The CENTRAL REGIONAL
HOSPITAL — medical profilak-ticheskoye the establishment providing qualified and specialized polyclinic and stationary (including advisory) the help to the population of the administrative region. C. river. is the center of the operational and organizational and methodical management of all healthcare institutions in the territory of the area, responsible for the organization and level of health care, quality of rendering the medical, disease-prevention and medicinal service to the population around activity (see the Lechebnoprofilaktichesky help).
162 CENTRAL REGIONAL HOSPITAL
In the second half of the 50th in Moldova, Altai Krai, and then and in the majority of areas of the Soviet Union the management of health care in rural areas was reorganized. As a result of reorganization rayzdravotdela were liquidated and functions of management of health care in the area are assigned on regional-tsy. Thus, the uniform administrative and organizational methodical control center of health care in the administrative region was created.
The carried-out enlargement of areas led to creation of C. river., to-rykh the largest would begin to perform functions regional, placed in the territory of the enlarged area. At the same time all organization of medical aid and the management of health care in ukrupnennokhm the adkhminist-rativny area were assigned to the chief physician Ts. river., at the same time being the chief physician of the area. At the same time for providing the qualified management of healthcare institutions of the area to the state of C. river. the position of the deputy chief physician for network and new structural division — organizational and methodical department (office) was entered.
C. river. depending on type of the settlement are subdivided into C. river., placed in city settlements, and C. river., placed in rural settlements. In 1983 total number of C. river. reached 3139; at the same time growth of number was noted generally at the expense of C. river., placed in city settlements, the number of such hospitals made 2273. Number C. river., placed in rural settlements, made 866 BCs.
Bed fund C. river. in city settlements in 1983 reached 646 053 beds. More than 150 thousand beds functioned in C. river., placed in rural settlements. Average power of C. river., located in city settlements, in 1983 reached 284 beds; more than 80 of them have the power of 600 and more beds. In such large departments and offices — in hospitals on 12 — 18, and in policlinics on the 30th wedge, to profiles, and also clinical diagnostic laboratories, X-ray and physiotherapeutic departments would function.
Along with C. river. in the territory of areas would be available regional, total number to-rykh in 1983 made 651.
In the country construction of standard multi-profile
C is carried out. river. on 400 and 250 beds with policlinics on 600 and 500 visits per shift respectively. In a number of the regions of RSFSR, USSR and other republics C function or are under construction. river. on 600, 800, 1000 and more beds (Podolsk central regional-tsa — more than 1200 beds, etc.).
Of river. irrespective of the bed power, number of the serviced population (the regional center and the periphery) and the radius of service according to the situation approved by the order M3 USSR has the following structural divisions: a hospital with reception, policlinic (with advisory receptions of specialists doctors for inhabitants of the periphery of the area), medical diagnostiche-skiye departments, offices and laboratories, organizational and methodical department, department of ambulance and emergency medical service, pathoanatomical department, a drugstore, kitchen, a vivarium, medical library and medical archive. When in the regional center there is no consultation and milk kitchen at independent children's hospital (see. Children's hospital, Children's policlinic, Milk kitchen) and clinic for women at a maternity home (see Clinic for women, the Maternity home), they join in polyclinic department of C. river. as structural divisions. According to the indications M3 of the USSR as a part of C. river. the mobile out-patient clinic can be created (see).
C. river. provides rendering main types of the qualified and specialized stationary and polyclinic help to the population of all area. The important role belongs to C. river. in strengthening of a preventive orientation in activity of healthcare institutions of the area by fuller coverage of the population various vidakhm of medoskhmotr (see. Medical examination), expansions of volume, upgrading and efficiency of medical examination (see), planned inoculations (see Immunization), sanitary education (see) etc.
Policlinic of C. river. is to lay down. - the prof. the center providing qualified and specialized advisory pokhmoshch by the patient directed from others to lay down. - the prof. of institutions of the area. Besides, C. river. renders medical aid to the population of the regional center and the assigned site, and also the population of all area on those specialties, to-rye are not presented in regional and local-tsakh and out-patient clinics. The polyclinic help to the population of the regional center and the assigned site will be organized by the local principle (see.
Medical site, Rural medical site) taking into account preferential service of the rural toilers occupied in the most important industries of agricultural production and agro-industrial complexes. Registry of policlinic of C. river. shall have three independent departments for storage of out-patient cards: patients of the regional center, the assigned site and directed to consultation from the area.
For approach of specialized medical aid to toilers of agricultural production and the population living in territories, remote from the regional center, many C. river. widely use mobile out-patient clinics. During creation of mobile out-patient clinics from states of C. river. doctors of various specialties and the nurse are allocated. The chief physician develops a route, the schedule, and also provides a mobile team with car of the increased passability, and in nek-ry cases — the boat, a snowmobile, etc. (see. Medical ambulance). In function C. river. also rendering fast and acute medical aid to the population (see Emergency medical service) living in the territory of the area enters. Departments of fast and acute medical aid at C are for this purpose created. river. and the branches of departments functioning at regional-tsakh.
In many areas on the basis of large C. river. interdistrict specialized departments for rendering specialized or highly specialized medical aid are created (cardiological, neurologic, urological, etc.).
C. river. carries out specialization and professional development of doctors and average medics to lay down. - the prof. of institutions of the area. During the planning of actions for professional development of paramedical staff, first of all, it must be kept in mind employees of medical and obstetrical centers (see). It is especially necessary in connection with expansion of a preventive orientation in activity of institutions and tasks of transition to annual medical examination of all population (see Prevention, Prevention primary).
C. river. provides timely development and widespread introduction in practice of work to lay down. - the prof. of institutions of the region of modern methods of prevention and diagnosis of diseases, treatments and rehabilitations of patients, and also the advanced forms and methods of work of healthcare institutions, the scientific organization of work (see).
Organizational and methodical department (office) of C. river. heads, directs and coordinates all organizational and methodical work as C. river., and others to lay down. - the prof. of institutions of the area, carries out the analysis and synthesis of data about health of the population of the area and activity of everyone to lay down. - the prof. of establishment of the area. Besides, the organizational and methodical department (office) will organize actions for rendering the medical and advisory and organizational methodical help to medical institutions of the area, and also an action for professional development of medics.
CENTRAL AFRICAN REPUBLIC 163
Activity of C. river. as state body health care of the rural area goes local party and Soviet bodies (see Management of health care). Competence of the chief physician Ts. river. is determined by management of health care of the area by the orders M3 of the USSR.
Measures for release of chief physicians of C are taken for improvement of management of health care in rural areas. river. from a number of the current obligations for the management-tsey, having assigned this work to the corresponding deputies; for operational management of the area of healthcare institutions at the chief physician of the area medical councils are created; the staff of organizational and methodical departments (offices) of C is increased. river.
At C. river. hospital council, council of nurses, sections of science medical foundations function, to-rye work according to the current situations approved by M3 of the USSR. At C. river. there is a public council (see. Public councils), work to-rogo is defined by the Situation approved by M3 of the USSR and the All-Union Central Council of Trade Unions.
In process of management of health care of the rural area identification of tasks, search and the choice not only optimal solutions, but also assessment of their efficiency are of great importance. Decisions concentrate, as a rule, in the operating and long-term plans, orders, orders based on data on incidence (see), demographic indicators (see. Demographic statistics), the existing statutes, orders and orders of higher bodies of management, and also information characterizing activity of healthcare institutions of the area.
Assessment of activity of C. river. it is carried out on the basis of the standard medico-statistics (see the Reporting medical, the Account medical, Statistics sanitary). Receipt of all necessary information is provided established for C. river. system of the account, collecting and processing of statistical data by forces of an organizational and methodical office.
In recent years value C. river. considerably increased due to the need of implementation medical - a dignity. the tasks provided in the Food programme of the USSR for the period till 1990 (see. The food programme) and the long-term program of the melioration approved October (1984) Plenum of the Central Committee of the CPSU.
See also Hospital, Regional hospital, Policlinic.
Bibliography: Gavrilovn. And. and Fo
the fan about in V. P. Organization of medical care to country people, M., 1982; And d and e in R. S. Bases of management and the organization of work in the central regional hospital, M., 1983; Serenkoa. T., Ermakov V. V. and Petrakov B. D. Bases of the organization of the polyclinic help to the population, M., 1982; X and h and to ý-I A. S's N. Experience of the organization of specialized medical care in the central regional hospital, M., 1975,
bibliogr. V. P. Fofanov.