the main Terminology

Health Development Program in the Russian Federation. Federal target programs aimed at protecting public health. Providing medical care for incurable patients, including children

REPORT

About the work done

For 2012

Medical sister

Urology Cabinet

MBUZ Polyclinic №2.

Patra Lydia Vladimirovna

Specialty nursing business

Introduction

Introductory:

Priority directions of health care reform in the Russian Federation,

Basic federal target programs For the protection of public health.

Main part:

1. Characteristics of the Polyclinic Area No. 2, its organizational structure.

2. Mesh population.

3. Urological service.

4. Organization of the work of the nurse of the Urological Cabinet.

5. Qualitative indicators.

6. Dispensary work.

7. Anti-epidemic work of a medical sister of a urological office.

8. Sanitary and educational work.

Final part:

Notes in the work of nurse clinics.

General conclusions and prospects for the nearest period.

I administration

Modern health care reform was decided to carry out in the form of modernization, allowing for a short period of time (2 to 3 years) to solve a number of tasks, such as: finding domestic resources of health financing, improving the efficiency of the health care system, strengthening the technical base of medical institutions. The purpose of the reform is to increase the availability and quality of medical care for the wide layers of the population. The main direction of reforming health care is to maintain the health of the population. In this regard, the Resolution has developed priority areas for reforming health.

Basic principles:

Priority measures for the prevention of diseases.

Ensuring sanitary well-being.

Sanitary education of the population.

Propaganda healthy image Life.

Providing guarantees and accessibility for citizens of free medical and medicinal care.

Security public Policy In the field of women's health and children.

Development of technologies ensuring the birth of viable children.

Reducing health costs on a hospital link and an increase in the volume and quality of an outpatient polyclinic service:

a) day hospitals;

b) improving the provision of drugs of the population;

c) creating a unified system information support in the health system;

d) Development of diagnostic services.

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

The reform involves the development of a new polyclinic model - an economical, as possible patient-oriented patient: development based on the polyclinic of ambulatory surgery centers, day stay departments, hospital houses. The phased transition to the provision of medical care on the principle of a family doctor is activated. According to these priorities at the level of the Ministry of Health of the Republic of Belarus, territorial and federal programs are being developed.

Protection of public health in the Republic of Belarus is one of the priorities of social policy.

II introductory part

Priority reform directions in Russian Federation.

1) Development of a complex of measures to ensure accessibility and improving the quality of medical care to the population.

2) Development of the preventive health care.

3) Investment project on the creation of a federal network medical centers providing high-tech types of medical care.

4) Measures to improve the medicinal support of certain categories of citizens eligible for state social assistance.

5) Proposals to attract non-state investments in health care.

6) Conducting measures to provide the primary health care facilities with medical personnel.

7) carrying out measures aimed at preventing and distributing on the territory of the Russian Federation specially hazardous and mass infectious diseases, toxic substances and dangerous products, measles and maintaining the status of a country free from polio, HIV prevention programs - infection and drug addiction, aimed at health care Teenagers.

8) the expansion of the list of diseases in which the fuzz (rehabilitation) patients under the conditions of sanatorium and resort institutions is ensured by social insurance.

9) approval of emergency medical standards.

10) the creation of favorable economic conditions for organizations implementing health promotion programs and disease prevention among employees, as well as for investors who guide their funds to improve social conditions and status ambientcontributing to a healthy lifestyle. Improving at the federal and territorial levels of the legislative and regulatory framework in the field of labor protection, the environment, creating conditions for physical education and increase physical activity, regulation of advertising and selling tobacco products.

11) A clear distinction between free and paid medicine and thereby protect the state from the requirements of citizens exceeding the budget opportunities.

As part of the implementation of the National Project "Health" MBUZ Polyclinic No. 2, the following equipment was allocated:

Electrocardiograph 6 Channel "MAC - 1200 ST"

Express - analyzer

Hardware Software Complex for Screening Assessment of Psychophysiological and Somatic Health

Heart screening system

Angional screening system

Spirometer

Bioimpeedan.

Smokylizer.

Pulasimmeter

Analyzer CO.

The main federal programs for the health of public health.

1. Federal Target Program "Improving the All-Russian Medicine Catastrophe Service".

The solution of this program is a state character. One of the main tasks of the service is participation in the preparation of the population and rescuers for the provision of first aid in emergency situations. In the Russian Federation created the All-Russian Medicine Service Catastrophe.

2. Federal Target Program "Preventing the dissemination of the disease in the Russian Federation caused by a human immunodeficiency virus (HIV infection).

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

The program includes basic problems on prevention, preventive and anti-epidemic activities, prevention of in-friendly infection, ensuring the safety of medical manipulations, improving the diagnosis and treatment of HIV infection, social protection of members of their family, medical workers, training of medical personnel.

3. The federal target program "Children of Russia".

The main tasks are to improve psychiatric and medical and psychological assistance to the population and the implementation of the long-term program for the protection of mental health of the Russian Federation.

4. the federal law "On veterans" from 02/01/2000.

A package of regulatory documents has been developed here.

5. Federal Law "On the Social Protection of Citizens Subjected to Radiation due to a Chernobyl disaster" of 24.11.1995.

This law has developed a package of documents where the basic valid legal regulations to the contingent of radiation risk.

III main part

(as amended by the Decree of the Government of the Russian Federation of 03/31/2017 N 394,

from 07.05.2017 N 539, from 12.08.2017 N 964)

Passport of the State Program of the Russian Federation "Development of Health"
Passport subroutines 1 "Prevention of diseases and the formation of a healthy lifestyle. Development of primary health care" State Program of the Russian Federation "Development of Health"
Passport subprogramme 2 "Improving the provision of specialized, including high-tech, medical care" State Program of the Russian Federation "Development of Health"
Passport Subprogramme 4 "Mother and Child Health Protection" of the State Program of the Russian Federation "Development of Health"
Passport subprogramme 5 "Development of medical rehabilitation and sanatorium-resort treatment, including children" of the State Program of the Russian Federation "Development of Health"
Passport subprogramme 6 "Providing palliative care, including children" State Program of the Russian Federation "Development of Health"
Passport subprogramme 7 "Personnel Support of the Health System" State Program of the Russian Federation "Health Development"
Passport subprogramme 8 "Development of international relations in the field of health protection" of the State Program of the Russian Federation "Health Development"
Passport subprogramme 9 "Expertise and supervisory and supervisory functions in the health sector" State Program of the Russian Federation "Development of Health"
Passport subprogrammes b "Medical and sanitary support of certain categories of citizens" of the State Program of the Russian Federation "Development of Health"
Passport subprogrammes G "Development of the industry" State Program of the Russian Federation "Development of Health"
Passport subprogramme D "Organization of compulsory medical insurance of citizens of the Russian Federation" State Program of the Russian Federation "Development of Health"
Passport subroutines and "development of emergency medical care" of the State Program of the Russian Federation "Health Development"
I. Priorities and objectives of public policy, including general requirements for state policy of constituent entities of the Russian Federation
III. General characteristics of the participation of the constituent entities of the Russian Federation in the implementation of the program
Appendix N 1. Information on indicators (indicators) of the State Program of the Russian Federation "Development of Health", subprogrammes of the State Program of the Russian Federation "Development of Health" and their values
Appendix N 2. List of basic activities of the State Program of the Russian Federation "Health Development"
Appendix N 3. Information on the main measures of legal regulation in the realization of the State Program of the Russian Federation "Development of Health"
Annex N 4. Resource Provision of the Implementation of the State Program of the Russian Federation "Development of Health" at the expense of the federal budget and budgets of state extrabudgetary funds of the Russian Federation
Appendix N 5. Plan for the implementation of the State Program of the Russian Federation "Development of Health" for 2017 and for the planning period 2018 and 2019
Appendix N 6. Rules for the provision and distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation and the city of Baikonur for the implementation of individual events of the State Program of the Russian Federation "Health Development"
Appendix N 7. Rules for the provision of subsidies from federal budget Within the framework of the State Program of the Russian Federation "Development of Health" budgets of the constituent entities of the Russian Federation for co-financing capital investments in the state ownership of the constituent entities of the Russian Federation, which are carried out from the budgets of the constituent entities of the Russian Federation, or in order to provide relevant subsidies from the budgets of the constituent entities of the Russian Federation to local budgets for co-financing capital investments in municipal objects that are carried out from local budgets
Appendix N 8. Rules for the provision of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation for the procurement of aviation services by state authorities of the constituent entities of the Russian Federation to provide medical care with aviation
Annex N 9. Rules for the provision and distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation on co-financing costs arising from the provision of high-tech medical care to citizens not included in the basic health insurance program
Appendix N 10. Information on the need for capital construction of health facilities in the Far East for 2017 - 2020
Appendix N 11. Information about targets (indicators) of the State Program of the Russian Federation "Development of Health" in the territory of the Far East
Appendix N 12. Information on the resource provision of the implementation of activities of the State Program of the Russian Federation "Development of Health" on the territory of the Far East at the expense of the federal budget
Appendix N 13. Information on the resource provision and forecast (reference) assessment of the costs of the federal budget, consolidated budgets of the constituent entities of the Russian Federation and other extrabudgetary sources to implement the activities of the State Program Development of Health in the Far East

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Ministry of Health and Social Development of Russia

State budgetary educational institution
higher professional education

"Siberian State Medical University"

Ministry of Health I. social Development Russian Federation

(GBOU VPO SIBGMU of the Ministry of Health and Social Development of Russia)

Faculty of Economics and Management in Health

Department of Health and Public Health

Course work

under the discipline "Medical and Social Fundamentals of Health"

Federal target programs aimed at protecting public health

Performed: Student 2 courses 7001 groups

Baldandorzhieva N.A.

Checked: dr. Honey. Sciences, professor

CM. Hinin

cand. honey. Sciences, Associate Professor O.V. Kudun

Tomsk 2011

Introduction

Currently, society and health care has been a very big problem - this is a decrease in public health, primarily the population of the working age. In connection with this health care, a number of federal targeted programs were developed to reduce the incidence, raising the standard of living of patients suffering from socially significant diseases, as well as the development of medical literacy of the population.

So, the topic of my course work "Federal Target Programs, aimed at protecting the health of the population" is relevant today, since federal targeted programs are designed to help solve the strategic tasks of health care and social sphere, especially in cases where it is necessary to concentrate resources to achieve Specific goals on specified time.

The purpose of the course work is:

Studying federal targeted programs, its directions, activities.

Analysis of implementation, activities, financing of the program

To achieve the goal, it is necessary to solve the following tasks:

1. Reveal the essence of the federal target program.

2. Examine funding, formation, approval of the target program.

3. To analyze the implementation of federal targeted programs in the Russian Federation and their role in financing budget investments.

Chapter 1. Characteristics of federal targeted programs

1.1. The basic concepts of the target program aimed at protecting the public health

In modern civilization, human rights to health ceases to be a purely individual property, it becomes an essential value for the state and civil society. Features of the right to protect health are that it relates to inalienable rights, belongs to a person before his birth, is an inherent condition for the life of society and is connected not only with the need for care for his health of every citizen, but also the responsibility of the state for the preservation and promotion of health His citizens. His life and his health are higher values \u200b\u200bfor society, including all other values \u200b\u200band benefits should be determined.

The protection of public health is a combination of measures of a political, economic, legal, social, scientific, medical, sanitary and hygienic and anti-epidemic nature, aimed at preserving and strengthening the physical and mental health of each person, maintaining its long-life active life, providing him with medical and medicinal care . Currently, the opinion is generally recognized that the program-target method is the most important tool for the implementation of state social and economic Development Countries and its individual regions along with forecasting methods and indicative planning.,

The Federal Target Program is associated with the tasks, resources and timing of implementation of a complex of research, development, design, industrial, socio-economic, economic and other events that ensure an effective solution to systemic problems in the field of state, economic, environmental, social and cultural development of the Russian Federation.

Target programs are one of the most important means of implementing the structural policy of the state, the active impact on its socio-economic development and should be focused on the implementation of the large-scale, the most important for the state of investment and scientific and technical projects aimed at solving systemic issues in the field of competence of the federal executive authorities.

The target program may include several subprogrammes aimed at solving specific tasks within the program. The division of the target program on the subprogrammes is carried out on the basis of the scale and complexity of solved problems, as well as the need for a rational organization of their decision.

Budget financing can be divided into two parts - financing services and specific target programs. In the first case, the funds go to a specific subject of budget expenditures, in the second financing can flow into a number of industries. In this case, financing is directed or directly to the Contractor, or through the Office.

The role of the customer of the long-term target program can be a state authority or local government body for municipal targeted programs. It is such an authority that acts on behalf of the state or municipality in the development of a long-term target program and its implementation.

Federal target programs are an effective tool for the implementation of state economic and social policy, especially when solving long-term tasks and implementing large infrastructure projects. It is this, a software-project approach, apply in the countries of the European Union, in the USA, Canada, Japan and others to solve the strategic tasks of the development of the economy and the social sphere, in cases where it is necessary to concentrate resources to achieve specific goals on specified time.

1.3. List of federal target programs aimed at protecting public health

Federal Target Program "Warning and Combating Socially Significant Diseases (2007 - 2011)"

1) Subprogram "Sugar Diabetes"

2) Subprogram "Tuberculosis"

3) Subprogramme "Vaccinoprofilaktika"

4) Subprogram "HIV-infection"

5) Subprogram "Oncology"

6) the subprogramme "sexually transmitted infection"

7) Subprogramme "Viral Hepatitis"

8) Subprogramme "Mental Disorders"

9) Program "Arterial Hypertension"

Federal Target Program "Children of Russia" for 2007 - 2010

· Program "Healthy Generation"

· Subprogram "Children and Family"

Federal Target Program "Improving Road Safety in 2006-2012".

1.3.1. Program "Warning and Combating Socio Significant Diseases (2007 - 2012)"

Federal Target Program "Warning and Combating Socially Significant Diseases (2007-2011)" (hereinafter - the program) was developed in accordance with the order of the Government of the Russian Federation of December 11, 2006 N 1706-P, a list of socially significant diseases approved by the Government Decree Of the Russian Federation of December 1, 2004 N 715, the procedure for the development and implementation of federal targeted programs and interstate targeted programs, in the implementation of which the Russian Federation is involved, approved by the Decree of the Government of the Russian Federation of June 26, 1995 N 594.

The need to prepare and implement the program is caused by a number of socio-economic factors affecting 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 incidence, disability and mortality, despite the implementation of the federal Target Program "Warning and Combating Social Diseases (2002 - 2006)".

The number of newly registered cases of HIV infection has reached 37.7 thousand cases, in correctional institutions Federal Service Execution of punishments - 2 thousand cases, the proportion of HIV-infected pregnant women included in the prevention program of infection with HIV infection of newborns was 75 percent.

The proportion of patients with visual localization of malignant neoplasms identified at the I and II stages of the disease, in the total number of patients with visual localization of the tumor, is 67.6 percent, the share of died of malignant neoplasms during the year from the date of the diagnosis is set to account for the first time In the previous year, 31.6 percent, mortality from malignant neoplasms per 100 thousand population is 233.1 cases in men, women - 170.3 cases. (as amended by the Government Decisions of the Russian Federation of 06.04.2011 N 254)

The incidence of syphilis is 72 cases per 100 thousand population, in correctional institutions of the federal sentence of 176.6 cases per 100 thousand people, the incidence of syphilis - 21.2 cases, gonorads - 23.4 cases per 100 thousand children's population. At the same time, the proportion of specialized medical institutions that monitor the variability of causative agents of sexually transmitted infections in the total number of dermatovenerological profile 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 sharp 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 proportion of patients covered by the brigade forms of psychiatric care, in the total number of patients observed is 5 percent, the share of patients in need of stationary psychiatric care, in the total number of patients observed - 16 percent. At the same time, the average duration of the patient's treatment in a psychiatric hospital is 75.6 days, and the proportion of repeated hospitalizes into a psychiatric hospital during the year - 20 percent.

The incidence of cerebral vascular disorders (cerebrovascular diseases, including stroke) due to arterial hypertension is 5,776 cases per 100 thousand population, and mortality from vascular brain disorders (cerebrovascular diseases, including stroke) due to arterial hypertension - 325 cases per 100 thousand population.

95 percent coverage of children with preventive vaccinations remains. The incidence of diphtheria, cow is currently 0.25 and 1.6 cases per 100 thousand population, respectively.

Main goals and objectives

The objectives of the program are to reduce the incidence, disability and mortality of the population with socially significant diseases, an increase in duration and improving the quality of life of patients suffering from these diseases.

The tasks of the program are:

W Improving the methods of prevention, diagnosis, treatment and rehabilitation in socially significant diseases;

W Development and implementation of modern methods of prevention, diagnosis, treatment and rehabilitation in socially significant diseases based on advanced technologies;

W Construction and reconstruction of specialized medical institutions.

The program is implemented in 2007-2012. (as amended by the Government Decisions of the Russian Federation of 06.04.2011 N 254)

The program provides for a complex of mutually related measures for the prevention, diagnosis, treatment and rehabilitation in socially significant diseases throughout the entire period of the program.

The program includes subroutines:

v "Sugar diabetes",

v "Tuberculosis",

v "HIV infection",

v "Oncology",

v "sex transmitted infections",

v "viral hepatitis",

v "mental disorders",

v "arterial hypertension",

v "Vaccinoprophylaxis"

Subprogram "Sugar Diabetes" (as amended by the Decisions of the Government of the Russian Federation of 02.06.2008 N 423, from 06.04.2011 N 254)

In patients suffering from diabetes, the need for medical care increases as their condition and the emergence of complications. It remains a high prevalence of threatening life and leading to disability vascular complications of diabetes, including diabetic retinopathy, diabetic nephropathy and cardiovascular complications.

The goals of the Sugar Diabetes subprogramme are:

Reducing the incidence rate of diabetes;

Improving the prevention measures of its complications;

an increase in the average life expectancy of patients with diabetes.

1) improving the prevention and diagnosis of diabetic diagnosis;

2) treatment and rehabilitation of diabetes patients;

3) the development and implementation of high-tech methods for the treatment of the disease and its complications;

4) Development and implementation of training programs for diabetes patients on the prevention and treatment of diabetes.

The share of complications for diabetes mellitus is currently 35 percent. Ampeuting limbs were carried out in 1 percent of patients. In total, for the first time during the year, 38.6 thousand people were recognized as a radical diabetes.

Subprogram "Tuberculosis"

In patients suffering from tuberculosis, the decisive factor of socio-economic is to reduce the level and quality of life.

Not all population groups are covered by preventive medical examinations carried out with the aim of early detection of tuberculosis. Adoption is necessary additional Mer to reduce the incidence, disability and mortality in tuberculosis, optimization of patients with tuberculosis, ensuring early diagnosis and prevention of heavy complications for tuberculosis, increase the duration and improvement of the quality of life of patients suffering from such a disease, including by strengthening the material and technical base of institutions Health.

The goals of the Tuberculosis subprogramme are a decrease in the incidence of tuberculosis and a decrease in the mortality rate from tuberculosis.

The tasks of the subprogramme are:

1) improving the methods of prevention of tuberculosis, including

2) Development of information programs for the population, educational

3) programs for patients with tuberculosis and in contact with them;

4) improving the measures of infectious control of tuberculosis;

5) improving the methods of diagnosis, treatment and integrated programs of medical and social rehabilitation;

6) Construction and reconstruction of tuberculosis medical institutions.

The incidence of tuberculosis in correctional institutions of the Federal Penitentiary Service is currently at present 1515 cases per 100 thousand people, mortality - 153.4 cases per 100 thousand people, the share of cases of cessation of bacteries - 73.5 percent, mortality from tuberculosis - 22.6 Case per 100 thousand population.

Subprogram "HIV-infection"

The continued growth in the number of registered HIV-infected persons is largely due to the factors of a socio-economic nature, the spread of drug addiction, insufficient public awareness. It is necessary to increase the share of HIV-infected pregnant women included in the prevention program of the infection of HIV infection of newborns. The study of the drug sustainability of the human immunodeficiency virus to antiretroviral drugs is required. Further development of safe technologies of blood harvesting and its components are necessary in order to reduce the risk of HIV transmission when using donor blood and its drugs.

The objectives of the subprogramme "HIV infection are:

Reducing the number of newly registered cases of infection with HIV infection;

The introduction of methods for the prevention of infection of HIV infection of newborns;

Ensuring the availability of antiretroviral drugs;

Reducing the mortality rate of patients with HIV infection.

The tasks of the subprogramme are:

1) Improving the prevention methods for the spread of HIV infection;

2) improving the methods of diagnosis, treatment and rehabilitation in HIV infection;

3) development and introduction of modern antiretroviral drugs;

4) Construction and reconstruction of specialized medical institutions and equipping them with modern medical and technological equipment.

Subprogram "Oncology"

There are extremely high disability indicators due to malignant neoplasms. A high proportion of patients who died from malignant neoplasms during the year from the moment of diagnosis is established. Insufficient organization of preventive medical examinations in order to early detecting oncological diseases. It is necessary to continue the study of substances, products, production processes, household and natural factors, carcinogenic for a person.

The objectives of the "Oncology" subprogramme are:

Ensuring diagnostics in the early stages of diseases;

Reducing disability and mortality in malignant neoplasms.

The tasks of the subprogramme are:

1) improvement of methods for the prevention of oncological diseases, early detection of tumor and precancerous diseases;

2) assessment of carcinogenic environmental factors;

3) monitoring carcinogenic industrial factors and industries;

4) ensuring the diagnosis of tumor diseases of visual location in the early stages;

The subprogramme "sex transmitted infection"

The amount of infectious diseases transmitted by sexual means increases annually (including neurosimifilis cases) identified among adolescents. The resistance of causative agents of sexually transmitted infections is developed, to the drugs used. In this regard, the conduct of sanitary and educational events and promoting a healthy lifestyle. In addition, the number of specialized medical institutions studying the variability of causative agents transmitted by sexually transmitted, to organize studies aimed at overcoming the therapeutic resistance of causative agents of sexually transmitted infections, and improving their diagnostics, taking into account the molecular characteristics of pathogens.

The purpose of the subprogramme "infection transmitted by sexual way" is to reduce the incidence of sexually transmitted infections.

1) Improving the prevention methods of sexually transmitted infections, including the development of information materials and educational programs for the population;

2) the development and implementation of modern methods of diagnosis, treatment and rehabilitation in sexually transmitted infections;

3) improving the system for monitoring the stability of causative agents of sexually transmitted infections, to the drugs used;

Subprogram "Viral hepatitis"

The incidence of chronic forms of viral hepatitis B and C, sharp forms of viral hepatitis C, as well as disability and mortality in these diseases, increases annually.

It is necessary to improve the methods of investigating cases of epidemic outbreaks of viral hepatitis, molecular methods of diagnostics, methods for the prevention of viral hepatitis, the further development of specialized medical care.

The tasks of the subprogramme are:

1) improving the methods for the prevention of viral hepatitis and epidemiological supervision;

2) ensuring the quality of diagnosis, treatment and rehabilitation of sharp and chronic viral hepatitis;

3) Development and implementation of modern medicines and diagnostic sets;

4) Construction and reconstruction of specialized medical institutions, equipping them with modern medical and technological equipment.

Subprogramme "Mental Disorders"

The incidence of population mental disorders and behavior disorders is growing. Every year about 60 thousand people dies from suicides.

The purpose of the subprogramme "mental disorders" (hereinafter refruning) is the development of a comprehensive system of prevention, diagnosis, treatment and rehabilitation in mental disorders.

The tasks of the subprogramme are:

1) Improving methods for preventing mental disorders, development and implementation of advisory assistance, training programs for the protection of mental health and prevention of suicide;

2) improvement of methods for the diagnosis and treatment of mental disorders, the introduction of brigade forms of work in a psychiatric hospital, day hospital, a psychoneurological dispensary and a rehabilitation hostel;

3) the introduction of modern methods of psychosocial therapy and psychosocial rehabilitation;

Subprogram "Arterial Hypertension"

The level of morbidity, disability and mortality of the population in case of circulatory system diseases, among which hypertensive disease occupies a leading place, remains high. In this regard, it is necessary to record and prevent factors contributing to the reduction in the quality of life of the population, including those caused by excessive stress loads.

Development and implementation of measures for the prevention of cardiovascular diseases are needed, the implementation of programs for organizing the rehabilitation treatment of patients with stroke and acute myocardial infarction.

The objectives of the "arterial hypertension" subprogrammes are a decrease in the number of diseases by vascular brain disorders (cerebrovascular diseases, including stroke) due to arterial hypertension and reduced mortality from its complications.

The tasks of the specified subroutine are:

1) creating an effective system for the prevention of arterial hypertension in risk groups;

2) Development and introduction of modern methods of early diagnosis, treatment of arterial hypertension and rehabilitation of patients with its complications.

Subprogram "Vaccinoprophylaxis"

When saving high level Children's coverage with preventive vaccinations continue to have occasions of diphtheria, measles and cough, as well as outbreaks of diseases with epidemic parotitis. It is necessary to create new vaccines for mass use and the introduction modern technologies their production. The development of the public awareness system is required about measures to prevent the dissemination of infections managed by means of specific prophylaxis.

The purpose of the subprogramme "Vaccintilaxia" is to reduce the incidence of infections managed by means of specific prophylaxis.

The tasks of the subprogramme are:

1) improving the methods for the prevention of infections managed by means of specific prophylaxis;

2) improving the methods for monitoring preventive and anti-epidemic measures;

3) Improvement of the vaccine transportation system.

1.3.2. The program "Children of Russia" for 2007 - 2010

29 million children live in the Russian Federation. The most vulnerable categories of children include orphans and children who remain without parental care (731 thousand children), disabled children (587 thousand children), children in a socially dangerous position (676 thousand children). These groups of children need primarily in social rehabilitation and adaptation, integration with society.

According to the forecast data, by 2010 the number of children will decrease compared with 2003 by 3.73 million people, which determines the further tendency to reduce the number of people's population. The birth rate does not provide simple reproduction of the population. Indicators of maternal and infant mortality remain at a high level, only 30 percent of newborns can be recognized as healthy. Over the past 10 years, the incidence of children in general has increased by more than 1.4 times.

Family disabilities, the asocial behavior of parents and the lack of control over the behavior of children leads the latter to early criminalization.

Statistics show a steady increase in juvenile crime (in 2003, 145.4 thousand crimes were committed, in 2004 - 154.4 thousand crimes, in 2005 - 154.7 thousand crimes).

The objectives of the program are the creation of favorable conditions for the integrated development and livelihoods of children, state support for children in difficult life situation.

The tasks of the program are:

Ensuring the safe maternity and birth of healthy children, the protection of children and adolescents, including reproductive health;

Prevention and reduction of children's and teenage incidence, disability and mortality;

The creation of a state system for the detection, development and address support of gifted children, the preservation of the national gene pool of the country, the development of the intellectual and creative potential of Russia;

Prevention of social disadvantaged families with children, protection of the rights and interests of children;

As a result of the fulfillment of the Federal Target Program "Children of Russia" for 2003-2006, a decrease in infant mortality (from 12.4 per 1000 born in 2003 to 11 per 1000 born alive in 2005), maternal mortality (from 31.9 per 100 thousand born alive in 2003 to 30.5 per 100 thousand born in 2005), a decrease in disability among children with chronic pathology, strengthening the health of children and adolescents at all stages of development. Compared to 2003, in 2005, the number of street children decreased by 3.2 thousand people (4.27 thousand against 7.5 thousand), children who were in a difficult life situation - by 274 thousand people (676 thousand. against 950 thousand). In 2005, more than 440 thousand families with disabled children received help in social service and children institutions, which is 26 percent of the level of 2003.

Within the framework of this federal target program, the construction and reconstruction of 42 institutions of birth and childhood, 77 institutions for orphans and children remaining without parental care, 60 children's boarding houses for children with disabilities and rehabilitation centers for children with disabilities were carried out.

The implementation of the Program made it possible to strengthen the material and technical base of more than 600 institutions of birth and childhood, 1,200 specialized agencies for minors who need social rehabilitation, including centers for families with children and crisis centers for women, more than 500 educational institutions, 92 temporary detention centers of minors The offenders of the internal affairs bodies, more than 50 educational colonies of the criminal executive system of the Federal Penitentiary Service, more than 300 specialized agencies for children with disabilities, more than 400 institutions for orphans and children left without parental care (equipped with motor vehicles, agricultural machinery, contemporary -Profilact, rehabilitation, computer, technological and household equipment).

It is proposed within the framework of the program to allocate the "Healthy Generation" subprograms, "gifted children", "Children and Family".

The purpose of the "Healthy Generation" subroutine is to preserve, restore and strengthen the health of children and adolescents, putting them the skills of a healthy lifestyle.

The tasks of the specified subroutine are:

Ensuring safe maternity, creating conditions for the birth of healthy children;

Introduction of high-tech methods for the diagnosis and prevention of hereditary diseases and congenital malformations in children;

Protecting the health of children and adolescents, including reproductive;

Promotion of healthy lifestyles;

Prevention of morbidity, disability and mortality in children's and adolescence;

The purpose of the "Gifted Children" subprogramme is to provide favorable conditions for creating a unified state system for identifying, developing and address support of gifted children in various areas of intellectual and creative activity.

The tasks of the subprogramme are:

Creating a state system for identifying, development and address support of gifted children, including based on innovative technologies identifying and supporting gifted children living in rural areas settlementsremoved from major centers of culture, education, science;

Coordination of the basic centers for working with gifted children and their support;

Providing advice to parents and teachers working with gifted children;

The goals of the subprogramme "Children and Family" are the protection and improvement of the situation of children in a difficult life situation, the prevention of social orphans and family disadvantages, a comprehensive solution to families with disabled children, ensuring their full-fledged life and integration with society, the development of family forms of children's children -Ship.

Due to the specifics of the problems of various categories of children, within the framework of the specified subprogramme, such directions are provided as "the prevention of neglect and offenses of minors", "Family with disabled children", "Children's orphans".

1.3.3. Program "Improving road safety in 2006-2012"

The problem of accidents associated with road transport (hereinafter - accidents), in the last decade, has acquired special acute in connection with the inconsistency of the road and transport infrastructure, the needs of society and the state in safe road traffic, insufficient efficiency of the functioning of the road safety system and extremely low discipline of participants road traffic.

In 2004, over 208 thousand road accidents occurred, in which 34.5 thousand people were killed. Compared with 1997, the death toll increased by 27.8 percent. In total over the past 10 years, 312.5 thousand people were killed as a result of road accidents, of which more than a quarter are the people of the most active working age (26-40 years old).

The root fracture in the emergency state occurred after 2000. The growth of the main indicators of accidents in 2001-2004 relative to 1 percent of the growth in the number of vehicles amounted to:

· Travel incidents - 3.6 percent;

· By the number of persons who died as a result of road accidents - 2.7 percent;

· By the number of persons who have been injured as a result of road traffic accidents, 4.5 percent.

Since 2000, such relative emergency rates are steadily growing, as the number of persons who died as a result of road accidents, by 10 thousand units of transport (transport risk) and the number of persons who died as a result of road accidents per 100 thousand population (Social risk). In 2004, they reached their maximum (more than 10 and more than 24 persons who died as a result of road traffic accidents, respectively).

Road traffic accidents cause significant damage to the economy in the last 4 years - 2.6 percent of the gross domestic product of the country (in 2004 the damage was 369 billion rubles, including the death and injury of people - 227.7 billion rubles).

The purpose of the program is to reduce the number of persons who died as a result of road accidents, 1.5 times in 2012 compared with 2004. This will allow the Russian Federation to come close to the level of road safety, characteristic of countries with developed motorization of the population, reduce accident performance and, therefore, reduce the social acute problems.

The conditions for achieving the objectives of the program is to solve the following tasks:

· Preventing the dangerous behavior of road participants;

· Development of a system of training drivers and their admission to participation in road traffic;

· Reducing child road traffic injuries;

· Improving the organization of traffic and pedestrians in cities.

Chapter 2. Implementation Analysis

2.1. "Warning and the fight against socially significant diseases (2007 - 2011)"

The solution to the problem of reducing the incidence, increasing the duration and improving the quality of life in socially significant diseases by software will be carried out through the reasonable choice of activities in all areas of implementation of the Federal Target Program "Prevention and Combating Socially Significant Diseases (2007-2011)".

Events for sale

When solving the problem of the incidence of socially significant diseases, the program-target method are possible 3 options for implementing a program that differs in the amount of financing.

First option - financial support Implementation of the program in the stated volumes.

Approval of the program according to the first option will allow to achieve the goal.

In this embodiment, the implementation of the program is associated with macroeconomic risks associated with the possibility of reducing the growth rate of the economy and the level of investment activity, the emergence of the budget deficit.

The second option is the adoption of a program with a financing amount of from 50 to 80 percent of the stated volume.

At the same time, the financing of the program will focus on the most effective measures to ensure the stabilization of the main rates of incidence of socially significant diseases, as well as at events requiring relatively small amounts of funding.

The third option is the adoption of a program with a financing of less than 50 percent. For this variant, the financing of the program is focused on the least costly priority events.

Financing

Financing the preparation of projects of the target program and the concepts of implementation of the program problem, the development of which is carried out by decision of the Government of the Russian Federation, is made at the expense of the funds provided for in the section "Other articles" of the federal budget. Approved target programs are implemented at the expense of the federal budget attracted to the implementation of these programs of extrabudgetary sources, funds of budgets of the constituent entities of the Russian Federation.

Federation can not be in the current financial year It is set below 5 percent with the condition for preserving the financing of the construction of objects by the subject of the Russian Federation at least 50 percent of the estimated cost of work during the program.

Funding of the program's activities is carried out at the expense of the federal budget, budgets of the constituent entities of the Russian Federation and the funds of extrabudgetary sources.

The total costs of implementing the activities of the program are 95820,8577 million rubles (in prices of the corresponding years), of which, at the expense of the federal budget - 45453.4577 million rubles, budgets of the constituent entities of the Russian Federation - 48763.2 million rubles, extrabudgetary sources - 1604.2 million rubles. (as amended by the Government Decisions of the Russian Federation of 06.04.2011 N 254)

Table 1.

Source of financing of FDP activities "Warning and the fight against socially significant diseases 2007-2011"

Fig. 1 source of financing of program activities

The financing of the program at the expense of the federal budget is carried out in the following areas:

· capital investments - 23064.9064 million rubles;

· Research and development and design work - 1238,7268 million rubles;

· Other needs - 21149.8245 million rubles, of which subsidies from the federal budget - 1593.716 million rubles.

Fig. 2 directions of spending FDP funds "Warning and the fight against socially significant diseases 2007-2011"

Performance at the expense of the federal budget of commitments to the construction and objects in state ownership of the constituent entities of the Russian Federation and in municipal property is carried out in the order of inter-budget relations in accordance with the provisions of the Budget Code of the Russian Federation.

Table 2. Financing subroutines

Subrogram	Million rub (plan)
Diabetes
Tuberculosis
Oncology
Sexually transmitted infections
Arterial hypertension
Vaccinoprophilaxia
Viral hepatitis
HIV infections
Mental disorders

Fig. 3 Financing Subroutines

Evaluation of the effectiveness of the program implementation is based on comparison with data for 2005 and taking into account the need to achieve the following indicators:

The increase in the average life expectancy of men, patients with type I diabetes, up to 55.4 years, women - up to 59.2 years;

An increase in the average life expectancy of men, patients with type II diabetes, up to 71.4 years, women - until 73.2 years;

Reducing the incidence of tuberculosis in correctional institutions of the Federal sentence of sentences to 1490 cases per 100 thousand people;

An increase in the abaclization rate of patients with tuberculosis held at the end of the year to 36.1 percent;

An increase in the number of cases of HIV infection again registered during the year to 65 thousand cases;

Reducing the number of cases newly registered during the year of infection of HIV infection in correctional institutions of the federal sentence service to 1.67 thousand cases;

An increase in the share of HIV-infected pregnant women included in the prevention program of the infection of HIV infection of newborns, up to 95 percent;

Improving indicators characterizing the early detection of malignant neoplasms, including an increase in the fraction of patients with visual localizations of the tumor, identified at the I and II stages of the disease, up to 72 percent;

Reducing the share of patients who died from malignant neoplasms throughout the year from the moment of diagnosis, in the total number of patients, for the first time taken into account in the previous year, up to 27.5 percent;

Reducing mortality from malignant neoplasms in men to 231.2 cases per 100 thousand population, in women - up to 170 cases per 100 thousand population;

Reducing the incidence of children with syphilis to 7.1 cases per 100 thousand children's population;

Reducing the incidence of children of gonorads to 7.7 cases per 100 thousand children's population;

The increase in the share of specialized medical institutions engaged in monitoring the variability of causative agents of sexually transmitted infections in the total number of cultivation of the dermatovenerological profile to 62 percent;

Increase in the number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections, up to 60 units;

Reducing the incidence of acute viral hepatitis B up to 2.6 cases per 100 thousand population;

Reducing the incidence of acute viral hepatitis C to 3.7 cases per 100 thousand population;

An increase in the share of patients covered by the brigade forms of psychiatric assistance in the total number of observed patients to 30 percent;

Elimination of cases of polyomelitis diseases;

Reducing the incidence of cow to 0.999 cases per 1 million population.

2.2 Program "Children of Russia for 2007-2010"

The implementation of the program activities will allow:

Improve the quality of life and health of children;

Improve the quality and availability of social services for families with children, primarily for families with disabled children;

Improve the state system of social protection and support of minors in order to ensure emergency and operational assistance Children who have fallen into a difficult life situation, as well as the fulfillment of long-term consistent work on the support of children in need of special care of the state.

The implementation of the "Healthy Generation" subprogramme events will continue to improve state support Maternity and childhood services, increase the availability and quality of medical care for women and children, achieve by 2011:

Decline in infant mortality rate to 9.8 per 1000 lively born;

Reduce maternal mortality rate up to 21 per 100 thousand born alive;

Reducing the mortality rate of children aged 0 to 4 years (inclusive) to 10.9 per 1000 newborn relevant year of birth;

Increase the share of children of the 1st group of health up to 37.5 percent of the total number of children;

Reducing the indicator of the primary access to the disability of children aged 0 to 17 years (inclusive) to 21.4 per 10 thousand children.

During the implementation of the subprogramme "Gifted children" will be created state system Detection, development and address support of gifted children, covering up to 40 percent of the children's population aimed at preserving the national gene pool of the country, the formation of the future highly professional elite in various areas of intellectual and creative activity.

The number of winners of All-Russian competitions, competitions, the Olympiads, tournaments conducted under the subprogramme will increase by 2011 by 8 percent compared with the 2006 data.

Assessment of the implementation of the direction "Prevention of neglect and offenses of minors" by 2011 will be carried out in the following indicators:

· The share of streets in the total number of children's population is 2.17 percent;

· The proportion of children who received social rehabilitation in specialized institutions for minors, in the total number of neglect and street children - 83.3 percent.

Assessment of the implementation of the "Family with disabled children" by 2011 will be carried out in the following indicators:

The proportion of children with disabilities who received rehabilitation services in specialized institutions for children with disabilities, in the total number of disabled children - 43.1 percent;

The proportion of families with disabled children who received services in specialized institutions for children with disabilities, in the total number of families in need of families with disabled children - 25.2 percent.

The implementation of the measures of this subprogramme will reduce the number of orphans and children left without parental care transmitted to the institutions for full state security, increase the number of orphans and children left without parental care transmitted to the education of citizens to ensure the effective socialization of children , founded in a difficult life situation, and their integration with society.

Evaluation of the implementation of the "Children's Syarotes" direction by 2011 will be carried out in terms of reflecting the share of orphans and children who remained without the care of parents transferred to the citizens' families in the total number of orphans and children left without parental care, which should Achieve 72 percent.

Financing

The total amount of financing of the program 47845.9 million rubles (in prices of the respective years), including:

At the expense of the federal budget - 10101.7 million rubles;

At the expense of budgets of the constituent entities of the Russian Federation - 36315.1 million rubles;

At the expense of extrabudgetary sources - 1429.1 million rubles.

Table 3. Source of financing of measures of FDP "Children of Russia 2007-2010"

In terms of consumption, funds are distributed as follows:

Capital investments - 25899.3 million rubles, including:

At the expense of the federal budget - 6917 million rubles;

At the expense of budgets of the constituent entities of the Russian Federation - 18812.3 million rubles;

At the expense of extrabudgetary sources - 170 million rubles;

Research and development work - 37.7 million rubles at the expense of the federal budget;

Other needs -21908.9 million rubles, including:

At the expense of the federal budget - 3147 million rubles;

At the expense of the budgets of the constituent entities of the Russian Federation -17502.8 million rubles;

At the expense of extrabudgetary sources - 1259.1 million rubles.

Fig. 4 sources of financing of the program

2.3 Program "Raise Road Safety in 2006-2012"

health population target investment

Performers of the program activities are determined in the manner prescribed by the legislation of the Russian Federation.

The implementation of the program is expected to be implemented within 7 years (2006-2012) in the 2 stages.

At the stage of the Stage (2006-2007), the main activities for implementation are allocated:

· Creating a system of propaganda impact on the population in order to form a negative attitude to offenses in the field of road traffic;

· Ensuring involvement in the preventive work of civil society institutions;

· Improving the licensing system in the field of training of drivers, development legal basis control over the implementation of independent training by citizens to obtain the right to managing vehicles of categories "A" and "B";

· Preparation of proposals for the introduction of driving schools of mechanisms to improve the quality of the preparation of drivers;

· Strengthening the control of the presence, health and use of security;

· Increasing the prevention of child road traffic injuries, the active introduction of children's retention devices;

· Implementation of pilot projects for replacing road traffic posts by technical automatic monitoring systems for compliance with parties to the road traffic rules of the Russian Federation and the use of helicopters to accelerate the arrival at the site of the road traffic accident;

· Prevention of road congestion, optimization of high-speed motion modes in the portions of the street-road network;

· Monitoring the dynamics of road traffic injuries, public opinion on road safety and implementation of program activities.

At stage in stage (2008 - 2012), the implementation of the following events is envisaged:

· Further increase in the volume of work on the organization of traffic and pedestrians, including the introduction of integrated projects and projects for the organization of road traffic, the movement of the movement of the main, district and city-wide value;

· Expansion of work on the construction of underground and overhead pedestrian crossings;

· Increasing the role of public associations and organizations in conducting preventive measures;

· Improving work on the prevention of child road traffic injuries;

· Improving forms and methods for monitoring and supervising compliance with the participants in the road traffic establishes established standards and rules;

· Improving forms and methods of international cooperation in the field of road safety;

· Continuing to monitor the dynamics of road traffic injuries, public opinion on road safety and implementing program activities.

The transfer of subjects of the Russian Federation of material and technical resources (equipment that does not require installation, special vehicles) acquired at the expense of the federal budget is carried out by government customers of the program in the manner established by the Government of the Russian Federation.

Financing

The total financing of the program is 47,755.51 million rubles, including:

At the expense of the federal budget - 21049.01 million rubles (of them - 2446.23 million rubles, capital investments - 15247.58 million rubles and other needs - on research and development work - 3355.21 million rubles);

At the expense of budgets of the constituent entities of the Russian Federation - 26245.4 million rubles (from them for capital investments - 21805.9 million rubles and other needs - 4439.5 million rubles);

At the expense of extrabudgetary sources - 461.1 million rubles (from them for capital investments - 359.9 million rubles and other needs - 101.2 million rubles) (as amended by the Decree of the Government of the Russian Federation of 18.08.2007 N 528, of 15.07.2008 N 538, of 14.02.2009 No. 132, from 02.08.2011 N 642) Reduction by 2012 the number of persons who died as a result of road accidents,

Table 4. Sources of financing FTP "Improving road safety in 2006-2012"

Fig. 5 sources of financing program

Conclusion

Upon completion, it can be concluded that today the federal target programs aimed at protecting the health of the population are one of the most important means of implementing the social policy of the state and the active impact on socio-economic development.

Evaluation of the effectiveness of the implementation of the programs under consideration is carried out on the basis of comparison with data for 2005.

The results of the effectiveness of the program "Warning and the struggle with socially significant diseases for 2007-2011"

Reducing the share of complications with diabetes mellitus up to 28.5 percent;

Reducing the incidence of tuberculosis in correctional institutions of the Federal sentence of sentences to 1490 cases per 100 thousand people;

Reducing the mortality from tuberculosis to 15.2 cases per 100 thousand population, including correctional institutions of the Federal Penitentiary Service - up to 104.9 cases per 100 thousand people;

Reducing the incidence of syphilis to 49.2 cases per 100 thousand population, including correctional institutions of the federal sentence service - up to 148 cases per 100 thousand people;

Reducing the incidence of chronic viral hepatitis B and C to 54 cases per 100 thousand population;

1. Reducing the rupture of public health indicators between individual regions of the Russian Federation and economically developed countries

The current gap of the health of the population of Russia and economically developed countries is primarily associated with the lack of a scientifically based state policy in the field of health care, insufficient resource support of the industry, as well as the imperfection of mechanisms effective use allocated for health care material and technical, financial, personnel and other resources.

To solve this problem, it is necessary, first of all, the implementation of the following measures:

Development and ensuring implementation (on federal, regional and municipal levels) effective state policy in the field of health health;
. the introduction of the Humanitarian Development Index as a criterion for assessing the socio-economic development of the regions;
. analyzing the causes of the identified differences in the health of the population from various socio-economic groups;

Introduction of monitoring and evaluation of the effectiveness of activities carried out in order to eliminate the differences in the health indicators of the population in individual socio-economic groups;
. Ensuring greater availability of medical and social assistance for low-income groups of the population due to a flexible system of benefits, benefits, etc.

2. Improving the health of children, adolescents, women

The answer to the question will largely depend on the implementation of this priority direction of health care development, whether Russia will be able to get out of the demographic crisis or not.

That is why it is necessary to put and solve strategic tasks to reduce the infant mortality rate on average by the Russian Federation to 7.5% O (in the constituent entities of the Russian Federation, which has reached this value is to reduce this indicator to the Middle Economy); reduction of at least 50% of the mortality rate and disability associated with accidents and acts of violence among children; reduce the number of children born with a body weight of less than 2500 g, at least by 20%; Reducing the maternal mortality rate on average in the Russian Federation up to 18.5 per 100 thousand live births (in the subjects of the Russian Federation, which has reached this value is a decrease in this indicator to the Middle Eastern level).

The most important tasks to reduce deaths and disability among schoolchildren and adolescents (associated with violence and accidents), at least 50%; reduce the number of young people who are characterized by the harmful habits of behavior related to drug use, tobacco and alcohol by 30%; Reducing the number of pregnancies in adolescent girls, at least by 25%.

To achieve these tasks, it is necessary to perform the following set of measures:

Expansion and intensification of preventive activities, including the dispensary of children of all ages;
. an increase in the volume of specialized and high-tech medical care to children;
. introduction of high-tech methods for the diagnosis and prevention of hereditary diseases and congenital malformations in children;
. Creation of modern perinatal centers in the country;
. Providing maternity houses modern medical equipment and special sanitary vehicles;
. development of family planning services and safe maternity;
. integration of generic institutions with a general medical and specialized network;
. the introduction of WHO principles for integrated childcare diseases;
. the introduction of WHO criteria to assign the status of the "Friendly Relationship Hospital";
. approaching primary health care services to the conditions of the daily lives of schoolchildren and adolescents (home environment, schools and other educational institutions, recreation sites);
. Development and implementation of regional medical and social programs for improving adolescent health, including young procraval and recruiting ages;
. development and implementation of interdepartmental programs on drug addiction, suicide, alcohol, prevention of accidents;
. Implementation of the WHO concept to form schools that promote health promotion;
. The introduction of the WHO criteria to assign the status of the "Hospital of a benevolent relation to adolescence" and others.

3. Preservation of the health of elderly

This priority direction definitely has not only medical and social, but also political importance.

People who have worked dozens of years and have reached older age, have the right to demand a higher level of medical care from society. In this case, the health care is to improve, at least 5-7% of the average duration of the upcoming life, as well as an increase in 30-50% of people aged 80, who have such a level of health that allows them to maintain independence. , self-esteem and appropriate place in society.

Achieving these results, of course, is not a task of only one health care system.

To solve them, an intersectoral approach is needed with the implementation of the next set of measures:

Coordination of health services and social protection services;
. development of primary health care taking into account the real needs of the elderly;
. systematic preventive measures aimed at improving hearing, mobility (replacement of the head of the hip joint), vision, dental prosthetics;
. organization of geriatric service in all subjects of the Russian Federation;
. improving the quality and availability of rehabilitation assistance;
. Preparation of specialists in the field of palliative care;
. development of hospital network for incrypanic patients (hospices);
. Creating conditions for a worthy care of elderly sick people from life (providing the opportunity to die in the place they choose, and surrounded by those people they wanted to see, if possible without pain and torment), etc.

4. Reducing the level of socially significant diseases

For many years, this priority direction in health care remains rather a political declaration than the system of targeted, focused on specific results of actions, confirmation of the prevalence and socio-economic consequences of socially significant diseases presented in the section - carrying out an in-depth study of the structure and level of "sociopathy", The identification of their main trends and causal relationships make it possible to scientifically substantiate a complex of interrelated tasks for their prevention and reduction.

These tasks, first of all, should be related to the need to reduce mortality rates associated with cardiovascular diseases, on average by 40%; reduction of mortality from malignant neoplasms of various localizations, at least 15% and a decrease in mortality due to lung cancer by 25%; A reduction in 30% of the number of amputations, blindness, renal failure and other serious disorders associated with diabetes mellitus.

Among the tasks, the objectives of the incidence, disability and mortality associated with chronic respiratory diseases, bone muscular disorders and other common chronic diseases are also essential tasks; prevention of mental disorders and reduce the number of suicides at least by 30%; reduction, mortality and disability as a result of road accidents and other accidents, at least by 30%; Ensuring reduce prevalence levels and mortality associated with HIV infection, AIDS and other sexually transmitted diseases.

To solve these problems and achieve concrete results, the implementation of a complex of measures is needed, and differentiated for each of the socially significant disease separately.

Prevention and treatment of cardiovascular diseases:

Development and introduction of modern medical preventive technologies for high-risk groups for the development of cardiovascular complications;
. Development of modern methods for the prevention, diagnosis and treatment of arterial hypertension and its complications;
. Development of scientifically based programs for organizing restorative treatment of patients with stroke and acute myocardial infarction;
. creating an effective system for the prevention of arterial hypertension and its complications;
. creation of a system for monitoring the implementation of measures for the prevention and treatment of arterial hypertension;
. Improving the system of the state register of patients with arterial hypertension;
. Improving methods for rehabilitation of patients with arterial hypertension, etc.

Prevention and treatment of diabetes:

Research on the study of the causes of the occurrence and mechanisms for the development of diabetes, its complications;
. improving the methods of prevention, diagnosis and treatment of diabetes;
. Equipment of diabetological units of specialized healthcare facilities with necessary equipment;
. Organization of schools for learning patients with diabetes;
. monitoring diabetes and its complications;
. ensuring the functioning of the state register of individuals with diabetes mellitus;
. Creating mobile medical and preventive modules, introducing modern medicines and diagnostic systems into the clinical practice, etc.

Prevention and treatment of malignant neoplasms:

Construction and reconstruction of specialized medical institutions providing assistance to the population in cancer;
. conducting research in the field of etiology and pathogenesis of malignant neoplasms;
. conducting scientific research in the field of prevention, diagnosis and treatment of malignant neoplasms;
. information support of the national register of substances, products, production processes, household and natural factors, carcinogenic for humans;
. ensuring the functioning of the state register of patients with malignant neoplasms;
. Improving the provision of specialized medical care patients with malignant neoplasms, etc.

Prevention and treatment of mental disorders and their consequences:

Improving psycho-emotional climate in everyday life and production;
. systematic training of district doctors, general practitioners on the diagnosis and treatment of depressive states;
. development of the system of psychiatric staff of emergency care;
. carrying out fundamental and applied research on the study of factors affecting mental health;
. Education of the population of rational behavior in extreme and stressful situations, etc.

Prevention of injury and mortality due to road traffic accidents and accidents:

. Perfection modern system sanavation and transportation of victims as soon as possible to the place of specialized medical care;
. development and implementation of medical care standards affected by accidents;
. organization of training personnel of life support services (Ministry of Internal Affairs, Ministry of Emergency Situations, etc.) to provide first aid;
. ensuring interaction, when providing emergency medical care to accidents and emergencies, health services, Ministry of Internal Affairs, Ministry of Emergency Situations, federal and regional executive bodies;
. Equipment for modern medical equipment, sanitary transport, means of communication organizations of health care, participating in the provision of specialized medical care affected by accidents, accidents, etc.

Fighting HIV infection:

Implementation of the exchange programs of the used injection needles to new drugs for those injecting intravenous drugs;
. ensuring wide access to condoms, other personal protective equipment;
. ensuring blood safety through proper screening and testing of donor blood and blood products;
. Ensuring effective, anonymous treatment of persons with sexually transmitted diseases, etc.

Prevention and treatment of tuberculosis:

Active detection of patients with tuberculosis using a microscopic study of sputum and target fluorographic examinations;
. Holding at the national level and in accordance with the recommendations of the WHO Tuberculosis Program based on DOTS strategy;
. Regular and uninterrupted supply of all major anti-tuberculosis drugs;
. Development of special observation services for the population of risk groups such as migrants, faces without a certain place of residence, HIV-infected, etc.

5. Reducing the prevalence of infectious diseases

Despite the significant results achieved in the prevention, early diagnosis and treatment of infectious diseases, there are sufficient reserves in the health system, and each year new opportunities appear for further reduction in the prevalence of infectious diseases.

Taking into account the latest scientific achievements in the field of epidemiology of infectious diseases for the next decade, it is quite realistic to achieve the following results:

Conducting a complex of anti-epidemic measures to prevent the propagation of influenza A / HI N1;
. Reducing the difference in the prevalence of diphtheria to the level of no more than 0.1 cases per 100 thousand population;
. Reducing the number of new cases of hepatitis virus to at least 80%;
. Reducing the prevalence of epidemic vapotitis, cough and invasive infections caused by Haemophilus influenzae type B to level no more than 1 case per 100 thousand population;
. Reducing the prevalence of congenital syphilis and rubella to a level of no more than 0.01 cases per 1000 live births;
. The fulfillment of the national calendar of vaccine-prevention and others.

6. Ensuring a healthy and safe habitat

Solving the problem of ensuring a healthy and safe human habitat is becoming increasingly relevant due to the increased number of man-made disasters, environmental pollution, the threat of disruption of environmental equilibrium.

This problem, along with the problem of the formation of a healthy lifestyle, is determining in preserving and improving public health and should be solved at the state level with the participation of institutions.

The most important role in its decision is given by the service of Rospotrebnadzor. The population of the country should be accommodated in a safe environment, in which the impact of dangerous factors does not exceed the envisaged international standards. It is necessary to ensure a significant reduction in the content of physical, chemical and microbial pollutants in aquatic and air environment, as well as in waste and soil representing a threat to health.

At the same time, we must provide the public to universal access to sufficient reserves of drinking water of satisfactory quality. The prevention of natural and technogenic disasters and the struggle with their consequences becomes the priority task of national security.

To solve these tasks, first of all requires the implementation of the next set of measures:

. improvement of social and hygienic monitoring integrated into the structure of the executive bodies and local self-government;
. creation of a geo-information system reflecting the spatial-temporal relationship of environmental environmental factors and public health;
. reduction of the risk of morbidity in 1.2-1.4 times depending on the intensity of the sanitary and epidemiological situation, provided that the anthropotechnogenic load is reduced by 1.0%;
. creating a mechanism for prognostic analysis of the consequences of political decisions in the field of hygienic safety;
. zoning the habitat with hygienic ranking of territories by the degree of danger of negative impact on health;
. The biosphere is sewn according to the criteria for the permissible anthropotechnogenic load on the environmental environment, etc.

7. Formation of a healthy lifestyle

The state of health of the population, as is known, more than 50% depends on the lifestyle of a person, so the formation of a healthy lifestyle among the population serves as a key in solving many problems associated with a decrease in the incidence, disability, population mortality, an increase in the average duration of the upcoming life.

Unfortunately, it is necessary to state that the problem of the formation of a healthy lifestyle The last decades have practically falling out of the system of public and state priorities, which as a result negatively affected the state of health of the citizens of the Russian Federation.

For many years will be required for the formation of behavioral strategies of commitment to a healthy lifestyle, the emergence of a dominant attitude towards their health. But this work should be started now, from setting specific tasks and identifying actually achievable results.

What are the tasks of the formation of a healthy lifestyle in the population seems to be necessary in the next decade? First of all, it is necessary to achieve an increase in at least 25-30% of the number of persons systematically engaged in physical culture, reducing the prevalence of excess body weight by 20-30%, expanding the range and accessibility of food safe for health.

To minimize the negative impact on health, primarily children, bad habits, it is necessary to take measures to increase the share of non-smoking among people over 17 years of age, at least up to 50%, and up to 95% among persons under the age of 15; Reducing the consumption of alcohol per capita to 10 l per year and the exclusion of alcohol consumption by persons under the age of 15. The same priority tasks should include a decrease in the prevalence of psychoactive drugs, at least 25%, and cases of death associated with this, at least 50%.

Of course, these are the priority tasks of various public and social institutions, the state as a whole, but health care should be played by a latter role.

At the same time, the top priorities with the participation of health care in solving the tasks can be attributed as follows:

. the development and adoption of the Code of Healthy Lifestyle;
. the formation of the population of behavioral strategies of adherence to a healthy lifestyle;
. creating conditions for increasing the value attitude of the population to their health;
. training specialists in promoting healthy lifestyles;
. Training of citizens to a healthy lifestyle using information programs, specially adapted to various age and social Groups population;
. Organization of patient schools (patients with bronchial asthma, diabetes, hypertension, etc.);
. development of the services of anonymous treatment of alcoholics and drug addicts;
. Development of a network of specialized agencies on the formation of a healthy lifestyle, including the preparation of relevant specialists and others.

8. Improving the mechanisms of state guarantees in providing the population free medical care

As noted earlier, one of the painful problems of modern health care is the persistent discrepancy between the obligations of the state to provide free medical care to citizens and allocated financial resources for these purposes.

Achieving such compliance by improving the mechanisms of state guarantees in providing the population of free medical assistance should be a priority for the activities of state bodies and local governments.

To solve this problem, the implementation of the next set of measures is appropriate:

. Improving legislation to ensure equality of the rights of citizens to receive free medical care, the same in terms of volume and quality, in all subjects of the Russian Federation;
. increasing the responsibility of government bodies and local governments for ensuring the population guaranteed free medical help;
. Development of uniforms for all subjects of the Russian Federation standards (protocols) of patients;
. improving the regulatory legal framework governing the separation of free and paid medical services in state and municipal health organizations;
. Wide awareness of citizens about rights in obtaining free medical care, etc.

9. Improving the efficiency of the health management system and financing

IN modern conditions One of the most important areas of health reform is the formation of a new management system.

Systems that provided primarily the effective use of logistical, financial, personnel and other resources sent to the industry. Without solving this task, further increasing the resource potential of the health care system will not be effective.

It remains an urgent task to delimit health authority at the federal, regional and municipal health management levels. Without it, it is not possible to avoid infinite duplication of the functions of health authorities and individual medical institutions (federal, regional, municipal) in the provision of certain types of medical care, especially high-tech.

Requires further continuation of the work launched by the Ministry of Health of the Russian Federation in the 90s of the last century of standardization. Improving the management of the industry, improving the quality of medical care, the effective use of resources is not conceivable without developing and establishing relevant standards, rules, requirements, technological regulations for the production of medical goods and services.

Special attention is required to develop scientifically based approaches to the formation of standards (protocols) of patients on various types of medical care at all stages of its provision.

Staging a "PU stream" of high-tech medical services, the creation of new medical centers, which will reduce the waiting time and will ensure the availability of high-tech medical care to patients regardless of their residence, require the earliest development of clinical minutes of patient management for these types of medical care.

Fundamentally new approaches should be implemented to implement such important management functions as planning and forecasting. These approaches should be based, first of all, on in-depth study of public health, modern methods of collecting and processing information, effective technologies for making management decisions.

First of all, it is necessary to develop and implement organizational and legal and economic mechanisms for the efficient use of financial and other resources. The creation of such mechanisms is seen only possible on the basis of the organization of a unified medical and social insurance system and the transition to a single-channel health financing system.

Specific perspectives in improving the management efficiency of the industry are associated with the development of legal and organizational mechanisms of a public-private partnership in health care.

This applies primarily to create conditions for the participation of healthcare organizations of private forms of ownership in the implementation of territorial programs of state guarantees, state support for venture capital innovative funds financing high-tech and high-tech health care projects, support for the development of business associations in health care, etc.

O.P. Schepin, V.A. Medic

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