIV infection and drug addiction aimed at health-preserving behavior teenagers

8) Expanding the list of diseases for which follow-up treatment (rehabilitation) of patients in sanatorium and resort institutions is provided at the expense of social insurance funds.

9) Approval of emergency medical care standards.

10) Creation of favorable economic conditions for organizations implementing programs for promoting health and preventing diseases among workers, as well as for investors directing their funds to improve social conditions and the environment conducive to a healthy lifestyle. It is necessary to improve at the federal and territorial levels the legislative and regulatory framework in the field of labor protection, the environment, creating conditions for physical education and increasing physical activity, regulating advertising and the sale of tobacco products.

11) A clear distinction between free and paid medicine and thereby protect the state from citizens’ demands that exceed the budget’s capabilities.

As part of the implementation of the national project “Health”, the following equipment was allocated to polyclinic No. 2:

Electrocardiograph 6 channel “MAS – 1200 ST”

Express analyzer

Hardware software package for screening assessment of psychophysiological and somatic health

Heart Screening System

Angion Screening System

Spirometer

Bioimpedance meter

Smokelyizer

Puloximeter

Analyzer with.

Main federal programs for the protection of public health.

1. Federal target program “Improving the All-Russian Service for Disaster Medicine.”

The decision of this program is of a state nature. One of the main tasks of the service is participation in training the population and rescuers in first aid in emergency situations. The All-Russian Disaster Medicine Service has been created in the Russian Federation.

2. Federal target program “Preventing the spread of the disease caused by the human immunodeficiency virus (HIV infection) in the Russian Federation.”

The main goal of the program is to prevent the spread of a disease called HIV infection in the Russian Federation.

The program includes the main tasks of prevention, carrying out preventive and anti-epidemic measures, preventing nosocomial infection, ensuring the safety of medical procedures, improving the diagnosis and treatment of HIV infection, social protection of their family members, medical workers, and training of medical personnel.

3. Federal target program “Children of Russia”.

The main objectives are to improve psychiatric and medical-psychological care to the population and implement a long-term program for the protection of mental health of the population of the Russian Federation.

4. Federal Law “On Veterans” of 01/02/2000.

A package of regulatory documents has been developed here.

5. Federal Law “On social protection of citizens exposed to radiation as a result of the Chernobyl disaster” dated November 24, 1995.

A package of documents has been developed for this law, which sets out the main current legal regulations regarding the radiation risk contingent.

III Main part

Tatarnikov M.A. Research Institute of Public Health and Health Management MMA named after. I.M Sechenova

The program-target method is the most important tool for implementing state socio-economic policy, incl. and in the field of health. Federal target programs (FTP) are a complex of research, development, production, socio-economic, organizational, economic and other activities linked by resources, implementers and implementation deadlines, ensuring the effective solution of problems in the field of government, economic, environmental, social and cultural development of the Russian Federation (RF). Their most important feature is the identification of priority problems and ways to solve them, taking into account the possibilities of financing program activities at the federal, regional or local levels. Thus, program-targeted management allows not only to concentrate resources on priority areas, but also to implement an integrated approach to solving the most pressing health problems based on intersectoral interaction.

Federal targeted programs in the field of public health stimulate the participation of constituent entities of the Russian Federation in solving health problems in their territories on the basis of co-financing or the adoption and implementation of their own similar programs.

Currently, a regulatory, legal and methodological framework has been created that defines the rules for the consideration, approval and financing of federal targeted programs. When working with target programs, the following stages are distinguished:

1. selection of problems for software development;
2. making a decision on the development of a target program and its formation;
3. examination and evaluation of the target program;
4. approval of the target program;
5. management of the implementation of the target program and monitoring the progress of its implementation.

According to the current legislation, any legal entities or individuals can act as initiators of raising problems in the field of health care to be solved using programmatic methods at the federal level. However, as a rule, the Ministry of Health and Social Development of Russia and its subordinate institutions act in this capacity.

The selection of problems for their software development and solution at the federal level is determined by the following factors:

• significance of the problem;
• the inability to comprehensively solve the problem within an acceptable time frame and the need for government support to solve it;
• fundamental novelty and high efficiency of technical, organizational and other measures necessary for the large-scale dissemination of progressive achievements;
• the need to coordinate intersectoral connections to solve this problem.

When justifying the need to solve problems using programmatic methods at the federal level, the priorities and goals of the socio-economic development of the Russian Federation and the results of an analysis of the economic and social state of the country are taken into account. In accordance with the approved procedure, proposals must contain:

• name of the problem and analysis of the reasons for its occurrence;
• possible ways to solve the problem;
• the need for financial resources and possible sources of their provision (federal budget, budgets of constituent entities of the Russian Federation, extra-budgetary funds);
• preliminary assessment of the socio-economic effectiveness and consequences of the program;
• government customers and developers of the target program, the time and cost of preparing the target program.

The Ministry of Economic Development (MED), together with the Ministry of Finance of Russia and other interested federal executive authorities and executive authorities of the constituent entities of the Russian Federation, based on forecasts of the socio-economic development of the country, prepares proposals for solving this problem using program methods at the federal level and sends them to the Government of the Russian Federation. Based on the submitted proposals, the Government of the Russian Federation makes a decision on the preparation of an appropriate target program, the timing and cost of its development, and determines the state customer.

The state customer is responsible for the timely and high-quality preparation and implementation of the target program, prepares the initial task for its formation, manages the actions of the developers, manages the program implementers after its approval, and ensures the effective use of funds allocated for the implementation of the program. The state customer of the federal target program in the field of public health protection is, as a rule, the Ministry of Health and Social Development of Russia.

The target program consists of the following sections:

• the content of the problem and the rationale for solving it using software methods;
• main goals and objectives, timing and stages of program implementation;
• system of program events;
• resource support for the program (from the federal budget and extra-budgetary sources, budgets of constituent entities of the Russian Federation and with the distribution of expenses among the regions of the country);
• program implementation mechanism;
• organizing program management and monitoring the progress of its implementation;
• evaluation of program effectiveness;
• passport of the target program.

The draft target program is accompanied by an explanatory note, a business plan with socio-economic and feasibility studies, a preliminary budget request for allocations from the federal budget to finance the program for the next year, a sheet of agreement with the interested federal executive authorities and, if necessary, agreements (agreements) of intent between the state customer of the program with enterprises, organizations, government bodies of the constituent entities of the Russian Federation, confirming the financing of the program from extra-budgetary sources, budgets of the constituent entities of the Russian Federation.

The Ministry of Economic Development and the Ministry of Finance of the Russian Federation evaluate the presented draft target program, paying special attention to:

• the priority nature of the problem proposed for a software solution;
• validity and complexity of program activities, timing of their implementation;
• the need to attract extra-budgetary funds, funds from the budgets of constituent entities of the Russian Federation for the implementation of the program in conjunction with the possibilities of its state support at the expense of centralized resources;
• effectiveness of the program implementation mechanism;
• socio-economic effectiveness of the program as a whole, expected final results of the program.

The Ministry of Economic Development, with the participation of the Ministry of Finance, prepares a conclusion on the draft target program and preliminary budget request. Taking into account comments and suggestions, the state customer of the target program, together with its developers, finalizes the draft program. The revised draft target program is re-sent to the Ministry of Economic Development.

In case of a positive assessment, the Ministry of Economic Development, in agreement with the Ministry of Finance of Russia, submits a draft target program for approval to the Government of the Russian Federation.

Target programs and government customers are approved by the Government of the Russian Federation. State customers are provided with financial resources in the amount established by the federal budget and are responsible for the implementation of federal target programs. The interaction of several state customers under one program is carried out by the state customer - coordinator, determined by the Government of the Russian Federation.

Forms and methods of organizing management of the implementation of the target program are determined by the state customer. The current management of the Federal Targeted Program for the protection of public health is carried out by a directorate formed by the state customer, headed by one of the Deputy Ministers of Health of the Russian Federation, responsible for the implementation of the target program.

The implementation of the target program is carried out on the basis of government contracts (agreements) concluded by the state customer of the program with all implementers of program activities. The selection of objects and projects of program activities and their performers is carried out on a competitive basis.

The Ministry of Economic Development, with the participation of interested government bodies, organizes expert inspections of the progress of implementation of individual target programs. At the same time, attention is paid to meeting the deadlines for the implementation of program activities, to the targeted and effective use of financial resources and the final results of the program.

Currently, the main current federal target program in the field of healthcare is the program “Prevention and Control of Socially Significant Diseases (2007-2011)”, which includes the subprograms “Diabetes Mellitus”, “Tuberculosis”, “HIV Infection”, “Oncology”, “Sexually transmitted infections”, “Viral hepatitis”, “Mental disorders”, “Arterial hypertension” and “Vaccine prevention”, approved by Decree of the Government of the Russian Federation of May 10, 2007 N 280 (as amended by Decree of the Government of the Russian Federation of February 18, 2008 N 95 , dated 06/02/2008 N 423, dated 04/09/2009 N 319). The program is an important component of the national priority project “Health”.

Characteristics of the problem the program is aimed at solving

The federal target program "Prevention and control of socially significant diseases (2007-2011)" (hereinafter referred to as the Program) was developed in accordance with the order of the Government of the Russian Federation dated December 11, 2006 N 1706-r, the list of socially significant diseases approved by the Decree of the Government of the Russian Federation dated 01.12.2004 N 715, the procedure for the development and implementation of federal target programs and interstate target programs in the implementation of which the Russian Federation participates, approved by Decree of the Government of the Russian Federation dated 06.26.1995 N 594.

The need to prepare and implement the Program is caused by a number of socio-economic factors influencing the decline in the quality of life of the population, including excessive stress loads, a decrease in the level of sanitary and hygienic culture, as well as still high rates of morbidity, disability and mortality, despite the implementation of the federal target program "Prevention and control of diseases of a social nature (2002-2006)".

The rate of complications in diabetes mellitus is currently 35 percent. Limb amputations were performed in 1 percent of patients. In total, for the first time during the year, 38.6 thousand people were recognized as disabled due to diabetes.

The incidence of tuberculosis in correctional institutions of the Federal Penitentiary Service is currently 1515 cases per 100 thousand people, mortality is 153.4 cases per 100 thousand people, the proportion of cases of cessation of bacterial excretion is 73.5 percent, mortality from tuberculosis is 22.6 cases per 100 thousand population.

The number of newly registered cases of HIV infection reached 37.7 thousand cases, in correctional institutions of the Federal Penitentiary Service - 2 thousand cases, the share of HIV-infected pregnant women included in the program for the prevention of HIV infection in newborns was 75 percent.

The proportion of patients with visual localizations of malignant neoplasms detected at stages I and II of the disease in the total number of patients with visual localizations of the tumor is 67.6 percent, the proportion of those who died from malignant neoplasms within a year from the date of diagnosis among patients registered for the first time in the previous year - 31.6 percent, mortality from malignant neoplasms per 100 thousand population was 186.8 cases for men, 93.5 cases for women.

The incidence of syphilis is 72 cases per 100 thousand population, in correctional institutions of the Federal Penitentiary Service - 176.6 cases per 100 thousand people, the incidence of syphilis in children is 21.2 cases, gonorrhea - 23.4 cases per 100 thousand children. . At the same time, the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions is 15 percent. The total number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections does not exceed 12 in the country as a whole.

The incidence of acute viral hepatitis B and C is currently 8.6 and 4.5 cases per 100 thousand population, respectively, chronic viral hepatitis B and C - 51.4 cases per 100 thousand population.

The share of patients covered by team forms of psychiatric care in the total number of observed patients is 5 percent, the share of patients in need of inpatient psychiatric care in the total number of observed patients is 16 percent. At the same time, the average duration of treatment of a patient in a psychiatric hospital is 75.6 days, and the proportion of repeated hospitalizations in a psychiatric hospital during the year is 20 percent.

The incidence of vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 5776 cases per 100 thousand population, and mortality from vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 325 cases per 100 thousand population.

95% coverage of children with preventive vaccinations is maintained. The incidence of diphtheria and measles is currently 0.25 and 1.6 cases per 100 thousand population, respectively.

The main goals and objectives of the program, the period of its implementation, as well as target indicators and indicators

The goals of the Program are to reduce morbidity, disability and mortality of the population due to socially significant diseases, increase the duration and improve the quality of life of patients suffering from these diseases.

The objectives of the Program are:

1. improving methods of prevention, diagnosis, treatment and rehabilitation for socially significant diseases;
2. development and implementation of modern methods of prevention, diagnosis, treatment and rehabilitation for socially significant diseases based on advanced technologies;
3. construction and reconstruction of specialized medical institutions.

The Program provides for the implementation of a set of interrelated measures for the prevention, diagnosis, treatment and rehabilitation of socially significant diseases throughout the entire period of the Program implementation.

Program implementation mechanism

The state customer - coordinator of the Program is the Ministry of Health and Social Development of Russia, the state customers of the Program are the Ministry of Health and Social Development of Russia, the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, the Federal Penitentiary Service and the Russian Academy of Medical Sciences.

The implementation of the Program is carried out on the basis of government contracts concluded by government customers with the implementers of the Program activities in accordance with the Federal Law "On placing orders for the supply of goods, performance of work, provision of services for state and municipal needs", as well as co-financing of the expenditure obligations of a constituent entity of the Russian Federation for the relevant regional (municipal) programs (plans).

Interaction between government customers and executive authorities of the constituent entities of the Russian Federation is carried out on the basis of agreements.

The implementation of the Program in the constituent entities of the Russian Federation is carried out through a set of measures aimed at reducing the incidence of socially significant diseases, improving methods of their prevention and early diagnosis, ensuring the quality of treatment and rehabilitation.

To manage the implementation of the Program activities, a coordination council (hereinafter referred to as the council) is created, formed from officials of the state customer - the Program coordinator, state customers of the Program and interested federal executive authorities.

The Council performs the following functions:

• develops proposals on the topics and volumes of financing of orders for the supply of goods, performance of work and provision of services within the framework of the Program;
• reviews materials on the progress of implementation of Program activities;
• organizes inspections of the implementation of Program activities, the targeted and effective use of funds allocated for their implementation;
• prepares recommendations for the effective implementation of Program activities, taking into account the progress of the Program implementation and trends in the socio-economic development of the Russian Federation;
• identifies scientific, technical and organizational problems during the implementation of the Program;
• considers the results of the examination of projects and activities proposed for implementation in the next financial year, in terms of their content and cost.

The Council approves the following developed by government customers:

Detailed organizational and financial plans for the implementation of Program activities;

Indicators for monitoring the implementation of Program activities.

The Council is headed by the Deputy Ministry of Health and Social Development of Russia. The regulations on the council and its composition are approved by the Minister of Health and Social Development of the Russian Federation.

Ministry of Health and Social Development of Russia:

• exercises control over the activities of government customers of the Program;
• prepares draft regulatory legal acts of the Government of the Russian Federation necessary for the implementation of the Program;
• annually, if necessary, clarifies the mechanism for implementing the Program, target indicators and indicators, costs for the implementation of Program activities;
• prepares, taking into account the progress of implementation of the Program in the current year, and submits in the prescribed manner to the Ministry of Economic Development a consolidated budget request for financing the activities of the Program in the next financial year;
• quarterly submits to the Ministry of Economic Development statistical, reference and analytical information on the progress of implementation of the Program as a whole, monitoring data on the implementation of Program activities;
• submits annually, before February 1, to the Ministry of Economic Development and the Ministry of Finance of Russia in the prescribed form, a report on the progress of work under the Program, the results achieved and the effectiveness of the use of financial resources;
• initiates, if necessary, expert reviews of the progress of implementation of individual Program activities;
• submits to the Ministry of Economic Development and the Ministry of Finance of Russia proposals to adjust measures for the implementation of the Program or to terminate its implementation;
• upon completion of the Program, submits a report to the Ministry of Economic Development and the Ministry of Finance of Russia on the implementation of the Program and on the effectiveness of the use of financial resources for the entire period of its implementation.
• Government customers of the Program:
• carry out ongoing management of the implementation of the Program;
• draw up a detailed organizational and financial plan for the implementation of Program activities;
• in the event of a reduction in the volume of funding for Program activities from the federal budget, additional measures are developed to attract funds from extra-budgetary sources to achieve results characterized by the target indicators of the Program, and, if necessary, develop proposals for their adjustment within the established time frame;
• make proposals to clarify target indicators and indicators, costs for the implementation of Program activities and subprograms, as well as to improve the mechanism for its implementation;
• ensure the effective use of funds allocated for the implementation of the Program;
• organize quarterly reporting on the implementation of the Program and subprograms, as well as monitoring the implementation of program activities;
• organize expert inspections of the implementation of individual activities of the Program and subprograms;
• carry out management of the activities of the implementers of the Program activities as part of the implementation of program activities;
• carry out the selection on a competitive basis of performers of works (services), suppliers of products for each event of the Program and subprograms, as well as the conclusion of government contracts (agreements);
• organize the use of information technologies for the purpose of managing and monitoring the implementation of the Program, ensure placement on the Internet of the text of the Program, regulatory legal acts, methodological materials regarding the management of the implementation of the Program and monitoring the implementation of its activities, as well as materials on the progress and results of the Program implementation;
• agree with the state customer - the Program coordinator and the main interested participants of the Program on the possible timing of the implementation of activities, volumes and sources of funding;
• quarterly provide the state customer - the Program coordinator with statistical, reference and analytical information on the progress of implementation of the Program activities;
• if necessary, submit proposals to the state customer - coordinator of the Program to extend the period or to terminate the implementation of the Program;
• submit annually, before January 25, to the state customer - the Program coordinator, in the prescribed form, a report on the progress of the Program, the results achieved and the effectiveness of the use of financial resources.

Assessment of the socio-economic effectiveness of the program

The effectiveness of the Program is assessed based on comparison with data for 2005 and taking into account the need to achieve the following indicators:

reduction in the proportion of complications in diabetes mellitus to 28 percent;

an increase in the average life expectancy of men with type I diabetes mellitus to 55.3 years, women - to 59.1 years;

an increase in the average life expectancy of men with type II diabetes mellitus to 71.5 years, women - to 73.5 years;

reduction in the incidence of tuberculosis in correctional institutions of the Federal Penitentiary Service to 1,495 cases per 100 thousand people;

an increase in the abacillation rate of tuberculosis patients registered at the end of the year to 35.9 percent;

reduction in mortality from tuberculosis to 17.8 cases per 100 thousand population, including in correctional institutions of the Federal Penitentiary Service - up to 140 cases per 100 thousand people;

reduction in the number of newly registered cases of HIV infection during the year to 31 thousand cases, in correctional institutions of the Federal Penitentiary Service - to 1.6 thousand cases;

increasing the proportion of HIV-infected pregnant women included in the program to prevent HIV infection in newborns to 98 percent;

improvement of indicators characterizing the early detection of malignant neoplasms, including an increase in the proportion of patients with visual tumor localizations identified at stages I and II of the disease, up to 73.1 percent;

reduction in the proportion of patients who died from malignant neoplasms within a year from the moment of diagnosis, among patients first registered in the previous year, to 27.8 percent;

reduction in mortality from malignant neoplasms in men to 171.6 cases per 100 thousand population, in women - to 90.1 cases per 100 thousand population;

reducing the incidence of syphilis to 50.1 cases per 100 thousand people, including in correctional institutions of the Federal Penitentiary Service - up to 150 cases per 100 thousand people;

reducing the incidence of syphilis in children to 7.2 cases per 100 thousand children;

reducing the incidence of gonorrhea in children to 10.2 cases per 100 thousand children;

increasing the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions to 60 percent;

increasing the number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections to 55;

reduction in the incidence of acute viral hepatitis B to 2.7 cases per 100 thousand population;

reduction in the incidence of acute viral hepatitis C to 3.8 cases per 100 thousand population;

reducing the incidence of chronic viral hepatitis B and C to 36 cases per 100 thousand population;

increasing the proportion of patients covered by team forms of mental health care in the total number of observed patients to 41 percent;

reducing the proportion of patients in need of inpatient psychiatric care in the total number of observed patients to 14.5 percent;

reduction in the average duration of treatment of a patient in a psychiatric hospital to 73.9 days;

reducing the share of repeated hospitalizations to a psychiatric hospital during the year to 17.5 percent;

reducing the incidence of cerebrovascular diseases in the population to 4680 cases per 100 thousand population;

reducing population mortality from cerebrovascular diseases to 270 cases per 100 thousand population;

increasing the number of newly diagnosed patients with arterial hypertension to 1000 thousand people per year;

increasing the number of people trained in health schools for patients with arterial hypertension to 1,400 thousand people per year;

maintaining a 95 percent level of coverage of children with preventive vaccinations;

reducing the incidence of diphtheria to 0.16 cases per 100 thousand population;

eliminating cases of polio;

reducing the incidence of measles to 0.8 cases per 100 thousand population.

It is assumed that the overall economic effect from the implementation of the Program’s activities will be achieved by reducing morbidity, disability and mortality of the population due to socially significant diseases.

The social effectiveness of the implementation of the Program’s activities will be expressed in improving the quality and increasing the life expectancy of patients, preserving labor potential, forming the foundations of a healthy lifestyle, reducing social and psychological tension in society due to the threat of the spread of socially significant diseases.

The state program for the development of healthcare for 2018 - 2025 was approved by Decree of the Government of the Russian Federation of December 26, 2017 No. 1640 “On approval of the state program of the Russian Federation “Development of healthcare””.

The state health care development program for 2018-2025 will be financed with more than 34.9 trillion. rubles

Among the goals of the program:

• increasing life expectancy at birth to 76 years by 2025;
• reducing the mortality rate of the working age population to 380 per 100 thousand population by 2025;
• reducing mortality from diseases of the circulatory system to 500 per 100 thousand population by 2025;
• reducing mortality from neoplasms to 185 per 100 thousand population by 2025;
• increasing the proportion of the population satisfied with the quality of medical care to 54 percent by 2025.

The state program provides for the development of the following areas (subprograms):

• improving the provision of medical care, including disease prevention and promoting a healthy lifestyle;
• development and implementation of innovative methods of diagnosis, prevention and treatment, as well as the fundamentals of personalized medicine;
• development of medical rehabilitation and sanatorium-resort treatment;
• development of human resources in healthcare;
• development of international relations in the field of health care;
• examination and control and supervisory functions in the field of health care;
• health care provision for certain categories of citizens;
• information technology and industry development management;
• organization of compulsory medical insurance for citizens of the Russian Federation.

The resolution declared the Decree of the Government of the Russian Federation of April 15, 2014 N 294 “On approval of the state program of the Russian Federation “Healthcare Development”” to be no longer in force.

GOVERNMENT OF THE RUSSIAN FEDERATION

RESOLUTION

ON APPROVAL OF THE STATE PROGRAM

RUSSIAN FEDERATION “HEALTH DEVELOPMENT”

The Government of the Russian Federation decides:

1. Approve the attached state program of the Russian Federation “Health Development”.

2. To the Ministry of Health of the Russian Federation:

place the state program of the Russian Federation “Healthcare Development”, approved by this resolution, on the official website of the Ministry, as well as on the portal of state programs of the Russian Federation on the Internet information and telecommunications network within 2 weeks from the date of official publication of this resolution;

take measures to implement the measures of the state program of the Russian Federation “Health Development”.

3. To recommend that the executive authorities of the constituent entities of the Russian Federation, when making changes to state programs of the constituent entities of the Russian Federation aimed at developing healthcare, take into account the provisions of the state program of the Russian Federation “Healthcare Development” approved by this resolution.

4.Recognize as invalid:

Decree of the Government of the Russian Federation of April 15, 2014 N 294 “On approval of the state program of the Russian Federation “Health Development”” (Collected Legislation of the Russian Federation, 2014, N 17, Art. 2057);

paragraphs 2 and 3 of the Decree of the Government of the Russian Federation of March 31, 2017 N 394 “On amendments and invalidation of certain acts of the Government of the Russian Federation” and paragraph 1 of the changes that are made to the acts of the Government of the Russian Federation approved by the specified resolution (Collection of Legislation of the Russian Federation Federation, 2017, N 15, Art. 2225);

Decree of the Government of the Russian Federation of May 7, 2017 N 539 “On amendments to the state program of the Russian Federation “Health Development”” (Collected Legislation of the Russian Federation, 2017, N 20, Art. 2924);

Decree of the Government of the Russian Federation of August 12, 2017 N 964 “On amendments to Appendix No. 9 to the state program of the Russian Federation “Health Development”” (Collected Legislation of the Russian Federation, 2017, N 34, Art. 5288).

Chairman of the Government

Russian Federation

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Source: Ministry of Economic Development of Russia

By Order of the Government of the Russian Federation dated December 24, 2012 No. 2511-r, the state program of the Russian Federation “Health Development” was approved.

The goal of the State program is to ensure accessibility of medical care and increase the efficiency of medical services, the volumes, types and quality of which must correspond to the level of morbidity and the needs of the population, and to the advanced achievements of science.

The total volume of financial support for the State program in 2013-2020 at current prices is 30.3 trillion. rubles The estimated amount of funding for the State program is: from the federal budget 2.7 trillion. rubles, funds from the consolidated budgets of the constituent entities of the Russian Federation 10.5 trillion. rubles, funds from the Federal Compulsory Medical Insurance Fund 17.1 trillion. rubles The additional need for federal budget funds is stated in the amount of 3.4 trillion. rubles

The State program includes 11 subprograms that define the main vectors for the development of the healthcare system: disease prevention and the promotion of a healthy lifestyle, the development of primary health care, improving the provision of specialized, including high-tech medical care, the development and implementation of innovative diagnostic and treatment methods , protection of maternal and child health, development of medical rehabilitation and sanatorium-resort treatment, including for children, staffing of the health care system, development of international relations in the field of health care, examination and control and supervisory functions in the field of health care, medical and sanitary provision of individual categories of citizens.

As a result of the implementation of the State program by 2020, it is planned to achieve the following indicator values:

1. Mortality from diseases of the circulatory system is 622.4 cases per 100 thousand population.

2. Mortality from neoplasms (including malignant ones) 190.0 cases per 100 thousand population.

3. Mortality from tuberculosis is 11.2 cases per 100 thousand population.

4. Mortality from road accidents is 10.0 cases per 100 thousand population.

5. Infant mortality rate is 6.4 per 1 thousand births.

6. Reducing the consumption of alcoholic products (in terms of absolute alcohol) to 10.0 liters per capita.

7. The prevalence of tobacco consumption among adults is 25%.

8. The prevalence of tobacco consumption among children and adolescents is 15%.

9. Maternal mortality 15.5 cases per 100 thousand population.

10. Life expectancy at birth is 74.3 years.

11. Ratio of doctors and nursing staff 1:3

12. The average salary of doctors and employees of medical organizations with higher medical (pharmaceutical) or other higher education, providing medical services (providing medical services) from the average salary in the corresponding region is 200%.

13. The average salary of paramedical (pharmaceutical) personnel (personnel providing conditions for the provision of medical services) from the average salary in the corresponding region is 100%.

14. The average salary of junior medical personnel (personnel providing conditions for the provision of medical services) from the average salary in the corresponding region is 100%.