What is a medical organization. Documents confirming the costs of treatment
In the Russian Federation, a network of medical institutions has been created and is functioning, which are divided into three main types: outpatient, inpatient and combined.
Outpatient health care facilities include: an outpatient clinic, a polyclinic, a health center, an ambulance station, Women's consultation. In this type of health facility, the patient receives medical services, but lives at home.
Inpatient facilities include: hospital, clinic, hospital, sanatorium. In this type of health facility, the patient receives medical services and lives there.
Combined type health care facilities include: a medical unit, a dispensary, and joint hospitals. They combine in their composition both outpatient clinics (polyclinics) and hospitals.
Lecture questions:
1. Classification of medical institutions.
2. Characteristics of hospitals.
3. Characteristics of dispensaries.
4. Characteristics of outpatient clinics.
5. Characteristics of institutions for the protection of motherhood and childhood.
6. Characteristics of sanatorium-and-spa institutions.
7. Characteristics of emergency medical institutions.
8. Characteristics of medical facilities of combined type.
Classification of medical institutions.
Treatment-and-prophylactic institutions (HCIs), taking into account their tasks and functions, are classified as follows:
hospital facilities (hospitals of various capacities);
dispensary institutions (anti-tuberculosis, skin and venereal, oncological, neuropsychiatric and others);
outpatient clinics (city, district clinics, outpatient clinics, medical health centers at enterprises);
institutions for the protection of motherhood and childhood (maternity hospitals, women's, children's clinics, nurseries, orphanages);
sanatorium-resort institutions;
emergency medical facilities;
sanitary and anti-epidemic institutions (centers of sanitary and anti-epidemic surveillance, disinfection, anti-malarial stations and others).
Characteristics of hospitals.
Hospital - the main medical and preventive institution of the health service. It performs the functions of prevention, diagnosis, treatment, rehabilitation, health education, training of medical and paramedical personnel, and for a sick person, the hospital becomes temporary housing. Hospital - medical institution stationary type for patients requiring 24/7 monitoring, treatment and care in a hospital bed.
Depending on the capacity and subordination, hospitals are divided into republican, regional, city, and district hospitals.
Hospital - a hospital where military personnel and combat invalids receive medical care.
Clinic - hospital facility. Where, in addition to treating patients, students are trained and research work is carried out by scientists from medical universities.
Currently, there is a clear trend towards the enlargement of hospitals and the complication of their structure. Modern large hospitals are equipped with the most sophisticated medical and sanitary equipment.
A modern hospital is a medical center designed for medical and preventive care of the population. Most hospitals provide services not only to hospitalized patients, but also to the population of the area of residence.
The success of inpatient treatment of patients depends on many factors. One of the leading ones is the hygienic optimization of the hospital environment, which is ensured by the creation in the hospital three types regime: medical-protective, hygienic and anti-epidemic.
Therapeutic and protective regime - it is a system of organizational measures and rules aimed at ensuring the physical and psychological comfort of patients, which is an important sanogenic factor.
Hygienic mode - it is a scientifically based system of rules and regulations governing proper communal conditions in hospital premises.
Anti-epidemic regime - is a multi-stage system of measures aimed at preventing nosocomial infections, that is, various infectious diseases occurring in patients during their stay in the hospital. This mode not only ensures optimal hygienic conditions in medical institutions and prevents the occurrence of nosocomial infections, but also positive influence for the recovery of the sick.
According to the type, volume and nature of the medical care provided and the system of organization of work, the hospital can be:
by profile - single-profile, multi-profile, specialized;
according to the organization system - united and not united with the polyclinic;
according to the volume of activity - different bed capacity.
City Hospital - leading hospital in this area.
The main tasks of this LPU are:
providing highly qualified medical and preventive care to the population.
Introduction into the practice of servicing the population of modern prevention methods, diagnosis and treatment of diseases.
Development and improvement of organizational forms and methods of medical care for the population and patient care, improving the quality and culture of work.
Sanitary and hygienic education of the population.
Involvement of the public in the development and implementation of measures for medical and preventive care of the population.
The hospital is headed by the administrative and managerial apparatus represented by the chief physician, chief nurse, deputy chief physicians for medical
part, for the polyclinic, for working with nursing staff, for the administrative and economic part, etc.
According to the mode of operation, city hospitals are divided into hospitals with round-the-clock stay of patients, day hospitals and mixed-mode hospitals.
The capacity and structure of urban hospitals is linked to the size of the population served.
The main structural divisions of the hospital are:
admission department, in which they carry out admission of patients, diagnosis, the issue of the need for hospitalization registering patients, triage, providing, if necessary, emergency medical care, sanitizing patients;
profiled medical departments, which are the main functional building blocks hospitals; they carry out the diagnosis of diseases, treatment, observation and care of the sick;
departments of special types of treatment - physiotherapy, hydrotherapy, exercise therapy, radiotherapy etc.;
diagnostic department, in which laboratory, X-ray, endoscopic and other studies are carried out.
The medical departments of the hospital are connected with the auxiliary and economic services common to the hospital. The states of the medical staff of the department are established depending on the number of beds, type and profile of the institution. The main positions in the staff structure of the hospital department are the head of the department, the resident doctor, the head nurse, the nurse, the housewife.
District hospital or rural outpatient clinic - is the main medical institution in the rural medical area. Character and volume medical care in the district hospital is determined by its capacity, equipment, the presence of specialist doctors .. the direct duties of the doctors of the district hospital, regardless of its capacity, include: the provision of outpatient and inpatient care therapeutic and infectious patients, assistance in childbirth, medical and preventive care for children, emergency surgical and trauma care. The staff of a rural district hospital, depending on its capacity, the number of people served and the distance to the central district hospital, may include doctors in the main specialties (generalists, surgeons, pediatricians, dentists, obstetricians and gynecologists).
Central District Hospital (CRH) - is designed to provide specialized medical care, functional examination, consultations of medical specialists to residents of rural areas. The CRH has the following structural divisions: a hospital with main specialized departments, a polyclinic for consulting and medical appointments with specialist doctors, medical and diagnostic departments, an organizational and methodological office, an ambulance and emergency department, etc.
The tasks of the CRH are: providing medical and advisory assistance, conducting preventive, organizational and methodological work, improving the skills of medical personnel of district and district hospitals and outpatient clinics, analyzing health indicators and risk factors that determine morbidity.
The work of the CRH is supervised by the chief physician, who is also the chief physician of the district.
Regional Hospital - provides highly qualified and specialized medical care to the population of the region, is a scientific, organizational, methodological and educational center for healthcare. Its main functions are: providing highly qualified, specialized, advisory polyclinic and inpatient medical care; provision of organizational and methodological assistance to healthcare facilities and emergency medical care by means of air ambulance; management and control over statistical accounting and reporting of health care facilities of the region; analysis of indicators of morbidity, disability, general and infant mortality, development of measures aimed at their reduction; carrying out activities for the specialization and improvement of doctors and paramedical personnel.
The structural subdivisions of the regional hospital are: a hospital, a consultative polyclinic, treatment and diagnostic departments, offices and laboratories, an organizational and methodological department with a medical statistics department, an emergency and planned advisory medical care department.
Characteristics of dispensary institutions
Dispensaries - these are specialized institutions whose activities are aimed at actively identifying patients, taking them into account, active monitoring and timely implementation of special medical and recreational activities.
There are several types of dispensaries: cardiological, oncological, skin-venereal, anti-tuberculosis, neuropsychiatric, narcological, endocrinological, medical and physical education.
In their composition, dispensaries can have a polyclinic (outpatient clinic) and a hospital, equipped with special equipment, devices for complete and accurate diagnosis. The dispensary puts the identified patients on record, conducts systematic treatment and monitoring of them.
Cardiology dispensary - agency providing specialized care patients with cardiovascular diseases. He provides methodological guidance to the cardiology departments of multidisciplinary hospitals, cardiology rooms of polyclinics and medical units. Cardiology dispensaries are designed to provide a specialized complex of step-by-step treatment. For the rehabilitation of patients who have suffered a myocardial infarction, suburban hospitals can be created rehabilitation treatment and a network of specialized cardiological sanatoriums.
Oncology Center - is the center of the organization of anti-cancer struggle. These dispensaries should be well technically equipped, have a large capacity of a polyclinic and a hospital, a boarding house for those who come for a consultation. In urban and district hospitals ah and polyclinics organize oncology rooms (1 room for 15-20 medical sites) associated with dispensaries.
TB Dispensary - center of treatment-and-prophylactic and organizational-methodical work to combat tuberculosis. In the general network of healthcare facilities, dispensary examinations of the entire population are organized with mandatory fluorographic control. The employees of the dispensary take an active part in conducting tuberculin tests, revaccinations, and chemoprophylaxis.
Psychoneurological dispensary - provides social and medical assistance to patients with mental disorders. The structure of the dispensary, in addition to a polyclinic (outpatient clinic) and a hospital, includes medical and labor workshops.
Drug Dispensary - the main link of the narcological service. He manages the work of narcological rooms of polyclinics and narcological centers at industrial enterprises. In addition to diagnostic and treatment-and-prophylactic work with patients, the narcological dispensary organizes and carries out extensive educational and educational activities in educational institutions, at industrial enterprises, in families.
Characteristics of outpatient clinics
Ambulatory - a medical institution serving the population of a rural or urban area, workers of a small enterprise. The staff of the outpatient clinic may include 1-5 doctors who provide qualified medical assistance both in the outpatient clinic and at home; study morbidity rates, carry out preventive and educational work. Outpatient clinics are subordinate in their activities to the polyclinic and control the work of feldsher-obstetric stations (FAPs).
FAP - an outpatient facility in a rural locality, is run by an outpatient clinic or a district hospital, is managed by a paramedic who provides first aid, is engaged in disease prevention, participates in current sanitary supervision in institutions for children and adolescents, in communal, food, industrial institutions, for water supply and treatment facilities; conducts analysis of morbidity, deals with issues of improving the environment.
Medical health centers - can be organized in enterprises with various forms property and in educational institutions as a structural subdivision of the state territorial medical institution (polyclinic or medical unit). Health centers are organized to provide first aid for diseases and injuries, organize and conduct preventive measures monitoring of sanitary and hygienic working conditions.
Polyclinic - This is a medical facility that provides medical care to incoming patients, as well as patients at home. The polyclinic is the main link in the organization of medical and preventive care for the population. The polyclinic sees doctors in various specialties, there are a number of laboratories and diagnostic rooms, procedural and manipulation rooms. In the polyclinic, inpatient departments, the so-called "day hospitals", can be organized, where patients undergo clinical and laboratory studies, they are given course treatment, and they go home at night.
Clinics are divided into:
on the organization of work - combined with a hospital and not combined (independent);
on a territorial basis - urban and rural;
by profile - general for servicing the adult or children's population, dental, consultative and diagnostic, physiotherapy, resort.
The main structural divisions of the polyclinic are: a registry with a desk of information, a prevention department, treatment and prevention units: therapeutic, surgical, neurological, etc., rooms (cardiological, rheumatological, endocrinological, etc.), treatment room; auxiliary diagnostic subdivisions: X-ray room, functional diagnostics room (department), accounting and medical statistics room, administrative and economic part.
The city polyclinic builds its work according to the district-territorial principle - to provide outpatient care to the population living in the area of its operation, and according to the shop (production) principle - attached workers of industrial enterprises, construction organizations and transport enterprises. The size of the territorial therapeutic area in terms of the adult population is currently 1600-1700 people.
The purpose of the polyclinic is to preserve and improve the health of the population served. The main tasks are:
provision of qualified and specialized medical care to the population;
provision of first and emergency aid;
carrying out preventive measures to prevent and reduce morbidity;
early detection sick;
clinical examination of healthy and sick people;
carrying out active work on sanitary and hygienic education of the population.
Characteristics of institutions for the protection of motherhood and childhood
Women's consultation - This is a healthcare facility that provides all types of outpatient obstetric and gynecological care to the female population.
The main tasks of the antenatal clinic are:
carrying out preventive measures aimed at preventing complications of pregnancy, childbirth, the postpartum period,
gynecological diseases, formation in women healthy lifestyle life;
providing medical obstetric and gynecological care to the female population of the attached territory;
work on contraception and abortion prevention;
putting into practice modern achievements on the diagnosis and treatment of pathology of pregnancy, diseases of puerperas and gynecological diseases, new organizational forms work contributing to the reduction of prematurity, maternal and perinatal mortality;
carrying out sanitary and educational work;
provision of social and legal assistance to women in accordance with the legislation on the protection of motherhood and childhood;
ensuring continuity in the examination and treatment of pregnant women, puerperas and gynecological patients with obstetric and gynecological hospitals and other medical facilities.
The antenatal clinic carries out its work according to the district principle, which provides for the provision of therapeutic and preventive care in the antenatal clinic, patronage and medical care at home.
Maternity hospital - This medical institution providing inpatient obstetric and gynecological care. The task of the maternity hospital is to provide qualified inpatient care to women during pregnancy, childbirth and postpartum period, as well as in gynecological diseases; provision of qualified medical care and care for newborns during their stay in the maternity hospital.
Characteristics of sanatorium-resort institutions.
Sanatorium-resort institutions - This is a medical facility designed for post-treatment of patients with predominantly natural therapeutic factors (mineral springs, therapeutic mud, healing climate, sea bathing, etc.) in combination with physiotherapy, physiotherapy exercises, therapeutic nutrition and other means with a mandatory combination of an established regimen that provides complete treatment and sick rest.
The main goal of the sanatorium is aftercare and disease prevention. The main tasks of the sanatorium are:
qualified examination and treatment of patients in accordance with accepted standards complex therapy with the predominant use of natural healing factors;
carrying out sanitary-hygienic and anti-epidemic measures and targeted sanitary-educational work among patients and attendants;
scientific and practical work with the aim further development theories and practices of resort business;
study of the nearest and long-term results sanatorium treatment of patients;
systematic increase special knowledge and business qualifications of doctors, paramedical and other personnel;
exchange of experience in order to introduce new methods of diagnosis and treatment, as well as new forms of patient care.
Sanatoriums can be single-profile, that is, intended for the aftercare of patients with similar diseases, and multi-profile, that is, with several specialized departments, intended for the aftercare of patients with various diseases.
Sanatorium - dispensary is a medical and preventive institution of a sanatorium type, designed to carry out medical and recreational work among workers and employees of enterprises, institutions, organizations, mainly without interruption from their work activities.
Characteristics of emergency medical institutions
Ambulance Station (AMS) may function as an independent institution or be a structural subdivision of other health facilities. Ambulance stations were created to provide the population with emergency and emergency medical care at any time of the day. The NSR stations operate on a territorial basis. The main functional unit of the station is a mobile team: medical, paramedical, intensive care, narrow-profile specialized. Providing emergency care for life threatening conditions in full and in the shortest possible time is often the decisive factor for saving lives.
The station includes: operational department, hospitalization department, transport department, organizational and methodological department, technical department, etc.
The main structural subdivision of the NSR are mobile teams: linear and specialized.
The main tasks of the EMS service at the present stage are:
providing patients with medical care aimed at preserving and maintaining vital important functions organism;
delivery of patients as soon as possible to the hospital for the provision of qualified and specialized medical care;
provision of emergency medical care, including resuscitation;
hospitalization, which is carried out through the ambulance dispatch service;
ensuring continuity with the clinic;
ensuring interconnection with the center of sanitary and epidemiological surveillance;
providing emergency care to patients who directly applied to the SMP.
Characteristics of medical facilities of the combined type.
Medical and sanitary unit (MSCH) is a complex medical and preventive institution organized to provide medical and sanitary assistance to workers of a large industrial enterprise. The tasks of the medical unit are: providing specialized qualified and timely medical care to workers with diseases and injuries; planning and implementation, together with the administration of the enterprise and the sanitary and epidemiological service, of sanitary and hygienic and anti-epidemic measures to improve working conditions, reduce general morbidity, industrial injuries and occupational diseases; control over the state of the health protection system of workers. The MSU usually includes a polyclinic and a hospital with medical support units.
In recent decades, other types of health facilities have emerged, such as hospices or nursing homes.
Hospice - This is an institution that provides assistance to terminally or long-term ill people. The purpose of the hospice is to create comfortable conditions for the patient and provide support to his family. The hospice is designed for palliative and symptomatic treatment of patients in the terminal stages and long-term illnesses; organization of qualified care for patients and socio-psychological assistance to patients and their relatives. The hospice is headed by a specialist with higher nursing education.
The hospice program includes three types of services:
Patient care at home.
Patient care in the hospital.
Psychological assistance to the patient's family.
Hospice can be organized on the basis of individual district hospitals, city multidisciplinary and specialized hospitals.
Continuity is one of the basic principles of the work of medical institutions. It means - the implementation of a single tactic in the treatment of people, medical care for the population in various health facilities in order to achieve a single strategic goal - the restoration and preservation of health.
Currently, there is a trend towards an increase in medical facilities of a combined type, in particular, united hospitals. Day hospitals are successfully functioning, which are now allocated to independent medical institutions. It is being introduced into the healthcare practice of the family doctor's outpatient clinic.
Thus, the development and improvement of various types of healthcare facilities continues.
In Russia, to provide medical care to the population, a wide network of medical and preventive institutions (MPU) has been created.
There are the following types of medical institutions:
Stationary
Outpatient
Sanatorium-resort
TO stationary(HCF) are hospitals And hospitals. They are designed to provide emergency medical care, as well as planned treatment, complex and voluminous diagnostic procedures and research where this is not possible outpatient settings By medical indications or for technical reasons. There are monoprofile, i.e. specialized hospitals that are designed to treat patients with any one disease and multidisciplinary. A multidisciplinary hospital includes several departments, for example, surgical, therapeutic, gynecological, etc. Inpatient institutions also include maternity, whose functions include obstetric care, treatment of pregnant women, puerperas.
hospitals they mainly provide medical care to current and former employees of the "power" departments, war veterans, as well as to persons injured as a result of hostilities.
Clinic (clinical Hospital) - a stationary institution in which, in addition to medical work in without fail performed Scientific research and training of students and specialists is carried out.
In addition to inpatient facilities, there are also outpatient facilities, sanatorium-resort facilities and ambulance stations.
The functions of outpatient facilities are different.
Dispensaries carry out treatment preventive care certain groups of patients (rheumatological, dermatovenereological, neuropsychiatric, anti-tuberculosis, oncological and other dispensaries).
The scope of this assistance includes:
Active identification of profile patients among the population;
Systematic active monitoring of identified patients (patronage);
Provision of specialized medical care;
Measures for prevention.
In addition, the dispensary conducts a study of morbidity and sanitary and educational work among the population and patients.
Polyclinics - multidisciplinary medical institutions (MPU) - are designed to provide medical (including specialized) care and examination of patients according to the territorial-district principle.
outpatient clinics- these are health care facilities, unlike polyclinics, providing specialized medical care in a smaller volume. Doctors conduct appointments only in the main specialties. The principle of operation of outpatient clinics is also territorial-district, but they are located mainly in rural areas, not far from feldsher-obstetric stations.
Feldsher-obstetric station (FAP)- an outpatient clinic in rural areas. Organized in rural areas locality remote from other medical institutions at a distance of more than 4-6 kilometers. Works on a district basis. It is part of a rural or central district hospital. As a rule, the staff of the FAP: paramedic - midwife - nurse. FAP staff provides first aid at an outpatient appointment and at home. He is entrusted with the fulfillment of doctor's prescriptions, the involvement of residents of the site for scheduled examinations, participation in the conduct of medical examinations of the population and the implementation of preventive measures.
An important section of the work of the FAP is the provision of medical care during pregnancy and childbirth, obstetric care, monitoring of puerperas at home, after their discharge from the hospital, monitoring of children under the age of 3 years, medical care for children preschool institutions and schools in the area. FAP employees provide early detection of infectious patients, carry out anti-epidemic measures, sanitary supervision of the territory of populated areas, industrial premises, water supply, public catering, trade, utility facilities. FAP staff provide emergency and emergency first aid. The structure of the FAP provides beds for hospitalization of women in labor, as well as for temporary isolation of infectious patients. There should be a pharmacy for the sale of ready-made medicines and sanitary and hygiene items.
health centers usually they are not independent health facilities and are either part of polyclinics or medical units. They are usually located near the workplace of the serviced contingent (large workshop, construction site, etc.) and are of two types: medical and paramedical. They provide pre-medical and first aid for injuries, poisoning, sudden illnesses. The staff of the health centers is actively involved in medical examinations and sanitary-educational work.
Outpatient facilities also include women's consultations . Their functions include early detection, treatment and clinical examination of patients with gynecological diseases; dispensary observation, and, if necessary, treatment of pregnant women. An important place in their work is given to health education and training of pregnant women in the necessary skills for caring for newborns.
Medical and sanitary unit (MSCH)- This is a complex of healthcare facilities designed for medical care of workers and employees of industrial enterprises and organizations. It operates on the principle of shop division and is as close as possible to the place of work of workers and employees. The MSU may include: a polyclinic, a hospital, health centers, a dispensary, etc. Functions of the medical unit: providing outpatient and inpatient medical care, conducting professional examinations, developing a set of preventive measures aimed at improving working conditions, identifying and monitoring occupational hazards.
Territorial Medical Association (TMO), as well as the medical unit, is a complex of healthcare facilities, however, TMO provides medical care not on a production basis, but on a territorial basis.
Ambulance stations- medical institutions providing round-the-clock emergency medical care to the population (in case of injuries, poisoning, wounds, life-threatening sudden illnesses) at the pre-hospital stage, as well as during childbirth, and hospitalization of patients in need of inpatient treatment or women in labor in maternity hospitals. In large cities, there are linear ambulance substations and specialized ones, such as, for example, cardiological, resuscitation, psychiatric, etc.
To institutions sanatorium type include sanatoriums, dispensaries and other institutions whose activities are based on the use of predominantly natural diseases for the treatment and prevention of diseases healing factors(climate, healing mud, mineral springs etc.), as well as diet therapy, physiotherapy and exercise therapy.
The hospital includes an admissions department, medical and diagnostic departments, administrative and economic blocks.
Hospitalization - placement in a hospital of a medical institution of persons in need of examination, treatment or obstetric care. Hospitalization can be of two types - emergency and planned.
Emergency hospitalization (as a rule, with the delivery of the patient to the hospital by linear and specialized ambulance and emergency teams) is carried out in cases where the patient's condition requires urgent qualified or specialized medical care in a hospital setting (patients with injuries, burns, acute or exacerbations of chronic diseases).
During planned hospitalization, the patient is admitted in the direction of a doctor of an outpatient clinic, in cases where the ongoing diagnostic and treatment measures are not effective or cannot be carried out at home. Depending on the severity of the patient's condition, his age, household factors, he can be taken to the emergency room by sanitary vehicles or come on his own: by transfer from another hospital after preliminary consultations of specialists, agreement and consent of the patient and the administration of these medical institutions.
In some cases, the patient may be transferred from another hospital.
The patient can also seek help without a referral, in cases where, for example, an accident occurred close to the hospital or a person felt unwell and independently turned to the nearest hospital.
The main types of health care institutions.
Order of the Ministry of Health and Social Development of the Russian Federation of October 7, 2005 No. 627 approved Unified nomenclature of state and municipal health care institutions . Today, the names of all health care institutions must comply with this Nomenclature.
The unified nomenclature includes four types of health facilities:
Therapeutic and prophylactic;
Institutions special type;
Institutions for supervision in the field of consumer protection and human well-being;
Pharmacy establishments.
Medical institutions include:
1) hospital facilities;
2) dispensaries: oncology, tuberculosis, etc.;
3) outpatient clinics;
4) centers, including scientific and practical ones;
5) emergency medical facilities;
6) institutions for the protection of motherhood and childhood;
7) sanatorium-resort institutions.
Clinical institutions are medical and preventive institutions (hospitals, dispensaries, maternity hospitals and other institutions) used for the purpose of teaching by higher medical educational institutions (faculties) or for scientific purposes by medical scientific organizations.
Hospitals . Distinguish the following types hospitals: district, district, city (including children's), and other types. Hospital facilities are designed to treat patients in a hospital setting (from Latin Stationarius - standing, motionless). Hospitals may have a polyclinic (outpatient clinic). It provides emergency medical care, as well as assistance to patients who need constant surveillance or the use of treatment methods that are impossible or difficult on an outpatient basis - at home or in a clinic (surgeries, frequent intravenous, intramuscular and other injections and other manipulations).
Distinguish monoprofile (specialized) hospitals dedicated to the treatment of patients with a single disease (e.g. tuberculosis) and multidisciplinary - these are hospitals, which include various departments (for example, surgical, neurological, therapeutic, etc.).
The structure of the hospital usually includes an admissions department, diagnostic and treatment departments, a pharmacy, a catering department, etc. The functional duties of a nurse in a hospital depend on the profile of the department and the specifics of her work in it (a nurse in the admissions department, surgical department, treatment room, ward nurse, etc.).
Specialized hospitals, including rehabilitation treatment, gynecological, geriatric, infectious, narcological, oncological, ophthalmological, neuropsychiatric, psychiatric, tuberculosis.
Hospital - (from Latin hospitalis, hospitable) a medical facility designed to provide medical care to military personnel. In a number of countries, civilian medical institutions are also called hospitals.
Treatment and prophylactic polyclinic type institutions - These are clinics and dispensaries.
Polyclinic - a multidisciplinary medical institution designed to provide medical care to patients, including specialized ones; if necessary - for examination and treatment of patients at home.
In the polyclinic, doctors of various profiles (therapists, surgeons, oculists, otolaryngologists, cardiologists, etc.) are received, as well as diagnostic rooms (endoscopic, radiological, functional diagnostics), laboratory, physiotherapy department, treatment room.
The basic principle of the polyclinic is territorial-district. The territory served by the polyclinic is divided into sections, which are assigned to the district doctor and the district nurse, with a certain number of people.
The local doctor and nurse are responsible for carrying out all therapeutic and preventive measures on the territory of this site. Besides, great importance given to the medical examination of the population.
Clinical examination - this is the organization of systematic monitoring of the health of the population, the study of working and living conditions, the identification of patients with chronic diseases.
The district nurse of the polyclinic helps the doctor during the reception of patients, maintains various documentation, explains to patients how to collect this or that material for laboratory research how to prepare for instrumental and X-ray studies, fills out statistical coupons, research referral forms, fulfills doctor's prescriptions at home, or, if necessary, teaches the patient's relatives the elements of caring for him.
In addition to district doctors, the polyclinic has procedural nurses, nurses of physiotherapy rooms, etc. Currently, there are offices first aid: here the nurse measures the patient's body temperature and blood pressure.
Ambulatory - This is a medical and preventive institution, which, like a polyclinic, provides medical care to patients in rural areas. The work of an outpatient clinic, like a polyclinic, is built according to the district-territorial principle, but unlike a polyclinic, a smaller amount of medical care is provided here. Usually no more than five doctors work in an outpatient clinic.
The work of an outpatient nurse resembles the work of a district nurse in a polyclinic, but requires even greater independence and responsibility from her.
Medical unit - a specialized health care institution designed to organize preliminary (when applying for a job) and periodic (during employment) medical examinations of workers with harmful and dangerous working conditions at large enterprises. Their activities are based on the principle of shop division.
The structure of medical and sanitary units is different, they may include a polyclinic or an outpatient clinic, a hospital, health centers, Dental clinic, dispensary, sanatoriums, children's health camps, etc.
The functions of the medical and sanitary units are varied. In addition to providing outpatient medical care, treating patients in a hospital, employees of the medical unit carry out great job but dispensary monitoring of the health of workers and employees through systematic preventive examinations identify individuals suffering from chronic diseases, all patients in an outpatient setting or a hospital.
District (shop) doctors and nurses, paramedics of health centers study the working conditions of workers and directly at the workplace, identify occupational hazards and take part in the development of a set of preventive measures aimed at improving the working and living conditions of the company's employees.
health centers (medical, feldsher) are structural units of health care institutions or organizations and are designed to provide first aid to workers, employees and students. The health center is not an independent medical and preventive institution, but is usually part of a polyclinic or a medical unit of an enterprise. medical staff health center (doctor, paramedic, nurse) provides pre-medical and first aid, conducts necessary procedures prescribed by the doctor of the polyclinic or medical unit (injections, dressings), vaccinates, performs sanitary and educational work.
Ambulance stations- These are medical institutions designed to provide round-the-clock emergency medical care to patients at the pre-hospital stage in all life-threatening conditions (trauma, wounds, poisoning, bleeding), as well as during childbirth. At ambulance stations, staff work in teams of 2-3 people (a doctor and one or two paramedics).
TO institutions for the protection of motherhood and childhood include antenatal clinics and maternity hospitals. Women's clinics, like polyclinics, operate on a district-territorial basis. Medical examinations are carried out here, women with gynecological diseases are identified and treated, and dispensaries are monitored for pregnant women.
The staff of antenatal clinics and maternity hospitals is doing a lot of sanitary and educational work with pregnant women and puerperas. Nurses they usually work in the treatment rooms of antenatal clinics and maternity hospitals, as well as in operating rooms, children's departments of maternity hospitals as ward nurses.
TO sanatorium-type institutions include sanatoriums (from Latin sanare - to heal, heal), dispensaries, recreation camps for children, and sanatorium recreation areas. The activities of these medical institutions are based on the use of predominantly natural healing factors for the treatment of patients ( mineral water, mud therapy), as well as herbal medicine, physiotherapy and exercise therapy.
In sanatoriums, patients undergo a course outpatient treatment. Dispensaries organized at large industrial enterprises are used for treatment and preventive measures, as a rule, in their free time.
The work of nurses in sanatorium-type medical and preventive institutions resembles the work of nurses in polyclinics, hospitals, dispensaries, etc.
Home (hospital) nursing care - a health care institution to provide qualified care for elderly patients and old age suffering from chronic diseases and for health reasons not in need of active treatment.
Hospice - a healthcare institution to provide medical, social, spiritual, psychological and legal assistance to incurable (not amenable to treatment) cancer patients and their families, both during the period of illness and after the loss of their loved ones.
Leper colony (from late Latin lergosus - leper). Medical institution for patients with leprosy. In some countries (Brazil, India) leprosy is treated on an outpatient basis.
Clinics - medical and preventive institutions (hospitals, maternity hospitals and other healthcare institutions) that are part of higher medical educational institutions, medical scientific organizations or subordinate medical schools and scientific organizations are their structural subdivisions.
Questions for self-preparation for practical lesson:
1. Structural levels of the healthcare system in the Russian Federation.
2.State organizational structures involved in nursing.
3. List outpatient and inpatient health facilities.
4. Main types medical records hospital.
Medical institutions are specialized medical and preventive institutions in which people with certain diseases receive a full range of medical services Key words: diagnostics, treatment, rehabilitation after illnesses.
As a rule, medical care for the population in Russia consists of several systems:
Therapeutic medical institutions,
Surgical and traumatological institutions.
pediatric medical institutions,
Preventive medical institutions - sanatoriums and dispensaries,
Special medical institutions - examination departments, stations and ambulance departments, medical services rescue, departments and blood transfusion stations,
Maternity.
Therapeutic
Therapeutic medical institutions unite institutions involved in the treatment, prevention and medical examination the population over 15 years of age in some cases, and the population since birth, the composition includes hospitals and clinics. Polyclinics have departments of local doctors, as well as specialized doctors - surgeons, neuropathologists, ophthalmologists, psychiatrists, phthisiatricians, endocrinologists. As a rule, polyclinics are departments at hospitals. The main forms of treatment in hospitals are inpatient care - the patient is sometimes in places of non-medical stay, as well as an outpatient clinic - the patient is not in places of medical stay. The hospitals have intensive care units, intensive care, surgery, otolaryngology, neurological, gynecological, andrological, and oncological departments. There are also departments of universities, and scientific institutions. There is a sanitary inspection room, a registry of patients. The system of therapeutic medical institutions also includes medical units and first-aid posts of enterprises, medical care institutions in transport, railway.
Pediatric
Pediatric medical institutions are similar in structure to therapeutic medical institutions. Patients under 15 years of age are monitored. There are doctors and nurses in schools and kindergartens, children's camps, Special attention given to children of small ages 0,1,2,3 years.
Prevention
Preventive medical institutions provide services of a sanatorium and medical nature to children and adults, both at the place of residence and in different regions of the country.
Special
Special medical institutions provide services of a special nature.
Medical centers alternative medicine
There is a large number medical centers specializing in the use of knowledge and techniques of alternative medicine in the treatment of various types of pathologies.
Hospital - a type of civil inpatient medical institution aimed at treating patients and / or specialized in-depth differential diagnosis diseases in stationary conditions. A military hospital is a hospital.
In general, hospitals are classified by type of organization and by specialization.
Types of hospital organization:
Decentralized - a type of device in which each department occupies a separate hospital building. The disadvantage of such a system is the large footprint. IN pure form almost never occurs, a relative example is 1 city hospital.
Centralized - the vast majority of departments are combined in one building, usually located on different floors or parts of the building. As a rule, with this type of organization, technical premises, a catering department, an outpatient department and thanatological (pathoanatomical) departments are taken out of one building. Example - 15 City Clinical Hospital of Moscow, Cardiocenter.
Mixed - a combination of the features of both types: there is one or two large buildings with many compartments and several smaller buildings for some compartments. Most large hospitals are organized according to this principle - for example, the Sklifosovsky Institute, the Botkin Hospital, the Filatov Hospital, the Burdenko Institute
By specialization (profile):
Specialized - aimed at treating a certain class of diseases: cardiological (Cardiocenter), neurosurgical (Institute of Neurosurgery), oncological (Oncocenter), urological, infectious and many others.
General - multidisciplinary institutions aimed at diagnosis and treatment a wide range diseases.
In accordance with the profile of treatment, it is planned to place wards in therapeutic and surgical and infectious diseases buildings
Sanitary checkpoint, also sanitary checkpoint
Therapeutic building
Surgical Corps
Gynecological department
Clinical department
Emergency room
Infirmary - a military medical facility, directly part of military units and subunits, designed to provide medical care and inpatient treatment of sick and wounded military personnel who do not need long-term treatment and complex diagnostic and specialized therapeutic measures. Infirmaries are created at separate military garrisons, in military units and on ships. Military personnel receive specialized medical care and treatment in military hospitals.
Ambulatory (lat. ambulatorius - performed on the go) - a medical institution that provides assistance to incoming patients and at home, but does not provide hospital beds.
Unlike a polyclinic, an outpatient clinic provides services only in the main areas, such as therapy, surgery, dentistry (sometimes pediatrics, obstetrics and gynecology).
Outpatient treatment is the organization of medical care for patients coming to a medical institution.
Outpatient treatment - treatment carried out at home or when the patients themselves visit a medical institution (as opposed to inpatient treatment, carried out with the placement of the patient in a hospital).
Pharmacy is a special specialized organization of the healthcare system engaged in the manufacture, packaging, analysis and sale of medicines. The pharmacy is traditionally considered as a healthcare institution, and its activities are formulated as "providing pharmaceutical assistance to the population." Pharmaceutical care includes the process of consulting a doctor and a patient in order to determine the most effective, safe and cost-effective course of treatment.
A sobering-up station is a medical institution that aims to keep people in a state of moderate alcohol intoxication, up to their sobering up. Persons suspected of being in a state of alcoholic intoxication are taken to the sobering-up station by employees of the internal affairs bodies. Where, upon arrival, they are examined by paramedics, and their identity is also established. When a person is recognized as being in a state of alcoholic intoxication, of an average degree, requiring sobering up, detention is made until the moment of sobering up. Persons who are in a state of severe alcohol intoxication, alcoholic coma delivered to medical facilities.
Women's consultation (LC) is an outpatient and polyclinic medical and preventive institution, the main task of which is outpatient and dispensary care women during pregnancy and the postpartum period, gynecological care. They work according to the district principle as part of maternity hospitals and perinatal centers, district and district hospitals, and can be independent medical institutions.
Dermatovenerological dispensary (CVD) is a specialized medical and preventive institution (dispensary) designed to provide consultative, diagnostic and therapeutic assistance to the population, as well as the implementation of preventive and anti-epidemic measures that prevent the occurrence of infectious skin diseases and sexually transmitted diseases.
Leprosarium (from late Latin leprosus - leper, from other Greek λεπρη - leprosy) is a specialized medical and preventive institution that actively detects, isolates and treats patients with leprosy (leprosy). Leprosarium is also an organizational and methodological center for the fight against leprosy.
Leper colonies are organized in endemic areas and usually in rural areas. The leprosarium includes a hospital, an outpatient clinic and an epidemiological department. Patients are provided with residential houses, they have subsidiary farms for agricultural work and various crafts. Depending on the type and severity of the disease, patients stay in the leper colony from several months to several years. The attendants usually also live on the territory of the leprosarium in an area conditionally separated (for example, by green spaces) from the area where patients live.
Therapeutic-labor dispensary, LTP in the USSR and some post-Soviet countries is a type of medical correctional institution intended for those who, by a court decision, were sent for compulsory treatment for drug addiction and alcoholism. In fact, the LTP was a place of deprivation of liberty, where the main method of treatment was the forced labor of the patient.
Polyclinic (from other Greek πόλις - city and other Greek κλινική - healing) is a multidisciplinary or specialized medical and preventive medical institution for providing medical care to incoming patients and patients at home.
In Russia, they are distributed on a territorial basis, and are the basic level of medical care for the population.
A psychiatric hospital is an inpatient healthcare facility that treats mental disorders, and also performs expert functions, dealing with forensic psychiatric, military and labor expertise.
Psychoneurological boarding school (abbreviated as PNI) - specialized boarding house, institution social security intended for the elderly and disabled who do not have relatives legally required to support them (or it is impossible to provide care at home), and do not need inpatient treatment, but due to chronic mental disorder need constant outside care and supervision, household and medical care. Psychoneurological boarding schools are part of the general system psychiatric care in the country and at the same time are institutions social protection population.
Maternity hospitals provide qualified medical care for women during pregnancy, as well as medical care for newborns. Relate to medical institutions. Observation of pregnant women begins during pregnancy. For medical supervision maternity hospitals have been set up for the birth of children. In maternity hospitals, sick women and newborns are completely isolated from healthy ones. As part of the maternity hospital, a women's consultation and a hospital, a physiological obstetric department, a department for women with pregnancy pathology, an obstetric observation department, wards for newborns in the 1st and 2nd obstetric department, gynecological department.
A sanatorium (from Latin sano “I heal, I heal”) is a medical and preventive institution for the treatment of mainly natural (climate, mineral waters, mud) and physiotherapeutic agents, diet and regimen.
Feldsher-obstetric station (FAP) is a medical and preventive institution that provides the initial (pre-medical) stage of medical care in rural areas. FAPs work as part of a rural medical district under the guidance of an outpatient clinic, district or district hospital.
Hospice is a medical institution in which patients with a predictable adverse outcome of the disease receive decent care.
MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION
ORDER
On approval of the nomenclature of medical organizations
In accordance with Article 14 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" (Collection of Legislation Russian Federation, 2011, N 48, article 6724; 2012, N 26, art. 3442, 3446; 2013, N 27, art. 3459, 3477; N 30, art. 4038)
I order:
1. Approve the nomenclature of medical organizations according to the appendix.
2. Recognize as invalid:
order of the Ministry of Health and Social Development of the Russian Federation of October 7, 2005 N 627 "On Approval of the Unified Nomenclature of State and Municipal Healthcare Institutions" (registered by the Ministry of Justice of the Russian Federation on October 12, 2005, registration N 7070);
order of the Ministry of Health and social development of the Russian Federation of February 19, 2007 N 120 "On Amendments to the Order of the Ministry of Health and Social Development of the Russian Federation of October 7, 2005 N 627 "On Approval of the Unified Nomenclature of State Healthcare Institutions" (registered by the Ministry of Justice of the Russian Federation on March 22, 2007, registration No. 9157);
order of the Ministry of Health and Social Development of the Russian Federation of November 19, 2008 N 653n "On Amending the Appendix to the Order of the Ministry of Health and Social Development of the Russian Federation of October 7, 2005 N 627 "On Approval of the Unified Nomenclature of State and Municipal Healthcare Institutions" (registered Ministry of Justice of the Russian Federation on December 22, 2008, registration N 12921).
Minister
V. Skvortsova
Registered
at the Ministry of Justice
Russian Federation
September 13, 2013
registration N 29950
Application. Nomenclature of medical organizations
Application
I. Nomenclature of medical organizations* by type of medical activity
________________
* Medical organizations in which the structural units of educational and scientific organizations on the basis of which practical training is carried out medical workers(clinical bases), include the word "clinical" in their name.
1. Treatment and preventive medical organizations:
1.1. Hospital (including children's).
1.2. Emergency Hospital.
1.3. District hospital.
1.4. Specialized hospitals (including those in the field of medical care), as well as specialized hospitals of the state and municipal systems healthcare:
gynecological;
geriatric;
infectious, including children;
medical rehabilitation, including children's;
narcological;
oncological;
ophthalmic;
psychiatric, including children's;
psychiatric (hospital) specialized type;
psychiatric (hospital) of a specialized type with intensive supervision;
psychoneurological, including children's;
tuberculosis, including children.
1.5. Maternity hospital.
1.6. Hospital.
1.7. Medical and sanitary part, including the central one.
1.8. Home (hospital) nursing care.
1.9. Hospice.
1.10. Leper colony.
1.11. Dispensaries, including dispensaries of the state and municipal health care systems:
medical and physical culture;
cardiological;
dermatovenerological;
narcological;
oncological;
ophthalmic;
anti-tuberculosis;
neuropsychiatric;
endocrinological.
1.12. Ambulatory, including medical.
1.13. Polyclinics (including children's), as well as polyclinics of the state and municipal health care systems:
consultative and diagnostic, including children's;
medical rehabilitation;
psychotherapeutic;
dental, including children's;
physiotherapy.
1.14. Women's consultation.
1.15. Children's home, including specialized.
1.16. Dairy cuisine.
1.17. Centers (including children's), as well as specialized centers of the state and municipal health care systems:
assisted reproductive technologies;
high medical technologies, including the profile of medical care;
geriatric;
diabetic;
diagnostic;
health;
consultative and diagnostic, including children's;
clinical diagnostic;
therapeutic and preventive nutrition;
treatment and rehabilitation;
physical therapy and sports medicine;
manual therapy;
medical;
medical genetic (consultation);
medical rehabilitation for soldiers-internationalists;
medical rehabilitation, including children's;
medical rehabilitation for the disabled and children with disabilities with the consequences of childhood cerebral palsy;
medical and social expertise and rehabilitation of the disabled;
medical and social rehabilitation, including with the department of permanent residence of the disabled and disabled children with severe forms of cerebral palsy, who do not move independently and do not serve themselves;
medical and social rehabilitation of drug addicts;
medical and surgical;
multidisciplinary;
general medical practice(family medicine);
protection of motherhood and childhood;
family health and reproduction;
protection reproductive health teenagers;
palliative care;
pathology of speech and neurorehabilitation;
perinatal;
occupational pathology;
prevention and control of AIDS;
psychophysiological diagnostics;
hearing rehabilitation;
rehabilitation;
specialized (according to the profiles of medical care);
specialized types of medical care;
audiological.
1.18. Medical organizations of emergency medical care and blood transfusion:
ambulance station;
blood transfusion station;
blood center.
1.19. Sanatorium-resort organizations:
balneological clinic;
mud bath;
resort polyclinic;
sanatorium;
sanatoriums for children, including for children with parents;
sanatorium-dispensary;
sanatorium health Camp year-round activity.
2. Medical organizations of a special type:
2.1. Centers:
medical prevention;
disaster medicine;
medical mobilization reserves "Reserve";
medical information and analytical;
medical biophysical;
military medical expertise;
2.2. The Bureau:
medical and social expertise;
medical statistics;
pathological and anatomical;
forensic medical examination.
2.3. Laboratories:
clinical diagnostic;
bacteriological, including the diagnosis of tuberculosis.
2.4. Medical detachment, including special purpose (military district, fleet).
3. Medical organizations for supervision in the field of consumer protection and human well-being:
3.1. Centers for Hygiene and Epidemiology.
3.2. Anti-plague center (station).
3.3. Disinfection center (station).
3.4. Center for hygienic education of the population.
3.5. Center for State Sanitary and Epidemiological Surveillance.
II. The nomenclature of medical organizations of the state and municipal health care systems on a territorial basis
4.1. Federal.
4.2. Territorial, republican, regional, district.
4.3. Municipal.
4.4. Interdistrict.
4.5. District.
