From Big Medical Encyclopedia

The ACCOUNT MEDICAL — uniform state system of registration, processing and analysis of data on the state of health of the population, the volume and the nature of activity of healthcare institutions, their material and sanitary and hygienic condition, and also a condition of objects of sanitary inspection and the environment.

At. the m is intended for evaluation test and efficiency of activity of healthcare institutions and providing an operating controls with medico-statistical information with health care for planning of actions io to development of health care, improvement of health and medical service of the population.

In a basis At. respect for the uniform, evidence-based methodological and organizational principles of the socialist account is necessary to m: unity of the program of uchetnostatistichesky indicators; uniform methodology of their receiving; unity of terms of drawing up reporting and its submission to higher instances; the most strict reporting discipline of institutions.

According to these principles in all to lay down. - the prof. institutions of the country is conducted primary medical documentation unified for the same institutions. The form of registration documents and standard instructive-methodological instructions on their maintaining are approved by M3 of the USSR (see Documentation medical). Forms of the reporting of medical institutions, bodies of health care and instructive-methodological instructions on their filling, and also an order and terms of their representation are approved by TsSU USSR on representation of M3 of the USSR (see the Reporting medical). Typification and standardization of documents facilitates statistical development of materials, creates conditions for use of computer aids on the mechanized data processing in all medical institutions and promotes receiving the comparable indicators characterizing the state of health of the population and activity of healthcare institutions for various regions of the country (see Statistics sanitary). At. the m provides fixation in registration documents (standard forms, cards, special books, etc.) registration indicators, i.e. signs, notifiable. At. the m includes the statistical and operational and technological account.

The statistical account provides registration of each case of the birth, a disease and death, hospitalization, visit of doctors in policlinic both with medical, and with the preventive purpose; a call on the house, captures under dispensary observation of the sick and healthy contingents of the population.

The account and assessment of resources of health care and efficiency of their use is extremely important: data on network of healthcare institutions (number, power, structure of BC, policlinics, MSCh, clinics, out-patient clinics, health centers, medical and obstetrical centers, day nursery, sanatoria, dignity. - epid. stations, drugstores, stations of fast and acute medical aid, hospitals for disabled people of the Great Patriotic War, blood transfusion stations, children's homes, houses a dignity. educations, etc.); data on medical shots (number of doctors, dentists, average and junior medics and other personnel) it is differentiated on number of positions and natural persons; data on number of beds in sick-lists, a dignity. - hens. institutions and their specialization, etc.

The operational and technological account consists in fixation by medical staff of the work in process to lay down. - the prof. and a dignity. - the prof. of activity: records of overseeing by a condition of the patient during his treatment (the conducted examination and treatment, stage epikriza, the description of surgeries and manipulations, etc.); description dignity. researches of tests of water, foodstuff, characteristic of a sanitary and material condition of establishment, etc.; various entries in documents for the purpose of control of timeliness and completeness of inspection and treatment of patients, and also ensuring succession in medical service by their various specialists and institutions. Data of the operational and technological account (the number of the made analyses, operations, researches, the released procedures, etc.) use also for the statistical account for the characteristic of volume of activity of institutions.

Special value has the alarm account on special registration documents of cases of emergence especially dangerous infectious (see. Emergency notice) and the major not epidemic diseases (active tuberculosis, malignant new growths, mental disorders, venereal and fungal diseases, leprosy, itch, trachoma), food toxicoinfections and poisonings, acute professional poisonings. Also cases of sports injuries, unusual reactions to an inoculation and side effects of pharmaceuticals are subject to this account.

At. the m has the current character, i.e. is conducted daily by medical staff in all divisions of healthcare institutions. For maintaining the account and the reporting positions of medical statisticians with secondary medical education and doctors-statisticians are provided in states of institutions and bodies of health care. They carry out control of completeness and quality of the medical account in establishment, instructive-methodological occupations with medical staff concerning maintaining the account, monitor respect for the registration and reporting discipline established for medical uchrezh/deniye, generalize and present aggregated periodic and annual data and statistical reports on network, shots and activity of medical establishment to relevant authorities.

Problems of improvement of information support of health services raise the questions of improvement of primary medical account, its volume and contents. Reduction of forms of the account, volume and structure of the reporting, their simplification (in large scales such reduction and simplification was carried out in 1934, 1954 and 1980-1983) is periodically carried out. Along with it there are new forms of the account and reporting reflecting specific requirements of the developing socialist health care.

Considerable reserves of improvement At. m are connected with use of computer aids and the COMPUTER (see. Electronic computer) in health care. The computer facilities are widely applied to information processing about the persons who left hospitals, inf. and mental diseases, malignant new growths, during creation of information retrieval systems of the accounting of scientific shots (see the Information retrieval system), planning of capital investments, medicamentous providing and management of pharmaceutical economy, etc. The majority of areas of the country and the main computer center (MCC) of M3 of the USSR on a centralized basis reduce and process data of annual statistical reports. One of conditions of effective use of computer aids in health care is the choice of the tasks which are subject to the decision according to the plan of development of standard programs and the unified information. These programs provide unification of concepts, definitions and terms of the medical account and use of uniform all-union and industry qualifiers of information as necessary condition of development of an automated control system (see) health care on the basis of a nation-wide automated control system (OGAS).

Voyenno - the medical account (the medical account in Armed Forces of the USSR) — evidence-based system of collecting, processing and analysis of information on medical providing the Soviet Army and the Navy, a condition of military-medical service and health of the military personnel in military and peace time. Scientific bases of the theory and practice of the military-medical account are developed by military-medical statistics (see Statistics sanitary, military-medical statistics).

The purpose of the military-medical account is timely providing medical service with the reliable, complete and exact data necessary for the organization of medical service of parts (ships), connections, associations of troops (forces of the fleet) and institutions of Armed Forces of the USSR in various situation; operating control by forces and means of medical service; control of efficiency, timeliness and succession carried out by medical service to lay down. - the prof., a dignity. - a gigabyte., anti-epidemic and medical and evacuation actions; studying, scientific generalization and assessment of results of activity of divisions, parts and institutions of medical service; timely informing command on a condition of military-medical service, and also health of the military contingents and medical providing troops (forces of the fleet).

The medical account in AF of the USSR is carried out by means of the system of military-medical documentation and special rules of registration, the analysis and assessment of military-medical and other information which is officially accepted on military and peace time. Voyen but - the medical account is based on registration by the doctor of basic data and begins with first-aid posts of military units (ships) and divisions, in to-rykh the doctor works.

Military-medical documentation is subdivided on registration, reporting, operational and staff and help and medical (see Documentation medical, military-medical documentation).

The military-medical account in wartime has specific tasks, of to-rykh are main: the accounting of sanitary losses (see) and indicators of health of staff of military units (ships), connections and associations of troops (forces of the fleet); the accounting of the movement, duration and the result of treatment of wounded and patients at stages of medical evacuation (see); accounting of a condition of forces and means of medical service; accounting of the main medical and evacuation, dignity. - a gigabyte. and anti-epidemic actions; account dignity. - epid. conditions of troops (forces of the fleet).

Medical account dignity. losses and activity of medical service it is carried out by means of specially established documents of personal medical registration, napr, primary medical card (see), and documents of the group medical account in each functional division (the book of the accounting of surgeries, the book of the accounting of wounded and patients, etc.) medical parts and institutions. Synthesis of data of the medical account, and also analysis dignity. losses, work of first-aid posts and to lay down. institutions carry out by means of system of medico-statistics of activity of medical divisions, parts and institutions, and also classification and the nomenclature of fighting defeats and diseases of wartime.

On the basis of statistical development of data of primary medical account make reporting medical documents (see the Reporting the medical, military-medical reporting). The list of these documents, order and terms of their representation at a camp in * livatsya by the sheet of urgent documents on wartime.

Tasks of the military-medical account in peace time are: accounting of level and dynamics of the state of health of the military personnel of the private and officers; the account to lay down. - the prof. of activity of divisions, parts and institutions of medical service; accounting of infectious (epidemic) incidence, dignity. - egshd. conditions of troops and carried out a dignity. - a gigabyte. and anti-epidemic actions; the accounting of outcomes and terms of treatment of the military personnel in military medical institutions. Main registration documents: the medical book voyenno

the employee, the book of the accounting of ambulatories, a card of the accounting of patients with injuries and inf. diseases. Assessment of the state of health of the military personnel is carried out by the analysis of negotiability behind medical aid, cases of hospitalization and results of periodic medical profound examinations, including medical examination (see). The analysis of these data allows to define the most important medico-statistics of health of the military personnel: physical development, incidence, frequency of dismissal for health reasons. mortality. Results of activity of medical service study and estimate on the basis of the separate groups of the servicemen given the medical accounting of dynamics of the state of health, and also on the volume and kind of work of first-aid posts, medical and other medical institutions.

The final materials characterizing the state of health of the military personnel and activity of military-medical service are presented in documents of the organic medical reporting (the medical report and reports) based on primary documents of the medical account.

In the analysis and assessment of data of the medical account the classification of diseases, injuries and causes of death used by medical service in peace time has importance.

On the basis of the analysis and assessment of final and current data of the military-medical account carry out planning of actions and management of health service (see).

Use of the COMPUTER, modern means of communication, mechanization and automation of management promotes optimization of the military-medical account, accelerates it, expanding possibilities for the profound analysis of statistical information, objective assessment of results of activity of medical service and optimization of the made decisions on medical providing troops (forces of the fleet).

M e d and c and N with to and y the account in Citizens to about ii to defense shall correspond strictly to features of its organizational creation, at the same time keeping succession in relation to documentation of bodies of health care and military-medical service of peace time.

Tasks of the medical accounting of GO in wartime is the personal account struck and patients among the civilian population; accounting of the sizes and structure dignity. losses; assistance to carrying out bystry sorting, ensuring succession in treatment of struck; the accounting of complications and associated diseases among struck, being on treatment; accounting of result of defeats; the accounting of the work which is carried out at stages of medical evacuation.

All persons who received the defeats connected using the opponent of this or that type of weapon are subject to personal registration and are considered as a dignity. losses. At the same time a sampling unit is everyone struck, incapacitated for term not less days. Technique of the account dignity. losses shall exclude a possibility of the incomplete account, and also their duplication. For this purpose the account is based on the concept «initially addressed for medical aid». Initially addressed are considered all struck, registered as a dignity. losses in OPM — group of first aid (see), and all struck, come to other medical institutions without medical cards of primary account. Besides, the medical account in MSGO shall facilitate the management of service, provide maneuver with medical forces and means, accumulation of materials for the analysis of experience of formations MSGO and a dignity. effects of war.

In the MSGO system a certain order of maintaining the medical account on wartime is established. It in general corresponds to the organization of the medical account in military-medical service, but has also the features.

Medical service GO distinguishes registration documentation of medical and evacuation purpose and documentation of the accounting of activity of medical institutions. Treat the first: the medical card of primary account, a case history, evakopasport, sheets of the accounting of loading to lay down. institutions of the administrative region in general and each medical establishment in it (see. Hospital base), the sheet of the account struck, passed the evacuation receiving station.

The medical card of primary account struck is the main document of the account a dignity. losses in wartime. It is filled with the registrar of medical formation or establishment where medical assistance struck or to the patient is for the first time given. The card is filled in the presence of struck, is checked and signed by the doctor. Since a reception sorting room, the card follows further together with struck. In the cases of death struck or patients in way between stages of evacuation of their card are transferred to the medical establishment which accepted the dead. On the back the cause of death and the place of burial of a corpse is specified. The main registration document of stationary medical institutions characterizing the state of health struck at receipt, stay it in to lay down. establishment and an extract, the case history is. Put a medical card of primary account in it.

To the account struck and their bystry distribution among medical institutions it is applied evakopasport, filled in OPM, the evacuation receiving station or head-tse on each unit of transport with struck.

On medical distribution points (MRP), in evacuation receiving stations and sorting platforms of head

BCs, hospitals sheets of the account where are noted time of the direction of an evakotransport, quantity being in it struck are kept and medical institution, in a cut they go.

Treat documents of the accounting of activity of medical institutions: the spra

the vochny coupon, to-ry is filled along with a case history and transferred to information desk of B B (see. Hospital base); the card left a hospital; certificate

of a disease and log-books (register reception, log-book of hemotransfusions, magazine of registration lab. researches, magazine of registration of the dead, magazine of registration of pathoanatomical openings, etc.). In addition to these documents a number of registration forms of health care of peace time — a procedural leaf, the card of the LFK which is treated in an office, the card which is treated in a physiotherapeutic office, the log-book of preventive inoculations, etc. is used. The main registration document for registration of the revealed patients inf. as diseases serves the card of epidemiological inspection of the center of an infectious disease.

The carried-out work on the organization of the medical account has operational and statistical and reference value. It helps to perform uniform system of treatment and operational management of rendering medical aid, gives the chance to signal timely about medical mistakes, to analyze and estimate activity of medical formations and GO institutions.

Bibliography: Babinsky P. P.

and Glebov N. I. Organization and tactics of health service of civil protection, Kiev, 1980; About p e l about in L. I. and Dubrovin V. I. Medical care to the population in the centers of defeat, M., 1982; The medical account and the reporting in municipal hospitals and policlinics, under the editorship of A. M. Merkov, M., 1949; M e republics about in A. M. and Polyakov L. E. Sanitary statistics, L., 1974; Mechanization and automation of processing of statistical information in medicine and health care, under the editorship of L. E. Polyakov, L., 1976; Notkin E. L. The guide to military-medical statistics, p.1 — 2, M., 1956 — 1958; The Guide to the organization of medical support at mass defeats of the population, under the editorship of

A. I. Burnazyana, t. 1, M., 1971; I. S. and C of e r to about in N y y is accidental G. F. Statistical information in management of healthcare institutions, M., 1983; The Manual on health service of civil protection, under the editorship of P. N. Safronov, M., 1981.

B. P. Nepomnyashchy; L. E. Polyakov (soldier.),

V. N. Zavyalov, V. I. Mikhaylov (MSGO).