close

Вход

Забыли?

вход по аккаунту

?

Демография

код для вставкиСкачать
Providing High-tech Health Care
in the Murmansk region
A.D. Rubin
2008
Territory
The Murmansk region is one of the
largest and economically
developed regions in European
north of Russia; it is the only
subject of the Russian Federation,
almost entirely located beyond the
Arctic Circle, it occupies the
whole of Kola Peninsula, which is
washed by the Barents Sea and
the White Sea.
The population density of 1 sq. km
is an average of 6.6 people.
It borders on
Norway and
Finland
Participant of
EuroArctic
Baretsregion
The nonfreezing
Kola Gulf
Direct access to the
Ocean
It occupies the Kola Peninsula, to the
north of the Arctic Circle
The territory of
144.9 thousand
sq.km.
The population density of 1 sq.
km is an average of 6.6 people.
Length From West to East – 550 km,
from North to South – 440 km.
Population health is influenced
by extremely adverse climatic
conditions of the Kola North (a
complex relief, unfavorable
wind and temperature
conditions, long polar day and
polar night, high magnetic
activity and humidity, frequent
changes in atmospheric
pressure, which cause a
syndrome of “polar stress”).
85
7
85
0,
9
07
20
05
20
04
20
03
20
02
20
01
20
00
20
99
19
98
19
97
19
06
20
86
4
87
2
89
1
96
6
97
8
98
8
10
01
10
33
10
17
The dynamics of the resident population size
in the Murmansk region (in thousands)
The number of births
in the Murmansk region
(according to the registry office data)
8800
8754
8750
8700
8650
8600
8550
8516
8455
8500
8450
8400
8350
8300
2005
2006
2007
9,
8
11
10
,7
,2
13
,4
9,
7
12
,7
13
,4
10
,2
12
,4
9,
2
6
13
11
,6
8,
8,
6
7,
7,
6
9
8,
1
8
9,
3
11
,1
10
8,
8
9
12
10
,1
14
2
Fertility. Mortality.
Natural increase.
4
-1
,5
-0
,7
2
-4
19 97
19 98
19 99
20 00
Рождаемость
Fertility
20 01
20 02
20 03
Смертность
Mortality
20 04
-2
,9
-3
,6
-3
,2
-3
,7
-3
,2
-3
-1
,2
-2
-2
,9
-2
,5
0
20 05
20 06
20 07
Ест.прирост
/ убыль
Natural increase\loss
The structure of the overall incidence
of adult population
5%
4%
6%
4%
10%
3%
22%
12%
5%
10%
Diseases
of the кровообращения
circulatory
болезни
системы
systemмочеполовой системы
болезни
Diseases of urogenital system
болезни
глаза
Eye diseases
Infectious
diseases
инфекц.
болезни
Skin and subcutaneous
бол.кожи и подкожной клетч.
adipose tissue diseases
травмы
отравления
Injuriesи and
intoxication
11%
8%
Diseasesкостно-мышечной
of the musculoskeletal
болезни
системы
system
болезни
пищеварения
Diseasesорганов
of the digestive
apparatus
болезни
эндокринной системы
Diseases of the endocrine system
новообразования
Tumors
Diseases of the nervous system
болезни нервной системы
прочие
Others
The structure of mortality
for the main classes of reasons
Diseasesсистемы
of the
болезни
circulatory system
кровообращения
12,2%
13,6%
3%
6%
1%
9%
55,6%
несчастные
случаи,
Accidents,
injuries
травмы
и отравления
and intoxication
Tumors
новообразования
болезни of
органов
Diseases
the
дыхания
respiratory apparatus
Diseases
the
болезни of
органов
пищеварения
digestive apparatus
Infectious and
инфекционные и
parasitic
diseases
паразитарные
болезни
прочие
причины
Other reasons
Providing high-tech health care (HHC)
to Russian population is one of the areas
of
priority
national
project
(PNP)
“Health”. It is regulated by the orders of
Ministry
of
Development
Federation
Health
of
and
the
(MHSDRF)
Social
Russian
with
the
allocation of quotas for the regions.
Annually about 1000 residents of the
Murmansk region receive treatment in
federal health centers.
To improve the quality and access to medical care
for those people, who need high-tech care, the following
documents were developed and adopted in the Murmansk
region:
1.Administrative Regulations on the provision of public
service “Submission and providing high-tech health care to
citizens of the Murmansk Region”;
2.An Order of the Murmansk Health Care Committee,
which regulates procedure of selection and Committee’s
activity on patients referral to treatment at clinics.
3.Software product ”Referral to treatment in Research
Institute (RI)”, which is the basis for annual reports.
Referral to high-tech care
in federal institutions
1400
1200
1000
800
600
400
200
0
2005
Application
заявка
2006
выделено
квот
allocated quota
2007
на 01.11.08
направлено
пациентов
referred patients
из children
них детей
Referral to high-
tech care
in federal
institutions and
Municipal
Regional Clinical
Hospitals
(MRCH)
Moscow
St. Petersburg
MRCH
MCH FSA “N.I. Pirogov NMSC”, Murmansk
2005
2007
Referral to high-tech care in federal institutions in
2007 on the following profiles
21%
25%
4%
4%
4%
14%
5%
3%
7%
кардиохирургия
Cardiosurgery
травматология
и ортопедия
Traumatology and Orthopedics
гематология
Hematology
ЧЛХ
Maxillofacial surgery
Rheumatology
ревматология
13%
офтальмология
Ophthalmology
онкология
Oncology
эндокринология
Endocrinology
урология
Urology
другие
Others
Certain types of medical care keep higher-priority:
implantation of large joints,
certain types of heart surgery, neurosurgical
treatment,
in vitro fertilization etc.
As at 01.10.2008,
244 persons are included into the
“waiting list “
(within the allocated quota)
Murmansk
population
is
provided by medical care of
the highest level, which is
financed from the federal
budget. In 2007 GHA “P.A.
Bayandin Murmansk Regional
Clinical Hospital” (MRCH)
was included in the List of
Medical Practical Institutions
(MPI), which
take part in the public task on
providing high-tech care.
Clinical, logistical, intellectual and industrial
facilities of the Region allow to use high-tech
treatment in cardio vascular surgery,
neurosurgery, traumatology and orthopedics.
As at 01.01.2008,
using funds for residents of
the Murmansk Region and
Republic of Karelia
from the federal budget,
the following operations
were performed:
180 cardio vascular operations (100%);
70 trauma and orthopedic operations
(100 %).
As at 01.10.2008,
using funds for residents of
the Murmansk Region and
Republic of Karelia
from the federal budget,
the following operations
were performed:
200 cardio vascular operations
(91% of the total quota);
91 trauma and orthopedic operations (91% of the total quota).
30 additional quotas in neurosurgical profile for residents of the Murmansk
region were allocated, in October 2008 7 operations were performed.
The cost of the regional budget
for providing high-tech medical
service in the Region
was in 2007 - 330.7
million rubles,
scheduled for 2008 –
375,1 million rubles.
Number of high-tech care recipients in
Murmansk Regional Clinical Hospital
for the period from 2003 to 2008
(from the federal and regional budgets).
The structure of patients
after high-tech care surgical treatment
in Murmansk Regional Clinical Hospital
in 2007
Urology
урология
34
Neurosurgery
нейрохирургия
87
травматология
и ортопедия
Traumatology
and
492
Orthopedics
сердечно сосудистая хирургия
Cardiosurgery
1220
офтальмология
1295
Ophthalmology
0
200
400
600
800
1000
1200
1400
The structure of patients
after high-tech care surgical treatment
in Murmansk Regional Clinical Hospital for
9 months in 2008
Neurosurgery
нейрохирургия
90
Traumatology
and
травматология
и ортопедия
333
Orthopedics
Urology
урология
560
Cardiosurgery
сердечно сосудистая
хирургия
797
Ophthalmology
офтальмология
975
0
200
400
600
800
1000
1200
Operations with artificial blood circulation and lethality
in Murmansk Regional Clinical Hospital for the period from
1992 to 2007
269
300
The number of
operations
250
200
98
150
64
100
50
29
64 62
118 124
96 103 82
128
137
167
223 218
Lethality
10,312,5 6,3 3,2 3,1 2,5 3,2 6,3 3,9 2,4 3,1 4,4 2,4 4,9
4,1 4,5
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
In January 2007, the 2000-th operation
with the use of coronary artery bypass grafting was performed in
Murmansk Regional Clinical Hospital
The number of operations on heart
with an coronary artery bypass grafting
(including operations on the working heart)
2005
2006
2007
The number
of operations
223
220
269
Mortality
4,8 %
3,7 %
4,42 %
The number of operations
on major arteries
2005
399
2006
410
2007
425
The number of implanted
pacemakers with radiofrequency
ablation
2005
265
2006
247
2007
341
The number of patients with
diagnostic and therapeutic
endovascular interventions
2005
2006
2007
Diagnostics
4639
5058
4134
Treatment
410
570
639
(stenting, angioplasty)
The number of rentgen-surgical
interventions and operations
The data of A.N. Bakulev SCCVS, RAMN
The average frequency
of rentgen-endovascular operations
to 1 million people in 2006
RF
Northwest
The
Northwest
The Murmansk
region
region
region
P.A. Bayandin Murmansk Regional Clinical
Hospital
takes the 15th place among all Russian clinics
by the number of endovascular coronary
interventions,
but in terms of 1 mln. population and
operating room workload –
one of the ten most active clinics in Russia.
(The data of A.N. Bakulev SCCVS, RAMN)
Today coronary arteriography is the «gold
standard»
of coronary heart disease (CHD) diagnosis
1400
Coronary arteriography
is the only method for
choosing the best tactics
of treatment in patients
with coronary heart
disease.
1228
1200
1104
1000
930
800
770
600
The need for coronary
arteriography per
1 million of population is
more than 3,000
procedures a year.
400
200
490
312
243
52
388
299
167
0
1993 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Replacement arthroplasty
Replacement arthroplasty
Hip joint
Knee joint
New high-tech methods of treatment were
introduced in Murmansk Regional Clinical
Hospital in 2003 - 2007:
- Knee replacement;
- Endovascular treatment of abdominal aneurysm;
- Endovascular treatment of hysteromyoma;
- Endovascular bifurcational stenting of coronary arteries in
coronary heart disease;
- New endovascular methods of treatment of ischemic stroke
and hemorrhagic stroke;
- Stabilizing operations on the spine using submersible systems;
- Laser discission of secondary cataract;
- Laser descemetogoniopunctura;
- Combined phacoemulsification with
profundus sclerotomy;
- Intravitrial introduction of Gemaza;
- Cataract phacoemulsification with
implantation of intracapsular ring in lens
subluxation;
- Application of allodrains in profundus
sclerotomy;
- Endoscopic operations on bile-excreting
tractus using endoscopes with side-optics;
- Operations for improving hearing;
- Endoscopic operations on the nose and
paranasal sinus;
- Associated operations in valvular defects
and coronary heart disease.
Completion of the reconstruction of
centralized operational unit in Murmansk
Regional Clinical Hospital in 2008
will increase implement of high-tech
methods of surgical treatment in 1,7 times
Документ
Категория
Презентации
Просмотров
3
Размер файла
9 528 Кб
Теги
1/--страниц
Пожаловаться на содержимое документа