Kemerovo Institute of Social Economic Problems in Healthcare, 

Kemerovo, Russia

 

The strategy of social economic development in Russia before 2020 is presented as the political solution about necessity for further development of Russian economics on the basis of its drastic rise in efficiency and social orientation.

The important direction of “Strategy 2020” is development of human potential in Russia, including population saving politics and healthcare development [1, 2, 3-5]. The strategy of economic development of Siberia supposes creation of dynamically developing social economic innovative system corresponding to the world standards [6-10].

Organization of medical assistance with rehabilitation (depending on patient’s state severity) includes three stages according to the article 40 from the Federal law, 21.11.2011, #323-FZ “About the foundations of population health protection in Russian Federation”, the Order of Russian Health Ministry, 29.12.2012, #1705 n.

In Kemerovo region hospital assistance is realized in 111 medical facilities, with 23,317 beds. 10 medical facilities provide high tech medical assistance. The regional hospitals include 273 physiotherapeutic departments (rooms), 118 department (rooms) of remedial gymnastics. Annually about 600,000 patients completed their hospital treatment. Transition to the second stage of rehabilitation is required for adult patients receiving treatment on 8,384 beds in 11 profile departments.

Specialized medical rehabilitation of the second stage is realized in 7 regional multiprofile medical facilities: Kemerovo city for the north of the region, Prokopyevsk and Novokuznetsk cities for the south.

There are 378 beds for the stage II of medical rehabilitation. The coverage is 1.4 beds for 10,000 of population. The stage II is related to 11 departments, with the annual number of patients exceeding 7,000.

6 departments with 165 beds are planned including 2 departments for CNS and sense organ diseases, department   20 beds for diseases of locomotor and peripheral nervous system, 2 departments with 65 beds for perinatal period diseases, and increasing rehabilitation beds (up to 10) in Kemerovo City Clinical Hospital #1 named after M.N. Gorbunova.

The schedule includes rehabilitation beds in the oncologic departments in Anzhero Sudzhensk and Belovo.

By 2020 the number of rehabilitation beds will increase to 803, the coverage will increase from 1.4 to 3.0 for 10,000 of population.

The third (III) stage of medical rehabilitation is realized in outpatient conditions in medical facilities and health resort organizations. The regional medical facilities include 50 departments and 383 rooms (physiotherapy, remedial gymnastics, reflexotherapy, manual therapy et al.).

The coverage of outpatient rehabilitation for adult population was 13 % in 2013, restorative treatment for disabled children ‒ 95 %.

At the basis of the outpatient and polyclinic department of M.N. Gorbunova City Clinical Hospital #1 the mobile team was created for home rehabilitation assistance for non-mobile patients.

According to the data from the Federal Service of State Statistics, Kemerovo region include 53 health resort facilities of different departmental affiliation, including 9 adult sanatoriums (2,328 beds), 16 children sanatoriums (1,645 beds), 1 day-and-night recreation camp (300 beds), 26 health and recreation resorts (2, 961 beds).

40 beds for palliative assistance were opened for children in Novokuznetsk and Kemerovo in 2013. The volume of palliative assistance was 0.08 bed-days per patient in 2013 (with consideration of nursing care beds). By 2016 increase to 0.115 bed-days per patient is expected.

On January, 1, 2014, two rehabilitation inhospital departments (each with 30 beds) for patients with circulating system diseases were opened at the basis of Kemerovo Cardiology Dispensary and Prokopyevsky Sanatorium.

In 2013-2020, as the part of development of stage III of medical rehabilitation, 11 additional rehabilitation departments of restorative treatment (including 3 pediatric departments) are projected in the facilities for inhospital assistance.

6 rehabilitation rooms were opened in 2013. Additionally, 8 rooms are planned in the regional medical facilities.

In Novokuznetsk and Kemerovo the project includes creation of mobile rehabilitation teams, which are activated according to decisions from a medical multidisciplinary team.