The Construction Of A "national Patient-centered Health Care System" Is Still Postponed

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The Construction Of A "national Patient-centered Health Care System" Is Still Postponed
The Construction Of A "national Patient-centered Health Care System" Is Still Postponed

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The construction of a "national patient-centered health care system" is still postponed

The draft Strategy for the Development of Healthcare of the Russian Federation until 2025 - a global document that defines the state policy in the field of healthcare - will be finalized. It contains no specifics for solving specific, in particular, personnel problems of the industry. In addition, there remains a shortage of financing for the compulsory medical insurance system - this is the conclusion reached by participants in parliamentary hearings in the State Duma.

The construction of a "national patient-centered health care system" is still postponed
The construction of a "national patient-centered health care system" is still postponed

Photo: kremlin.ru /

The draft Strategy for the Development of Healthcare of the Russian Federation until 2025 - a global document that defines the state's health policy for the next 7 years - will be finalized. According to the plans of the Ministry of Health, the construction of a "national patient-centered health care system" was to begin in 2019. However, in the next version of the document there is still little specificity, and, in addition, there is a shortage of financing for the compulsory medical insurance system - this was the conclusion of the participants in the parliamentary hearings in the State Duma.

The document prepared by the Ministry of Health more than a year ago suggests the continuation of preparatory “structural reforms” in healthcare until 2019 for the transition to a preventive healthcare model in Russia. As promised in the Ministry of Health, the system aimed at increasing the availability and quality of medical care will combine all the best that is available in the medical field in the world and in Russia. Among the main directions of the Strategy are the creation of a unified system for informing and motivating citizens to a healthy lifestyle, innovative development of medicine with the introduction of modern technologies, improvement of drug supply, elimination of staff shortages, development of a quality management system for medical care, improvement of the compulsory medical insurance system, development of mechanisms for public-private partnership …

It is expected that these measures will make it possible to increase the life expectancy of Russians to 78.5 years by 2025, significantly reducing mortality, primarily among the working-age population

This is not the first time the document is being finalized. According to Deputy Health Minister Natalya Khoreva, in 2018 the project was discussed twice in the Security Council, in March it was considered in the Federation Council Committee on Social Policy. The remarks of Rospotrebnadzor and the MHIF were taken into account. Nevertheless, as the auditor of the Accounts Chamber of the Russian Federation, Mikhail Men, said at the hearing in the Duma, there is still a shortage of financing for territorial programs of state guarantees for free medical care.“We think this chapter needs to be expanded,” Men said. "Both the national project and federal projects on primary care and staffing of medical organizations do not include specific indicators." In addition, according to him, the issues of the availability of medical care in remote settlements are not reflected. The level of access to medical care was recently assessed by monitoring carried out by the ONF.

Nikolai Govorin, deputy chairman of the Health Protection Committee, said that Russia needs "a gradual, evolutionary transition to a preventive health care model." According to him, it is necessary to "radically change the system of primary medical care," where the district doctor performs the functions of a "dispatcher" for referring patients to other medical institutions. “It should become a filter, so the criteria for its assessment should be the index of the number of healthy people in each age group in its area. And the quality assessment should be carried out on the basis of a specific analysis of each neglected case,”Govorin suggested including such proposals in the text of the Strategy.

According to Sergei Shishkin, Director of the Center for Health Policy at the Higher School of Economics, the state of the domestic district service is of particular concern: a study conducted by the HSE showed that, for a number of indicators, its level is lower than in all the former post-Soviet countries. In particular, the share of district doctors is only 13%, while the workload on them often exceeds the federal standard by 2-3 times. At the same time, in his opinion, the measures prescribed in the draft Strategy to improve the quality of primary medical care are not enough.

The document sets only goals - elimination of personnel imbalance and shortages in certain specialties, increasing targeted training, continuous professional development. How the Ministry of Health intends to solve these problems is not specified.

A package of amendments concerning the solution of personnel issues in medicine was proposed by the rector of Sechenov University, a university participating in Project 5-100, chairman of the Council of Rectors of medical and pharmaceutical universities of the country, Petr Glybochko. In his opinion, it is possible to transfer part of the responsibilities of general practitioners to graduates of medical universities who studied under the Nursing Education program, including organizing and monitoring prophylactic medical examinations, vaccinations, and working in school medical organizations. And in order to support graduates who come to work in rural areas or in remote regions, the content of the social package should be legally determined.

In addition, Glybochko offers to check the qualifications of doctors working in government institutions, primarily oncologists, pediatric and cardiovascular surgeons. The audit teams, in his opinion, should include employees of national medical research centers and medical universities. As for additional medical education, competition should be limited in its market, the rector said. In his opinion, private educational organizations often do not have qualified personnel and the necessary material and technical support.

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