The strategic goal of the program is: Improving the health care system for preventing diseases, preserving and strengthening the physical and mental health of each person, maintaining its long-life active life, providing him with medical care. The strategic goal of the program is achieved by 2020 through reducing the values \u200b\u200bof the following indicators:

• mortality from all reasons - up to 10.3 cases per 1000 population;
• infant mortality - up to 6.4 cases per 1000 born alive;
• maternal mortality - up to 15.5 cases per 100 thousand population;
• mortality from diseases of the circulatory system - up to 551.4 cases per 100 thousand population;
• mortality from road traums - up to 10 cases per 100 thousand population;
• mortality from neoplasms - up to 189.5 cases per 100 thousand population;
• mortality from tuberculosis - up to 8.2 cases per 100 thousand population;
• consumption of alcoholic beverages (in recalculation of absolute alcohol) - up to 10 liters per capita per year;
• the prevalence of tobacco consumption among adults - up to 25%;
• the prevalence of tobacco consumption among children and adolescents is up to 15%;
• the incidence of tuberculosis is up to 35.0 cases per 100 thousand population;

increased values \u200b\u200bof the following indicators by 2020:

• life expectancy at birth to 75.7 years;

achievements by 2018 the values \u200b\u200bof the following indicators:

• the ratio of wages of doctors and employees of medical organizations with higher medical (pharmaceutical) or other higher education, to the average wage in the respective region - 200%;
• the ratio of wages of a medium medical (pharmaceutical) personnel to the average wage in the corresponding region is 100%;
• the ratio of wages of junior medical personnel (personnel providing conditions for the provision of medical services) to the average wage in the relevant region is 100%.

Program tasks

The tasks of the transformation of Russia in the global leader of the global economy, reaching the level of developed countries in social welfare indicators, new requirements for the health care system are dictated.

Ensuring the priority of prevention in the health and development of primary health care

In the direction of solving this task, it is necessary to increase the effectiveness of primary health care, optimize the cumulative kainy fund, increase the efficiency of inpatient care. The practical implementation of the transition to a healthy lifestyle is impossible without approaching preventive medicine to a person. In this regard, priority is to ensure the population, primarily healthy people and people with chronic diseases outside the exacerbation, prophylactic help of walking distance. The development and implementation of the mechanisms for stimulating a polyclinic link may be more early to identify diseases and prevent the development of diseases to a stage leading to hospitalization. The implementation of these measures is aimed at improving the performance of the temporary disability of the working population.

The formation of the population of the responsible attitude towards their health, the refusal of tobacocuria, alcohol and drug abuse, ensuring the conditions for conducting a healthy lifestyle, correction and regular control of behavioral and biological risk factors of noncommunicable diseases on population, group and individual levels should be the most important area of \u200b\u200bpolicies in Health areas.

Noncommunicable diseases (diseases of the circulatory system, oncological diseases, respiratory diseases and diabetes mellitus) are the cause of more than 80% of all deaths of the population of the Russian Federation, while 56% of all deaths are due to cardiovascular diseases. The development of noncommunicable diseases is based on a single group of risk factors associated with an unhealthy lifestyle (smoking, low physical activity, irrational nutrition, alcohol abuse).

The World Health Organization has 7 leading risk factors that contribute to the main contribution to the premature mortality of the Russian population, including:

• elevated blood pressure (35.5%), hypercholesterolemia (23%),
• smoking (17.1%),
• unhealthy food, insufficient use of fruits and vegetables (12.9%),
• obesity (12.5%),
• alcohol abuse (11.9%), low physical activity (9%).

Risk factors can accumulate in individuals and interact with each other, creating a multiple effect: the presence of several risk factors in one person increases the risk of his death from the diseases of the circulatory system 5-7 times.

On the experience of many countries (Finland, USA, United Kingdom, New Zealand, etc.), it has been proven that the modification of the lifestyle and a decrease in the level of risk factors can slow down the development of the diseases of the circulatory system both before and after the appearance of clinical symptoms.

Systematic analysis shows that due to changes in the lifestyle and the nature of nutrition, you can reduce the risk of death from coronary heart disease both in the population and among patients with this disease. So, the cessation of smoking reduces the risk, respectively, by 35% and 50%, an increase in physical activity - by 25% and 20-30%, moderate alcohol consumption - by 25% and 15%, a change in at least 2 factors in nutrition - at 45 % and 15-40%.

Another systematic analysis shows that treatment of patients with coronary heart disease and other diseases of the blood circulation system drugs from the Antiagregant Group reduces the risk of complications in such patients by 20-30%, beta-blockers - by 20-35%, ACE inhibitors on 22- 25%, statins - by 25-42%.

Analysis of the reasons for a significant reduction in mortality from diseases of the circulatory system in many countries has shown that the contribution of recovery (lifestyle changes) and reduce the levels of risk factors in a decrease in such mortality ranges from 44% to 60%.

Factor analysis of the reasons leading to high rates of incidence of cancer and mortality showed that the influence of group A factors (tobacocco, excessive use of alcohol, overweight body, imbalance of nutrition, other factors (production, natural medium, dwelling, infectious carcinogenic factors .) It is 65%, and the factors of group b (late detection and treatment of precancerous diseases, late diagnosis of cancer, lack of screening, lack of formation and monitoring of risk groups, irregular prophylactic examinations of the population, the absence of reconciliation of risk groups, the lack of cancer alerts of the primary network, Lack of educational work among the population, insufficient work on the motivation of the population for active and conscious participation in screening events, the lack of unified screening programs at the federal level, the lack of the register of persons included in screening programs) is 35%.

The basis of propaganda of a healthy lifestyle Along with informing the population about the dangers of tobacco consumption, irrational and unbalanced nutrition, low physical activity, alcohol abuse, drugs and toxic substances should be learning skills to comply with the rules of hygiene, labor and study regimes. At the same time, an increase in the motivation of the population to conduct a healthy lifestyle should be accompanied by the creation of the conditions appropriate for this. In addition, priority should be given to measurements not only to the timely detection of risk factors and non-infectious diseases, but also timely correction.

When reforming the primary health care system to the population, the tasks of changing the assistance system of the rural population are issued; upgrades of existing institutions and their divisions; building patient flows with the formation of uniform routing principles; the development of new forms of medical care - the hospital of replacement and exit methods of work; the development of emergency care on the basis of polyclinic divisions; Improving the principles of cooperation with stationary institutions and emergence of ambulance.

Lining the modern system for the provision of primary health care to the population should include both the most small towns and major cities.

Improving the efficiency of specialized, including high-tech, medical care, emergency, including emergency specialized, medical care, medical evacuation

High-tech medical care is part of specialized medical care and includes the use of new, complex and (or) unique, as well as resource-intensive treatment methods with scientifically proven efficacy, including cellular technologies, robotic techniques, information technologies and methods of genetic engineering, developed on the basis of achievements medical science and related industries of science and technology.

To improve the availability and quality of medical care, activities will be implemented to improve the organizational system for the provision of specialized, including high-tech, medical care, improving medical care in socially significant diseases, including patients with diseases of the circulatory system, tuberculosis, oncological, Endocrine and some other diseases, the introduction of innovative treatment methods, the development of infrastructure and resource support for health, including financial, material and technical and technological equipment of medical and prophylactic institutions based on innovative approaches and standardization principle.

The federal law "On compulsory medical insurance" provides for the inclusion since 2015 high-tech medical care in the system of compulsory medical insurance. One of the conditions for such an inclusion is the development of the possibility of providing high-tech medical care in medical institutions of constituent entities of the Russian Federation.

The main tasks of providing an ambulance, including emergency specialized, medical care, medical evacuation at the present stage should be the provision of patients and affected medical care aimed at preserving and maintaining vital functions of the body, and shipping them in the shortest possible time in the hospital for the provision of qualified Specialized medical care. This work should be implemented mainly by Feldsherian brigades.

It is necessary to increase the role and efficiency of using medical teams of emergency medical care as brigades intensive therapy and, if necessary, highly specialized brigades.

Successful solution to the problems of the organization and the provision of emergency medical care is possible only in close linking with the improvement of the work of the outpatient polyclinic service, including the transition to the organization of primary medical care on the principle of a physician general medical practice (family doctor), day stay hospitals, hospitals House.

Development and implementation of innovative methods of diagnosis and treatment

In the next decade, developed countries will switch to the formation of a new technological base of economic systems based on the use of the newest achievements in the field of biotechnology, computer science and nanotechnology, including health care. The development of information technologies and the emergence of progressive technologies for calculating and processing information will allow the prognostic approaches based on modeling in the field of health. First of all, interest causes the possibility of creating epidemiological models that will analyze and predict the prevalence of various diseases in the population, thereby increasing the effectiveness of preventive measures.

The need for the formation of targeted scientific programs on priority areas to maintain the health of the population and the formation of a healthy lifestyle, development and implementation of new effective technologies for early diagnosis into the practice of a health care system is observed.

Taking into account forecasts of the intensive introduction of biomedical technologies in advanced health care practices of developed countries, an important task is to create the necessary conditions for the development and implementation of such products and technologies in the domestic health system.

Improving the efficiency of the service of objects and childhood

Mother and child health issues are named as a priority in all fundamental healthcare development documents, the goal of reducing maternal, infant and infant mortality are proclaimed among the Millennium Development Goals. The decline in maternal, infant and infant mortality is a greater complexity due to the presence of numerous factors, mainly difficult managed, which affect these indicators. The maternal mortality rate depends on the socio-economic state of the country, geographical features, development of medical care, cultural and educational level of the population.

In Russia in 2011, the maternal mortality rate amounted to 16.2 per 100 thousand born alive. With this level of the indicator, 320-350 women of working age are dying every year, which lies with a grave burden on families, reduces the number of children who could be born in the future, increases an underdeveloped contribution to GDP. According to WHO, the Middle Economic Indicator of Maternal Mortality in 2010 amounted to 20 per 100 thousand born alive and for the period 2005-2010 decreased by only 9.1%. The lowest maternal mortality in countries with developed economies, high population density developed by transport infrastructure. For example, in Germany in 2010, the maternal mortality rate was 7.0 per 100 thousand born, in France - 8.0, in the UK - 12.0. At the same time, in Eastern Europe countries, the maternal mortality rate is significantly higher. In particular, in the Republic of Moldova, the maternal mortality rate in 2010 amounted to 41.0 per 100 thousand born, in Latvia - 34.0, in Ukraine - 32.0, in Romania - 27.0, in Hungary - 21, 0.

In countries with a larger area of \u200b\u200bthe territory, all other things being equal, it is usually higher than in the extent of the countries in the US, the Maternal mortality rate of 21.0 in 2010, in Canada -12.

Infant mortality has similar patterns - low infant mortality rates are characteristic of the countries with a high standard of living of the population, a small area of \u200b\u200bterritory and high population density. For example, in Germany in 2010, the infant mortality rate was 3.5 per 1,000 born alive, in France - 4.1, in the UK - 5.0, in Belgium - 3.5, in Austria - 3.9. In countries with a high standard of living of the population, but the high length of the territory, the presence of regions with a low population density indicator of infant mortality is somewhat higher. For example, in the US, infant mortality rate in 2010 amounted to 6.0 per 1000 born alive, in Canada - 5.0, in Australia - 5.0.

At the same time, in some European countries, infant mortality rate is higher than in the Russian Federation. In particular, in the Republic of Moldova, the infant mortality rate in 2010 amounted to 11.8 per 1,000 alive born, in Ukraine - 9.1, in Romania - 9.8, in Montenegro - 10.0, in Macedonia - 7.7 .

Low indicators of maternal and infant mortality to a certain extent correlate with health costs (% of GDP), which are in the United States - 15.2%, in Germany - 11.1%, in France - 10.1%. In Russia, the increase in expenditures for healthcare from 3.1 to 3.7% of GDP was accompanied by a decrease in maternal and infant mortality rates. The level of infant mortality is influenced by a number of factors requiring an interdisciplinary approach.

First of all, this is the state of the material and technical base of objects and childhood institutions. To date, most regions are not fully provided with intensive care and intensive therapy for newborns, which have modern high-tech equipment. The network of perinatal centers is not formed, in which medical assistance is provided to the most severe contingent of pregnant women, feminines, herds and newborn children. In developed states, perinatal centers are organized at the rate of 1 center per million population in countries with high population density, and 500 thousand population in low density countries. With this calculation, the number of perinatal centers in Russia requires a significant increase.

The presence of highly qualified specialists in the institutions of birth and childhood plays a huge role in reducing the infant mortality rate. Russia has a huge personnel shortage of both neoatologists and nurses, which is due, first of all, with low wages. As a rule, in the Russian Federation to 1 medical sister, the branches of resuscitation and intensive care for newborns accounts for from 4 to 10 critical patients of newborns. In the US and European countries, 1 medical sister accounts for 1 extremely severe patient newborn, or 2 seriously ill newborn, or 3 stable children.

A great influence on the quality of medical care to newborns who was born with pathology, and the result of their treatment is provided by the level of funding for medical organizations. In the Russian Federation, the cost of treating one child in the resuscitation department is about 200-300 US dollars. In the UK, the cost of treatment per day is 1600-2000 pounds. In the US, depending on the severity of the state of the newborn, it ranges from 2000 to 5,000 US dollars, in Europe countries - from 1500 to 4,000 euros per day. At the same time, a significant proportion of funds falls on the remuneration of medical workers.

Other factors also have a significant impact on the level of maternal and infant mortality - the quality of the road communication, sufficient availability of automotive and aviation sanitary transport, a healthy lifestyle of the population, control of migration processes.

Reducing infant and child mortality from injuries, violent actions, neglecting parents from socially disadvantaged families to the health and well-being of their children is the zone of responsibility not only and not so much medical workers, how many social protection bodies of the population, Ministry of Internal Affairs of Russia, EMERCOM of Russia, etc.

Thus, improving the availability, quality and organization of medical care mothers and children, reducing the number of abortions, it is possible to reduce maternal and infant mortality by 2020 to 6.5-6.0%, maternal - to level 15.5 - 15, 0 per 100 thousand born alive. The decrease in infant mortality to a level of 3-4%, and the maternal - up to 5-8 is possible only in the development of the economy, transport infrastructure, responsible public relations to their health comparable to the level of the most developed countries of Western Europe.

The decrease in infant mortality rate from 8.5% (taking into account new registration criteria) to 6.4% will affect the preservation of at least 4 thousand children's lives every year. Since each case of the child's death determines an underdeveloped contribution to GDP of 6 million rubles, the total indicator of GDP loss while maintaining the indicator at the current level will be 24 billion rubles. Even if you consider the possible payment of disability pensions to a maximum of 5% of saved children, this amount will be 100 million rubles, and the overall increase in GDP at the expense of saved lives will be 23.9 billion rubles. But these calculations, of course, can not take into account all the benefits of the implementation of the Program - Improving the quality of the Assistance will lead to a decrease in children's mortality up to 5 years and up to 17 years, which will increase the expected increase in the contribution of GDP to a greater extent. that indirectly can contribute to raising the birth rate.

Since the mortality rate of newborns is 55-70% of the infant and 40% of the mortality of children under 5 years, an important direction to reduce the mortality of the children's population is to improve the help of a newborn, an extremely significant aspect of which is the development of the network of perinatal centers. Perinatal Center is not only a bright and visual certificate of state concern about mothers and children, it is essentially high-tech centers that allow you to provide effective assistance in the most severe pathology, develop innovative treatment methods (as well as fetal and neonatal surgery, resuscitation and intensive Help mothers and children in critical states). The creation of a network of perinatal centers will allow you to switch throughout the country to a full-fledged and efficiently functioning three-level system for the provision of medical care for women during pregnancy and childbirth and newborn, which will increase the qualifications of medical personnel and the quality of medical care in all of the relations of the anniversary institutions. In fact, within the framework of the Program, it is planned to create a slender system not only to provide differentiated help levels, but also a system of interaction, monitoring, training training using simulation centers. It is envisaged to create an absolutely new system of relations between institutions of obstetric and pediatric profiles in the territory, tightening requirements and the creation of opportunities for full and adequate routing of patients, changing reporting forms, the creation of new approaches to personnel motivation.

After mass commissioning of perinatal centers in 2010-2011, maternal mortality in the country decreased from 22.0 per 100 thousand born in 2009 to 16.2 in 2011, i.e. by 26.4%, infant mortality -, respectively, with 8.1 per 1000 born alive up to 7.4, i.e. 8.6%. Moreover, in the constituent entities of the Russian Federation, where perinatal centers function, the decrease in the indicators was more significant.

In fact, thanks to the perinatal centers, the conditions were created for the transition of the Russian Federation in 2012 to the International Criteria of Birth Registration, recommended WHO, starting with body weight 500.0 g, which, although formally, will lead to a certain increase in infant mortality, but at the same time Time will allow annually to maintain more than a thousand children's lives. To solve the problem of improving children with an extremely low body weight and a decrease in the level of disability, this contingent is also aimed at the Program section concerning the improvement of the equipment of the resuscitation and pathology of newborn children, since the life support process of these children requires modern high-tech equipment. This section is inextricably linked with the development of the network of perinatal centers.

To reduce death mortality, a well-established system of early detection and correction of developmental disorders is extremely important. The most effective tool for the prevention of congenital and hereditary diseases is the complex prenatal (prenatal) diagnosis, comprising ultrasonic and biochemical screening for serum markers of the mother, an individual risk program, invasive diagnostic methods (molecular genetic, cytogenetic studies, sequencing). The effectiveness of prenatal diagnostics can be provided only by a mass examination of pregnant women in a timely manner, to ensure that this section of the program is sent. The development of neonatal surgery was aimed at ensuring the effective correction of disrupted during the prenatal diagnosis of violations, and the early correction of metabolic changes identified in neonatal screening will allow you to create a sick child opportunities and conditions for normal development, education, vocational training, subsequent employment and full-fledged life. The further development of prenatal diagnosis will allow 50% to reduce the number of children born with congenital developmental anomalies, and reduced children's mortality from severe developmental defects by 50-70%.

To date, a high need for the development of specialized medical care for children is preserved. In 14 regions of the Russian Federation, there are no edges, republican, regional children's multidisciplinary hospitals. In a number of regions, the existing medical organizations of the pediatric profile do not comply with modern requirements, allowing children with severe pathology, including the children of the first year of life and, first of all, born with a low and extremely low body weight. This situation requires permission, since it does not allow fully availability and quality of medical care to children. Not fully provided with high-quality medical care children with oncological diseases, a system of providing medical care for children with autoimmune diseases and diseases of immune genesis, neurosurgical and traumatular-orthopedic assistance remains inaccessible to children, requires serious modernization of psychiatric, drug treatment and phthisiatric assistance.

The key to improving the quality of medical care to children will be the development of multidisciplinary and specialized pediatric hospitals in the constituent entities, taking into account regional needs for specific types of medical care.

The solution to the issue of state support for the construction and reconstruction of regional (regional, republican) children's multidisciplinary hospitals, the structure of which should fully comply with modern requirements, will ensure the real achievement of the goals and objectives of the program. Moreover, this section is inextricably linked with the development of a network of perinatal centers. Because on the basis of perinatal centers, medical care for children is provided only in the first days and months of life, children's hospitals should be the most important part of the functional network, providing the entire cycle of the child.

The problem remains the problem of preventing the vertical transfer of HIV from the mother to the child. Despite the high figures of the chemoprophylaxis of HIV-infected pregnant women, the transmission of infection during perinatal contacts remains high, as a whole in the country at about 6%, which probably indicates a not enough effective efficiency of the chemoprophylaxis of the vertical transfer of HIV to the mother, and dictates the need to improve Systems for the provision of this type of care and its monitoring.

Development of medical rehabilitation to the population and improving the system of sanatorium-resort treatment, including children

An important component of solving the task of improving the quality and availability of medical care is the development of a system of medical rehabilitation, spa treatment. An analysis of the provision of medical rehabilitation in the Russian Federation showed that it requires a serious reorganization and bringing it into a slim system of complex rehabilitation.

Currently, difficulties in the availability of medical rehabilitation are associated with a deficit of rehabilitation beds, the slow introduction of modern rehabilitation certified in Russia, the insufficient number of professionally trained medical personnel, a weak material and technical base of rehabilitation institutions.

The shortage of a karea fund to assist in the medical rehabilitation of children, both at the federal level and at the level of the constituent entities of the Russian Federation, as well as the shortage of trained medical personnel (doctors and medium-sized medical workers) does not fully meet the need for these medical services. Currently, medical rehabilitation receive only 50% of children in need of it.

The problem of increasing the availability and quality of medical rehabilitation and sanatorium treatment is relevant in pediatrics and is due to an increase in the number of children suffering from severe chronic (disabled) diseases, and disabled children. In the Russian Federation, more than 500 thousand children with disabilities were registered in the Russian Federation, of which more than 340 thousand need medical rehabilitation. The need for rehabilitation assistance to other contingents of children is significantly higher. Currently, medical rehabilitation receive only 50% of children in need of it.

Solving the problems of health and social protection of children suffering from severe chronic (disabled) diseases, children with disabilities and their families are possible when ensuring the availability and quality of medical rehabilitation through the further development of a network of children's profile rehabilitation institutions (regional, interdistrict), as well as complexes To implement high-tech treatment methods with bias (branches of hospitals) for fake and rehabilitation. The solution to this task will reduce the load on the "expensive" bed in hospitals, increase their throughput.

The modern level of development of world medicine requires an objective assessment (according to the criteria of evidence-based medicine) the effectiveness of sanatorium-resort treatment, as well as the improvement of the existing and developing new wellness and therapeutic techniques.

Currently, there is an urgent need for a complex of activities aimed at preserving the capacity of the resort sphere and the formation of a modern resort complex that can decide both the medical and social tasks of providing accessible to the population, effective sanatorium-resort treatment, and the economic problems of the formation of the sphere of the resort. It should be borne in mind that decay of the resort in Russia, of course, has become one of the important factors of deterioration of the health indicators. Under these conditions, the restoration of the system of sanatorium-resort treatment and recovery, its availability for the bulk of the population, the revival of Russian resorts is an important nationwide task that can make a great contribution to increasing the level of public health of the people.

Providing medical care for incurable patients, including children

Against the background of demographic aging of the population in the Russian Federation, every year the number of patients who need palliative care are increasing.

Not only medical, but also social, spiritual and psychological aspects of the provision of palliative care of incrarative patients are extremely important.

The main directions in the provision of palliative care inhibitory patients should be not only a decrease in patient suffering, but also adequate psychological assistance, social support, communication with relatives, allowing to prepare family members to the inevitable final.

In order to create optimal conditions for children suffering from incurable, limiting the life expectancy of diseases, as well as assistance to family members in the conditions of the incurable disease of the child, it is planned to develop a network of medical and social institutions specializing in the provision of palliative to children in the Russian Federation (the opening of the departments of palliative care for children in Multidisciplinary hospitals and independent hospitality institutions), based on the approximate calculation of 2-3 beds per 100 thousand children's population.

The concept of palliative care is that the struggle with pain, the solution of psychological, social or spiritual problems of patients is of paramount importance. Thus, the main task of providing medical care to the dying patient becomes the provision, as far as possible, a person worthy of quality of life at its final stage.

Creating palliative care departments will reduce the load on expensive beds, on which resuscitation and intensive assistance is provided, at least 15%.

It should be noted that at present, the organizational and socio-medical aspects of palliative care are not presented in educational medical institutions at the bottomroom level at the Department of Public Health and Health.

This indicates the need to introduce teaching the basics of palliative care not only to students of universities, but also on a postgraduate stage for both doctors of all specialties and health organizers.

Providing health care system with highly qualified and motivated personnel

In this direction, the most relevant is the task of creating a system of continuous vocational education in order to prepare highly qualified specialists focused on the permanent improvement of their own knowledge, skills and skills necessary to achieve and maintain high quality professional activities.

It is planned to carry out measures to improve the system of practical training of medical and pharmaceutical workers in order to improve the quality of vocational training, expand the list of skills and skills acquired by a specialist during the training period.

Training programs for medical and pharmaceutical professionals in the stages of postgraduate and additional vocational education will be both and implemented, as well as programs to improve the qualifications of scientific and pedagogical workers of educational and scientific organizations that implement medical and pharmaceutical education programs developed taking into account changes in the preparation of medical and pharmaceutical professionals in Communications with the introduction of federal state educational standards of secondary and higher professional education of the third generation.

Until 2020, the development of professional standards of medical and pharmaceutical workers, who will form uniform approaches to determine the level of qualifications and a set of competencies of medical and pharmaceutical workers needed to occupy professional activities are planned.

A system of accreditation of medical and pharmaceutical specialists will be created and implemented, which will allow personal admission of specialists to a specific type of professional activity, taking into account the competencies acquired during the training.

Together with the constituent entities of the Russian Federation, it is planned to conduct measures to improve the quality of life of medical and pharmaceutical workers and their families, a decrease in personnel outflow from the industry, including through the provision of residential premises, land plots, housing subsidies, interest rate subsidies for the purchase of residential Premises with medical and pharmaceutical workers, the provision of individual categories of medical and pharmaceutical workers the right to extraordinary enrollment in pre-school educational institutions.

Education activities will also be organized to increase the prestige of the profession.

In the aggregate, the solution of these tasks will improve the quality of training of medical and pharmaceutical professionals, reduce the level of medical personnel and, as a result, improve the quality of medical care and pharmaceutical services provided to citizens.

In addition to the decree of the President of the Russian Federation of May 7, 2012 No. 598 "On the improvement of public health policy" in the constituent entities of the Russian Federation, the adoption of programs aimed at improving the qualifications of medical personnel, to assess the level of their qualifications, the phased elimination of medical personnel deficit, As well as the development of differentiated social support measures of medical workers, primarily the most deficit specialties.

Enhancing the role of Russia in global health care

The main areas of international relations in the field of health protection should be to ensure the provision of solid and authoritative positions of Russia in the world community, which is most of the interests of the Russian Federation as one of the influential centers of the modern world; creation of favorable external conditions for the modernization of Russia; formation of relations of good neighborliness with adjacent states; search for consent and coincidences with other states and interstate associations in the process of solving the tasks defined by the national health priorities in the field of health protection, the creation of a system of bilateral and multilateral partnerships on this basis; Comprehensive protection of the rights and legitimate interests of Russian citizens and compatriots living abroad; promoting the objective perception of the Russian Federation in the world; Support and popularization in foreign countries of domestic health care.

The priority sphere of foreign policy of Russia in health care is to cooperate with the Member States of the Commonwealth of Independent States, the Eurasian Economic Community. The development of healthposts in the framework of Asia-Pacific economic cooperation should be important.

Improving control and supervisory functions

The main task of the functioning of the quality control system and the security of medical activities will be to monitor the process of providing medical care, its compliance with the approved standards and procedures for the provision of medical care, the interaction of medical personnel with patients.

The interaction of subjects of the system of quality control and security of medical activities, their activities, powers and responsibility are governed by regulatory legal acts approved in the prescribed manner.

The main task of state control (supervision) in the field of drug circulation will be controlling the appeal of drugs and the compliance of its current legislation of the Russian Federation.

The main task of the functioning of the state control system for the treatment of medical devices is to identify and withdraw from the appeal of poor-quality medical devices, as well as falsified and counterfeit medical products, with subsequent disposal and destruction, identifying and preventing possible negative consequences of the use and use of medical products in circulation in the territory Of the Russian Federation, warnings about the facts of this kind of potential users, as well as medical personnel.

An important task of health development is the modernization of state forensic expert activities in the Russian Federation. Forensic and forensic psychiatric examination in the Russian Federation are a special medical-legal type of activity aimed at providing the bodies of inquiry, investigators and judgment by the results of special research obtained in compliance with legal norms carried out by experts or doctors involved for the production of expertise, licensed as a separate type of medical activity.

In addition, government forensic experts perform an important function to determine the causes and essence of defects in the provision of medical care.

In this regard, there is a task of determining unified approaches to expert activities in the Russian Federation, creating a unified methodological basis for the production of forensic psychiatric and forensic examinations, ensuring the modern material and technical base of all state institutions carrying out forensic psychiatric and forensic examination .

The effectiveness of the implementation of the federal state sanitary-epidemiological supervision and the organization of ensuring the sanitary and epidemiological well-being of the population is achieved by the aggregate activities of the territorial bodies of Rospotrebnadzor, directly carrying out control and supervisory activities, as well as institutions of Rospotrebnadzor, ensuring control and supervision, through a wide range of laboratory research, implementation of scientific research and scientific and methodological developments, performing anticipate events.

Reducing the harmful effects of habitat factors for the population will be ensured by measures to ensure the safe habitat of the population - atmospheric air, water bodies, soil; improving the quality and safety of food products; ensuring radiation safety of the population.

Medico-biological support for the health of the population

An important factor in ensuring the radiation, chemical and biological safety of the population and territories served by the Federal Medical Biological Agency is the health care system of the FMBA of Russia, one of the main tasks of which is to conduct measures to identify and eliminate the impact of particularly dangerous factors of physical, chemical and biological nature on the health of employees of serviced organizations and the population of served territories.

The medical support system of such enterprises and facilities includes preliminary medical examinations, pre-inspection medical examinations, periodic medical examinations, conducting medical and preventive and rehabilitation measures, monitoring the health of staff and population personnel.

The goal of health care in the field of health and health and biological support of higher achievements is prevention of the incidence and disability of athletes and the consistent increase in the level of their provision of medical and biological technologies for effective adaptation to intensive sports loads.

The main tasks in the field of medical and biomedical support of athletes of national teams of the Russian Federation: the formation of the infrastructure of therapeutic and prophylactic purposes, geographically integrated with the databases for training sports teams of the Russian Federation, allowing to provide 100% candidates for sports teams of the Russian Federation by type sports with all kinds of medical care during training and competitive activities; Providing qualified medical personnel of sports teams of the Russian Federation; The implementation of medical and biological technologies providing a training and competitive level of preparing candidates for sports teams of the Russian Federation by sports.

Activities for the prevention and elimination of the effects of emergencies of the FMBA of Russia directly or through its territorial bodies, subordinate organizations in cooperation with other federal executive bodies, the executive authorities of the constituent entities of the Russian Federation, local governments.

The tasks of the protection of certain categories of citizens from the impact of particularly dangerous factors of physical, chemical and biological nature are the provision of breakthrough results in medical studies capable of providing new drugs, technologies and products, the development of innovative infrastructure for the provision of health care to certain categories of citizens.

Providing health care systemics

In modern conditions, the creation and functioning of distributed information systems and analytical data processing tools are the "Gold Standard" of the organization of industry management. The introduction of new medical technologies is impossible without parallel introduction of information systems that ensure optimization of the process of providing services. Creating this kind of systems is required to resolve issues related to the calculation of the full cost of medical services, forecasting the necessary volume and cost of medical care and drug security, assessing human health needs, evaluating and predicting the epidemiological situation. Thus, the task of implementing and using modern information and telecommunication technologies in health care is a key providing problem, which depends on the effectiveness of most measures of the State Program "Development of Health".

The State Program for the Development of Health for 2018 - 2025 was approved by the Decree of the Government of the Russian Federation of December 26, 2017 No. 1640 "On approval of the State Program of the Russian Federation" Development of Health ".

The State Health Development Program for 2018-2025 will be financed by more than 34.9 trillion. rubles.

Among the program purposes:

• an increase by 2025 of the life expectancy at birth to 76 years;
• reduced by 2025 permissal mortality in working age up to 380 per 100 thousand population;
• reduced by 2025 mortality from diseases of the circulatory system to 500 per 100 thousand population;
• reduced by 2025 years of mortality from neoplasms up to 185 per 100 thousand population;
• raising by 2025 the share of the population satisfied with the quality of medical care is up to 54 percent.

The state program provides for the development of the following directions (subprogram):

• improving medical care, including prevention of diseases and the formation of a healthy lifestyle;
• development and implementation of innovative methods for diagnosing, prevention and treatment, as well as the foundations of personalized medicine;
• development of medical rehabilitation and sanatorium treatment;
• development of personnel resources in health care;
• development of international relations in the field of health care;
• examination and supervisory functions in the field of health care;
• medical and sanitary support of certain categories of citizens;
• information technologies and industry development management;
• organization of compulsory medical insurance of citizens of the Russian Federation.

Resolution recognized as invalid by the Resolution of the Government of the Russian Federation of April 15, 2014 N 294 "On approval of the State Program of the Russian Federation" Development of Health ""

Government of the Russian Federation

Decision

On approval of the state program

Russian Federation "Development of Health"

The Government of the Russian Federation decides:

1. To approve the accompanying state program of the Russian Federation "Development of Health".

2. Institute of Health of the Russian Federation:

post a state program of the Russian Federation "Development of Health", approved by this Decision, on the official website of the Ministry, as well as on the Portal of State Programs of the Russian Federation in the Internet Information and Telecommunications Network within 2 weeks from the date of the official publication of this Regulation;

take measures to implement the activities of the State Program of the Russian Federation "Development of Health".

3. To recommend the executive authorities of the constituent entities of the Russian Federation when amendments to the state programs of the constituent entities of the Russian Federation, aimed at developing health care, take into account the provisions of the State Program of the Russian Federation "Health Development" approved by this Decree.

4. To know the lost strength:

resolution of the Government of the Russian Federation of April 15, 2014 N 294 "On approval of the State Program of the Russian Federation" Development of Health "" (Meeting of the legislation of the Russian Federation, 2014, N 17, Art. 2057);

paragraphs 2 and 3 of the Government Decisions of the Russian Federation dated March 31, 2017 N 394 "On Amendments and Recognizing Some Acts of the Government of the Russian Federation" and paragraph 1 of the Changes that are made to the acts of the Government of the Russian Federation approved by this Resolution (Meeting of the Legislation of the Russian Federation, 2017, N 15, Art. 2225);

decree of the Government of the Russian Federation of May 7, 2017 N 539 "On Amendments to the State Program of the Russian Federation" Development of Health "" (Meeting of the legislation of the Russian Federation, 2017, N 20, Art. 2924);

decree of the Government of the Russian Federation dated August 12, 2017 N 964 "On Amendments to Annex N 9 to the State Program of the Russian Federation" Development of Health "" (Meeting of the legislation of the Russian Federation, 2017, N 34, Art. 5288).

Chairman of the government

Russian Federation

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The consistent implementation of public health policies, the implementation of federal and regional medical and social programs made it possible to achieve certain results to preserve the health of residents of the Russian Federation, improving the activities of the health system.

The interest of state authorities, managers of organizations and enterprises of the region in addressing the health problems of citizens increased.

However, despite the measures taken, a number of unsolved problems remain in the health of Russia. Among them, the continued discrepancy between the obligations of the state for the provision of free medical care to citizens and allocated for these purposes financial resources.

There is an insufficient accessibility of medical care, especially for the least secured segments of the population, and the high differentiation of municipalities in population health and provision of health issues. The commercialization of state and municipal health care is growing, one of the reasons for which is the lack of effective existing state regulation mechanisms in this area.

Despite publicly allocated to the state for health development, additional financial and material and technical resources, the effectiveness of their use remains low. The lack of a boob motivation system adapted to market mechanisms does not allow full use of available health care provisions to increase the amount and quality of medical care to the population. A number of questions related to the preparation and retraining of qualified personnel of health workers, the development of a complex of measures on their social protection are remained unsolved.

In most of the population, there is no motivated value attitude to their own health as the necessary life resource, which, in turn, turns out to be the main factor that impedes the formation of a healthy lifestyle among the population. The behavioral factors and bad habits are still a big impact on the state of public health: the prevalence of alcoholism, tobacocuriasis, lack of interest in physical culture exercise among a significant part of the population.

Despite the outlined positive trend, the average duration of the upcoming life in the Russian Federation remains at a low level (men - 61.8; women - 74.2 years) and lags behind a number of developed countries. For example, in Japan, this indicator is 78.6 for men, for women - 85.6, in Norway, respectively, 77.8 and 82.8, in Sweden - 78.5 and 82.9 years.

A high level of mortality in the working age is maintained, primarily due to cardiovascular diseases, malignant neoplasms, road traffic accidents. In the incidence of population, the proportion of neurotic and mental disorders increases, due to the use of alcohol, psychotropic substances, there is an increase in the professional morbidity associated with unsatisfactory working conditions, violation of sanitary and hygienic standards and rules.

The deepening of differentiation of population health indicators continues depending on the social and property situation. There remains high incidence of infectious and socially significant diseases, the prevalence of which is still a significant impact of a lack of living standard of most of the population (low wages and pension funds, deterioration of living conditions, labor, recreation, environmental conditions, quality and nutritional structures and Dr.).

Medical and social diagnosis and analysis of problems characterizing the current state of health of the population, as well as the study of social needs of society in the field of health, allowed the authors to develop, substantiate and submit a set of measures to improve health measures at the regional level to the IISTR RF.

These measures, in particular, entered the Complex for the Development of Health of the Russian Federation for the period up to 2020, which were considered and approved by the II Congress of the Russian Public Organization "Russian Society for the Organization of Health and Public Health".

Thus, priority areas of improving the health system are as follows:

1. Reducing the rupture of public health indicators between individual regions of the Russian Federation and economically developed countries.
2. Improving the health of children, teenagers, women.
3. Preservation of the health of elderly.
4. Reducing the level of socially significant diseases.
5. Reducing the prevalence of infectious diseases.
6. Ensuring a healthy and safe habitat.
7. Formation of a healthy lifestyle.
8. Improving government guarantees in providing public medical care.
9. Improving the efficiency of the management and health financing system.
10. Creation of the necessary conditions for innovative health care development.
11. Modernization of the training and retraining of personnel in health care.
12. Improving the legislative health care framework.

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 indicators of Russia and economically developed countries is primarily associated with the lack of a scientifically based state policy in the field of citizen health, insufficient resource support of the industry, as well as the imperfection of the mechanisms for the efficient use of material and financial health, 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 (at the federal, regional and municipal levels) of effective state policy in the field of citizen 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 homes with modern medical equipment and special sanitary transport;
. 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:

. Improving the modern system of sanabathing and transporting 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 hazardous 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 through information programs specifically adapted to various age and social groups;
. 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

2. The Government of the Russian Federation establishes the procedure for the development and implementation of federal targeted programs, and the executive authorities of the constituent entities of the Russian Federation establish the procedure for developing and implementing regional healthcare facilities.
3. Regional healthcare trusted programs, including aimed at leveling differences in the level of medical care to citizens living in various administrative and territorial entities of the constituent entity of the Russian Federation, are created on the basis of federal health care programs in accordance with the mandatory government norms and regulations, taking into account the characteristics, needs and capabilities of the constituent entities of the Russian Federation. Regional healthcare trusted programs cannot limit the state-guaranteed norms and regulations included in federal healthcare trusted programs.
4. The federal and regional healthcare trusted programs are formed taking into account state social standards in the field of health.
5. Local governments are involved in the implementation of federal and regional healthcare facilities, including investment and personnel policies. Financing specific programs in this case is carried out at the expense of the federal budget, budgets of the constituent entities of the Russian Federation, other funds in the manner prescribed by the legislation of the Russian Federation.
6. In the implementation of federal and regional healthcare targeted programs, in accordance with the contracts (contracts) of the health organization, regardless of the forms of ownership. The choice of health organizations for the implementation of federal and regional healthcare facilities is carried out on a competitive basis.

Ministry of Health and Social Development of Russia

State budgetary educational institution
Higher professional education

"Siberian State Medical University"

Ministry of Health and Social Development of the 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:

Disclose the essence of the federal target program.

Examine funding, formation, approval of the target program.

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. The main concepts of the target program aimed at protecting 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, it is generally accepted that the program-target method serves as the most important tool for the implementation of the state social and economic development of the country 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"

) Subprogramme "Vaccinoprophylaxis"

) Subprogram "HIV infection"

) Subprogram "Oncology"

) Subprogramme "sex transmitted infection"

) Subprogram "Viral hepatitis"

) Subprogramme "Mental Disorders"

) 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".

3.1.
Program "Warning and Combating Socio Significant Diseases (2007 - 2012)"

Federal Target Program "Warning and Combating Socially Significant Diseases (2007-2011)" (hereinafter referred to as the program) is developed in accordance with the order<#"663364.files/image001.gif">

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"

Execution 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<#"663364.files/image003.gif">

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;

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

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;

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 to children who have fallen into a difficult life situation, as well as the fulfillment of long-term consistent work to support children who need special care of the state.

The implementation of the "Healthy Generation" subprogramme event will continue to improve the improvement of state support for motherhood and childhood service, increase the availability and quality of medical care to women and children, achieve 2011:

During the implementation of the subprogramme "Gifted children", a state system for identifying, developing and address support of gifted children will be created, 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 activities.

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

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, the development of the legal framework for monitoring the implementation of citizens of independent training to obtain the right to managing the 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 (from them - 2446.23 million rubles, capital investments - 15247.58 million rubles and other needs - 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, from 07/15/2008 N 538, dated February 14, 2009 No. 132, from 02.08.2011 N 642) Reduction by 2012 the number of persons who died as a result of road traffic 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;

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;

FDP "Children of Russia 2007-2010"

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.

FTP "Improving road safety in 2007-2012"

When implementing a program, the number of dead in road accidents compared with 2005 will be reduced by 2012 by 1.5 times, and the number of road accidents with victims is 10 percent. At the same time, as part of the implementation of the program's activities, the implementation of the regional programs of regional programs aimed at improving road safety is taken into account.

Thus, a number of federal targeted programs aimed at protecting public health have significantly improved the health of citizens, but some results want to expect the best.

List of used literature

1. Vyalkov, A.I. Modern problems of health of the population of the Russian Federation / A.I. Vyzhkov // Probl. Health Management. 2009. - №3.

2. Vyalkov, A.I. Management and Economics of Health: Tutorial / Ed. A.I. Vyshkov; A.I. Vyalkov, V.Z. Kucherenko, B.A. Raisberg et al. - M.: Goeotar Media, 2009. - 664 p.

Medkov, V.M. Health management / under. ed. V.Z. Kucherenko. M.: Teis, 2007. - 448 p.

Trucina L.Yu., Tleplasishev R.A., Trushkin A.G. and others. Economics and health management. M. 2002.

Federal Target Programs of Russia, Department of State Target Programs and Capital Investments: - Electronic resource [Access Mode ]

Federal Target Programs of Russia: Electronic Resource [Access Mode ]

FDP "Improving road safety in 2007-2012" -Electr. Resource [Access Mode ]

Federal Law of July 22, 1993 N 5487-1 Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens (as amended from 1, 29 December 2004, March 7, 2005)

Central Research Institute of Organization and Informatization of Health: - Electric. Resource [Access Mode ]

Shilenko Yu.V., Raysberg B.A., Vyazkov A.I. Management and Economics of Health . M., 2002.