CHILDREN'S POLICLINIC in the USSR — the state treatment and prevention facility which is structural division of children's hospital or independent medical institution a cut provides around activity the extra hospital help to children from the birth up to 14 years inclusive.
In pre-revolutionary Russia extra hospital help to children was given in out-patient clinics for adults. In the second half of 19 century at large nurseries-tsakh of St. Petersburg and Moscow out-patient clinics where to children there was a medical aid for a payment were created. Reception of children with somatic and infectious diseases was carried out jointly.
At the initiative of the advanced doctors of that time (N. F. Filatova, etc.) at the expense of charity children's consultations, part of them with the milk kitchens known under the name «Drop of Milk» began to open also. They were the first attempt of the organization of scheduled maintenance with children.
Broad and systematic development of the out-patient and polyclinic help to children began to be carried out after Great October socialist revolution. Its organizational forms changed depending on stages of our development about-va, achievements of the Soviet health care, medical science and practice.
In the 20th years the children's consultations which were carrying out at that time were actively created to lay down. and preferential scheduled maintenance with children to 3 years and carrying out wide a dignity. - a gleam, work among the population. At these institutions milk kitchens were created. In consultations schools of mothers were organized, female mothers were given social legal aid.
Lech. - professional, the help to children is more senior than 3 years rendered children's out-patient clinics. In 30 — the 40th in children's consultations and out-patient clinics were organized receptions of specialists in skin, eye, ear, nervous and other diseases. Recreational platforms, day hospitals were created. Since 1948 association of children's consultations with out-patient clinics in uniform Dative began.
For the purpose of the maximum satisfaction of the children's population with different types of the specialized out-patient and polyclinic help and its approach to the residence of children the network of Dative annually increases, improves their material and technical resources. In the long term development of network of Dative is provided due to construction of independent institutions according to standard projects and reconstruction of rooms according to the construction norms and rules (Construction Norms and Regulations) approved by the State Committee for Construction of the USSR — see table.
The equipment of Dative (polyclinic departments of children's hospitals) shall meet the modern requirements of science and practice, as much as possible to facilitate work of the doctor, average medical and service personnel. In them there have to be visual aids by methods of care of children, their education and the prevention of diseases.
Child care out-patient and polyclinic facilities are the centers of health protection of children in which work the main attention is given to dispensary observation behind health of the child, his physical. and psychological development, to rendering different types of medical aid to sick children, dignity. - a gigabyte. to education of children and their parents.
Contents and the organizational principles of work of Dative are defined by the orders and instructions approved by the Ministry of Health of the USSR.
Independent Dative shall have the main pediatric departments, specialized offices (children's surgery, otorhinolaryngology, ophthalmology, nephrology, etc.), diagnostic offices, offices to lay down. physical culture and massage.
In the conditions of the large cities in one of Dative interdistrict specialized offices on children's urology, nephrology, allergology, pulmonology, hematology, etc. shall be organized. Such Dative is called advisory.
Dative provides around activity:
a) preventive (including dignity. - a gleam.) work by overseeing by newborns, carrying out routine maintenances and medical examination of children; carrying out preventive inoculations; the organizations of gathering donor breast milk and ensuring work of the milk and distributing points which are its part; the organizations of lectures, conversations, exhibitions, conferences for parents, occupations at schools of mothers, etc.;
b) to lay down. the help to children at home, in policlinic, the direction of children on treatment in hospitals of BC and sanatoria, selection of children in child care recreational facilities;
c) to lay down. - professional, work in preschool institutions and schools.
Dative holds events for professional development of doctors and paramedical staff (the organization of conferences — theoretical, on exchange of experience, participation in work scientific about-va doctors, etc.).
Work with in total Dative by the principle of an uchastkovost. The district of their activity is divided into sites. Regular standards of doctors and other medical staff in the city and in the village are established depending on the number of children around activity of Dative and other factors.
In Dative reception by local pediatricians and other specialists is conducted according to the sliding schedule in morning and evening hours. The call of the doctor on the house is made by phone and directly in registry of policlinic in the hours determined by administration. In Dative reception only of healthy children, the children who are on dispensary observation and convalescents is conducted. All sharply sick children and being in contact with infectious patients are observed by the doctor only at home. Drugs for treatment of children of the first year of life are given free of charge.
For an exception of a possibility of entering of an infection in Dative there have to be 2 entrances: one for healthy children, another for children with suspicion of any disease. In case of identification on reception of the sick child the doctor examines it in boxing.
The ambulance appears specially allocated pediatric crews, and also doctors of other crews of the station of emergency medical service. Acute management appears doctors on duty of Dative.
Specialized help to children in Dative is given more than on 18 specialties. Its such main types as surgical, ophthalmologic, otolaryngologic and psychoneurological, are available in all city children's policlinics.
For the purpose of approach of the specialized help to the children's population receptions of narrow specialists practice in district clinics in strictly allocated hours and days of the week.
The chief physician of Dative provides performance of the tasks facing policlinic timely informs personnel orders, orders and instructive-methodological indications of higher bodies and provides their timely performance; studies the best practices of work and implements it in practice of the institution run by it, controls quality of inspection and treatment of sick children; reports for activity of policlinic to higher body of health care.
The local pediatrician possesses the leading role in rendering preventive and to lay down. help to children in Dative. He carries out reception of children; appoints according to the state of health and I will increase the mode, a balanced diet, establishes terms of carrying out immunobiol. tests, preventive inoculations and other actions for strengthening of health; visits newborns in the first three days after an extract from a maternity home at home; controls visit of newborns by the patronage sister at home; provides preventive overseeing by children of the first year of life at least once a month, for children of the second year of life — quarterly, for children from 3 to 7 years — at least once a year; carries out overseeing by the children taken on medical examination (the premature, being on artificial feeding, receiving an early feeding up, suffering rickets, frustration of food weakened, convalescents, hron, sick); conducts examination of children before receipt in preschool institutions, schools; performs treatment of the revealed patients, visits them at home, if necessary directs children to consultation to specialists and to hospitalization; carries out selection of the children needing a sanatorium therapy; carries out a dignity. - a gleam. work. The local pediatrician works according to the plan, made on the basis of the analysis of incidence, mortality and physical. development of children.
For the aid to the district doctor the local nurse is allocated, edges makes patronage overseeing by children (see. Patronage, children ); visits all pregnant women last month of pregnancy, the newborns, children of the first year of life having rickets, frustration of food, who are often ill of convalescents at home; finds out living conditions of mothers and children; gives advice on improvement a gigabyte. conditions of the house; trains parents in rules of hygiene and care of the child, feeding it; carries out appointments of the doctor.
The system of rendering the ambulatornopoliklinichesky help to children in rural areas considers the factors defining features of organizational forms of rendering medical aid to country people (see. Rural medical site ). Active overseeing by children of early age, dispensary observation for the children who are lagging behind in development, ill hron, diseases, treatment of sick children is carried out by doctors of the central, regional and local BCs under the direction of and control of the regional children's doctor. The advisory, specialized help to children appears specialists of policlinics of the central regional hospitals, advisory policlinics of regional children's BCs (departments), exit consultations and city policlinics which are a patron of rural districts.
Activity of policlinics is estimated on indicators preventive and to lay down. works. Treat these indicators: percent of coverage systematic medical observation of children of the first year of life (13 visits of the pediatrician on 1 child a year); the number of the children who are on chest and artificial feeding; number of children with rickets, frustration of food; specific weight of the children captured by routine maintenances from total number of the children who are subject to surveys according to the plan; level and structure of incidence and mortality.
See also Children's hospital .
Table. FLOOR AREA of CHILDREN'S POLICLINICS
Bibliography: Belovo A. P. Organization of medical care to children in the conditions of the large city, L., 1973, bibliogr.; Manannikova N. V. Health protection of children in the USSR, M., 1973, bibliogr.; Fifty years of the Soviet health care, 1917 — 1967, under the editorship of B. V. Petrovsky, M., 1967, bibliogr.; Serenko A. F., Ermakov V. V. and Petrakov B. D. Bases of the organization of the polyclinic help to the population, page 265, M., 1976.
I. I. Grebesheva, L. K. Skornyakov.