The SHOP MEDICAL SITE (the shop therapeutic site) — the territory or collective (the workshop, the site of production, group of the small industrial enterprises) with a certain labor work force combined on a production sign. C. century at. it is assigned to the shop district doctor of a medical medical unit (see M an ediko-sanitary part) or policlinics and is primary link and an organizational basis of activity of the healthcare institutions which are carrying out the production principle of preferential rendering to lay down. - the prof. of the help to workers and employees of the industry, construction and transport. C. century at. will organize at the rate on 1500
st working at the enterprises the chemical, coal, mining and oil processing industrial 190 SHOP MEDICAL SITE and on 2000 other industries of the national economy working at the industrial enterprises. According to the Resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About additional measures for improvement of public health care» (1982) the Ministry of Health of the USSR provided to bring by 1987 labor work force, serviced by one shop doctor, to 1700 people, except for industries, for to-rykh lower standards are established. Considering that in structure of C. century at. quite often not one enters, and several work rooms, during the formation of the site are considered first of all the production principle, i.e. workshops with similar a dignity are selected. - a gigabyte. working conditions, production technology and professional structure of working. However on the large industrial enterprises during the formation of C. century at. sometimes it is necessary to consider other, not less important factor — territorial placement of workshops, to-rye shall not be too far apart that provides more rational use of time of doctors at visit of workshops for studying and improvement of the working conditions working. This circumstance is important very especially for territorial policlinic,
edges on the basis of a shop uchastko-vost are carried out by the production principle of preferential rendering medical aid by the worker of the industrial enterprises with a small number working in the area captured by activity of this policlinic.
C. century at. arose in days of the Great Patriotic War. Experience of their creation completely came true also in 1951. The m3 of the USSR issued the special provision on the shop therapist. In the next years on the basis of studying and generalization of the best practices of work of shop local therapists on improvement and improvement of medical aid by the worker and the employee of the industrial enterprises M3 of the USSR new regulations on work of the therapist Ts were periodically reconsidered and approved. century at. (I960, 1978, 1981). All this, undoubtedly, played a positive role in further development and improvement of a shop uchastkovost, edges strongly entered a health system and became the leading method in the organization to lay down. - the prof. of the help to workers and employees.
The number of shop therapeutic sites, especially as a part of territorial policlinics (table) constantly grows in the country. So, if in the USSR M3 system total number tse-
hovy therapeutic sites countrywide in 1984 increased approximately by 3,7 times in comparison with 1960, then in medical medical units (MSCh) — only by 2,6 times, and in open network almost by 6,5 times.
For the last thirty years the shop method of the organization of medical aid by the worker was constantly improved. So, at the beginning of the 50th shop therapeutic sites began to combine functionally in pairs that allowed to provide at the sliding working schedule of shop doctors their interchangeability and succession in reception of therapeutic patients from the integrated sites.
In the subsequent the brigade form of a shop uchastkovost in service of workers when a little (most often 4) shop therapists and doctors on the main specialties was a part of medical crew began to be implemented into practice of health care (the surgeon, the neuropathologist, etc.). This progressive form of work of doctors of various specialties allowed to assign organizationally them to certain shop sites and to provide these active participation in a rachey-spetsi of sheets in studying of working conditions and extent of influence of these conditions on health of workers.
For further improvement of health protection of workers at the enterprises the engineering and medical crews which are fullestly reflecting joint efforts of administrative, trade-union and health workers in the complex solution of the medical, technical and social problems directed to improvement of labor protection and the accident prevention, upgrading of medical aid, timely holding recreational actions began to be created. Experience of engineering and medical crews of MSCh Chelyabinsk tractor and Kryvyi Rih metallurgical the plants, the generalized M3 of the USSR and the All-Union Central Council of Trade Unions
in 1973, was recommended for a wide spread occurance in work of MSCh of the country.
In a crust, time in practice of health care there are three forms of the organization of a shop uchastkovost, each of to-rykh has the features and advantages: 1) the usual shop site (the site included only workers and the works serving in the place); 2) the mixed territorial and shop site (the site captured a part of working, generally small enterprises, and a part of the population); 3) the uniform shop territorial site (workers of this site are serviced by the same doctors and in the place of work, and on the residence). The last form finds the increasing distribution since it provides full succession in observation and treatment of patients for the beginning of a disease before recovery and recovery of working capacity.
The organizer of all many-sided work on C. century at. the therapist, to-ry according to «The provision on the therapist local the shop medical site» is 1981) will organize and carries out (with participation of doctors of other specialties) all complex to lay down. - the prof. and recreational actions among workers and employees in close contact with administration and the trade-union organization of the workshop.
The main objectives of the shop local therapist are rendering the qualified therapeutic help to patients and holding the preventive actions directed to improvement of working conditions, the prevention and decrease in incidence (the general, professional and with temporary disability) and traumatism; carrying out the prof. of surveys, selection of the patients needing in stationary and in a dignity. - hens. treatment, dietary food, the direction in sanatorium dispensary, etc. The leading place in work of the shop doctor (and doctors
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other specialties) is occupied by medical examination (see) workers and employees. The shop local therapist in close contact with the doctor but occupational health of the sanitary and epidemiologic station (see) systematically studies and exercises control of working conditions of workers and employees, attracting to these purposes of average medics of health centers (see) and dignity. the asset, participates in development and control over the implementation of recreational actions for a comprehensive plan of social and economic development of the workshop and to the collective agreement. Very important task in work of the shop doctor is the account and the analysis of the reasons of incidence with temporary disability and on the basis of it development of purposeful medical and recreational actions for its decrease. Besides, the shop doctor as required and for the purpose of ensuring succession will organize and comes into contact with doctors territorial to lay down. - prof. of institutions, to-rye service workers in the place of their residence.
The table GROWTH of NUMBER of SHOP THERAPEUTIC SITES IN SYSTEM of the MINISTRY OF HEALTH of the USSR In 19 60 — 1984.
Bibliography: B about and t y r e in I. D. Zabo
a levayemost and treatment-and-prophylactic service of industrial workers, M., 1962; Zakharov F. G. Organization of medical care by the industrial worker of Russia and USSR, M., 1969; Seren-k about And. T., E r m and to about in V. V. and Pyotr-to about in B. D. of a bsnova of the organization of the polyclinic help to the population, M., 1982;
Shakhgeldyantsa. E. Treatment-and-prophylactic help to workers of the industrial enterprises, M., 1978.
A. E. Shakhgeldyants.