According to the Federal Law of 11/21/2011 No. 323-FZ "On the basics of the health of citizens in the Russian Federation", medical assistance is provided by medical organizations.

Methods for the provision of medical care:

0 diagnostics using anamnestic, organoleptic, express, laboratory and instrumental research methods;

On the correction of the condition of the body due to surgical, pharmacological, physiotherapy and psychotherapeutic methods of impact;

• 0 Creating comfortable conditions due to immobilization, protection of skin, wound and burn surfaces, warming or cooling, anesthesia;
• 0 medical care (meal, toilet, catheterization).

Medical assistance is:

• 0 outside the medical organization;
• 0 outpatient - in conditions that do not provide for round-the-clock medical observation and treatment, including at home when calling a medical worker;
• 0 in day hospital - in conditions providing for medical observation and treatment during daytime, but not requiring round-the-clock medical observation and treatment;
• 0 stationary - in conditions providing round-the-clock medical observation and treatment.

Medical care is carried out in the following forms:

• 0 Emergency - Medical assistance provided with sudden acute diseases, conditions, exacerbation of chronic diseases pose a threat to the patient's life;
• 0 Emergency - Medical assistance provided with sudden acute diseases, conditions, exacerbation of chronic diseases without explicit signs of the patient's life threat;
• 0 Planning - Medical Assistance, which is provided during preventive measures, for diseases and conditions that are not accompanied by the threat of a patient's life who do not require emergency and emergency medical care, and delaying the provision of which at a certain time will not entail the deterioration of the patient's condition, the threat of his life and health.

The following types of medical care are distinguished: primary health care, specialized, including high-tech, ambulance, including an ambulance specialized, palliative.

Primary health care It is the basis of a medical care system and turns out to be in the outpatient conditions and conditions of the day hospital.

The main sections are prevention, diagnosis, treatment of diseases and states, medical rehabilitation, monitoring the course of pregnancy, forming a healthy lifestyle, sanitary and hygienic education.

Primary prefabricated medical and sanitary assistance is paramedic, obstetres and other medical professionals with secondary medical education.

Primary medical care providers turns out to be therapist physicians, therapist physicians, pediatrician-pediatrics, pediatrician communistrators and general practitioners (family doctors).

Primary specialized health care assistance is provided by specialists, including doctors of specialized medical organizations providing specialized medical care, including high-tech.

It turns out to be medical experts in stationary conditions and in the conditions of the day hospital and includes prevention, diagnosis and treatment of diseases and conditions (including during pregnancy, childbirth and postpartum), requiring the use of special methods and complex medical technologies, and Also medical rehabilitation.

Ambulance, including ambulance, medical care It turns out to be citizens in diseases, accidents, injuries, poisoning and other states requiring urgent medical intervention, in emergency or urgent form outside the medical organization, as well as in outpatient and inpatient conditions.

If, after providing emergency medical care, victims need further treatment, and therefore, in evacuation, they receive evacuation destination.

In emergency situations of peaceful and military time, depending on the conditions, ambulance can be provided in full or limited volume.

Depending on the conditions of the situation and the nature of medical manipulations, assistance may be provided: Proponal, first medical, qualified, specialized.

Promotional and first medical care are in medical detachments and preserved near the focus of the defeat of medical organizations (at the first stage of medical care for victims).

First medical care - Therapeutic and preventive measures performed by doctors (or as directed by the doctor) and aimed at eliminating the effects of dangerous factors directly threatening the life of the victim, to prevent the development of complications and prepare the victim if necessary for further evacuation. First medical care can be provided in full or abbreviated volume.

With abbreviated volume, emergency measures perform, the refusal of which threatens the injured death or the occurrence of severe complications. Events that may be forced to be delayed (urgent), and events that can be rendered at the next stage are held later.

Typical medical measures for first medical care include: stopping outdoor bleeding, maintenance of cardiovascular system, resuscitation, tracheostomy or trachea intubation, imposition of a hermetic dressing with an open pneumothorax, drainage of the pleural cavity, immobilization of the head, neck, spine, limbs, infusion therapy, etc. .

Qualified medical care Includes medical and prophylactic emergency and urgent events performed by the specialist physicians - surgeons and therapists.

At the same time, surgeons through various operational interventions eliminate heavy, threatening states caused by damage, and conduct measures to prevent subsequent complications and ensuring further evacuation. The amount of care and treatment methods depend on the specific medical situation. It is necessary to strive to expand the amount of assistance.

In emergency situations in health care, all activities of qualified surgical assistance are forced to share for three groups of surgical interventions - emergency, urgent first stage, urgent second queue.

Emergency surgical interventions Qualified medical care, i.e. Interventions applied by life indications is:

• 0 final stopping outdoor and internal bleeding;
• 0 Complex therapy of acute blood loss, shock and traumatic toxicosis;
• 0 Elimination of asphyxia;
• 0 Surgical processing and stitching of wounds when opening pneumothorax, thoraccentsis with valve pneumothorax;
• 0 Laparotomy with wounds and closed abdomen injuries with damage to the internal organs;
• 0 operations for bladder damage and rectum;
• 0 amputation in the separations and destruction of the limbs;
• 0 operations for anaerobic infection;
• 0 Decompressive trepanation of the skull in injuries and damage accompanied by the squeezing of the brain.

Emergency surgical interventions of qualified medical care of the first stage - Operations, the deferment of which leads to obviously heavy complications:

• 0 imposition of a supraid fistula in damage to the urethra;
• 0 imposition of an unnatural rear passage in the pasting damage to the rectum;
• 0 amputation with ischemic finiteness necrosis;
• 0 Primary surgical treatment of wounds with significant damage to soft tissues.

Emergency surgical interventions of qualified medical care second stage - Operations, the deferment of which, subject to the early and systematic use of antibiotics, does not necessarily lead to the development of hazardous complications:

• 0 surgical treatment of wounds of soft tissues that are not subject to surgical treatment;
• 0 Treatment of highly contaminated burn surfaces;
• 0 imposition of seams in patchwork wounds of the face;
• 0 Ligatural binding of teeth during fractures of the lower jaw with a defect.

Specialized medical care includes a complex of exhaustive medical events performed by specialist physicians of various profiles in specialized medical organizations using special equipment.

In accordance with the specialization of doctors, surgical specialized assistance may be: an ophthalmic, neurosurgical, otorinolaryngological, dental, traumatological, obstetric-gynecological, angiorurgical.

The varieties of therapeutic specialized assistance are toxicological, radiological, psycho-neurological.

When providing emergency medical care if necessary, medical evacuation is carried out - transportation of affected (patients) in order to save the lives and maintenance of health, including persons who are in medical organizations in which there is no possibility of providing the necessary medical care in life-threatening states, Women during pregnancy, childbirth, postpartum and newborns, persons affected by emergency situations and natural disasters.

Medical evacuation is carried out by the departure teams of emergency medical care with conducting medical care activities during transportation, including using medical equipment, and includes:

• 0 Sanitary and aeronautical evacuation carried out by aviation transport;
• 0 Sanitary evacuation carried out by terrestrial, water and other types of transport.

Palliative medical care It is a complex of medical interventions aimed at getting rid of pain and alleviating other severe manifestations of the disease, in order to improve the quality of life, incurable sick citizens and turns out to be at the outpatient conditions and inpatient conditions with medical workers who have learned to provide such assistance.

The organization and provision of medical care in emergency situations, including medical evacuation, are carried out by the All-Russian Catastrophe Medicine Service in the manner established by the authorized federal executive authority.

All-Russian Medicine Catastrophe Performs:

About rapid response, mobilization of material and technical equipment and personnel in emergency situations in order to save the life and maintaining the health of the greatest number of people by providing them with all types of medical care in a timely and in full;

On the elimination of epidemic foci;

On the creation of a reserve of material reserves;

On training for medical care to citizens, including medical evacuation, emergency situations.

The organization of medical support of the population is carried out in accordance with the decisions of the Chiefs of Civil Defense.

TEST QUESTIONS

• 1. List the main tasks of the medical forces of civil defense.
• 2. What is part of the medical forces of civil defense?
• 3. Describe the role of heads of health authorities and medical organizations in the preparation and management of civil defense.
• 4. What is the medical support of the population? Where is it carried out?
• 5. Expand the participation of medical professionals in conducting civil defense activities.
• 6. What should I have in each medical organization to provide emergency medical care at the scene?
• 7. What should every doctor do when conducting a medical sorting?
• 8. What types and conditions for the provision of medical care are established by the Federal Law of the Russian Federation of 21.11.2011 No. 323-FZ "On the basis of the health of citizens' health in the Russian Federation"?
• 9. What are the forms of medical care established by this law?
• 10. What functions are assigned to the All-Russian Medicine Catastrophe service?

Institutions included in the health care system of the Russian Federation provide people with various types of medical care.

Health care- A combination of medical and preventive measures conducted with diseases, injuries, poisoning, as well as during childbirth, persons having a higher and secondary medical education.

Medical assistance can be provided in the following conditions:

1) outside the medical organization (at the place of call the brigade, including emergency specialized, medical care, as well as in a vehicle during medical evacuation);

2) outpatient (including home when calling a medical worker, in day hospital), that is, in conditions that do not provide for round-the-clock medical observation and treatment;

3) inpatient, that is, in conditions providing round-the-clock medical observation and treatment.

There are several classifications of types of medical care. According to the "Basis" allocate:

Primary health care, including prefidence, medical care;

Specialized, including high-tech, medical care;

Ambulance, including an ambulance specialized, medical care;

Palliative medical care.

The most massive view of medical care is primary health care.

Primary health careit is the basis of the medical care system to citizens and includes measures for the prevention, diagnosis, treatment of diseases and states and their medical rehabilitation, monitoring pregnancy, the formation of a healthy lifestyle and sanitary and hygienic education. Primary health care is to citizens in outpatient and polyclinic and hospital institutions.

Specialized medical careincludes treatment of diseases requiring special diagnostic and treatment methods, the use of complex medical technologies, as well as medical rehabilitation. Specialized medical assistance is provided by medical professionals in specialized outpatient and hospital and hospital institutions.

High-tech medical careincludes the use of new, complex and / or unique, as well as resource-intensive treatment methods, including cellular technologies, robotic techniques, information technologies and genetic engineering methods. High-tech medical care is provided by medical organizations in accordance with the list of types of high-tech medical care established by the Ministry of Health and Social Development of Russia.

Emergency- round-the-clock emergency medical care in sudden diseases, threatening the lives of patient, injuries, poisoning, deliberate self-injunations, childbirth outside medical institutions, as well as disasters and natural disasters (for more details, see HL 15).

Palliative medical careit is a complex of medical interventions aimed at improving the quality of life of hopelessly sick citizens and members of their families, in order to get rid of pain and alleviate other severe manifestations of the disease. Palliative medical care is provided by medical professionals who have been trained on the provision of palliative care.

Other classification of medical care is based on the nomenclature of health facilities, as well as challenges facing them:

Ambulatory-polyclinic (community-acquired) medical care;

Hospital (stationary) medical care;

Emergency medical care;

Emergency;

Sanatorium-resort medical care.

In the form of medical care may be:

Planned - medical assistance provided for diseases and conditions that are not accompanied by the threat of a patient's life that do not require emergency and emergency medical care, a delay in the provision of which at certain times will not entail a deterioration in the patient's condition, the threat of his life and health;

Emergency - medical assistance provided with sudden acute diseases, states, exacerbation of chronic diseases, not life-threatening and non-emergency medical care;

Emergency - medical care provided with sudden, life-threatening conditions, acute diseases, exacerbation of chronic diseases, to eliminate the patient's threatening life.

Besides, medical assistance taking into account the stages of its provision and level of specialization Can be classified as follows.

Round-the-clock hospital

This is a medical institution intended for a 24-hour stay of patients, continuous surveillance and providing them with the necessary assistance.

Hospitalization in a 24-hour hospital is carried out in the direction of the attending physician or doctor - a specialist of an outpatient - a polyclinic institution, as well as with an independent treatment of a patient to provide emergency medical care in the presence of testimony for hospitalization.

Inpatient care procedure

1. Stationary medical care is provided in conditions providing round-the-clock medical observation and treatment.
2. Extremely medical assistance is independent of the place of residence, the availability of personal documents, the insurance medical policy under states that are threatening the life or health of a citizen or those surrounding it, caused by sudden diseases, exacerbations of chronic diseases, accidents, injuries and poisoning, in pathology of pregnancy and childbirth to all applied.
3. A citizen for obtaining planned medical care is obliged to present an insurance policy of compulsory insurance and an identity document, in medical organizations funded at the expense of compulsory medical insurance.
4. The patient's direction for inpatient treatment is carried out by the attending physician.
5. When providing planned medical care in stationary conditions, a sequence is allowed (in accordance with the "List of Waiting") on the planned hospitalization of no more than 25 working days from the date of receipt of the direction to hospitalization, with registration of the date of treatment in the prescribed manner.
6. The order of providing inpatient medical care in a planned form depends on the severity of the state of the patient, the severity of clinical symptoms requiring the hospital regime, active therapy and round-the-clock medical observation.
7. The order is registered by a medical organization doctor in the "List of Expectations", as made by the relevant entry in the direction of hospitalization.
8. Patients with emergency and urgent states are serviced out of turn.
9. When providing medical care in stationary conditions:
   • the patient is examined by a doctor in the receiving department no later than 30 minutes from the moment of appeal in the case of emergency medical care, with hospitalization for emergency testimony - immediately. In the presence of testimony for planned inpatient treatment, the patient is examined no later than 2 hours;
   • the patient may be in the ward of observation of the reception office to 12 hours in order to conduct medical and diagnostic measures in cases where dynamic observation is required for final diagnosis.
10. The patient is placed in the wards for 4 or more places in compliance with the existing sanitary and hygienic standards. In the absence of free sections in the profile compartment, the patients received by emergency testimony are allowed, outside the chamber for a period of no one day.
11. The placement of patients in municipal chambers (boxes) is carried out at medical and (or) epidemiological indications. A list of medical and epidemiological indications for the placement of patients in municipal chambers (boxes) approved by the Order of the Ministry of Health and Social Development of the Russian Federation of 15.05.2012 No. 535-H "On approval of a list of medical and epidemiological indications for the placement of patients in Motherboard Chambers (Boxes)".
12. Ensuring the patient with therapeutic nutrition is carried out in accordance with the norms approved by the Ministry of Health of the Russian Federation;
13. If it is necessary to care for the child under the age of four years inclusive (with a child over four years old - with medical testimony) a member of the family (adopter, guardian), caring, has the right to provide a bed and nutrition (in compliance with existing sanitary and hygienic standards ), as well as the registration of a sheet of temporary disability in the manner prescribed by the current legislation of the Russian Federation.
14. The amount of diagnostic and medical measures for a particular patient is determined by the attending physician in accordance with the procedures for medical care, clinical guidelines and guidelines, other regulatory legal documents. The patient must be informed by the volume of diagnostic and therapeutic measures.
15. For states that threaten the lives, or the impossibility of providing medical care in the context of this medical organization, the patient is sent to another medical organization for the next stage of medical care in accordance with the procedures for medical care, approved by the Ministry of Health of the Russian Federation.

Article 11. Federal Law of 21.11.2011 No. 323-FZ "On the basis of the health of citizens' health in the Russian Federation" (hereinafter referred to as the text - FZ No. 323) suggests that in emergency form it turns out a medical organization and a medical worker to a citizen without delay and free. Refusal to provide it is not allowed. A similar wording was in the old basis of the legislation on the protection of citizens' health in the Russian Federation (utensils. Armed Forces of the Russian Federation 22.07.1993 N 5487-1, it was raised from 01/01/2012), though it appeared the concept of "". What is emergency medical care and what is its difference from urgent form?

An attempt to separate emergency medical care from emergency or familiar to each of us emergency medical care was made earlier than the officials of the Ministry of Health and Social Development (from May 2012 -). Therefore, in about 2007, it is possible to talk about the start of some extraction or distinction of the concepts of "emergency" and "emergency" assistance at the legislative level.

However, in the intelligent dictionaries of the Russian language, there are no clear differences between these categories. Urgent - one that cannot be postponed; urgent. Emergency - urgent, extraordinary, urgent. FZ No. 323 put the final point in this matter, approve of three different forms of medical care: emergency, urgent and planned.

Emergency

Medical assistance provided with sudden acute diseases, conditions, exacerbation of chronic diseases representing the threat of the patient's life.

Emergency

Medical assistance provided with sudden acute diseases, states, exacerbation of chronic diseases without explicit signs of the threat of the patient's life.

Planned

Medical assistance, which is provided during preventive measures, with diseases and conditions that are not accompanied by the threat of a patient's life who do not require emergency and emergency medical care, and delaying the provision of which for a certain time will not entail the deterioration of the patient's condition, the threat of his life and health.

As you can make sure, urgent and emergency medical care is opposed to each other. To date, an absolutely any medical organization is required for free and immediately provide emergency medical care. So are there any significant differences between the two concepts discussed?

The main difference is that EMF is found in cases constituting threat to life man, and urgent - without explicit signs of life threat. However, the problem is that the legislation is clearly not defined, what cases and states to consider the threat, and which is not. Moreover, it is not clear what to consider an obvious threat? Diseases, pathological conditions, features indicating exactly the threat of life are not described. The mechanism for determining the threat is not indicated. Among other things, the condition may not be a threat to life at a particular moment, but the unconvention of the help will lead to a state-threatening life.

In view of which there is a fair question: how to distinguish the situation when it is necessary for emergency assistance, how to carry out a line between emergency and emergency assistance. An excellent example of the difference between emergency and emergency care is indicated in the article by Professor A.A. Mokhova "Features of legislative regulation of emergency and emergency care in Russia":

Sign	Medical assistance form
	Emergency	Emergency
Medical criterion	Threat of Life	There is no obvious threat to life
Base of assistance	Circulation of the patient for help (willing; contracting regime); Appeal of other persons (lack of will; legal regime)	Treatment of the patient (his legal representatives) for help (contract mode)
Terms of rendering	Outside the medical organization (dog hospital); in a medical organization (hospital stage)	Ambulatory (including at home), within the day hospital
Person obligated to provide medical care	Doctor or ambulance officer, any medical worker	Specialist doctor (therapist, surgeon, ophthalmologist, etc.)
Time interval	Help must be provided as quickly as possible.	Help must be rendered within a reasonable time

But unfortunately, this is also not enough. In this question, unambiguously without the participation of our "lawmakers" can not do. The problem resolution is necessary not only for the theory, but also for "practice." One of the reasons as has already been said earlier - the obligation of each medical organization to provide free medical care in emergency form, while emergency assistance may be provided on a paid basis.

It is important to note that the "image" of emergency medical care is still "collective". One of the reasons is territorial Programs of state guarantees of free provision of medical care (hereinafter referred to as TPGH), which contain (or do not contain) various provisions regarding the procedure and conditions for the provision of EMF, criteria for emergency, the procedure for reimbursement of EMF costs and so on.

For example, TPGG 2018 of the Sverdlovsk Region denotes that the case of medical care in emergency shape must meet the criteria for an emergency case: suddenness, acute condition, threat of life. Some TPHGs mention the criteria for emergency, referring to the order of the Ministry of Health and Social Development of the Russian Federation of April 24, 2008 No. 194n "On approval of medical criteria for determining the severity of harm caused by human health" (hereinafter referred to as the order No. 194n). For example, TPGH 2018 of the Perm Territory denotes that the criterion of emergency medical care is the presence of threatening life of the states defined in:

• clause 6.1 of the Order No. 194n (harm to health, dangerous for a person's life, which in its nature directly creates a threat to life, as well as harm to the health, which caused the development of the threatening life of the state, namely: the head of the head; the bruise of the cervical spinal cord with his impaired functions, etc. *);
• clause 6.2 of the Order No. 194n (harm to the health of a person who caused a disorder of the vital functions of a person's organism, which cannot be compensated by the body independently and usually ends with death, namely: Shock heavy III - IV degree; sharp, abundant or massive Bloodstocks, etc. *).

* The full list is defined in order No. 194n.

According to officials of the Ministry, emergency medical care is in the event that the existing pathological changes in the patient are not life-threatening. But from various regulatory acts of the Ministry of Health of the Ministry of Health of Russia, it follows that there are no significant differences between emergency and emergency medical help.

Some TPGH indicate that the provision of medical care in emergency form is carried out in accordance with standards for emergency medical care, approved by the orders of the Ministry of Health of Russia, according to states, syndromes, diseases. And, for example, TPGH 2018 of the Sverdlovsk Region denotes that emergency assistance is carried out in outpatient, stationary conditions and conditions of day hospitals in the following cases:

• when an emergency condition occurs in a patient on the territory of a medical organization (when treating a patient for medical assistance in a planned form, for diagnostic research, consultations);
• with an independent treatment of a patient or delivery to a medical organization (as closest) relatives or other persons in the event of an emergency;
• if an emergency condition occurs in the patient at the time of treatment in a medical organization, hold planned manipulations, operations, research.

Among everything, it is important to note that in the state of the health of a citizen who requires medical care in emergency form, the examination of a citizen and therapeutic measures are carried out at the place of his appeal immediately a medical worker, to whom he turned.

Unfortunately, FZ No. 323 contains only the analyzed concepts without "dividing" the concept of criteria. In view of which a number of problems arise, the main of which is the complexity of determining in practice the presence of a threat to life. As a consequence, an urgent need for a clear description of diseases and pathological conditions, signs indicating the threat to the sickness of the patient, with the exception of the most obvious (for example, penetrating injuries of the chest, abdominal cavity). It is unclear what should be the mechanism for determining the threat.

Order of the Ministry of Health of Russia of 20.06.2013 No. 388n "On approval of the procedure for providing an ambulance, including emergency specialized, medical care" allows you to bring some states indicating the threat of life. The order states that the reason for the emergence of emergency care in emergency form There are sudden acute diseases, states, aggravation of chronic diseases, representing the threat of a patient's life, including:

• disturbances;
• respiratory disorders;
• circulatory disorders;
• mental disorders, accompanied by the actions of the patient, representing the immediate danger to him or other persons;
• pain syndrome;
• injuries of any etiology, poisoning, injuries (accompanied by bleeding, representing the threat of life, or damage to internal organs);
• thermal and chemical burns;
• bleeding of any etiology;
• birth, threat of abortion.

As you can see, it is only an exemplary list, however, we believe that it can be used by analogy when providing other medical care (not soon).

However, from the analyzed acts it follows that it is often a conclusion about the presence of a threat to life makes either the victim himself or the emergency dispatcher, based on the subjective opinion and the evaluation of the resulting person asking for help. In such a situation, both reassessment of hazard for life and the obvious underestimation of the severity of the patient's condition.

I would like to hope that the most important details will soon be spelled out in the acts. To date, medical organizations are likely to still ignore the medical understanding of the emergence of the situation, the presence of a threat to the patient's life and urgency of actions. In a medical organization, there must be a local instruction on emergency medical care on the territory of the organization with which all health workers should be familiar to the organization.

Article 20 of Law No. 323-ФЗ states that the necessary prerequisite for medical intervention is the date of informed voluntary consent (hereinafter - the IDC) of a citizen or his legal representative for medical intervention on the basis of a medical person provided in the affordable form of complete information about the objectives, methods of medical care associated with them risks, possible options for medical intervention, about its consequences, as well as the estimated results of medical care.

However, the situation of medical care in emergency form (which is also considered medical intervention) falls under the exception. Namely, medical intervention without the consent of the person on emergency testimony to eliminate the threat of a person's life, if the condition does not allow to express their will, or there are no legal representatives (paragraph 1 of Part 9 of Article 20 of the FZ No. 323). Similarly, the basis for the disclosure of medical mystery without the consent of the patient (paragraph 1 of Part 4 of Article 13 of the FZ No. 323).

In accordance with paragraph 10 of Article 83 of the Federal Law No. 323, the costs associated with the provision of free medical care citizens in emergency form of a medical organization, including the medical organization of a private health care system, are subject to refund. For reimbursement of expenses for the provision of EMP, read in our article: reimbursement of expenditures for free medical care in emergency form.

After entry into force Order of the Ministry of Health of Russia of 03/11/2013 No. 121n "On approval of the requirements for the organization and performance of work (services) when providing primary healthy-sanitary, specialized (including high-tech) ..." (hereinafter referred to as the order of the Ministry of Health No. 121n), many citizens had a completely reasonable misconception that emergency medical care It is necessary to include licensed for medical activities. The view of the medical service "Emergency Medical Help", subjectable, also specified in Decree of the Government of the Russian Federation of 04/16/2012 № 291 "On licensing of medical activities."

However, the Ministry of Health of the Russian Federation in his letter No. 12-3 / 10 / 2-5338 dated 23.07.2013 gave the following clarification on this topic: "With regard to the work (services) on emergency medical care, this work (service) was introduced to licensing the activities of medical Organizations, which, in accordance with Part 7 of Article 33 of the Federal Law, N 323-FZ created in their structure of the unit to provide primary health care in emergency form. In other cases of medical care in emergency form, obtaining a license providing for the performance of work (services) for emergency medical care is not required. "

Thus, the type of medical service "Emergency Medical Help" Licensing is subject to only those medical organizations, in the structure of which, in accordance with Article 33 of FZ No. 323, the units of medical assistance are created, providing specified emergency assistance.

The article uses materials from the article Mokhova A.A. Features of emergency and emergency care in Russia // Legal issues in health care. 2011. № 9.

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1) Outside a medical organization (at the place of call the brigade, including emergency specialized, medical care, as well as in a vehicle during medical evacuation)

2) outpatient (in conditions not providing for round-the-clock medical observation and treatment), including at home when calling a medical worker

3) in day hospital (under conditions providing for medical observation and treatment during the daytime, but not requiring round-the-clock medical observation and treatment)

4) stationary (in conditions providing round-the-clock medical observation and treatment)

5) all listed correctly

40. Forms of medical care are

1) Emergency

2) Emergency

3) Planned

4) all listed correctly

41. Specialized medical care

1) turns out to be specialist doctors and includes prevention, diagnosis and treatment of diseases and conditions (including during pregnancy, childbirth and postpartum), requiring the use of special methods and complex medical technologies, as well as medical rehabilitation

2) turns out to be specialist doctors and includes prevention, diagnosis and treatment of diseases and conditions requiring the use of special methods and complex medical technologies, as well as medical rehabilitation

42. The subject of studying medical statistics are

1) information about the health of the population

2) information on the effect of environmental factors on human health

3) information about frames, networks and activities of institutions and health services

4) information on the results of clinical and experimental studies in medicine

5) all of the above

43.The health of the population is considered (studied) as

1) a multifactoric problem that includes goals and objectives for the health of the population and affecting environmental factors

2) the amount determining the health of society as a holistic functioning organism

3) all of the above

44. Statistical public health gauges population are

1) demographic indicators

2) morbidity

3) Disability

4) physical development

5) temporary disability

45. The main sources of information about the health of the population are the following, except

1) official information on mortality

2) data insurance companies

3) epidemiological information

4) Environmental Monitoring and Health

5) case registers, accidents and injuries

46. The main methods of studying the incidence of everything except

1) for death reasons

2) by handling

3) According to the population census

4) According to medical examinations

47. Essence of the term "soreness"

1) newly identified diseases in this year

2) all diseases registered in this year

3) Diseases identified with target medical examinations

4) Diseases identified with periodic medical examinations

48. Specify the main account

1) control Map of Dispensary Observation

2) outpatient card

3) History of the disease

4) disability sheet

49. Reporting medical statistical documentation is necessary for

1) generalizations of the main characteristics of the health system activities according to annual reports

2) comparison of institutions and health services for the main statistical indicators in dynamics and territories

3) health planning

4) Prediction of Health

5) all of the above

50. Selection of a unit of observation depends

1) from the research program

2) from the research plan

3) from the purpose and objectives of the study

51. Current observation is

1) observation, covering part of units of aggregate for the characteristics of the whole

2) observation, timed to one at any moment

3) observation in the order of current registration

4) Examination of all units of the common aggregate without exception

52. Citizens sent by medical organizations and health authorities for treatment in clinics of research institutes (institutes) of resortology, physiotherapy and rehabilitation, a disability sheet is issued by a medical professional on the basis of a decision of the Medical Commission

1) at the time of treatment

2) at the time of treatment and travel to the place of treatment

3) at the time of treatment and travel to the place of treatment and back

53. In the direction of patients with tuberculosis patients with tuberculosis in specialized (anti-tuberculosis) sanatoriums for treatment with the first revealed active form of tuberculosis in the case when sanatorium treatment replaces the stationary treatment of disability sheet is issued by the decision of the VK anti-tuberculous dispensary and extends to the SP specialized (anti-tuberculous) sanatorium for the entire period

1) treatment and travel

2) Fingering and travel

3) treatment, fake and travel

54. In which cases, a leaflet of care is not issued

1) For a sick member of a family over 15 years old with inpatient treatment

2) for chronic patients during remission

3) during the annual paid vacation and leave without salary salary

4) during the period of maternity leave and childbirth

5) During the leave for child care until they reach the age of 3 years

6) in all listed cases

55. Working capacity-capacity is a type of medical activity, the purpose of which is

1) Assessment of the patient's health

2) Definition of terms and degree of disability

3) establishing the possibility of professional activities (labor forecast)

4) quality assurance and effectiveness of the treatment

5) all of the above

56. Basic principles of disability examination

1) Accessibility

2) Collegiates

3) Preventive approach

4) all of the above

57. With the occurrence of temporary disability during the vacation period without preserving the content of disability sheet issued

1) from the 1st day of disability

2) from the 3rd day of disability

3) from the 6th day of disability

4) from the 10th day of disability

5) from the end of the holiday

58. How long can one sole prolong disability sheet attending a doctor

1) up to 15 days

2) up to 10 days

3) up to 25 days

4) up to 30 days

59. For what maximum time can extend the VK sheet of disability

1) up to 2 months

2) up to 3 months

3) up to 6 months

4) up to 10 months, and in some cases up to 12 months

5) up to 4 months

60. Goals of creating a medical commission in a medical organization

1) improving the organization of medical care

2) decision-making in the most difficult and conflict cases on prevention, diagnosis, treatment and medical rehabilitation

3) determining the working capacity of citizens and professional suitability of some categories of workers

4) Implementation of the assessment of the quality, validity and effectiveness of therapeutic and diagnostic measures, including the appointment of drugs

5) Ensuring the appointment and correction of treatment in order to account for patients with drugs, transplantation (transplantation) of human organs and tissues, medical rehabilitation

6) all of the above

61. Mandatory medical insurance is

1) the type of compulsory social insurance, which is a system of legal, economic and organizational measures created by the state, aimed at ensuring that the insured person's guarantees to the insured person of medical care at the expense of the OMS

2) the type of compulsory social insurance, which is a system of legal, economic and organizational measures established by the state, aimed at ensuring that the insured person's guarantees to the insured person of medical care at the expense of OMS, within the territory of the OMC territorial program

3) the type of compulsory social insurance, which is a system of legal, economic and organizational measures created by the state, when an insured event occurs, the guarantees of free provision of medical care to the insured person at the expense of the CHI within the territorial program of the OMS and in the cases established by federal law within the basic program OMS

62. The insured person is

1) a person on which compulsory medical insurance is distributed

2) an individual to which compulsory medical insurance is distributed

3) an individual on which compulsory medical insurance is distributed in accordance with the Federal Law of November 29, 2010 N 326-FZ "On Mandatory Medical Insurance"

63. Participants in compulsory medical insurance are

1) Territorial Funds

2) Insurance medical organizations

3) medical organizations

4) all listed correctly