It became known how the standards of medical care for Russians have expanded

Authorities are concerned about reproductive health

In recent years, people have been trying to pay as much attention as possible to disease prevention. This is not surprising: a healthy lifestyle and early identification of risk factors or alarming symptoms helps either delay the development of the disease or avoid its occurrence altogether.

This year, budget expenditures on preventive measures (including medical examinations and medical examinations) under the state guarantee program increased by 17.3%. Additional funds will be spent, among other things, on new types of diagnostic examinations, which are included in the medical examination program. We are talking about blood tests for antibodies to viral hepatitis C, as well as a number of studies that can help identify disorders of the reproductive system. According to compulsory medical insurance expert Mikhail Pushkov, if antibodies to hepatitis C are detected in a patient, one can suspect that he has either already suffered an acute form of the disease or suffers from it in a chronic form, which will allow starting therapy to prevent exacerbations and the occurrence of severe complications (including including cirrhosis and liver carcinoma). “In addition, early diagnosis and screening for hepatitis C helps detect the disease in its early stages, when there are no symptoms yet, which increases the effectiveness of treatment and reduces the risk of complications.”

All patients aged 25 years and older will now be able to be screened for antibodies to viral hepatitis C, although only once every 10 years.

As for reproductive health, it will have to be monitored by specialized doctors during medical examination. Among other things, the age of first consultation with a gynecologist for girls has been reduced from 14 to 13 years from the beginning of 2024.

New in dispensary observation

Another innovation is changes regarding dispensary monitoring of chronic patients. True, not everyone. In the coming year, it is proposed to establish financial standards and average volumes of medical care for three types of observation: for cancer patients, patients with diabetes mellitus and cardiovascular diseases (it is these groups of diseases that make up the largest share of all chronic patients). Taking into account the average standards for observation, the state guarantee program includes more than 101 billion rubles from the Compulsory Medical Insurance Fund. Experts believe that this will make dispensary monitoring of patients more effective, as it encourages medical organizations to be more responsible in providing medical care in these areas. In addition, thanks to the prevention of disease complications, funds for treating patients can be saved, which means that hospitals will become freer. And although this innovation will not directly change the current procedure for dispensary observation, each region will be required to set a tariff for it. According to the expert, this will create an additional economic incentive for medical organizations to actively monitor such patients in clinics.

Rehabilitation

Patient rehabilitation will also receive more attention than before. Competent medical rehabilitation can significantly reduce the risk of possible complications, and also prevents the development of postoperative consequences, and generally improves the quality of life of patients.

Therefore, the task has been set: over the next three years, to increase the average standards for the volume of medical care in the area of ​​rehabilitation measures, both outpatient and inpatient. And this will lead to an increase in the volume and availability of this type of assistance, which, unfortunately, is rarely found anywhere today.

For example, for outpatient facilities, for the first time, the volume of medical rehabilitation is established for groups of diseases that make the greatest contribution to mortality. Medical care standards in this area will increase by 5.5%. More specifically, clinics will now have to provide rehabilitation measures to patients with cardiovascular diseases; those who have health problems after suffering from COVID-19, as well as patients with diseases of the central nervous system, musculoskeletal system and peripheral nervous system.

As for rehabilitation in hospitals, a standard has been set: long-term rehabilitation (more than a month) should occupy at least 1% in all areas. The Ministry of Health of the Russian Federation emphasizes that this will make it possible to carry out rehabilitation for patients with limited mobility with serious illnesses, “while they will remain in hospital inpatient units for as long as the treatment process requires.”

And experts remind that the list of indications for medical rehabilitation is very wide. And, if there is evidence for it, any person can undergo medical rehabilitation – free of charge, under the compulsory medical insurance policy.

Psychologists will come to clinics

Among the new things in the state guarantee program for 2024, it is worth highlighting a fundamentally new direction – medical and psychological counseling of patients. Yes, yes, clinical psychologists will now officially work in clinics and will provide free consultations to patients under the compulsory medical insurance policy. Such consultations may be required for those who have a history of serious illness, as well as for those experiencing stressful situations. Very often, medical and psychological counseling literally pulls people out of depression or other mental disorders.

The specialist working in such an office will decide whether the patient needs further psychological, psychotherapeutic or psychiatric help. To receive medical and psychological counseling, you will need to take a referral from your attending physician. Priorities include pregnant women, patients during childbirth and the postpartum period, etc. “Post-traumatic syndrome after stressful situations requires timely treatment,” Mikhail emphasizes.

Day hospitals

The adjustments made to the state guarantee program for this year will also affect the provision of medical care in day hospitals. In this regard, even a separate cost standard has been established (19.1 thousand rubles per case) and volumes for receiving primary specialized medical care.

Let us remember that a day hospital is something like an intermediate link between consultation in a clinic and treatment in a hospital. It is stipulated that therapeutic and diagnostic measures in day hospitals are carried out for diseases and conditions that do not require round-the-clock medical supervision. In other words, medical care will become easier to obtain in situations where the patient does not need complex instrumental diagnostics or high-tech treatment.

You can receive a referral for treatment in a day hospital from your attending physician. As a rule, these types of medical care today are received by people who have worsened chronic diseases or developed acute conditions that do not require round-the-clock medical supervision. In addition, patients who are registered at a dispensary for chronic diseases can be referred there for a course of preventive or rehabilitative treatment. Well, the third group is patients who need medical care in a hospital setting, but do not require round-the-clock monitoring due to their health status (for example, when using medications, after the use of which medical supervision must be carried out for a certain time due to possible adverse reactions ). By the way, this year for the first time, standards for the volume and financial costs of receiving care for people with viral hepatitis C in a day hospital setting have been identified.

High-tech medical care is expanding

Since the beginning of this year, three new types of high-tech medical care have appeared in the basic compulsory medical insurance program, which relate to the profiles of “obstetrics and gynecology,” “pediatrics,” and “cardiovascular surgery.”

In particular, the state guarantee program now includes: various types of gynecological operations for the treatment of uterine fibroids; high-tech types of treatment for patients with true placenta accreta; uterine artery embolization and ultrasound ablation under ultrasound or MRI guidance. Multicomponent treatment of congenital anomalies of the trachea, bronchi, and lungs using chemotherapy and genetically engineered biological drugs in children. Coronary angioplasty or stenting in combination with intravascular rotational atherectomy for coronary heart disease – with the installation of 1-3 stents per vessel. “These types of high-tech medical care are now included in the basic compulsory medical insurance program,” explains the specialist. — Territorial programs of state guarantees for the provision of free medical care and territorial compulsory medical insurance programs cannot be less than the basic program. This makes it possible at the federal level to determine the boundaries of the provision of modern medical care, taking into account its funding, which is sent to the regions. Thus, at the regional level, medical technologies are being developed to provide medical care free of charge to the patient.”