Central district hospital: structure, functions and role in providing medical care to the rural population. Central district hospital: structure, organization of work, district specialists, Their role in medical care. serving the rural population Interdistrict specialization

Territorial Medical Association (TMO). Central District Hospital (CRH).(1990 - 137 with a number of beds of 37397, 2000 - 137 - 33796, 2005 - 126 with a number of beds of 26889)
The central district hospital is the main institution for providing qualified medical care. At the same time, the Central District Hospital is the center of organizational and methodological management of the district’s healthcare.
Based on capacity, central district hospitals are divided into 5 categories:
Category 1 – 600 or more beds;

The capacity of the central district hospital and other structural medical institutions is determined by the average annual number of deployed beds. Regardless of the bed capacity, the size of the population served and the service radius, the central district hospital must have a certain list of structural units:

1. clinic;

2. hospital with treatment departments for basic medical specialties;

3. reception department;

4. diagnostic and treatment departments (offices) and laboratories;

5. organizational and methodological office;

6. emergency department;

7. utility block (catering unit, laundry room, garage, etc.).

If the district center does not have an independent children's hospital with a consultation and a dairy kitchen, or a maternity hospital with a antenatal clinic, then the women's and children's clinics and the dairy kitchen, as structural units, are included in the clinic of the Central District Hospital.

The central district hospital implements the principle of unity of command in the person of the chief physician of the central district hospital (TMO). A medical council is created under the chief physician, there is a certain number of deputies, a chief accountant, and a chief nurse.

Peculiarities:

1. is a legal entity;

2. is the manager of financial resources;

3. has public governance structures (medical council, council of paramedics, council of nurses, etc.).

4. makes organizational and management decisions;

5. has specialized departments;

6. has an organizational and methodological office (department);

7. has an emergency medical service;

8. departments (services) can perform inter-district functions;

9. has chief specialists;

In the region, in addition to the central district hospital, specialized dispensaries (anti-tuberculosis, skin and venereal diseases) can be organized, which operate as inter-district institutions (serve the population of nearby areas). In enlarged districts that emerged as a result of the merger of two or more districts, former district hospitals continue to function, retaining all their functions, organizational structures and standards for serving the population.

In each district of the republic, sanitary and anti-epidemic service institutions are also organized and functioning - regional centers of hygiene and epidemiology (RCHE). Settlements located around the district center and served by the district's medical institutions (clinic or central district hospital) are called assigned areas.

TMO tasks:

1) providing the required volume of highly qualified inpatient and outpatient medical care to the population;

2) operational, organizational and methodological management, as well as control over the work of all healthcare institutions and individuals engaged in individual medical activities in the district;

3) planning, financing and organizing logistics for health care institutions in the district;

4) planning and implementation of measures to develop a network of medical institutions;

5) development and implementation of measures aimed at improving the quality of medical care for the population of the region, reducing morbidity, disability, hospital mortality, child and general mortality and improving the health of children, adolescents and women;

6) timely and widespread introduction of modern methods and means of prevention, diagnosis, treatment and rehabilitation into the practice of all health care facilities in the region;

7) development, organization and implementation of measures for the deployment, rational use, professional development and education of medical personnel and other personnel of health care institutions in the district;

8) maintaining hospital facilities.

The chief physician has a certain number of deputies:

1) deputy for medical services - supervises the organizational and methodological support of the work of health care facilities in the district, supervises the work of the main specialists;

2) deputy for medical affairs - supervises inpatient medical care and emergency medical services;

3) deputy for outpatient work - supervises outpatient medical care;

4) Deputy for Medical and Rehabilitation Expertise - oversees morbidity with temporary and permanent disability, all types of examinations;

5) Deputy for Childhood and Obstetrics - oversees issues of maternal and child health;

6) deputy for administrative and economic work - oversees the issues of logistical support for the work of health care facilities.

135. State Sanitary Epidemiological Centers. supervision (GSEN): functions, structures, basic methods of work.

Pages and functions: 1) information and analytical. block: a) social gig department with departments for studying the health of us, software and hardware, b) department for organizing the state sanitary and epidemiological service with departments for organizing and planning activities, service for training and employing personnel, metrology and standardization, hygienic. Arrangement with a press center. 2) block of organization of the State Sanitary and Epidemiological System, which includes: a) department of organization of the State Sanitary and Epidemiological System with departments of epidemiology, food hygiene, labor, children and adolescents, municipal hygiene, sanitary, radiation hygiene, etc. b) department of organization of laboratory control with laboratories san. or microbiological ,physical f-drov, disinfection. stations and government unitary enterprises with disinfection profile - the main function of disinfection measures: disinfection, disinfestation, extermination on request. Anti-plague stations - prevention of the spread of especially dangerous infections: monitoring of pathogens, vectors, training of specialists.

Structure of the Central District Hospital:

1. Polyclinic with specialized departments (up to 20 physician specialties).

2. Hospital.

3. Emergency department.

4. Pathology department.

5. Organizational and methodological office.

6. Auxiliary structural units.

Functions of the Central District Hospital:

1. Providing the population of the regional center and district with qualified specialized medical care.

2. Operational, organizational and methodological management, control over the activities of all healthcare institutions in the district.

3. Planning and financing the activities of medical institutions.

4. Carrying out activities aimed at improving the quality of medical care.

5. Advanced training of medical personnel.

The average bed capacity of the central district hospital is 300-320 beds.

CRH – main health care facility of the territorial medical association(II stage of providing medical care to the rural population).

Performance indicators of the central district hospital: See hospital performance indicators (question 73).

103. Rural medical station (VU). Medical organizations SVU. Rural district hospital. Organization and content of treatment, preventive and anti-epidemic work - see question 30.

End of work -

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Answers to the state exam on public health and healthcare

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• 1. Health care in pre-revolutionary Russia (zemstvo medicine, factory medicine, the system of Duma doctors)
• 2. Healthcare in Russia during the formation and development of the state healthcare system (1917-1940)
• 3. Healthcare of the USSR during the Great Patriotic War and in the post-war years.
• Section 1. General provisions - contains a definition of the concept of “protecting the health of citizens”, the basic principles of protecting the health of citizens and other organizational provisions.
• 5. Health care workforce. Modern problems of undergraduate and postgraduate training of medical personnel.
• 6. Attestation and certification of medical personnel.
• 7. Public health care system. Main advantages and disadvantages.
• 8. Private enterprise healthcare system. Main features, advantages and disadvantages. Healthcare in the USA. Medicare and Medicaid programs.
• 9. Insurance, basic principles and types of insurance in Russia. Social insurance
• 10. History of the development of medical health insurance in foreign countries. Basic principles, advantages and disadvantages of health insurance.
• 11. Law of the Russian Federation “on medical insurance of citizens in the Russian Federation” (1991). Purpose, types and subjects of health insurance.
• Section IV (Articles 20-28) - activities of medical institutions in the health insurance system.
• 12. Rights of citizens in the health insurance system.
• 13. Policyholders in the health insurance system. Their rights and responsibilities.
• 14. Rights and obligations of medical insurance organizations.
• 15. Qualification requirements for experts of insurance organizations, their rights and obligations.
• 16. Medical institutions in the health insurance system.
• 17. System of quality control of medical care: subjects, means, control mechanism.
• 18. Quality of medical care, its components. Objectives of departmental quality control of medical care, its subjects, means and control mechanism.
• 19. Non-departmental quality control, its subjects, means and control mechanism. Types of standards.
• I. By administrative-territorial division:
• II. By objects of standardization:
• III. By mechanism of use:
• 20. Licensing of medical care in the Russian Federation.
• 21. The role and place of outpatient clinics in the Russian healthcare system. Structure and performance indicators of the clinic. Main directions of reforming outpatient care.
• 1.1 Indicator of population provision with polyclinic care
• 1.2 Indicator of population provision with medical personnel (per 10,000 population)
• 2.1 Average number of 1 therapeutic site
• 3.1 Compliance with locality at outpatient appointments
• 3.3 Number of outpatient visits
• 22. Medical examination of the population, the main elements of the clinical examination method, clinical observation groups. Main indicators characterizing the effectiveness of clinical examination.
• 2. Number of cases of temporary disability per 100 workers
• 2. Average duration of bed operation per year
• 3. Average length of stay of a patient in bed
• 5. Bed downtime
• 2. Cost of maintaining one bed per year
• 2. Percentage of agreements (discrepancies) between clinical and pathological diagnoses
• 3. Rate of postoperative complications
• 4. Postoperative mortality
• 25. Organization of hospitalization. Functions of the admission and discharge department.
• 26. Organization of obstetric care in cities. Objectives, structure
• 27. Organization of dental care in the Russian Federation. Structure and tasks of the dental clinic.
• 28. Organization of statistical accounting and performance indicators of the dental clinic.
• I. Percentage of patients identified during planned sanitation:
• 1. Number of cases of VUT per 1000 workers
• 2. Number of working days per 1000 workers
• 3. Average duration of one case
• 30. Modern problems of organizing assistance to the rural population. Rural medical district, medical and preventive institutions and their tasks.
• 31. Structure, tasks and organization of work of the central district hospital. Organization of dental care in rural areas.
• 32. Structure, organization of work and main tasks of the regional hospital. Regional healthcare management.
• 33. Organization of sanitary and epidemiological service in Russia. Structure of the center for sanitary and epidemiological surveillance. Preventive and ongoing supervision.
• 2. Information and analytical support department
• 3. Department of financial and material support
• 34. Public health. Groups of indicators characterizing population health. Demographic indicators. Static indicators. Indicators of mechanical movement of the population.
• 1. Number of arrivals (departures) per 1000 population
• 35. Fertility, calculation methods and procedure for registering births in the Russian Federation. The dynamics of the birth rate in Russia and the factors influencing its level. Average life expectancy.
• 1. Total fertility rate
• 2. Total fertility rate
• 3. Age-specific fertility rate
• 36. Mortality rate. Calculation method. Registration procedure. Infant mortality. Dynamics of indicators and factors influencing their level.
• 1. Crude mortality rate
• 2. Mortality rate of persons of a given age and gender
• 3. Mortality from this disease
• 4. Infant mortality (Rats formula)
• 37. Indicators of physical development of the population.
• 39. Types of morbidity according to the population’s seeking medical care. Methods of registration and study.
• 1) Indicators of general morbidity
• 1. Primary morbidity
• 2) Infectious morbidity
• 1. Number of identified infectious diseases
• 4) Morbidity: temporary disability
• 1. Number of cases of VUT per 1000 workers
• 2. Number of working days per 1000 workers
• 5) Hospitalized morbidity
• 40. The main tasks of medical labor examination. Levels of examination of temporary disability.
• 41. Functions of the attending physician in conducting an examination of temporary disability.
• 42. Functions of the clinical expert commission of a medical institution,
• 43 Documents certifying temporary disability. Functions of a certificate of incapacity for work. Registration of certificates of incapacity for work by paramedics and private practitioners
• 44. Registration of a certificate of incapacity for work during the period of regular leave and leave without pay
• 45. Registration of certificates of incapacity for work for outpatient and inpatient treatment of nonresident patients.
• 46. ​​Types of violation of the regime and the procedure for issuing a certificate of incapacity for work for various types of violation of the regime.
• 47. Registration of a certificate of incapacity for work for pregnancy, childbirth and in case of termination of pregnancy (for medical, social reasons and for induced abortion).
• 48. Registration of temporary disability to care for a sick child during outpatient and inpatient treatment.
• 49. Registration of a certificate of incapacity for work during quarantine.
• 50. Medical and social examination and its tasks. The procedure for referring citizens for medical and social examination and the rules for preparing medical documentation and certificates of incapacity for work.
• 52. Medical ethics and deontology. Problems of bioethics. Iatrogenesis. Problems of euthanasia in the “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens.”
• 53. Management as a science. History of development. Management methods and style.
• 1) Administrative
• 54. Control functions. Management cycle and algorithm for making management decisions.
• 55. Health care planning, principles and methods. Main sections of the health plan. Features of planning outpatient and inpatient care.
• 56. Health Economics. Concepts about economic effect and economic efficiency. Medical and social effectiveness of treatment and preventive measures.
• 57. New economic mechanism in healthcare. Brigade, collective and rental contracting.
• 59. Methods of payment for inpatient medical care, their advantages and disadvantages.
• 60. Methods of payment for outpatient care, their advantages and disadvantages.
• 1) External:
• 62. Loans, their types and lending principles. The concept of leasing and factoring.
• 63. Main directions of economic analysis of the activities of a medical institution. Indicators of hospital bed utilization and cost indicators.
• 1) Use of hospital capacity:
• 2) Average duration of bed operation per year:
• 1 Cost of one bed-day:
• 2. Cost of maintaining one bed per year
• 64. Market and principles of its functioning. Market relations in healthcare. Market functions. State regulation of the healthcare market.
• 65. Supply and demand. Factors influencing the level of demand for medical services and the level of their supply. Market equilibrium point.
• 66. Price as an economic category. Bid price and supply price. Their influence on the level of supply and demand. Market price.
• 67. Pricing in healthcare. Pricing principles. Cost, cost and profit.
• 68. Types of prices and pricing methods in healthcare.
• 69. The mechanism for setting prices in healthcare, main elements.
• 71. Entrepreneurial activity with the formation of a legal entity. Commercial and non-profit organizations.
• 72. Marketing in healthcare. Prerequisites for the emergence of marketing of medical services. Marketing categories: need, requirement, request, product, exchange, amount, market.

• 1. Rural - rural medical station (paramedic-obstetric

  point, local hospital)

  2. District- central district territorial medical association (central district hospital - Central District Hospital, district center of the State Sanitary and Epidemiological System)

  3. Regional - regional hospital with a clinic, dispensaries, dental clinic, regional center of the State Sanitary and Epidemiological Service, etc.

  The second stage of providing medical care to the rural population is the district (central district territorial medical association), in which the main importance is central district hospital (CRH). There are central district hospitals in all district administrative territories. There is a SSES center in each regional center.

  There may be inter-district specialized centers, dispensaries, health centers, etc.

  Rural residents go to the district hospital following referrals from medical institutions in the rural area (territorial medical institution) if they need specialized medical care, a functional examination, or consultation with medical specialists.

  The Central District Territorial Medical Association is the main link in healthcare of the rural administrative territory, which carries out specialized, qualified medical care according to its main types.

  The Central District Hospital includes the following divisions:

  1. Hospital with main specialized departments

  2. Clinic with consultations with specialist doctors

  3. Treatment and diagnostic departments

  4. Organizational and methodological office

  5. Ambulance and emergency medical care department

  6. Other structural units (morgue, catering unit, pharmacy, etc.).

  To provide methodological and advisory assistance to doctors of the rural (district) territorial medical association, the district hospital allocates so-called regional specialists. They go for consultations, conduct demonstration operations, examine and treat patients, send teams of medical specialists to medical institutions in rural areas, hear reports from local hospital doctors, heads of medical and obstetric centers, and analyze work plans.

  In order to better provide specialized medical care, inter-district specialized centers(branches) equipped with modern equipment. They provide medical and advisory assistance, carry out organizational and methodological work, and improve the qualifications of medical personnel at district and district hospitals and clinics.

  Dental help .

  In complex cases, as well as for prosthetics, patients from the rural medical district are sent to the central district hospital (CRH). Here the patient can receive not only outpatient, but also inpatient dental care.

  32. Structure, organization of work and main tasks of the regional hospital. Regional healthcare management.

  The regional stage of medical care for the rural population involves the provision of highly qualified medical care in all specialties.

  The regional stage includes such institutions as regional hospital with clinic, dispensaries, dental clinic, regional center of state sanitary epidemiological surveillance and etc.

  Regional Hospital provides highly qualified and specialized medical care, is a scientific, organizational, methodological and educational center for healthcare.

  Functions of the regional hospital:

  1. Providing highly qualified, specialized, advisory and inpatient medical care

  2. Providing organizational and methodological assistance to treatment and preventive institutions

  3. Providing emergency medical care by air ambulance

  4. Management and control of statistical accounting and reporting of medical institutions in the region

  5. Analysis of qualitative indicators of morbidity, disability, general and child mortality, development of measures aimed at reducing them

  6. Carrying out activities for the specialization and improvement of doctors and nursing staff.

  Structural divisions The regional hospital includes: a hospital, a consultative clinic, treatment and diagnostic departments, offices and laboratories, an organizational method and department with a department of medical statistics, a department of emergency and planned advisory medical care. The main specialists of the health care committee (chief surgeon, therapist, pediatrician) and freelance regional specialists (most often heads of specialized and highly specialized departments) take part in the organizational and methodological work of medical institutions in the region.

  The bed capacity of a regional hospital depends on the population of the region. The most appropriate are regional hospitals with 700 - 1000 beds with all specialized departments.

  Regionaladvisory clinic performs the following tasks:

  1. Diagnosis and treatment of patients referred from medical institutions at the local or district level

  2. Determining the need for inpatient care in the departments of the regional hospital.

  3. Assessment of the quality of work of rural doctors, district and district hospitals

  Patients are referred to the regional clinic, as a rule, after preliminary consultation and examination by regional medical specialists. To evenly distribute the flow of patients, the regional clinic regularly reports the availability of free places in the dormitory, in hospital departments, and coordinates the timing of admission of patients from rural institutions.

  For each patient, the advisory clinic provides a medical report, which indicates the diagnosis of the disease, the treatment provided and further recommendations. The clinic systematically analyzes cases of discrepancies in diagnoses, errors made by doctors in medical institutions in the districts when examining and treating large patients locally.

  Department of emergency and planned advisory medical care, using facilities air ambulance or other transport, provides emergency and advisory assistance with travel to remote settlements.

  In a regional or regional, republican hospital dental outpatient and inpatient care It is provided to residents of the region in all types: therapeutic, surgical, orthopedic, orthodontic.

  For health care management in the region regional hospital is being created department of clinical-external and organizational-economic work. It performs organizational, methodological, scientific and practical, planning and regulatory, statistical, personnel and other functions. The department is the base for regional healthcare management.

The second stage of medical care for the rural population.

The main institution of the second stage of medical care for the rural population is the central district hospital (CRH). It provides the rural population with qualified treatment and preventive care, both inpatient and outpatient.

Basic tasks of the central district hospital:

providing highly qualified, specialized inpatient and outpatient care to the population of the district and regional center;

operational, organizational and methodological management and control over the activities of all healthcare institutions;

planning, financing and organizing logistics for health care institutions in the region;

development and implementation of measures aimed at improving the quality of medical care for the population of the region, reducing morbidity, disability, hospital mortality, child and general mortality and improving the health of adolescents;

timely implementation of modern methods and means of prevention, diagnosis and treatment into the practice of health care facilities;

implementation of measures for the deployment, rational use and improvement of professional qualifications of personnel;

carrying out activities aimed at the effective use of funds and forces, strengthening the material and technical base of the district, improving the systems of organizational, methodological and operational management, management of all health care facilities in the district, using modern scientific achievements;

provision of ambulance and emergency care in the region.

The central district hospital, regardless of bed capacity, population size and service radius, has a hospital, a clinic, a pharmacy, a prosector, paraclinical and administrative services, an organizational and methodological office (OMK), an ambulance and emergency department.

The in-patient department of the Central District Hospital must have at least 5 departments according to specialties; therapy, surgery, pediatrics, obstetrics and gynecology, infectious diseases. In addition to the required minimum, large central district hospitals can organize departments for other specialties (neurology, otorhinolaryngology, ophthalmology, traumatology, etc.).

In the outpatient department of the Central District Hospital, specialized care is provided in 1015 specialties, and such departments often serve as inter-district specialized centers.

Patients living in an area assigned to a district hospital are served directly by the hospital. Patients living in other areas are admitted to the district hospital on the referral of doctors from local hospitals. Local doctors refer patients to the district hospital in cases where the necessary specialized care cannot be provided on site, when patients need consultation, clarification of the diagnosis, X-ray or laboratory clinical diagnostic examination. The participation of specialists from district hospitals during clinical examinations is widely used.

Rural residents turn to the district hospital following referrals from medical institutions in the rural area if they need specialized medical care, functional examination, or consultation with medical specialists.

Mobile assistance plays an important role in the work of the Central District Hospital. Mobile medical teams are formed by the chief physician and see patients in 5-7 specialties. The composition of the team's medical specialists is determined depending on the development of the network of outpatient clinics in a given territory, its staffing with doctors and the population's needs for appropriate types of medical care. It may include doctors: therapists, pediatricians, surgeons, obstetricians-gynecologists, ophthalmologists, neurologists, etc. The visiting team is provided with vehicles, including special ones, and is equipped with the necessary equipment (mainly portable) and equipment for examining and treating patients . The leadership of the mobile medical team is entrusted to one of the qualified doctors of the team who has experience in medical and organizational work. Fluorographic and dental offices, clinical diagnostic and bacteriological laboratories regularly visit the village.

Ambulance and emergency care is provided by the relevant department, which is part of the Central District Hospital, which is responsible for providing this type of assistance to the population of the district center and the settlements assigned to it.

One of the most important structural units of the Central District Hospital is the organizational and methodological office (OMK), headed by the deputy chief physician of the Central District Hospital for medical care of the population of the district. OMK is the main assistant to the chief physician in matters of management, organization and coordination of all organizational and methodological work of the Central District Hospital and other medical institutions in the region.

The main tasks of OMK include:

analysis and synthesis of data on the health status of the population and the activities of health care facilities in the district;

calculation of evaluation indicators and analysis of the activities of the Central District Hospital as a whole and for individual specialized services;

compiling a summary report on the network, personnel and activities of health care facilities in the district; identifying shortcomings in the work of health care facilities and developing measures to eliminate them; development of an action plan for medical care of the entire population of the district, monitoring its implementation;

implementation of measures to improve the quality of treatment and preventive work,

advanced training of specialists,

study and dissemination of new modern forms of work in medical care,

long-term planning for the development of healthcare in the region,

organization of work on off-budget commercial activities and health insurance.

The OMK work plan is actually a plan for the organizational and methodological work of the entire central district hospital. Its mandatory sections are:

analysis of demographic indicators and reporting materials on the network, personnel and activities of health care facilities in the area and on the health status of the population;

organization and implementation of measures to provide treatment, advisory and organizational and methodological assistance to medical institutions in the region;

carrying out activities to improve the qualifications of medical workers; strengthening the material and technical base of health care facilities in the region.

assessment of the activities and effectiveness of the district’s medical institutions and departments of the Central District Hospital;

measures to improve the quality of medical care, ambulance and emergency care;

introduction of new types of diagnostics and treatment;

improvement of ethical and deontological aspects in the staff of medical institutions.

Based on a systematic analysis of the health status of the region's population and the plans of district institutions, the cabinet draws up a comprehensive action plan to improve medical care and strengthen the health of the region's population.

Providing methodological guidance and control over accounting and statistical work in all institutions of the district is the most important function of the organizational and methodological office. The duties of the offices include receiving annual reports. Based on data from reporting forms and special analysis, the organizational and methodological department compiles an overview of the health status of various population groups and evaluates health indicators. Organizational and methodological rooms should contain information about regional conferences and classes with doctors and paramedical personnel, seminars with the participation of regional specialists, specialization and advanced training of medical workers.

The chief (district) specialists of the district, who are also heads of specialized departments of the central district hospital, work in close contact with the OMK of the Central District Hospital. Currently, in almost all regions there are regional specialists in therapy, pediatrics, surgery, obstetrics and gynecology, and phthisiology. They are appointed by the chief physician of the district in agreement with the chief regional specialists and report directly to the chief physician of the Central District Hospital or his deputy.

The main functions of district specialists are:

organizational and methodological management of the work of the relevant specialized service;

regular visits in accordance with the schedule to local hospitals, medical outpatient clinics and first aid stations;

improvement of methods of diagnosis, treatment, prevention of specialized diseases;

observation and control of the dispensary population, especially persons in leading agricultural professions;

Organization and provision of qualified medical care to the population,
– organization and implementation of a set of preventive measures aimed at reducing morbidity, disability, maternal, child and general mortality,
– organizing and conducting events for sanitary and hygienic education of the population, widespread promotion of a healthy lifestyle,
– organizing and conducting quality control of patient treatment,
– pharmaceutical activities,
– control over the circulation of narcotic and (or) psychotropic substances.

To perform the main tasks and functions, the hospital, through its employees, organizes and carries out work to provide us with medical care, which we experience ourselves when we see a doctor (for example, timely hospitalization or referral for examination, etc.).

State Healthcare Institution “Efremovskaya District Hospital” includes the following structural divisions:

· polyclinic No. 1, st. Dachnaya, 4;

· polyclinic No. 2, st. Slovak Uprising, 18;

· women's consultation, st. Slovak Uprising, 18;

· children's clinic, st. Dachnaya, 4;

· branch of the children's clinic, st. Druzhby, 26;

· Intermunicipal diagnostic and treatment center, st. Slovak Uprising, 18;

· outpatient hemodialysis department, st. Slovak Uprising, 18;

• hospital with 325 round-the-clock beds according to the profile, including:
• surgery department
• infectious diseases department
• maternity ward
• cardiology department
• day hospital with 43 beds according to the profile;
• Stepnokhutorskaya outpatient clinic, Stepnoy Khutor village;
• Bolsheplotavskaya outpatient clinic, Bolshie rafts;
• Shilovskaya outpatient clinic, village. Shilovo;
• twenty-three FAPs;
• ambulance station

2. Purpose and objectives of the work:

Goal of the work: conducting a general assessment of the provision of outpatient care in the Efremovsky district and the associated development of measures to increase the efficiency of resource use in healthcare, aimed at preserving and improving the health of the population of the Efremovsky district.

Tasks:

1. Select indicators to assess the volume of outpatient care in the Efremovsky district for the period 2008-2012.

2. Compare the selected indicators with similar indicators in the Tula region.

3. Conduct a general assessment of indicators.

4. Draw a conclusion about the effectiveness of providing medical care to children based on the results of the data obtained.

3. Analysis of selected indicators for the work of outpatient care in the Efremovsky district and the Tula region for 2008-2012.

1. Availability of outpatient clinics (units) in the Efremovsky district of the Tula region (per 10,000 population) 2008-2012.