HEALTH CENTER, point of health care — primary lechebnoprofilaktichesky establishment at the industrial enterprises, in the construction organizations, state farms and educational institutions.
For the first time the term «health center» appeared in 1930 in the course of reorganization of work of health care and approach of medical aid to production.
Before Great October socialist revolution organized medical aid by the worker appeared only on some large industrial enterprises and came down to the first medical aid in case of accidents, it was carried out, as a rule, by paramedics,
From first years of the Soviet power points of the first medical aid began to be created at most the industrial enterprises. By the end of 1929 only at the enterprises of RSFSR there were 1038 such points, from them 578 had in staff of the doctor. However the structure and kind of work of point of the first medical aid not completely corresponded to requirements of the developing industry. Industrialization and development of all national economy of the country demanded further improvement of a health system at the industrial enterprises.
In the resolution of the All-Union Communist Party (bolsheviks) of the Central Committee from 22/X 11 1929 g. «About medical care of workers and peasants» need of radical reorganization of all work of health care, bigger attention to improvement of medical service of workers in the main industrial districts of the country, expansion of network of points of the first medical aid was emphasized. First meeting of doctors of the industrial enterprises of RSFSR (December, 1930) defined ways of further improvement of medical service of workers at the industrial enterprises, changed the name of points of the first medical aid at the industrial enterprises to «points of health care» (health centers) and respectively planned the new content of their work. Along with rendering the first medical aid 3. planned carrying out on production wide a dignity was imputed a duty. - a gigabyte. and to lay down. - professional, actions for decrease in the general and the prof. of incidence, operational injuries and improvement of working conditions and life.
3. for a long time became the advanced sites of all system medical - a dignity. service of workers and employees. There were 3. in the construction organizations, state farms and educational institutions. Number 3. in the country began to increase quickly. Two types 3 were created. — medical and medical assistant's (tab. 1).
After issue of the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of health care and development of medical science in the country» (1968) the shop principle as fullestly personifying rendering medical aid by the worker and employee preferential in the place of work continues to develop and become stronger. Becomes the main organizational form of service of the working industrial enterprises shop medical site (see) in this connection the number medical 3 decreases a little. and part of them will be reorganized in shop medical assistant's 3. Medical 3. are created and continue to function where in connection with local conditions it is not possible to organize shop medical sites — at the industrial enterprises, in the construction organizations, state farms, educational institutions.
Medical 3. is a part of a medical medical unit, the nearest territorial hospital or policlinic.
For medical 3. according to standards of the order of the Minister of Health of the USSR No. 340 from 30/IV 1968 g with a number working (studying) from 1200 to 2000 people is defined the state: doctor, average medic, nurse. At number working the St. 2000 people in addition one position of the average medic is entered; if there is an equipped dental surgery, the position of the dentist (stomatologist) can be entered.
Medical assistant's 3. also are a part of a medical medical unit or policlinic of territorial network and will be organized directly at the enterprises (in technical training colleges), in the construction organizations with number of working (pupils) not less 500th persons. At the motor transportation enterprises for carrying out pre-trip surveys of drivers of motor transport medical assistant's 3. will be organized in the presence of 400 and more drivers.
Medical assistant's 3. will be organized according to the following staff list (tab. 2).
During the work of the enterprise in two or three changes for the organization of the round-the-clock watch for medical and medical assistant's 3. additional positions of the average medic are established.
Provides the room and equips medical and medical assistant's 3. enterprise; equipment 3. it is made according to the special sheet.
Placement, design of the room 3. and the possibility of free bringing and carrying out of victims, rendering first aid and temporary accommodation of victims to them shall provide its device. Obligatory rooms 3. — the ozhidalny room, a dressing room, the insulator and the room for personnel on duty.
3. under the direction of MSCh, policlinic the dignity holds events for decrease in incidence among workers and serving (pupils) of the enterprise, to their dispensary service, improvement. - a gigabyte. working conditions, to prevention of traumatism and occupational diseases, rendering the first medical aid in case of accidents and patient. In particular, 3. shall provide before arrival of the corresponding specialists rendering medical aid at sudden diseases, acute poisonings and injuries (imposing of an aseptic bandage, a stop of bleeding, an immobilization at changes, actions for stimulation of cordial activity, an artificial respiration, administration of antitetanic serum, elementary antishock actions, at acute poisonings with the known etiol, a factor — performing antidotal therapy, at food poisonings — a gastric lavage, etc.).
Doctor 3. has the right to give a leaf of disability for a period of 3 days with the subsequent direction of patients in policlinic (hospital).
In tasks medical 3., besides, enters: the account and the analysis of incidence at the enterprise; the organization and participation in carrying out (together with the involved doctors of other specialties) medical examinations of the allocated working groups and employees, the working (studying) teenagers; studying together with SES of working conditions on production for identification of sites with profvrednost; participation in control of observance of safety regulationss and condition of protective constructions; supervision of compliance with the law on labor protection of teenagers and women; overseeing by performance dignity. governed on production, household and food objects and carrying out protivoepid, actions; organization and carrying out dignity. - a gleam, works; training of workers and pupils most and mutual assistance.
Medical assistant's 3. carries out all work under the leadership of the shop doctor (therapist), and in the absence of the doctor — under the leadership of doctors of medical establishment, in a cut it enters. Besides, 3. controls performance by administration of the recommendations made by the shop doctor or the worker of SES and carries out on doctor's orders some types to lay down. actions.
Manager. 3. together with doctors of a medical medical unit, SES, administration and the trade-union organization of the enterprise participates in development of a unified comprehensive plan of actions for improvement of working conditions, to decrease in incidence and traumatism.
About a condition of incidence and necessary additional measures for improvement of working conditions the doctor 3. (in the presence of medical assistant's 3. — the shop doctor) periodically reports at meetings of administration of the enterprise and at meetings of the trade-union organization.
3. shall have the plan providing the organization and ensuring medical aid at mass accidents, a stock of a dressing material, tires, medicines, and in need of expansion of temporary beds — a stock of the equipment and bed linen.
Table 1. DYNAMICS of NUMBER of MEDICAL AND MEDICAL ASSISTANT'S HEALTH CENTERS In the USSR.
Table 2. STATE of the MEDICAL ASSISTANT'S HEALTH CENTER
Bibliography: Petrovsky B. V. Achievements of the Soviet health care for years of the ninth five-years period, M., 1976; Semashko N. A. and Sorts Ya. I. Zdravpunkt in fight for decrease in incidence and traumatism at the enterprise, M., 1943; Social hygiene and the organization of health care, under the editorship of A. F. Serenko and V. V. Ermakov, M., 1977; Freydlin S. Ya. Organization of work of a health center, L., 1949.
G. I. Labezov.