TREATMENT-AND-PROPHYLACTIC HELP in the USSR — state system of rendering medical care to the population of all types.
L. - the pct is under construction on the principles of free of charge, general availability and a preventive orientation, uchastkovost and succession in work. System L. - pct, or as it was called earlier, «medical business» — one of the main functions of the Soviet health care.
L. - to pct to the USSR it is presented by wide network of the out-patient and polyclinic institutions, stations of fast and acute medical aid, medical, dispensary, sanatorium institutions, institutions of protection of motherhood and the childhood, blood transfusion stations and other institutions completed with shots and equipped with modern technical means, rendering medical aid as in institutions, and at home. L. - by pct it is brought closer to the population, it appears as at the place of residence (territorial to lay down. - professional, institutions), and in the place of work (MSCh) is also based on the local principle (see. Medical site , Rural medical site , Shop medical site ).
Material and technical resources of L. - by pct it is actually created for years of the Soviet power. In 1913 in Russia there were 5,7 thousand medical and medical assistant's institutions giving to the population an ambulatory care and 5,3 thousand medical institutions with fund of 207,6 thousand beds, or 13 beds on 10 000 zhit., dispersed on subordination more than in 12 departments. In 35% the cities of the country of BC were not. The number of hospital beds by 1979 increased more than by 15,4 times, security with them increased by 9,3 times, and the number of medical out-patient and polyclinic institutions increased almost by 6 times. The bed fund of the country by 1979 reached 3 million 206 thousand, at the same time security of the population with the hospital help made 122 beds on 10 thousand population. Also the number of the doctors rendering to the population of L increased. - pct and other types of medical providing. Their quantity by 1979 reached 923 thousand, and by the end of the tenth five-years period will make 960 thousand and will approach an indicator of 36 doctors on 10 thousand zhit.; health of the people is guarded by more than six-million army of medics.
Growth of number of the institutions rendering L. - the pct to the population, and numbers of hospital beds is shown in tab. 1.
Most idiosyncrasy of development of L. - pct are: all increasing number of the large multi-profile, technically equipped medical institutions and reduction of small; gradual differentiation of the operating and newly created institutions; specialization of intra office structure, bed fund, and also medical shots.
Instead of 3 — 4 types to lay down. the institutions operating during the pre-revolutionary period in the country it is created and render L. - pct to the population of St. 50 types specialized to lay down. institutions. Average power of regional BCs for 1970 — 1976 increased from 549 to 736 beds, city — with 166 to 197, central regional — from 65 to 213 beds.
The order M3 USSR No. 1000 of October 23, 1978 enacted the nomenclature to lay down. - the prof. of institutions.
The general direction of improvement to lay down. - the help to the population in the USSR its specialization and integration at base large multi-profile is professional to lay down. - the prof. of the institutions integrated with policlinic, and also creation of independent out-patient and polyclinic institutions (see. Out-patient clinic , Hospital , Policlinic ). Volume to lay down. - professional, to help given in the USSR by stationary institutions in 1960 — 1975 it is presented in tab. 2, specialization of bed network — in tab. 3.
Important feature of L. - the pct is the fact that instead of small out-patient clinics of pre-revolutionary Russia powerful policlinics (from 400 to 1600 visits per shift) with existence in their structure to 25 specialized diagnostic gained broad development, research and to lay down. departments, offices (pre-medical receptions, viewing), clinical, biochemical, cytologic, endoscopic laboratories, dispensary and methodical departments etc. In the 70th in policlinics departments of recovery treatment began to be created (see Policlinic).
Development of network of the medical institutions giving medical out-patient and polyclinic assistance in 1960 — 1975 is presented in tab. 4.
In out-patient and polyclinic institutions annually addresses for medical aid of St. 50% of the population of the cities and districts, from them from 80 to 90% take a full course of treatment.
The volume of activity of ambulatornopoliklinichesky institutions of the USSR for 1960 — 1975 is specified in tab. 5.
Feature of L. - the pct to country people is staging. At the first stage medical aid is the rural medical site (a collective-farm maternity home, out-patient clinic, local-tsey, and pre-medical — medical and obstetrical center, etc.). At the second stage medical aid is rendered regional to lay down. - professional, institutions (central regional-tsa, integrated with policlinic, regional-tsa, a clinic) where patients receive specialized medical aid on its main types, and on the third — regional (regional, republican)-tsey, clinics and city institutions where to villagers there are all types of specialized medical aid. In 1975 counting on 100 zhit. villages it would be hospitalized in regional and-tsy, located in the cities, 22,5 people, and counting on 100 zhit. the cities this indicator made 21,3 that is a big stride in alignment of level and quality of L. - pct to urban and country people.
At the industrial enterprises, in the construction organizations and on transport are created medical and sanitary parts (see) as a part of integrated with policlinic-tsy, shop medical sites, health centers (see), sanatoria dispensaries (see), etc. They perform function to lay down. - professional, the help to workers taking into account working conditions, and also health protection actively participate in the solution of questions of improvement of working conditions also.
L. - pct and nek-ry others render to patients with cardiovascular, oncological, dermatovenerologic, psychoneurological diseases, tuberculosis clinics (see. Clinic ).
The dental help to the population (see. Stomatology, organization of the dental help ) it is carried out in stomatol, policlinics, dental surgeries and departments of BC. In the country by 1976 was 23 550 stomatol, policlinics, departments and offices and 6114 dentoprosthetic offices.
Distinctiveness to lay down. - the prof. of the help is medical examination (see) and active overseeing by health of certain contingents of the population. In 1977 the dispensary method serviced St. 35 million persons. At the same time great attention is given to periodic medical examinations of working certain workshops and professions, routine maintenances of the children, the pupils called in ranks of the Soviet Army playing physical culture and sports, etc. The mass target medical examinations of the population directed to early detection of diseases or patol, the processes caused by various factors are widely carried out. In 1975 medical examination there underwent 106,9 million people (see. Medical examination ).
The service of fast and acute medical aid is presented by wide network of stations of fast and acute medical aid (see. Ambulance and emergency medical service ). In the large cities in their structure are created specialized cardiological, traumatologic, pediatric, toxicological, neurologic, resuscitation, an intensive care and other crews, and also would will be organized fast and acute medical aid, integrated with stations. In 1975 the emergency medical aid was rendered more than 71 million patients and victims. Blood transfusion institutions are presented blood transfusion stations (see).
To system L. - pct belong also institutions of protection of motherhood and the childhood: a children's day nursery and a day nursery gardens (see. Day nursery, day nursery gardens ); children's homes (see. Children's home ); milk kitchens (see. Milk kitchen ); maternity homes (see); clinics for women (see), being structural division of a maternity home; policlinics or out-patient clinics. L. - pct render to children children's hospitals and policlinics (see. Children's hospital , Children's policlinic ). See also Health care, health protection of women and children ; Health protection of children and teenagers ; Protection of motherhood and childhood .
Organization of rest and dignity. - hens. treatments of the population plays an important role in system to lay down. - professional, the help to the population. In 1975 in the country there were 11 697 sanatoria and institutions of rest on 1795 thousand places (see. Health care, sanatorium help ). The main type to lay down. institutions in resorts is sanatorium (see). Lech. procedures are, as a rule, carried out in balneological clinics (see. Balneolechebnitsa , Balneary ), mud baths (see) etc. The patients who are not needing a high sanatorium regime receive out-patient and course treatment in resort policlinics.
For further development of system L. - the pct to the population in the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of national health care» (1977) planned the comprehensive program, improvement of primary links of health care (policlinics, institutions of fast and acute medical aid, rural local BCs and out-patient clinics), development of material and technical resources of health care on the basis of a rational combination of building of multi-profile and specialized medical institutions, expansion of MSCh network, strengthening of the central regional BCs is provided in a cut and others to lay down. - professional, the institutions rendering medical aid by the worker of the industrial enterprises and to country people. Upgrading and cultures of rendering medical aid to the population on the basis of widespread introduction is provided in medical practice of achievements of science and technology, the best practices and the scientific organization of work (see. the Scientific organization of work in health care ), improvement of the prof. of preparation and ideological and political education.
By 1980 in the USSR there will be St. 60 thousand powerful specialized and well equipped joint BCs of g the bed fund of 3,5 million beds (13 beds for 1000 of the population) providing within a year full completion of hospitalization of St. 60 million inhabitants, polyclinic and dispensary institutions on 2,5 billion visits a year (9 — 10 visits on each inhabitant in a year) that will provide satisfaction of needs of the population for out-patient and polyclinic types of the help.
See also Health care, treatment-and-prophylactic help .
NOMENCLATURE OF TREATMENT AND PREVENTION FACILITIES
Hospital on the water transport (central basin, basin, port, linear)
Hospital on railway transport (central, road, otdelenchesky, nodal, linear)
the Municipal hospital
the Municipal hospital of emergency medical service
Hospital for disabled people of Patriotic war
Children's hospital on railway transport
regional Children's Children's municipal hospital (regional, republican) hospital Children's district hospital Regional (regional, republican) hospital
District hospital Regional hospital Local hospital the Central municipal hospital the Central district hospital the Central regional hospital
Specialized hospitals: children's infectious diseases hospital; children's ortopedo-surgical hospital of recovery treatment; children's insane hospital; children's tubercular hospital; infectious diseases hospital; ortopedo-surgical hospital of recovery treatment; otorhinolaryngological hospital; ophthalmologic hospital; psychoneurological hospital (for patients with an alcoholism); insane hospital; tubercular hospital; physiotherapeutic hospital;
Treatment and prevention facilities of special type
Medical and sports
Out-patient and polyclinic institutions
the Medical health center
Children's city policlinic
Children's dental policlinic
the Cosmetology clinic
Policlinic on the water transport (central basin, basin port, linear)
Policlinic on railway transport (central, road, otdelenchesky, nodal, linear)
the Medical assistant's health center
the Medical assistant's and obstetric health center
the Central district clinic
Institutions of ambulance and emergency medical service and blood transfusion institution
Blood transfusion station
Station of ambulance and emergency medical service
Institutions of protection of motherhood and childhood
Children's day nursery (Day nursery gardens)
Collective-farm maternity home
Children's balneological clinic
Children's mud baths
Specialized sanatorium summer camp of year-round action
Table 1. GROWTH of NUMBER of the MEDICAL INSTITUTIONS In the USSR GIVING to the POPULATION TREATMENT-AND-PROPHYLACTIC HELP * And NUMBERS of HOSPITAL BEDS (1940 — 1975; all departments)
Table 2. GROWTH of the VOLUME of the TREATMENT-AND-PROPHYLACTIC HELP GIVEN by STATIONARY INSTITUTIONS in 1960-1975 * (in institutions of the USSR M3 system)
Table 3. GROWTH of SECURITY of the POPULATION In the USSR HOSPITAL BEDS ON SEPARATE SPECIALTIES in 1960-1975
Table 4. DEVELOPMENT In the USSR NETWORKS of the MEDICAL INSTITUTIONS GIVING MEDICAL OUT-PATIENT and POLYCLINIC ASSISTANCE in 1960 — 1975.
Table 5. The VOLUME of ACTIVITY of OUT-PATIENT and POLYCLINIC INSTITUTIONS In the USSR in 1960 — 1975 (USSR M3 system)
Bibliography:Zakharov F. G . Organization of medical care by the industrial worker of Russia and USSR, M., 1969; The National economy of the USSR in 60 years, page 625, M., 1977; Bases of the organization of the stationary help in the USSR, under the editorship of A. G. Safonov, etc., M., 1976, bibliogr.; The guide to social hygiene and the organization of health care, under the editorship of N. A. Vinogradov, t. 2, page 81, M., 1974; Serenko A. F., Ermakov V. V. and Petrakov B. D. Bases of the organization of the polyclinic help to the population, M., 1976; 60 years of the Soviet health care, glavn. edition B. V. Petrovsky, page 7, 143, M., 1977.
F. G. Zakharov.