On approval of levels of medical organizations in the provision of medical care to the population

Adopted Department of the health of the population of the Kemerovo region

1. In accordance with the Federal Law "On the Fundamentals of the Health of Citizens in the Russian Federation" N 323-ФЗ dated November 21, 2011, in order to implement the recommendations of the Ministry of Health of the Russian Federation on the implementation of a three-level system for providing medical care:
2. 1. Approve:
3. 1.1. Levels of medical organizations with a three-level medical care system (Appendix 1).
4. 1.2. List of medical organizations providing medical assistance to the relevant level, requirements for them (Appendices 2, 3, 4, 5).
5. 2. Chief Specialists of the Public Health Department until December 1, 2012, develop routes of patients with diseases of the corresponding profile to medical levels of the level corresponding to the severity of the disease, taking into account the optimal transport accessibility and time of patient delivery.
6. 3. Control over the execution of the order shall be entrusted to the first deputy head of the Department of Health of the Public Health of the Kemerovo Region O.V. SELEDETSOVA.
7. The head of the Department
8. V.K. Tsoy

Medical Support Levels

1. 1. The first level is primary health care, rendered in outpatient conditions and in a day hospital.
2. 2. Second level - specialized medical care provided in hospital conditions.
3. Medical organizations providing a second level of medical care are divided into medical organizations of level 2a and level 2b.
4. 3. Third level - specialized, including high-tech medical care performed in the medical institutions of the clinical level.

application

1. (CENTER) Requirements for medical organizations providing primary health care (/ center)
2. Primary health care provider provides medical organizations with any form of ownership, independent or included in medical organizations as structural divisions.
3. Primary health care is carried out by the territorial-precinct principle.
4. Medical organizations providing primary health care must have in the state:
5. - therapist doctors (for adults);
6. - therapeutors of precinct (for adults);
7. - pediatricians (for the children's population);
8. - pediatricians of precinct (for the children's population);
9. - general practitioners (family doctors).
10. A day hospital will be deployed to provide medical care for hospitative technologies in a medical organization.
11. Medical organizations providing primary health care include:
12. 1. Independent clinics:
13. MBUZ "Clinical Polyclinic N 5" G. Kemerovo;
14. MBUZ "Polyclinic N 6" G. Kemerovo;
15. MBUZ "City Clinical Polyclinic N 20" G. Kemerovo;
16. MBUZ "Clinical Advisory Diagnostic Center" Kemerovo;
17. MBUZ "Center for General Medical Practice" Kemerovo;
18. MbBPU "City Polyclinic N 1 (OVP)" Novokuznetsk;
19. ImblPA "Ambulatory N 4 (OVP)" Novokuznetsk;
20. MBUZ "City Polyclinic" Prokopyevsk;
21. MBUZ "City Hospital N 2" of Kaltan;
22. MBUZ "City Polyclinic N 6" G. Belovo;
23. Flp "Clinical Hospital N 1 of the Main Directorate of the Federal Penitentiary Service for the Kemerovo Region";
24. Kemerovo Azot OJSC;
25. OJSC "Coke";
26. CJSC Medical and Sanitary Part "Health Center" Energy ";
27. NUZ "Nodular polyclinic at the station Mariinsk of the Open Joint Stock Company" Russian Railways ".
28. 2. Polyclinics (polyclinic compartments), which are part of hospital polyclinic associations of any form of ownership.

application
To order of November 13, 2012 No. 1635

1. (CENTER) Requirements for medical organizations 2A (/ CENTER)
2. Medical organizations level 2A include multidisciplinary hospitals.
3. Level 2A institutions should be included in:
4. - inter-municipal specialized centers or inter-municipal specialized branches;
5. - along with the main profiles of beds (therapy, surgery, obstetrics and gynecology, pediatrics, infectious diseases) at least two specialized departments (specialized beds in other departments are not taken into account);
6. - the presence of medical personnel to comply with licensing requirements, orders and standards for medical care;
7. - Conditions for emergency and planned medical care.
8. To medical organizations level 2A include:
9. 1. MBUZ Anzhero-Sudzhensky City District "Central City Hospital"
10. 2. MBUZ "City Hospital N 8" G. Belovo
11. 3. MBUZ "Children's City Hospital N 1" G. Belovo
12. 4. MBUZ "City Hospital N 4" G. Belovo
13. 5. MBUZ "City Infectious Hospital N 3" G. Belovo
14. 6. MBU City Hospital N 1 G. Belovo
15. 7. MBUZ "Central City Hospital" Berezovsky
16. 8. MBUZ "City Clinical Hospital N 1 name M.N. Gorbunova" Kemerovo
17. 9. MBUZ "City Clinical Hospital N 2" Kemerovo
18. 10. MBUZ "City Infectious Clinical Hospital N 8" Kemerovo
19. 11. MBUZ "City Clinical Hospital N 11" Kemerovo
20. 12. MBUZ "Children's Clinical Hospital N 2" Kemerovo
21. 13. MBUZ "Children's Clinical Hospital N 7" Kemerovo
22. 14. MBUZ "Children's Clinical Hospital N 1" G. Kemerovo
23. 15. MBU "City Hospital N 2" G. Kiselevsk
24. 16. MBUZ "City Hospital N 1" G. Leninsk-Kuznetsky
25. 17. MBUZ "City Infectious Hospital" G. Leninsk-Kuznetsky
26. 18. MBUZ "Central City Hospital" Myski
27. 19. MBUZ "Central City Hospital" Mr. Mezhdchensk
28. 20. MBUZ "Central City Hospital" of the Mariinsky Municipal District
29. 21. MbbPA "Children's City Clinical Hospital N 3" Novokuznetsk
30. 22. MbbPA "City Clinical Hospital N 11" Novokuznetsk
31. 23. MBLPU "City Clinical Hospital N 22" Novokuznetsk
32. 24. MBLPU "City Clinical Hospital N 5" G. Novokuznetsk
33. 25. MbbPU "City Clinical Hospital N 2 of the Holy Great Martyr George Victorious" Novokuznetsk
34. 26. Mbbpa "Major House N 2" Novokuznetsk
35. 27. MBLDU "Clinical Motherland House N 3" Novokuznetsk
36. 28. MBLDU "City Clinical Infectious Hospital N 8" Novokuznetsk
37. 29. GBUZ "Novokuznetsky clinical oncological dispensary"
38. 30. MBUZ "City Hospital" of the Osinnikovsky City District
39. 31. MBUZ Children's City Hospital G. Osinniki
40. 32. MBUZ "Central City Hospital" G. Polesaevo
41. 33. MBUZ "City Hospital N 1" Prokopyevsk
42. 34. MBUZ "City Hospital N 3" G. Prokopyevsk
43. 35. MBUZ "City Infectious Hospital" Prokopyevsk
44. 36. MBUZ "Children's City Hospital" G. Prokopyevsk
45. 37. MBUZ "City Hospital N 1 of the city of Yurgi"
46. 38. MBUZ "City Hospital N 2 of the city of Yurgi"
47. 39. MBUZ "Tashtagolskaya Central District Hospital"
48. 40. MBUZ "Central District Hospital of the Tsulsky district"
49. 41. MBUZ "Yurgin Central District Hospital"

application
To order of November 13, 2012 No. 1635

1. (Center) Requirements for medical organizations 2B (/ Center)
2. Medical organizations level 2B include hospitals working on regional standards for urban and district hospitals and federal standards for individual diseases.
3. Level 2B institutions should be included in:
4. - branches for the main profiles of medical care (therapy, surgery, obstetrics, gynecology, pediatrics, infectious diseases);
5. - the availability of medical personnel to fulfill licensed requirements;
6. - Conditions for emergency and planned medical care. The 2B medical organizations include:
7. 1. MBUZ "City Hospital N 2" G. Belovo
8. 2. MBU "City Hospital N 1" G. Kiselevsk
9. 3. MBU "Children's City Hospital" Kiselevsk
10. 4. MBUZ "City Hospital N 13" Kemerovo
11. 5. MBUZ "Hospital N 15" Kemerovo
12. 6. MBUZ "City Clinical Hospital N 4" Kemerovo
13. 7. MBUZ "Central City Hospital" Kaltan
14. 8. MBUZ "Krasnobrodskaya City Hospital"
15. 9. MbbPU "City Hospital N 16" Novokuznetsk
16. 10. MBLPU "City Hospital N 26" Novokuznetsk
17. 11. MBLPU "City Children's Hospital N 28" Novokuznetsk
18. 12. MBLDU "City Children's Hospital N 6" Novokuznetsk
19. 13. MBUZ "City Hospital N 2" G. Prokopyevsk
20. 14. MBUZ "City Hospital N 4" G. Prokopyevsk
21. 15. MBUZ "Belovskaya Central District Hospital"
22. 16. MBUZ "Central District Hospital" of the Guryevsky Municipal District
23. 17. MBUZ "Izhmor Central District Hospital"
24. 18. MBUZ "Kapivinsk Central District Hospital"
25. 19. MBUZ "Central District Hospital" Kemerovo Municipal District
26. 20. MBU "Central District Hospital Novokuznetsky district"
27. 21. MBUZ "Prokopyev Central District Hospital"
28. 22. MBUZ "Central District Hospital of the industrial region"
29. 23. MBUZ "Central District Hospital of the Topkinsky Municipal District"
30. 24. MBUZ "Thazhskaya Central District Hospital"
31. 25. MBUZ "Central District Hospital of Chebuli Municipal District"
32. 26. MBUZ "Eagle Central District Hospital"
33. 27. MBUZ Yashkinsky Municipal District "Yashkin Central District Hospital"
34. 28. MBUZ "Central District Hospital" Leninsk-Kuznetsky Municipal District
35. 29. FCU "Medical and sanitary part of the Ministry of Internal Affairs of the Russian Federation for the Kemerovo Region"
36. 30. NUZ "Department of Hospital at the station Kemerovo Open Joint Stock Company" Russian Railways "
37. 31. NUZ "Nodal Hospital at the station Belovo of Open Joint Stock Company" Russian Railways "
38. 32. Flp "Hospital N 2 of the General Directorate of the Federal Penitentiary Service for the Kemerovo Region"
39. 33. NUZ "Nodogo hospital at the station Novokuznetsk of the Open Joint Stock Company" Russian Railways "
40. 34. NUZ "Nodal Hospital at the Taiga Station of the Open Joint Stock Company" Russian Railways "

The capacity of hospitals is determined taking into account their profitability and the needs of the population in specialized, including high-tech types of medical care.

Medical third-level organizations should have:

sufficient security with medical personnel with high professional training;

the presence of modern equipment in accordance with the tableness of equipment approved in the prescribed manner and updated with the moral, and physical wear;

the presence on the basis of the medical medical organization of the Department of Accredited Higher Educational Institutions;

Participation of practical doctors in research work (the presence of academic degrees, monographs, publications, development of new medical technologies and their implementation, patents).

The third-level medical organizations include:

1. GBUZ KO "Kemerovo Regional Clinical Hospital"

2. GBUZ KO "Regional Clinical Hospital for War Veterans" Kemerovo

3. GBUZ KO "Kemerovo Regional Clinical Ophthalmology Hospital"

4. GBUZ KO "Regional Clinical Oncological Dispensary" Kemerovo

5. MBUZ "Kemerovo Cardiology Dispensary"

6. MBUZ "Children's City Clinical Hospital N 5" Kemerovo

7. MBUZ "City Clinical Hospital N 3 IM. M.A.Podgorbunsky" Kemerovo

8. GBUZ KO "Regional Clinical Perinatal Center named after L.A. Peshetova" Kemerovo

9. MbBPU "City Clinical Hospital N 29" Novokuznetsk

10. Mbbpa "City Clinical Hospital N 1" Novokuznetsk

11. MBLDU "Zonal Perinatal Center" Novokuznetsk

12. MBLPU "City Children's Clinical Hospital N 4" Novokuznetsk

13. GBUZ KO "Regional Clinical Orthopedosurgical Hospital of Rehabilitation Treatment" Prokopyevsk

14. Federal State Budgetary Institution - "Research Institute of Comprehensive Problems of Cardiovascular Diseases" of the Siberian Branch of the Russian Academy of Medical Sciences (FGBU "NII CPSSZ" with RAMS) Kemerovo (as agreed)

15. Federal budget medical and prophylactic institution "Scientific and Clinical Center for Health Security Miners" (FGBLPU "NKTSOSSH") Leninsk-Kuznetsky (as agreed)

16. Federal State Budgetary Institution "Novokuznetsky Scientific and Practical Center for Medical and Social Expertise and Rehabilitation of Disabled" of the Ministry of Labor and Social Protection of the Russian Federation (FGBU NNPTS ITU and Ri Mintrud Russia) Novokuznetsk (as agreed)

January 22 2020, electronics. Microelectronics. Supercomputer technology. Photonic Approved strategy for the development of the electronic industry of the Russian Federation for the period up to 2030 Order of January 17, 2020 №20-p. The purpose of the strategy is to create a competitive industry on the basis of the development of scientific and technical and personnel potential, optimization and technical re-equipment of production facilities, the creation and development of new industrial technologies, as well as the improvement of the regulatory framework for meeting the needs in modern electronic products.

October 8, 2019, emergency settlement The government has introduced a bill to the State Duma on improving the mechanisms of resettlement of citizens from emergency housing Order of October 7, 2019 №2292-p. Prepared for the instructions of the President of Russia at the end of the meeting with members of the government on the resettlement of citizens from the emergency housing stock.

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August 14, 2019, drugs of drugs, medical devices and substances It was decided to conduct an experiment on the labeling of wheelchairs related to medical devices RESOLUTION of August 7, 2019 No. 1028. From September 1, 2019 to June 1, 2021, an experiment on labeling by means of identifying wheelchairs related to medical devices will be carried out. The purpose of the experiment is to study the work of the charming chairs and monitoring of their turnover, the organization of the effective interaction of state authorities, including control bodies, with parties to the trap-wheelchairs.

1

Similar changes occur in other districts, but we will tell about them in the following issues of the newspaper.

Long queues for reception to doctors, difficulties with receiving a tongue to narrow specialists, unsatisfactory quality of medical care - all this, which has long become a parable in pags, goes into the past. Measures taken by the Department of Health of Moscow in the framework of the modernization program of the metropolitan health care, make it possible to change the situation for the better.

A three-tier medical care system has been developed, as a result of the introduction of which each healing institution will be assigned to one of three levels.

First level: Polyclinics, including children, designed to provide primary prefigure, medical care and some types of primary specialized health care.

Second level: outpatient centers, including children who provide primary prefigure, medical care and primary specialized health care for clarifying the diagnosis and determining the tactics of further patient maintenance.

The third level: Consultative and diagnostic centers and hospitals, including children's, and scientific and practical centers, where they provide advisory and diagnostic assistance in an outpatient basis at the pre-hospital stage and after discharge of patients from the hospital.

On the territory of the Northern District will continue to work 26 polyclinic for adults and a 14 polyclinic for children. In addition, pediatric polyclinic departments of a children's infectious hospital number 12 and urban polyclinic №193 will continue to provide outpatient care for children.

The contingent of patients of therapeutic institutions of the 1st, 2nd and 3rd levels is determined.

Polyclinics of the first level:

Healthy patients for conducting preventive measures, dispensary inspections;

Patients with chronic diseases in the remission stage for monitoring the course of the disease and the production of drugs;

Patients doctor-gerontologist;

Primary patients with acute pathology;

Patients observed at home;

Second-level polyclinics - outpatient centers:

Patients with acute pathology aimed at the polyclinic branch for reassessing and treatment;

Dispensary patients of working age, consisting of medical professionals;

Patients who are examined before the direction in the third-level centers before planned hospitalization, obtaining high-tech medical care;

Day hospital patients.

Therapeutic institutions of the third level:

Patients in need of high-tech medical care types;

Patients who need advisory narrow specialized assistance (for example: the center of deep mycoses, a somnological office, a center of paroxysmal states, arrhythmological service and others);

Day hospital patients.

For the adult network, the work of four outpatient centers is organized, for each of which the first-level polyclinics are fixed:

An outpatient center based on urban polyclinic №6 will serve patients of urban polyclinic №№21, 44, 93, 105, 142, 159, 164;

The outpatient center on the basis of the Consultative Diagnostic Center No. 6 will serve patients of urban polyclinic №№138, 146, 155, 188, 193;

The outpatient center on the basis of medical and sanitary part No. 51 will serve patients of urban polyclinic №№28, 81, 108, 136, 154;

An outpatient center based on urban polyclinic №62 will serve patients of urban polyclinic №№ 39, 62, 71, 113, 156, 157.

The children's network also organizes the work of four outpatient centers, for each of which children's first-level polyclinics are fixed:

An outpatient center on the basis of children's city clinic No. 39 will serve patients of children's urban polyclinic №№19, 43, 22, 39, the Polyclinic separation of Dibe№12;

An outpatient center on the basis of children's urban polyclinic №86 will serve patients of children's urban polyclinic №79, 68, 86, pediatric branch of the city clinic №193;

An outpatient center on the basis of children's city clinic No. 15 will serve patients of children's urban polyclinic №№15, 77, 76;

An outpatient center based on children's urban polyclinic №133 will serve patients of children's urban polyclinic №№ 37, 87, 45, 133.

If you, dear Muscovites, have questions about the creation of outpatient polyclinic associations, add them to the website of the Moscow Department of Health - Moscow - [Email Protected] Mail.ru.

Press service of the State Health Directorate of SAO.

1. Consider the draft exemplary health program modernization program of the constituent entity of the Russian Federation for 2011-2012 (see www.minzdravsoc.ru).

2. Prepare and submit information on Appendix 1 (not provided) (Tables 1.2, 2.2, 2.3, 2.4, 2.5, 2.6, 3.4, 3.5, 3.8.1, 3.8.2, 3.8.3, 3.10, 4):

- To fill in electronic form in the EAIS system (Moszdrav), the Module "Health Modernization Program". Execution time: until 12.00 19.08.2010;

- on paper with the signature of the head and printing institutions to the Department of Health (4th floor, conference room) 08/18/2010 from 15.00 to 17.00; 08/19/2010 from 10 to 12 hours.

When preparing information, be guided by an exemplary classification of health care facilities on the levels of medical care (an application to the instruction).

3. Questions for the project of an exemplary health upgrade program direct e-mail: [Email Protected]

First Deputy Head of the Health Department of the City of Moscow, Chairman of the Working Group S.V. Polykov

Annex to the instructions of the Moscow City Health Department of August 13, 2010 N 2-18-81

Classification of health care facilities for medical care

1 Level - Healthcare Institutions, Legal entities providing specialized medical care, including high-tech specialized assistance:

1. GKB N 1 name N.I. Pirogova, 4, 7, 12, 13, 15 named OM Filatova, 19, 20, 23 named after Medsantrud, 24, 29 N.E. Bauman, 31, 33 named prof. A.A. Ostrumova, 36, 40, 47, 50, 52, 57, 59, 62, 64, 67, 68, 70, 81, GKB named S.P. Botkin, GKUB N 47, GOKB N 62, OKB.

2. GWV N 1, 2, 3, maxillofacial hospital for wars veterans.

3. Moscow City NPCs Combating Tuberculosis.

4. Moscow NPC otorinolaryngology.

5. Ambulance Research Institute named after N.V. Sklifosovsky.

6. Scientific and practical center of interventional cardioagiology.

7. Center for speech pathology and neurorelabating.

8. Family planning center and reproduction.

9. Central Research Institute of Gastroenterology.

10. Scientific and practical medical center for children with defects in the development of the cranial-facial region and congenital diseases of the nervous system.

11. Research Institute of Emergency Children's Surgery and Traumatology.

12. Children's urban clinical hospital N 9 named G.N. Speransky.

13. Morozovskaya Children's urban clinical hospital.

14. Tushinsky Children's City Hospital.

15. Children's urban clinical hospital of St. Vladimir.

17. Children's psychoneurological hospital N 18.

18. Children's urban clinical hospital N 13 named after N.F. Filatova.

2 Level - Healthcare Institutions - Legal entities providing specialized medical care (without high-tech medical care):

1. GKB N 6, 11, 14 them. V.G. Korolenko, 51, 53, 55, 60, 61, 63, 71, 79;

GB N 3, 9, 10, 17, 43, 49, 54, 56, 72;

SCB of reducing treatment.

2. IKB N 1, 2, 3.

3. TKB N 3 them. prof. G.A. Zaharin, 7;

4. PKB N 1. ON. Alekseeva, 4 them. PB Gannushkin, 12, 15;

PB N 2 them. O.V. Kercikova, 3 them. V.A. Gilyarovsky, 7, 9, 10, 14, 16;

SKB N 8 them. Z.P. Solovyov (clinic of neurosis).

6. Moscow NPC Narcology.

7. The center of medical and social rehabilitation with the separation of permanent residence of adolescents and adults disabled with heavy forms of cerebral palsy, independently not moving and not servicing themselves.

8. Moscow Sports Medicine NPC.

9. Center for restoration medicine and rehabilitation.

10. Diagnostic center (female health clinic).

11. Children's psychiatric hospitals N 6, 11.

12. Children's city hospital of reducing treatment N 3.

13. Children's city hospital N 19. TS Cheapin.

14. Children's sanatoriums N 20, 23, 39, 44, 64, 68.

15. Maternity houses N 1, 2, 3, 4, 5, 6 them. A.A. Apricot, 8, 10, 11, 14, 16, 17, 18, 20, 25, 26, 27, 32.

3 Level - Healthcare Institutions - Legal entities providing specialized and primary health care (agencies on the basis of which there are monopropyl and multidisciplinary specialized inter-municipal centers):

1. Station of ambulance and emergency medical care. A.S. Puchkov.

2. NPC emergency medical care.

3. City Hospital N 8.

4. Gynecological hospitals N 1, 5.

5. City Consultative and Diagnostic Center for Specific Immunopiltilax.

6. Moscow city center for the rehabilitation of patients with spinal injury and consequences of cerebral palsy.

7. Center for manual therapy.

8. Family planning centers and reproduction N 2, 3.

9. Diagnostic clinical center N 1;

diagnostic centers N 2, 3, 4, 5, 6.

10. MSC N 2, 6, 8, 13, 14, 15, 17, 18, 23, 26, 32, 33, 34, 26, 66, 33-4, 63, 66, 68, 34, 63, 66, 68, 34, 63, 66, 68, CHAIR 68.

11. Polyclinics of reducing treatment N 1, 2, 3, 4, 6, 7.

12. SCD N 7, 8, 10, 23, 29;

QD N 1, 3, 5, 6, 9, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 26, 27, 28, 30, 31, 31.

13. PND N 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24.

14. Narcological clinical dispensary N 5;

narcological dispensaries N 1, 2, 3, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 14.

15. Anti-tuberculosis clinical dispensaries N 4, 12, 21;

PDD N 2, 5, 6, 7, 8, 10, 13, 14, 15, 16, 17, 18, 20.

16. Oncological clinical dispensary N 1;

17. Endocrinological dispensary.

18. Cardiology dispensary N 2.

19. Medical and physical scientific dispensaries N 4, 5, 6, 11, 13, 16, 17, 19, 27.

20. First Moscow Hospice.

21. Hospps N 2, 3, 4, 5, 6, 7, 8.

22. Children's infectious hospitals N 4, 5, 6, 8, 12, 21.

23. Child houses specialized for children with organic damage to the central nervous system and psyche violation N 6, 9, 12.

24. Specialized children's homes N 20, 21, 23.

25. Sanatorium tuberculosis N 5, 58.

26. Children's nephrological sanatorium N 6.

27. Children's bronchopulating sanatoriums N 8, 15, 23, 29.

28. Children's tuberculosis sanatoriums N 17, 64.

29. Children's cardiorevmatological sanatoriums N 20 "Red Pahra", 42.

30. Children's psycho-neurological sanatoriums N 30, 44, 65, 66.

31. Children's pulmonary sanatorium N 39.

Improving the organization of medical care in our country will be based on three blocks:

• First of all, that the patient can get as quickly as possible to the institution that can provide medical care according to Standard.

• The second is a very important unit - the stratitude of medical care according to Order.

• The third important unit is the introduction of target performance indicators reflecting not only the types and volumes of medical care provided, but also its quality.

Level 1. Primary health care

Primary health care, organized by the territorial-precinct principle, was and remains a priority direction of domestic healthcare due to the tremendous size of the country and uneven population density.

• Liquidation of frame shortages due to intra-separable migration redistribution.
• Disaggaling plots: Reducing the number of attached adults from 1700-2500 people up to 1.2-1.5 thousand people per section (it will be possible when frame shortages will be eliminated).
• The creation of human conditions for work is to increase the standards of a given time per adult patient up to 20 minutes.
• Reducing the load due to the transfer of medium medical staff of a number of events: prefigible assistance in acute pathology, dispensary observation of patients with chronic pathology, etc.
• Returning of the primary link to the hospital technologies - the development of "hospital houses" systems and active patronage.
• Transition to other targets of work with an emphasis on preventive activities. For example, the proportion of healthy people of all age groups of the total number of attached population, the percentage of disease detection in the early stages among all the victims for the first time.

2 level. Stationary help

• The main point is the intensification of the work of the bed. This will be possible, on the one hand, if the replacement hospital technology will be introduced into the primary link, and the network of compartments for fake and rehabilitation will be deployed. Stationary medical care should be intended only for patients requiring round-the-clock observation.
• Creating a routing service in each hospital through which patients will be made from the hospital. This service will provide the organization of phased rehabilitation and rehabilitation, continuity under the patient at all stages, the transfer of information on patient and medical and social recommendations to the district patronage division at the place of residence of the patient.
• The phased creation of head regional centers coordinating the entire volume of preventive, diagnostic and medical measures on socially significant medical problems.
• Improving the work indicators of the stationary institutions reflecting the quality of medical care (mortality, degree of recovery of disturbed functions).

3 level. Rehabilitation

None of the previous concepts of health development, including the Soviet period, did not enter this stage (remember, the Ministry of Health did not have its own sanatoriums?). Thus, in Russia a three-level (instead of a two-level) health care system is created: primary health care, inpatient care and rehabilitation service (rehabilitation).

• Creation and expansion of a network of institutions (branches) of rehabilitation treatment (fogging), rehabilitation, medical care by recruitment of part of working hospitals and sanatorium-resort institutions.
• Determination of target performance indicators reflecting the quality of medical care (the degree of restoration of disturbed functions, primary disability and weight gain of disabilities).

4 level. Paralegal service

This is just a pilot project that will be launched in those regions that have achieved good development by 2014-2015.

The essence of the project: The organizational structure is created, into which the hospital selection department and ambulance station are combined, plus the deposit and routing services of patients, patronage primary service and fill service.

This service will be designed for:

• providing the population of emergency and emergency medical care (for the first time sick and persons with the exacerbation of chronic disease);
• determining the need (or lack of need) in hospitalization of the patient in the hospital;
• a set of diagnostic and medical measures in pathological conditions that do not require continuous round-the-clock observation;
• organizations of the optimal stratification of the patient ("homepost", separating rehabilitation and rehabilitation, hospice) and the implementation of active or passive patronage.