From Big Medical Encyclopedia

MEDICAL AND OBSTETRICAL CENTER — the treatment and prevention facility organized as a part of the rural medical site and on construction objects out of settlements for rendering pre-medical medical care to the population and holding preventive and sanitary and anti-epidemic actions in the territory of service.

T. - and. the item will be organized according to the petition of village councils of People's Deputies, to-rykh they are under authority, under settlements with population from 700 to 3 Ltd companies of the inhabitants located at distance of St. 2 km before the nearest medical establishment. T. - and. the item can be organized in settlements with smaller number of inhabitants (300 — 700) if the distance before the nearest medical establishment exceeds 4 km. At number of inhabitants in the settlement less than 300 F. - and. items will organize if distance before the nearest medical establishment of St. 6 km. Heads F. - and. the item the manager, the Crimea can be the paramedic (see), the midwife (see) or the nurse (see). Opening and closing F. - and. the item is made in accordance with the established procedure. General and methodical leadership in activity F. - and. the item carries out hospital or out-patient iolikliniches - which establishment, he submits to Krom.

Personnel F. - and. the item is guided in the work as the current legislation, provision on medical and obstetrical center, orders, instructions and the methodical indications M3 of the USSR and federal republics, and also instructions and orders of the head of establishment, F submits to Krom. - and. item.

Acute requirement of army and all population for elementary medical aid in 17 century caused the necessity of attraction to this work of medical assistant's structure. Creation by a zemstvo of traveling medical aid, and also local first-aid posts, in to-rykh worked generally the paramedic, increased demand for this category of workers. Considerable part of medical assistant's positions because of shortage of paramedics was employed in mandative and territorial institutions by the so-called company paramedics who did not have neither the general, nor medical education. It were the former soldiers who had long-term experience of service as hospital attendants in infirmaries, hospitals or in a dignity. parts of regiments. For years of the Soviet power number F. - and. the item more than by 20 times increased.

All of them are staffed by paramedics and obstetricians with secondary vocational education.

On F. - and. items are assigned the following duties: rendering pre-medical medical aid to the population (see. Pre-medical help), timely and in full performance of appointments of the doctor; the organization and carrying out patronage of children and pregnant women (see Patronage), systematic overseeing by the state of health of disabled people of Patriotic war and leading experts of agriculture (machine operators, cattle breeders, etc.); carrying out under the leadership of the doctor of a complex preventive, anti-epidemic and a dignity. - a gigabyte. the actions directed to decrease in incidence, first of all by infectious and parasitic diseases, agricultural and household traumatism (see. Anti-epidemic actions, Sanitary and preventive m e r about p r and I am t and I, Traumatism). Special significance is attached a dignity. - a gleam, work (see. Sanitary education) and to actions for decrease in child and maternal mortality (see Protection of motherhood and the childhood).

Medical aid by the diseased depending on their age, a state and the nature of a disease appears at home or on point in cases when competence of the doctor is not required. The big share in the village of persons of advanced and old age, and also obliges children of preschool age to wider organization of medical aid at home. At acute diseases the population, as a rule, calls the paramedic or the midwife on the house. All patients with the unspecified diagnosis and also demanding medical assistance, the paramedic is obliged to direct timely in rural local-tsu (out-patient clinic), and then to carry out appointments of the doctor. The midwife conducts outpatient appointment ginekol. patients, patronage of all pregnant women, women in childbirth and children of early age carries out and in cases of need accepts uncomplicated childbirth at home. Frequency of patronage visits of healthy children is defined by age of the child and social conditions of a family. Patronage visits have thematic character. Their main objective — increase in medical literacy, practical training of mother and other family members to methods of leaving, feeding and education of children.

Direct proximity of workers F. - and. and. to country people the nase-leiiya allows to involve these workers as the closest assistants to doctors in implementation of annual medical examination (see Medical examination). The preliminary routine medical examinations which are carried out by them according to the established special tests allow to allocate groups of persons with suspicion for existence of a disease or group of «the increased risk» for the first-priority direction to the doctor. Doctors profoundly inspect the persons selected by paramedics and obstetricians. The paramedical staff controls timeliness of an appearance to doctors of the contingents which are under dispensary observation, and the revealed patients, carries out medical overseeing is frequent and long ill and will see off protivore-tsidiviy and other types of course treatment to destination doctors. They also monitor timely performance by administration of collective farms and state farms of recommendations about employment, improvement of working conditions and life of toilers of fields.

13th activity F. - and. and. rely on the active help of the population. Paramedic and midwife F. - and. items participate in implementation of the current sanitary inspection (see) behind institutions for children and teenagers, utility, food, industrial and other facilities, water supply and cleaning of settlements. In the presence of epidemic indications they carry out household bypasses for the purpose of identification inf. the patients contacting to them persons and suspicious on inf. diseases; inform in accordance with the established procedure territorial SES on infectious, parasitic and occupational diseases, poisonings of the population and the revealed disturbances a dignity. - a gigabyte. requirements.

Room F. - and. shall answer the item a dignity. - a gigabyte. to requirements and tasks of work of this establishment, equipment — to correspond to the sheet of the equipment. T. - and. the item shall have means of communication. Usually construction norms and rules for F. - and. items are provided the following rooms: ozhidalnya, an office of the paramedic, an office of the midwife, an office of the patronage sister, procedural, the dressing room, the room of temporary stay of the patient, the room for the emergency reception of childbirth used in exceptional cases. As a rule, women in labor are hospitalized in the nearest obstetric department of rural local BCs or a regional maternity home (department). Providing F. - and. the item is made by vehicles for performance of the tasks assigned to its personnel free of charge according to «Bases of the legislation of USSR and federal republics about health care» in the order established by executive committees of local councils of People's Deputies.

On F. - and. items can be assigned functions of pharmaceutical point (see. And p-teka) selling Placeleniyu of ready dosage forms and other pharmaceutical goods.

Standard states F. - and. items are defined by the order M3 USSR. The number of average medics depends on the number of the serviced population.

Sheet of the equipment F. - and. the item

approved by M3 of the USSR provides seven types: medical,

disinfection, the equipment for a dignity. - a gleam, works, linen and soft stock, furniture, the economic equipment, tableware.

On F. - and. items are in accordance with the established procedure formed and submitted in higher bodies of health care plans and reports on the activity, registration and reporting medical documentation is kept.

The most general criteria and indicators of quality and efficiency of activity F. - and. items are: the state of health of the serviced population determined by incidence, physical development, child and general mortality; organization of dispensary observation; dignity. - a gigabyte. improvement of the settlement, epidemic wellbeing of the population; state dignity. - a gleam, works; level of traumatism; efficiency of actions but to improvement of working conditions of page - x. workers, collective farmers, etc.

See also Rural medical site.

Bibliography: B and t to and with G. A. and. Pekarev L. G. Social hygiene and organization of health care, page 532, M.,

1969; Gavrilov N. I. and Fofanov V. GT. Organization of medical care to country people, M., 1982; Lavrova I. And Maillet of t-r and x K. V. Social hygiene and organization of health care, page 181, M.,

1981; L e to and p e in L. G. Rural medical site, page 40, M., 1964.

N. A. Kravchenko, L. G. Lekarev.