Second stage of medical care rural population.
The main institution of the second stage of medical care for the rural population is the central district hospital (CRH). It provides the rural population with qualified treatment and preventive care, both inpatient and outpatient.
Basic tasks of the central district hospital:
providing highly qualified, specialized inpatient and outpatient care to the population of the district and regional center;
operational, organizational and methodological management and control over the activities of all healthcare institutions;
planning, financing and organizing logistics for health care institutions in the region;
development and implementation of measures aimed at improving the quality of medical care for the population of the region, reducing morbidity, disability, hospital mortality, child and total mortality and promoting adolescent health;
timely introduction into the practice of health care facilities modern methods and means of prevention, diagnosis and treatment;
implementation of measures for the placement, rational use and improvement of professional qualifications of personnel;
carrying out activities aimed at efficient use means and forces, strengthening the material and technical base of the district, improving the systems of organizational, methodological and operational management, management of all health care facilities in the district, using modern achievements science;
provision of ambulance and emergency care on the territory of the region.
The central district hospital, regardless of bed capacity, population size and service radius, has a hospital, a clinic, a pharmacy, a prosector, paraclinical and administrative services, an organizational and methodological office (OMK), an ambulance and emergency department.
The in-patient department of the Central District Hospital must have at least 5 departments according to specialties; therapy, surgery, pediatrics, obstetrics and gynecology, infectious diseases. In addition to the required minimum, departments in other specialties (neurology, otorhinolaryngology, ophthalmology, traumatology, etc.) can be organized in large central district hospitals.
In the outpatient department of the Central District Hospital, specialized care is provided in 1015 specialties, and such departments often serve as inter-district specialized centers.
Patients living in an area assigned to a district hospital are served directly by the hospital. Patients living in other areas are admitted to the district hospital on the referral of doctors from local hospitals. Local doctors refer patients to the district hospital in cases where the necessary specialized care cannot be provided on site, when patients need consultation, clarification of the diagnosis, X-ray or laboratory clinical diagnostic examination. The participation of specialists from district hospitals during clinical examinations is widely used.
Rural residents go to the district hospital according to referrals medical institutions rural area if specialized medical care, functional examination, consultation with medical specialists is necessary.
Mobile assistance plays an important role in the work of the Central District Hospital. Mobile medical teams are formed by the chief physician and see patients in 5-7 specialties. The composition of the team's medical specialists is determined depending on the development of the network of outpatient clinics in a given territory, its staffing with doctors and the population's needs for appropriate types of medical care. It may include doctors: therapists, pediatricians, surgeons, obstetricians-gynecologists, ophthalmologists, neurologists, etc. A visiting team is provided vehicles, including special ones, is equipped with the necessary equipment (mainly portable) and equipment for examining and treating patients. The leadership of the mobile medical team is entrusted to one of the qualified doctors of the team who has experience in medical and organizational work. Fluorographic and dental offices, clinical diagnostic and bacteriological laboratories regularly visit the village.
Ambulance and emergency care is provided by the relevant department, which is part of the Central District Hospital, which is responsible for providing this type of assistance to the population of the district center and the settlements assigned to it.
One of the most important structural divisions The central district hospital is an organizational and methodological office (OMK), headed by the deputy chief physician of the central district hospital for medical care of the population of the district. OMK is the main assistant to the chief physician in matters of management, organization and coordination of all organizational and methodological work of the Central District Hospital and other medical institutions in the region.
The main tasks of OMK include:
analysis and synthesis of data on the health status of the population and the activities of health care facilities in the district;
calculation of evaluation indicators and analysis of the activities of the Central District Hospital as a whole and for individual specialized services;
compiling a summary report on the network, personnel and activities of health care facilities in the district; identifying shortcomings in the work of health care facilities and developing measures to eliminate them; development of an action plan for medical care of the entire population of the district, monitoring its implementation;
implementation of measures to improve the quality of treatment and preventive work,
promotion qualifications of specialists,
study and dissemination of new modern forms medical work,
long-term planning for the development of healthcare in the region,
organization of work on extrabudgetary commercial activities and health insurance.
The OMK work plan is actually a plan for the organizational and methodological work of the entire Central District Hospital. Its mandatory sections are:
analysis of demographic indicators and reporting materials on the network, personnel and activities of health care facilities in the area and on the health status of the population;
organization and implementation of measures to provide treatment, advisory and organizational and methodological assistance to medical institutions in the region;
carrying out training activities medical workers; strengthening the material and technical base of health care facilities in the region.
assessment of the activities and effectiveness of the district’s medical institutions and departments of the Central District Hospital;
measures to improve the quality of medical care, ambulance and emergency care;
introduction of new types of diagnostics and treatment;
improvement of ethical and deontological aspects in the staff of medical institutions.
Based on a systematic analysis of the health status of the district population and the plans of district institutions, the cabinet draws up comprehensive plan measures to improve medical care and strengthen the health of the region's population.
Providing methodological guidance and control over accounting and statistical work in all institutions of the district is the most important function organizational method of the office. The duties of the offices include receiving annual reports. Based on the data from reporting forms and special analysis, the organizational and methodological department compiles a review of the state of health various groups population and evaluates health indicators. Organizational and methodological rooms should contain information about regional conferences and classes with doctors and paramedical personnel, seminars with the participation of regional specialists, specialization and advanced training of medical workers.
The chief (district) specialists of the district, who are also heads of specialized departments of the central district hospital, work in close contact with the OMK of the Central District Hospital. Currently, in almost all regions there are regional specialists in therapy, pediatrics, surgery, obstetrics and gynecology, and phthisiology. They are appointed by the chief physician of the district in agreement with the chief regional specialists and report directly to the chief physician of the Central District Hospital or his deputy.
The main functions of district specialists are:
organizational and methodological management of the work of the relevant specialized service;
regular visits in accordance with the schedule to local hospitals, medical outpatient clinics and first aid stations;
improvement of methods of diagnosis, treatment, prevention of specialized diseases;
observation and control of the dispensary population, especially persons in leading agricultural professions;
analysis of statistical reports on your service; advanced training of medical personnel.
In order to better provide specialized medical care, inter-district specialized centers(branches) equipped with modern equipment. Interdistrict specialized centers provide medical and advisory assistance, carry out organizational and methodological work, improve the qualifications of medical personnel of district and local hospitals and clinics, analyze health indicators and risk factors that determine morbidity in a particular specialty
Territorial Medical Association (TMO).
Central District Hospital (CRH).(1990 - 137 with a number of beds of 37397, 2000 - 137 - 33796, 2005 - 126 with a number of beds of 26889)
The central district hospital is the main institution for providing qualified medical care. At the same time, the Central District Hospital is the center of organizational and methodological management of the district’s healthcare.
Based on capacity, central district hospitals are divided into 5 categories:
Category 1 – 600 or more beds;
Power of the central district hospital and other structural medical institutions determined by the average annual number of deployed beds. Regardless of the bed capacity, the size of the population served and the service radius, the central district hospital must have a certain list of structural units:
1. clinic;
2. hospital with medical departments according to the main medical specialties;
4. diagnostic and treatment departments (offices) and laboratories;
5. organizational and methodological office;
6. emergency department;
7. utility block (catering unit, laundry room, garage, etc.).
if the district center does not have an independent children’s hospital with consultation and a dairy kitchen, maternity hospital With antenatal clinic, then women's and children's clinics and a dairy kitchen as structural units are included in the clinic of the Central District Hospital.
The central district hospital implements the principle of unity of command in the person of the chief physician of the central district hospital (TMO). A medical council is created under the chief physician, there is a certain number of deputies, chief accountant, chief nurse.
Peculiarities:
1. is legal entity;
2. is a manager financial resources;
3. has public structures management (medical council, council of paramedics, council of nurses, etc.).
4. accepts organizational and management decisions;
5. has specialized departments;
6. has an organizational and methodological office (department);
7. has an emergency medical service;
8. departments (services) can perform inter-district functions;
9. has chief specialists;
In the area, in addition to the central district hospital, can be organized specialized dispensaries(anti-tuberculosis, skin and venereal diseases), which operate as inter-district institutions (serve the population of nearby areas). In enlarged districts that emerged as a result of the merger of two or more districts, former district hospitals continue to function, retaining all their functions, organizational structures and standards for serving the population.
In each district of the republic, sanitary and anti-epidemic service institutions are also organized and functioning - regional centers of hygiene and epidemiology (RCHE). Settlements, located around the district center and served by the district’s medical institutions (clinic or central district hospital), are called assigned areas.
TMO tasks:
1) providing the required volume of highly qualified inpatient and outpatient medical care to the population;
2) operational and organizational-methodological management, as well as control over the work of all healthcare institutions and individuals, engaged in individual medical activities on the territory of the region;
3) planning, financing and organizing logistics for health care institutions in the district;
4) planning and implementation of measures to develop a network of medical institutions;
5) development and implementation of measures aimed at improving the quality of medical care for the population of the region, reducing morbidity, disability, hospital mortality, child and general mortality and improving the health of children, adolescents and women;
6) timely and widespread introduction of modern methods and means of prevention, diagnosis, treatment and rehabilitation into the practice of all health care facilities in the region;
7) development, organization and implementation of measures for the deployment, rational use, professional development and education of medical personnel and other personnel of health care institutions in the district;
8) maintaining hospital facilities.
The chief physician has a certain number of deputies:
1) deputy for medical services - supervises organizational and methodological support for the work of health care facilities in the district, supervises the work of chief specialists;
2) deputy for medical affairs - supervises inpatient medical care and emergency medical services;
3) deputy for outpatient work - supervises outpatient medical care;
4) Deputy for Medical and Rehabilitation Expertise - oversees morbidity with temporary and permanent disability, all types of examinations;
5) Deputy for Childhood and Obstetrics - oversees issues of maternal and child health;
6) deputy for administrative and economic work - oversees the issues of logistical support for the work of health care facilities.
135. State Sanitary Epidemiological Centers. supervision (GSEN): functions, structures, basic methods of work.
Pages and functions: 1) information and analytical. block: a) social gig department with study departments health us, software and hardware, b) department for organizing the state sanitary and epidemiological service with departments for organizing and planning activities, service for training and employing personnel, metrology and standardization, hygienic. Arrangement with a press center. 2) block of organization of the State Sanitary and Epidemiological System, which includes: a) department of organization of the State Sanitary and Epidemiological System with departments of epidemiology, food hygiene, labor, children and adolescents, municipal hygiene, sanitary, radiation hygiene, etc. b) department of organization of laboratory control with laboratories san. or microbiological ,physical f-drov, disinfection. stations and government unitary enterprises disinfection profile - the main fucking function of disinfection measures: disinfection, disinfestation, extermination on request. Anti-plague stations - prevention of the spread of especially dangerous infections: monitoring of pathogens, vectors, training of specialists.
Structure of the Central District Hospital"
Central Regional Hospital: location of the institution: Leningrad region,
The planned capacity of the Central District Hospital is:
Inpatient – 331 round-the-clock beds;
Outpatient clinic - 1830 visits per shift, 66 day hospital beds of a therapeutic clinic;
The institution includes separate divisions without branch rights.
Structurally, the Central District Hospital consists of:
Hospital;
Clinic;
Soviet Hospital and Soviet Clinic;
Kondratieff outpatient clinic.
Inpatient care is provided to patients in the following structural units:
1. Hospital.
Located in the Leningrad region, it consists of three buildings (surgical, therapeutic, catering) and includes the following divisions:
1.1 Clinical departments(308 beds):
Surgical department (50 beds);
– on the basis of the department, level 2 trauma center (22 beds from total number) and emergency dressing;
Otolaryngology department (28 beds);
Therapeutic department (49 beds);
Department of Anesthesiology and Reanimation – 6 beds in specialized departments and a block intensive care for 6 beds as part of the cardiology department.
1.2 Diagnostic departments:
Endoscopy department;
Clinical diagnostic laboratory, including serological and immunological laboratories;
Cabinet functional diagnostics(as part of the cardiology department).
1.3 Other medical and auxiliary departments:
Reception department;
Operating department (3 operating rooms, including a shock operating room);
Central sterilization department;
Transfusion therapy room;
Organizational and methodological department (statistics office, insurance desk, archive, information technology department);
Civil Defense and Emergency Cabinet;
Planning and economic department and accounting department;
Human Resources Department;
Administrative and economic part;
Auto transport;
Food block.
2. Soviet hospital .
Located at: Vyborg district, town. Sovetsky, st. Komsomolskaya 1. Distance from the central district hospital – 25 km. It includes a department palliative care for 23 beds, catering unit, laundry.
Outpatient care is provided:
1. Clinic.
Located Distance from the central district hospital - 2 km. Has 5 buildings in various parts city of Vyborg. It has a planned capacity of 1,300 visits per shift, as well as 30 day hospital beds and a home hospital for 600 visits per year. It contains:
1.1 Branches:
Surgical department (surgeon, traumatologist, oncologist, urologist);
Therapeutic department (precinct physicians);
Department of specialized specialists (cardiologist, neurologist, endocrinologist, ophthalmologist, infectious disease specialist, epidemiologist, ENT);
Department of Dermatovenerology (dermatologist, venereologist).
Department of Medical Prevention;
Physiotherapeutic department;
Pre-medical rooms;
Emergency room;
Day hospital(20 beds in 2 shifts), hospital at home;
Treatment room;
Vaccination office;
Examination room;
MIBP storage warehouse;
Registry;
Office of Medical Statistics;
Insurance desk;
Hospitalization Center;
Endoscopy room;
Department of Radiation Diagnostics;
Doctors department general practice for 14 plots;
Psychoneurological department;
Anti-tuberculosis department;
Health Center.
1.2. 2 rural outpatient clinics:
1. Outpatient clinic in the village of Seleznevo. The distance from the central district hospital is 10 km. Capacity 30 visits per shift. Day hospital – 3 beds in two shifts.
Population served – 4,621 people.
2. Outpatient clinic in Krasnaya Dolina. The distance from the central district hospital is 50 km. Population served – 6,341 people. Capacity 95 visits per shift. Day hospital – 8 beds per shift.
3.Medical and midwifery stations:
1. Medical and obstetric station of the village. Tokarevo - Leningrad region, Vyborg district, village. Tokarevo, st. Klenovaya, building No. 5 a;
2. Medical and obstetric station of the village. Dyatlovo - Leningrad region, Vyborg district, village. Dyatlovo, st. Sadovaya, 4;
3. Medical and obstetric station of the village. Torfyanovka - Leningrad region, Vyborg district, village. Torfyanovka, b/n;
4. Medical and obstetric station of the village. Zhitkovo - Leningrad region, Vyborg district, village. Zhitkovo, house No. 22;
5. Medical and obstetric station in the village of Veshchevo - Leningrad region, Vyborg district, village. Veshchevo, house number 16;
6.Medical and obstetric station of the village. Baryshevo - Leningrad region, Vyborg district, village. Baryshevo, building No. b/n, lit. A. ;
7.Medical and obstetric station of the village. Sokolinskoye - Leningrad region, Vyborg district, village. Sokolinskoye, Primorskaya street, house No. 21;
8.Medical and obstetric station of the village. Gavrilovo - Leningrad region, Vyborg district, village. Gavrilovo, Shkolnaya street, house No. 6;
9.Medical and obstetric station of the village. Revival - Leningrad region, Vyborg district, village. Revival, building No. b/n, lit. A;
10.Medical and obstetric station of the village. Perovo - Leningrad region, Vyborg district, village. Perovo, building No. b/n, lit. A;
11.Medical and obstetric station of the village. Goncharovo - Leningrad region, Vyborg district, village. Goncharovo, house No. 3;
12. Medical and obstetric station in the village of Bolshoye Pole - Leningrad region, Vyborg district, village. Big field, Rimsky-Korsakov street, house number 25, lit. A, A 1, a;
13. Medical and obstetric station of the village. Kamyshovka - Leningrad region, Vyborg municipal district, Primorskoe state enterprise, village. Kamyshovka, st. Poselkovaya, house No. 10;
14. Medical and obstetric station in the village of Ryabovo - Leningrad region, Vyborg municipal district, Primorskoe State Enterprise, pos. Ryabovo, house No. 1
15. Medical and midwifery station in Vysotsk, Leningradskaya region,
Medical offices:
educational institution "Kamenskaya secondary general education
school, Russian Federation, Leningrad region, Vyborg
district, Kamenka village
17. Medical office in a municipal budgetary preschool educational institution " Kindergarten village Kondratyevo", Russian Federation, Leningrad region, Vyborg district, Kondratyevo village, office. No. 29,31,32,33,34.
18.Medical office in the municipal budget preschool educational institution "Kindergarten combined view "Islet" village. Sovetsky, Russian Federation, Leningrad region, Vyborg district, office. No. 61,62,63,64,65,66,67,68,69.
19. Medical office in the municipal budgetpreschool educational institution "Kindergarten combined view "Rosinka" village. Sovetsky, Leningrad region, Vyborg district, urban settlement Sovetsky, st. Sadovaya, Zb-A, room. No. 15,16,17,18,19.
20. Medical office in the municipal budgetary preschool educational institution “Kindergarten of a general developmental type with priority implementation of activities in the cognitive and speech direction of children’s development “Vesely Rucheek” village. Seleznevo, Russian Federation, Leningrad region, Vyborg district, Seleznevo village, st. Central, building 15a, room. No. 37,38,39.
21. Medical office in the municipal budgetary preschool educational institution "Kindergarten "Yagodka" in the village of Tokareva, Russian Federation, Leningrad region, Vyborg district, village of Tokarevo, st. Klenovaya, 10a, room. No. 58.38.
22. Medical office in the municipal budget preschool educational institution "Kindergarten "Malyshok" village of Krasnaya Dolina, Russian Federation, Leningrad region, Vyborg district, village of Krasnaya Dolina, pom. No. 37, 39,40.
23. Medical office in the Municipal Budget educational institution"Average secondary school Sovetsky village", Leningrad region, Vyborg district, Sovetsky village, Sadovaya street, house 32, block A1, room. No. 11.
24.Medical office in the Municipal Budget general education institution "Krasnodolinskaya average comprehensive school", Leningrad region, Vyborg district, Krasnaya Dolina village, pom. No. 11.
25. Medical office, Leningrad region, Vyborg district, municipal district "Vyborg urban settlement" Vyborg, st. School room 3.
2. Soviet clinic.
Located at: Vyborg district, pgs. Sovetsky, st. Shkolnaya 59. Distance from the central district hospital – 25 km. Capacity 330 visits, including day hospital - 14 beds.
Therapy rooms.
Offices of narrow specialists.
Pre-medical office.
Dental office.
Dentist's office.
Treatment room.
Physiotherapeutic office.
Fluorography room
It consists of 2 FAPs:
FAP p. Dyatlovo. Distance 18 km. Adult population 257, children – 46.
FAP p. Tokarevo. Distance 12 km. Adult population 825, children – 155.
The population served is 8,107, of which 6,821 are adults, including 1,237 rural people. Child population– 1,286, including rural – 201 people.
3. Kondratieff outpatient clinic.
Located at the address: Vyborg district, Kondratyevo village. The distance from the central district hospital is 40 km.
Population served: 1455 people. Capacity 25 visits per shift. Day hospital – 8 beds per shift. Hospital at home – 600 visits per year. It includes 1 first medical point in the village of Torfyanovka.
CRH" serves a population of 101,462 people, including an urban population of 72,531 people. (of which children - 2,694), rural - 28,931 people. (of which 1,557 are children).
Central district hospital - in the area, a clinic attached to it (surgeons, therapists, ophthalmologists, ENT doctors, pediatricians, obstetricians-gynecologists), a hospital attached to it (almost all departments).
Problems: reduction of beds.
Central District Hospital is a center for the provision of specialized and qualified medical care. assistance to the rural population in the area.
Structure:
1) hospital,
2) clinic,
3) treatment and diagnostic rooms and laboratories
4) branches ambulance,
5) pathology department,
6) organizational and methodological office,
7) auxiliary (pharmacies, kitchen, etc.)
1) providing the population of the region with specialized inpatient and outpatient care,
2) organization of ambulance and emergency care,
3) organization of advisory and practical assistance to doctors of rural district hospitals on issues of medicine activities,
4) planning, financing and organizing the material and technical supply of health care institutions in the region,
5) control over the activities of all medical institutions in the district.
6) Reducing morbidity and disability among residents of the area.
Chief physician of the Central District Hospital ( chief physician district) is subordinate to the district (city).
60. Rules for issuing and extending certificates of incapacity for work for illnesses. 2.1. In case of illnesses and injuries, the attending physician issues a medical document individually and at a time for a period of up to 10 calendar days and extends it individually for a period of up to 30 calendar days,
2.2. A mid-level medical worker who has the right to issue medical information, up to 5 days and extends up to 10 days, in exceptional cases, after consultation with a doctor at the nearest medical institution, for a period of up to 30 days.
2.3. For periods of temporary disability of more than 30 days, resolving the issue further treatment and extension of the certificate of incapacity for work is carried out by the CEC, appointed by the head of the medical institution.
By decision of the clinical expert commission, LN can be extended until full recovery disability, but for a period of no more than 10 months, in some cases (injuries, conditions after reconstructive operations, tuberculosis) - no more than 12 months, with renewal frequency by the commission no less than every 30 days.
2.4. In case of illnesses (injuries), a certificate of incapacity for work is issued on the day the incapacity for work is established, including holidays and weekends. It is not allowed to be issued for the past days when the patient was not examined by a doctor.
In exceptional cases, a certificate of incapacity for work may be issued for the past period by decision of the clinical expert commission.
2.5. Citizens who seek medical help at the end of the working day are issued a certificate of incapacity for work, with their consent, starting from the next calendar day.
2.6. Citizens sent by a health center to a medical institution and recognized as incapacitated for work are issued a certificate of incapacity for work from the moment they contact the health center.
2.7. For citizens in need of treatment in specialized medical institutions, the attending physicians issue a certificate of incapacity for work with subsequent referral to institutions of the appropriate profile to continue treatment.
2.10. In cases where the disease or injury that caused temporary disability was the result of alcohol, drug, or non-drug intoxication, a certificate of incapacity for work is issued with an appropriate note about the fact of intoxication in the medical history ( outpatient card) and on the certificate of incapacity for work.
2.12. Citizens sent by court decision for a forensic medical or forensic psychiatric examination who are recognized as incapacitated for work are issued a certificate of incapacity for work from the date of admission for examination.
The second stage of medical care for the rural population.
The main institution of the second stage of medical care for the rural population is the central district hospital (CRH). It provides the rural population with qualified treatment and preventive care, both inpatient and outpatient.
Basic tasks of the central district hospital:
providing highly qualified, specialized inpatient and outpatient care to the population of the district and regional center;
operational, organizational and methodological management and control over the activities of all healthcare institutions;
planning, financing and organizing logistics for health care institutions in the region;
development and implementation of measures aimed at improving the quality of medical care for the population of the region, reducing morbidity, disability, hospital mortality, child and general mortality and improving the health of adolescents;
timely implementation of modern methods and means of prevention, diagnosis and treatment into the practice of health care facilities;
implementation of measures for the placement, rational use and improvement of professional qualifications of personnel;
carrying out activities aimed at the effective use of funds and forces, strengthening the material and technical base of the district, improving the systems of organizational, methodological and operational management, management of all health care facilities in the district, using modern scientific achievements;
provision of ambulance and emergency care in the region.
The central district hospital, regardless of bed capacity, population size and service radius, has a hospital, a clinic, a pharmacy, a prosector, paraclinical and administrative services, an organizational and methodological office (OMK), an ambulance and emergency department.
The in-patient department of the Central District Hospital must have at least 5 departments according to specialties; therapy, surgery, pediatrics, obstetrics and gynecology, infectious diseases. In addition to the required minimum, departments in other specialties (neurology, otorhinolaryngology, ophthalmology, traumatology, etc.) can be organized in large central district hospitals.
In the outpatient department of the Central District Hospital, specialized care is provided in 1015 specialties, and such departments often serve as inter-district specialized centers.
Patients living in an area assigned to a district hospital are served directly by the hospital. Patients living in other areas are admitted to the district hospital on the referral of doctors from local hospitals. Local doctors refer patients to the district hospital in cases where the necessary specialized care cannot be provided on site, when patients need consultation, clarification of the diagnosis, X-ray or laboratory clinical diagnostic examination. The participation of specialists from district hospitals during clinical examinations is widely used.
Rural residents turn to the district hospital following referrals from medical institutions in the rural area if they need specialized medical care, functional examination, or consultation with medical specialists.
Mobile assistance plays an important role in the work of the Central District Hospital. Mobile medical teams are formed by the chief physician and see patients in 5-7 specialties. The composition of the team's medical specialists is determined depending on the development of the network of outpatient clinics in a given territory, its staffing with doctors and the population's needs for appropriate types of medical care. It may include doctors: therapists, pediatricians, surgeons, obstetricians-gynecologists, ophthalmologists, neurologists, etc. The visiting team is provided with vehicles, including special ones, and is equipped with the necessary equipment (mainly portable) and equipment for examining and treating patients . The leadership of the mobile medical team is entrusted to one of the qualified doctors of the team who has experience in medical and organizational work. Fluorographic and dental offices, clinical diagnostic and bacteriological laboratories regularly visit the village.
Ambulance and emergency care is provided by the relevant department, which is part of the Central District Hospital, which is responsible for providing this type of assistance to the population of the district center and the settlements assigned to it.
One of the most important structural units of the Central District Hospital is the organizational and methodological office (OMK), headed by the deputy chief physician of the Central District Hospital for medical care of the population of the district. OMK is the main assistant to the chief physician in matters of management, organization and coordination of all organizational and methodological work of the Central District Hospital and other medical institutions in the region.
The main tasks of OMK include:
analysis and synthesis of data on the health status of the population and the activities of health care facilities in the district;
calculation of evaluation indicators and analysis of the activities of the Central District Hospital as a whole and for individual specialized services;
compiling a summary report on the network, personnel and activities of health care facilities in the district; identifying shortcomings in the work of health care facilities and developing measures to eliminate them; development of an action plan for medical care of the entire population of the district, monitoring its implementation;
implementation of measures to improve the quality of treatment and preventive work,
advanced training of specialists,
study and dissemination of new modern forms of work in medical care,
long-term planning for the development of healthcare in the region,
organization of work on off-budget commercial activities and health insurance.
The OMK work plan is actually a plan for the organizational and methodological work of the entire Central District Hospital. Its mandatory sections are:
analysis of demographic indicators and reporting materials on the network, personnel and activities of health care facilities in the area and on the health status of the population;
organization and implementation of measures to provide treatment, advisory and organizational and methodological assistance to medical institutions in the region;
carrying out activities to improve the qualifications of medical workers; strengthening the material and technical base of health care facilities in the region.
assessment of the activities and effectiveness of the district’s medical institutions and departments of the Central District Hospital;
measures to improve the quality of medical care, ambulance and emergency care;
introduction of new types of diagnostics and treatment;
improvement of ethical and deontological aspects in the staff of medical institutions.
Based on a systematic analysis of the health status of the region's population and the plans of district institutions, the cabinet draws up a comprehensive action plan to improve medical care and strengthen the health of the region's population.
Providing methodological guidance and control over accounting and statistical work in all institutions of the district is the most important function of the organizational and methodological office. The duties of the offices include receiving annual reports. Based on data from reporting forms and special analysis, the organizational and methodological department compiles an overview of the health status of various population groups and evaluates health indicators. Organizational and methodological rooms should contain information about regional conferences and classes with doctors and paramedical personnel, seminars with the participation of regional specialists, specialization and advanced training of medical workers.
The chief (district) specialists of the district, who are also heads of specialized departments of the central district hospital, work in close contact with the OMK of the Central District Hospital. Currently, in almost all regions there are regional specialists in therapy, pediatrics, surgery, obstetrics and gynecology, and phthisiology. They are appointed by the chief physician of the district in agreement with the chief regional specialists and report directly to the chief physician of the Central District Hospital or his deputy.
The main functions of district specialists are:
organizational and methodological management of the work of the relevant specialized service;
regular visits in accordance with the schedule to local hospitals, medical outpatient clinics and first aid stations;
improvement of methods of diagnosis, treatment, prevention of specialized diseases;
observation and control of the dispensary population, especially persons in leading agricultural professions;
