National Health Project. State program of the Russian Federation "health care development". See what is "National Project" Health "" in other dictionaries

By 2006, Russian healthcare came with the following accumulated problems :

underfunding of the industry;

outdated material and technical base of medical institutions;

structural imbalances;

outdated methods of hospital management (ineffective use of industry resources).

In addition, essential disadvantage the health care system was a weakening of the preventive focus, health education of the population and the formation healthy way life.

The lack of results of the reforms carried out in the 80s - 90s of the twentieth century and the ongoing crisis in public health led to the need to revise the state policy in relation to health care.

To correct the current situation, at the suggestion of the President of Russia, the Ministry of Health and Social Development of the Russian Federation developed , and December 21, 2005 approved national project "Health", whose main priorities are:

1. Development of primary health care:

making payments to doctors of general (family) practice, district general practitioners, district pediatricians and nurses of district general practitioners and district pediatricians, taking into account the volume and results of their activities;

training and retraining of general doctors (family practice, district general practitioners and district pediatricians;

organizing the opening of offices of general practitioners

equipping outpatient clinics with diagnostic equipment

providing medical assistance to women during pregnancy and childbirth in state and municipal health care institutions on the basis of birth certificates;

equipping ambulances, including ambulances;

2. Strengthening the preventive focus of health care:

the formation of a culture of health among a significant part of the population, an increase in motivation to preserve it;

additional medical examination of the working population;

immunization of the population within the framework of the national immunization schedule;

prevention of HIV infection, hepatitis B and C, identification and treatment of HIV patients;

examination of newborns for galactosemia, adrenogenital syndrome and cystic fibrosis;

3. Provision of the population with high-tech medical care:

construction of federal centers of high medical technologies;

increasing the availability and volume of high-tech medical care.

At a meeting with members of the government, the leadership of the Federal Assembly and members of the Presidium of the State Council on September 5, 2005, President of Russia V.V. Putin was told: “ I consider it necessary to pay special attention to the development of primary medical care, primary medical care, prevention of diseases, including vaccination and effective clinical examination of the population…».

Project "Health" as tasks, which will be decided in the coming years, are determined:

Increased life expectancy,

Reducing infant mortality and improving the effectiveness of care for women during pregnancy and childbirth,

Reducing the number of infectious diseases due to vaccine prevention and vaccination.

Responsible for project implementation:

Ministry of Health and Social Development of the Russian Federation

Ministry of Finance of the Russian Federation

Ministry economic development and trade of the Russian Federation

Ministry of Education and Science of the Russian Federation

Ministry information technologies and communications of the Russian Federation.

Financing a national health project will amount to 208.9 billion rubles, including 88.4 billion rubles in 2006.

Main activities and expected results of the national project "Health":

It is planned to reorganize the health care system so that a standard set of quality health services is provided to all those in need. Health care opportunities will be balanced with the available financial resources, and the regions will receive equal financial opportunities in the social sphere;

Primary health care will become more accessible and of better quality;

General practitioners, district therapists and district pediatricians will undergo advanced training and professional retraining;

The prestige of the work of primary health care workers will increase, as a result, young qualified specialists should come to the district service;

Outpatient clinics will be equipped with the necessary diagnostic equipment, which means that waiting times will be reduced and the quality of diagnostic tests will increase;

New machines will be delivered to the regions " Ambulance", This will increase the efficiency of the ambulance service;

Organization of mass screening of newborns to detect hereditary diseases (phenylketonuria, congenital hypothyroidism, adrenogenital syndrome, galactosemia, cystic fibrosis) will prevent the disability of children;

Organization of additional free immunization of the population will lead to a decrease in morbidity;

Timely detection and prevention of diseases will become possible due to the mass free medical examination of working citizens (aged 35 - 55 years) and citizens working in industries with harmful and hazardous industrial conditions;

The detection of diseases will increase by 1.5 times and the average life expectancy of patients after the first diagnosis by 3.5 years (up to 12 years), the number of days of temporary disability will decrease by 30%;

It will become possible to reduce the incidence of hepatitis B by 3 times, rubella - up to 10 cases per 100 thousand population, elimination of congenital rubella; the incidence of influenza is stabilized in the absence of a pandemic virus; the frequency of HIV infection will decrease (per 1000 people per year);

Due to the construction of new federal centers of high medical technologies, waiting times will decrease and the availability of high-tech (expensive) medical care, especially for residents of remote areas, will increase;

The transparency of the queue for receiving high-tech (expensive) types of medical care will be ensured through the introduction of a “waiting list” system;

The quality of medical care provided to pregnant women, both in antenatal clinics and in maternity hospitals, will improve through the introduction of a system of birth certificates.

In the long term, in the course of the successful implementation of the Health project, it is expected:

* Reducing mortality and disability rates population by increasing the availability and quality of medical care;

* Meeting the need population of the Russian Federation in free high-tech (expensive) medical care;

* Approximation domestic health care to European standards medical assistance to the population;

* Reducing economic losses by strengthening and restoring the health of citizens, reducing financial costs for the payment of disability pensions and benefits for temporary incapacity for work;

* Strengthening Russia's position in the domestic and international markets of medical services and medical technologies (economic and professional incentives for the implementation of domestic developments at the international level and the attraction of foreign patients to Russian clinics).

Announced by the President of the Russian Federation Vladimir Putin in 2005 as part of the implementation of four national projects.

Goals and objectives of the project:

1. Strengthening the health of the population of Russia, reducing the level of morbidity, disability, and mortality.
2. Increasing the availability and quality of medical care.
3. Strengthening primary health care, creating conditions for the provision of effective medical care at the pre-hospital stage.
4. Development of preventive health care.
5. Meeting the needs of the population for high-tech medical care.

The main areas of the priority national health project include:

Development of primary health care, which provides for the following activities: training and retraining of general (family) practice doctors, district general practitioners and pediatricians; increase wages medical workers of primary care, feldsher-obstetric points and ambulances; strengthening the material and technical base diagnostic service outpatient clinics, emergency medical care, antenatal clinics; prevention of HIV infection, hepatitis B and C, identification and treatment of HIV-infected; additional immunization of the population within the framework of the national immunization schedule; introduction of new screening programs for newborns; additional medical examination of the working population; providing medical assistance to women during pregnancy and childbirth in state and municipal health care institutions.

Providing the population with high-tech medical care: increasing the volume of high-tech medical care; construction of new centers of high medical technologies, training of highly qualified doctors and nurses for these centers.

In 2008, the national project "Health" included new measures aimed at reducing the mortality rate of the population of the Russian Federation from manageable causes and preserving the country's labor potential:

Improving the organization of medical care for victims of road traffic accidents, which will help reduce deaths from road traffic accidents by 2,700 annually, as well as reduce disability to 8 thousand cases per year. Within the framework of this direction, it is planned to equip 1,130 state and municipal health care institutions with medical vehicles (610 units) and medical equipment (4,182 units).

Improvement of medical care for patients with cardiovascular diseases will ensure a decrease in mortality from cardiovascular diseases by 1.3 times (from 325 cases to 250 cases per 100 thousand population). Within the framework of this direction, it is planned to create regional vascular centers for minimally invasive surgery in healthcare institutions of the constituent entities of the Russian Federation and municipalities.

The development of new high medical technologies on the basis of federal medical institutions, as well as medical institutions under the jurisdiction of the constituent entities of the Russian Federation and municipalities, which will increase the level of provision of the population with high-tech types of medical care to 70% of the need.

In 2009, the following areas were additionally included in the national project "Health":

Formation of a healthy lifestyle among Russians... Within the framework of this direction, the Ministry of Health and Social Development of Russia plans to conduct a large-scale information campaign aimed at combating alcoholism and tobacco smoking, as well as at promoting a healthy lifestyle.

Reducing morbidity and mortality from tuberculosis... The program provides for the implementation modern methods diagnosis and prevention of tuberculosis, treatment and rehabilitation of patients.

Methodological recommendations and reporting forms for the regional project of St. Petersburg "Development of the primary health care system"

Minutes No. 2 dated 12/13/2018 of a joint meeting of project committees for the national projects “Demography” and “Healthcare”, the Council for Demographic Development of St. Petersburg and the Coordination Council for Family and Childhood Issues in St. Petersburg approved the passport of the regional project of St. Petersburg “ Healthcare ", consisting of 7 passports of regional projects of St. Petersburg:

The Ministry of Health approved the National Healthcare Project. Below are the main points that are planned to be implemented by the Ministry together with the regions of Russia.

The National Healthcare Project is an interdepartmental project, 10 federal executive authorities, the Russian Export Center and 85 regions of the country will take part in its implementation. the main task, which stands before the project - to fulfill the goals that were formulated by the President of the Russian Federation in Decree No. 204 dated 05/07/2018: reducing the mortality rate of the working-age population from two main causes - cardiovascular and oncological diseases, and reducing infant mortality.

The main emphasis in the federal project is devoted to improving the availability, quality and comfort of primary health care. It is planned to more than double the coverage of the population with preventive examinations. The task set by the President is that every Russian can undergo a preventive examination once a year.
The process of introducing lean technologies - creating a comfortable environment in polyclinics - for both children and adults - is already underway. Technologies include a conveniently working reception desk, no queues when making appointments and at doctor's offices, problem-free medical examination, separation of flows of healthy and sick patients, etc. More than 7 thousand polyclinics and polyclinic departments should be included in this project by 2024.

The project is associated with a project to improve the staffing situation in Russian healthcare, therefore, a separate block in it is devoted to the replenishment of medical posts, posts of paramedical personnel in primary care. The target has been set - to reach 95% of staffing.

The federal project is further dedicated to reducing mortality from cardiovascular diseases and improving the quality and availability of care for patients with cardiovascular diseases, ranging from prevention, including population, development of a healthy lifestyle and individual prevention. Of course, these programs are also closely related to the first task - with the passage of prophylactic examinations, medical examination and correction of the identified risk factors. The Ministry of Health plans to implement modern clinical guidelines and treatment protocols for all patients.

It is planned to reduce mortality from diseases of the circulatory system from 587 to 450, that is, by more than 130 thousand. This means that in 2024 the number of deaths from vascular causes will decrease by more than 200 thousand.

Next is the task of combating cancer. A total alertness to oncological diseases in the primary care should be formed, for which not only all district doctors are subject to special training, but also narrow specialists working in outpatient institutions. The Ministry of Health has developed a special illustrated program, informational, remote, which allows you to undergo initial testing and then improve your level of qualifications for mastering this material. Currently, already 80% of local therapists have completed this program and received the appropriate certificate. We need to connect district pediatricians, narrow specialists and general practitioners, family doctors to it. The second point is the formation of outpatient oncological services at the inter-district, inter-municipal level.

A separate part of the program is not just eliminating the shortage of personnel in the oncological service, but creating a new generation of personnel, including not only medical personnel but also the engineering staff. This training will be carried out in cooperation with the Ministry of Science and higher education RF. Clusters for the training of radiochemists, medical physicists, and radiophysicists - those specialists without whom radiology cannot develop - will be jointly formed.

The fourth direction is the improvement of medical care for children, including the development of children's infrastructure. It includes the development of a preventive movement and the introduction of new preventive technologies.

The fifth direction is devoted to personnel policy in health care. First of all, the shortage of personnel in primary care should be eliminated. The next task is to develop digital medicine. By 2022, in each of the 85 regions, a full-fledged information system should be created that meets strict uniform criteria, with the connection of all medical organizations to this regional information system. To do this, unified centralized servers, a digital archive of images, laboratory research, centralized regional dispatching ambulances, and not only road, but also air ambulance, are being introduced - that is, those systems that allow you to ensure the continuity of medical care and monitor its quality, patient routing etc.

There is also a project to develop the export of medical services. It raises the image of Russian medicine and attracts additional resources for the development of clinics. The potential here is very large - over the past two years, the number of foreign patients in hospitals in our country has significantly increased - from 20 thousand to more than 110 thousand. This direction allowed only last year hospitals earn about $ 250 million. The task set by the President is to quadruple the volume of revenues, to $ 1 billion a year. For this, a special communication campaign will be developed.

Undoubtedly, the complexity of the implementation of this project is due to the fact that the main powers for the implementation of medical care are given in our country to the subjects of the Russian Federation. The task of the Ministry of Health is to organize the management of this national project in such a way that there are no distortions during its implementation in the regions. To this end, the Ministry of Health plans to create 85 regional projects on the basis of a generally approved national project. They will be individualized according to the specific needs of a particular region, they will understand all the indicators, lined up by year. The Ministry of Health will not only control, but also very actively help the regions in order to achieve the set goals. If all this is done as planned, Russian medicine will move to a different quality level.

Objectives of the project

Strengthening the health of citizens
Improving the availability and quality of medical care
Development of primary health care
The revival of the preventive direction in health care
Providing the population with high-tech medical care

Main directions

As part of the development of primary health care, the following activities are envisaged:

training and retraining of general practitioners
an increase in the salary of primary health care workers.

Since January 1, 2006, district general practitioners, district pediatricians and general (family) practice doctors are additionally paid 10 thousand rubles, nurses working with them - 5 thousand rubles.

Since July 1, 2006, the ambulance personnel receive incentive payments in the amount of: 5000 rubles. for doctors, 3500 rubles. for paramedics and 2500 rubles. for nurses.

strengthening the material and technical base of emergency medical care

As part of providing the population with high-tech medical care, it is planned to:

improving the quality and volume of high-tech medical care
construction of new medical centers and training of personnel for them (construction of 15 federal medical centers is planned).

Financing

In 2006, 78.98 billion rubles were allocated from the federal budget and state extra-budgetary funds for the implementation of the project. Moreover, additional funds were allocated by the subjects of the Russian Federation and municipalities... In 2007, 131.3 billion rubles will be allocated.

For 2007-2009, expenses related to the implementation of the project are planned in the amount of 346.3 billion rubles.

Immediately after the start of the national project, it turned out that the financing of several important items of expenditure had not been taken into account during its development. For example, incentive payments received by medical staff, contrary to Art. 139 Labor Code not included in average earnings and, therefore, these payments did not affect the amount of "vacation" and "sick leave". In this regard, a huge number of appeals were sent to the Ministry of Health both from regional health leaders and from ordinary employees. The first to achieve justice on this issue was therapist Anatoly Popov from the Vladimir region.

The issue of the so-called “ northern allowance”, Which is a significant part of the salaries of the population of the northern regions. This premium should apply to all types of earnings, regardless of their source, but none of the budgets provided funds for these purposes. In a number of regions, after medical workers have applied to the courts, arrears on "northern allowances" for incentive payments are reimbursed only to those who apply for it to the court. Health authorities continue to challenge court decisions with varying degrees of success, according to which employers were ordered to pay arrears under the "northern allowance". Funding problems continued in 2008 and 2009, part of the costs were shifted to the shoulders of regional, city and even municipal authorities, which did not contribute to the achievement of the project's goals.

Implementation results

Life expectancy in Russia

At the beginning of July 2007, 5834 doctors had been trained and retrained (2939 specializing in Therapy, 2298 in Pediatrics and 597 in General Medical Practice). In the first half of 2007, more than 150 thousand medical workers (more than 70 thousand doctors and 79 thousand nurses) received additional cash payments totaling more than 6.6 billion rubles.

At the beginning of July 2007, 3267 units of diagnostic equipment were delivered to the regions (512 sets of laboratory equipment, 71 ultrasound machines, 788 X-ray machines with 443 developing machines, 438 units of endoscopic equipment, 465 electrocardiographs and 550 fetal monitors). It was planned that in 2007 375 children's polyclinics will be equipped with modern diagnostic equipment.

At the end of 2009, life expectancy in Russia increased to 69 years. In February 2010, Russian Deputy Prime Minister Alexander Zhukov said that the increase in life expectancy is the success of priority national projects.

Criticism

Despite the good intentions of the curators of the national project, it was not possible to significantly change the situation in healthcare. Some experts call the national project "Health" a failure.

There was no one to work on the supplied equipment, Consumables quickly ended, and the quality of the equipment itself leaves much to be desired.

Against the backdrop of optimistic reports from the ministry about the success of the national project, the State Duma deputies said that the situation with drug supply and the staff of medical institutions leaves much to be desired.

Sources of

Links

National project "Health". Official site of the Council under the President of Russia for the implementation of priority national projects and demographic policy
News feed on the national project "Health" on IA REGNUM

Wikimedia Foundation. 2010.

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Government program Of the Russian Federation "Healthcare Development" (hereinafter - the State Program) was approved by the Decree of the Government of the Russian Federation dated December 26, 2017 No. 1640 "On Approval of the State Program of the Russian Federation" Healthcare Development ".

Decree of the Government of the Russian Federation No. 380 of March 29, 2019 "On Amendments to the State Program of the Russian Federation" Development of Health Care "approved changes to the State Program concerning the adjustment of goals, the composition of co-executors and participants, the structure and timing of the pilot State Program, the rules for the provision and distribution subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation.

The state program was developed in accordance with the Rules for the Development, Implementation and Evaluation of the Effectiveness of Certain State Programs of the Russian Federation, approved by the Decree of the Government of the Russian Federation dated October 12, 2017 No. 1242 "On the Development, Implementation and Evaluation of the Effectiveness of Certain State Programs of the Russian Federation."

The state program was prepared taking into account the provisions:

Messages of the President of the Russian Federation to the Federal Assembly of the Russian Federation dated March 1, 2018; dated February 20, 2019;
Decree of the President of the Russian Federation of May 7, 2018 No. 204
"On national goals and strategic objectives of the development of the Russian Federation
for the period up to 2024 ";
The main directions of activity of the Government of the Russian Federation for the period up to 2024, approved by the Chairman of the Government of the Russian Federation D.A. Medvedev on September 29, 2018 No. 8028p-P13;
Methodological guidelines for the development of national projects (programs) approved by the Chairman of the Government of the Russian Federation D.A. Medvedev on June 4, 2018 No. 4072p-P6;
Organization regulations project activities in the Government of the Russian Federation, approved by the Government
Russian Federation dated October 31, 2018 No. 1288;

documents strategic planning Russian Federation
in the field of health care;
decisions (instructions) of the President of the Russian Federation
and the Government of the Russian Federation; and etc.

Taking into account the Decree of the President of the Russian Federation of May 7, 2018 No. 204 "On national goals and strategic objectives of the development of the Russian Federation for the period up to 2024" (hereinafter - Decree No. 204), the goals of the State Program have been adjusted.

Objectives of the State Program:

1) decrease in mortality of the working-age population by 2024
up to 350 cases per 100 thousand population;

2) reduction by 2024 of mortality from diseases of the circulatory system to 450 cases per 100 thousand population;

3) decrease in mortality from neoplasms by 2024, including
from malignant, up to 185 cases per 100 thousand population;

4) a decrease in infant mortality by 2024 to 4.5 cases per 1,000 live births.

Target values by year of implementation are indicated
in the passport of the State Program.

The deadline for the end of the implementation of the State program from 2025 has been changed
for 2024 in accordance with the deadline for completing the implementation of the national project "Health". This change was approved by the order of the Government of the Russian Federation dated October 13, 2018 No. 2211-r "On amendments to the list of state programs of the Russian Federation."

The project part of the pilot State Program includes the national project "Health" (hereinafter - the National Project).

As part of the National Project, structural elements reflect
8 federal projects:

"Development of the primary health care system";

"Fight against cardiovascular diseases";

"Fight against cancer";

"Development of children's health care, including the creation of a modern infrastructure for the provision of medical care to children"

"Provision of medical organizations of the healthcare system with qualified personnel";

"Development of a network of national medical research centers
and the introduction of innovative medical technologies ”;

"Creation of a unified digital circuit in healthcare based on a unified state information system health care (EHISZ) ";

"Development of the export of medical services";

Passports of federal projects are approved by the minutes of the meeting of the project committee for the national project "Health"
dated December 14, 2018 No. 3.

In addition, the structure of the project part of the State Program includes 2 federal projects implemented within the framework of the national project "Demography":

“Strengthening public health”;

"Older generation".

The process part of the State Program includes 24 departmental target programs (VTsP), developed on the basis of individual activities.

Development and approval of VTsP projects was carried out in accordance with
with the Regulation on the development, approval and implementation of departmental
target programs approved by the Government of the Russian Federation of April 19, 2005 No. 239 (as amended on February 23, 2018 No. 196).

The State Program includes in the form of appendices the Rules for the distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation, as well as summary information on the advanced development of priority territories of the Russian Federation. The list of priority territories has been brought in line with clause 1 of the Decree of the President of the Russian Federation dated November 3, 2018 No. 632 "On Amending the List of Federal Districts Approved by the Decree of the President of the Russian Federation No. 849 dated May 13, 2000".