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Florence Nightingale
12 May 1820 13 August 1910
GENERAL CHARACTERISTIC
OF THE INPATIENT MEDICAL
AID
GENERAL CHARACTERISTIC
OF THE INPATIENT MEDICAL AID
(1)
Organizational forms of rendering of the in-patient
services to the population, structure of hospital
establishments and their accommodation depend
on:
o morbidity level among population on the territory;
o disease structure of the population;
o age-sexual structure of the population;
o features of residence.
GENERAL CHARACTERISTIC
OF THE INPATIENT MEDICAL AID
(2)
The hospital medical aid is carried out at the
heaviest diseases demanding application of
complex methods of diagnostics, therapeutic
treatment, operative intervention, constant
medical supervision and qualified care.
This is the most expensive type of medical aid
but the most effectiveness from the medical and
social point of view.
OPTIMISATION HOSPITAL
SERVICES IN RUSSIA
(1)
OPTIMISATION HOSPITAL
SERVICES IN RUSSIA (2)
2. Introduction to the clinical departments of
hospitals:
o disease management protocols and standards
of care;
o registers for hospital patients;
o health care quality management system.
3. Installation and stuffing of hospitals with
qualified personnel according to approved
standards.
OPTIMISATION HOSPITAL
SERVICES IN RUSSIA (3)
4. Expansion of volumes and the introduction of
new types of high-tech medical assistance.
5. Round-the-clock telemedicine links between
municipal and regional level hospitals.
6. To intensify the work of hospital beds through
the introduction of hospital-replacing diagnostic
technologies at the outpatient level and
organization of gradual rehabilitation (medical
attendance service, the system aftercare and
rehabilitation).
OPTIMISATION HOSPITAL
SERVICES IN RUSSIA (4)
7. Improvement of the tariff policy, based on the
consideration not only of the type and amount of
medical assistance, but also on its quality;
quality
8. Improvement aims of the hospital work
reflecting the quality of medical aid (lethality rate,
the degree of restoration of the disturbed
functions).
CLASSIFICATION
OF IN-PATIENT
ESTABLISHMENTS
(1)
Number of beds
II
600-800
III
500-600
IV
400-500
300-400
CLASSIFICATION
OF THE IN-PATIENT
ESTABLISHMENTS (2)
Depending on a kind there are:
are
o multifield hospitals
o specialized hospitals
o dispensaries
CLASSIFICATION
OF THE IN-PATIENT
ESTABLISHMENTS (3)
Due to the regulations of hospitalization there are:
are
o first aid hospitals
o hospital for list hospitalization
o hospital for the general (mixed) hospitalization.
CLASSIFICATION
OF THE IN-PATIENT
ESTABLISHMENTS (4)
According to the system of their organization there
are:
o united with polyclinic hospitals
o non-united with polyclinic hospitals.
For the district, regional and federal hospitals
presence of polyclinic as a structural part is always
obligatory.
FUNCTIONS
OF THE IN-PATIENT
ESTABLISHMENTS BY WHO
HOSPITAL STRUCTURE
Management department: the head-physician, his deputies (for
medical department, polyclinic, medical working capacity
examination), medical statistics department, medical archive,
accounts department, library, etc.
reception department
medical (curative) department (surgical, therapeutic,
neurological, urological, etc.)
the specialized medical departments (physiotherapeutic,
exercise therapy, massage, etc.),
separate diagnostic services (it includes different laboratories,
rooms electrocardiographic, x-ray, etc.)
drugstore,
department of morbid anatomy,
maintenance department (nutrition unit, storehouses, laundry,
technical department, transport, etc.)
AN ANALYSIS OF ACTIVITY
OF INPATIENT MEDICAL
More than 100 different parameters of inpatient medical aid are
SERVICE
widely used. All parameters can be grouped, since they reflect
certain directions of functioning of hospital:
supply of the population with inpatient aid;
load of the medical staff;
material and medical equipment;
use of bed fund;
completeness of medical staff;
quality of the inpatient medical aid and its efficiency
AN ANALYSIS OF QUALITY OF
TREATMENT IN A HOSPITAL^
PARAMETERS
OF BED FUND USE
mean annual occupation of bed (average occupation of a bed
for municipal hospital is 330-340 days, for rural hospitals 300310 days; for municipal maternity homes 300-310 days, for rural
maternity home 280-290 days);
mean duration of patients stay in a hospital from 17 to 19
days (causes of long-lasting treatment in a hospital: severity of
disease, late diagnostics of diseases, cases when patients arent
prepared for hospitalization not examined, etc.);
bed turnover is one of the major parameter of efficiency of bed
fund use (mean number of patient is 17-20 and more patients)
a mean idle time of a bed;
dynamics of bed fund
GENERAL CHARACTERISTIC
OF THE INPATIENT MEDICAL
AID
Approximate standard for the inpatient medical aid
to the population (per 1000 people)
Kind of beds
Standard
General
13,2
Therapeutic
2,8
Surgical
0,9
Obstetrical
0,8
17
THE ORGANIZATION OF
MEDICAL AID
TO RURAL POPULATION
The factors that determined organizational forms and
methods of work of rural medical institutions:
character of spreading of the population,
area of coverage,
seasonal prevalence of works,
influence of weather conditions at the field works,
specific conditions of labor process,
disorder of economic - household activity and
conditions of life,
regional and national features and customs,
educational and cultural level, etc.
STRUCTURE OF A PRIMARY
LINK OF MEDICAL AID TO
RURAL POPULATION
The rural paramedical-obstetric outpost is a link of first
patients contact in system of health services.
Its primary goals are rendering the pre-medical help and
carrying out sanitary-antiepidemic actions directed on
prophylaxis of diseases, decrease in morbidity and
traumas, increase of sanitary and hygienic culture of the
population.
Paramedical staff renders the first medical aid at acute
conditions and traumas, carry out vaccination,
physiotherapeutic actions, etc.
Paramedical and obstetrical outposts are organized in
settlements where number of inhabitants varies from 700
up to 1000
STRUCTURE OF A PRIMARY
LINK OF MEDICAL AID TO
RURAL POPULATION
STRUCTURE OF SECONDARY
LINK OF MEDICAL AID TO
RURAL POPULATION