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BecmHUK Ka3HMy №4-2017
BASIC ASPECTS OF MEDICAL AND ORGANIZATIONAL APPROACHES OF NEUROSURGICAL CARE TO PATIENTS OF CHILDREN'S AGE
A.A. Zhailganov, A.M. Aringhazina, E.S. Uteuliyev, I.K. Kentayeva
Kazakhstan's Medical University «KSPH», Almaty
One of the top-priority task of any state is the protection of children's health and development child health. In the best interests of the child in the health is being maintained and improved free health care to children. Thus, the issues of infant, child and maternal mortality rates in the Republic remain relevant and are under special control. Especially neurosurgical care to patients of children's age in a large city.
Keywords: healthcare System, neurosurgical assistance, mandatory social health insurance, sick children in the Republic of Kazakhstan.
UTC 617:614.2(364-4)
Relevance of the study. One of the priorities of the state policy and an important element of national security is to protect the health of the population. The problem of the population's health is determined by many factors. Leading among them are
heredity, the environment, lifestyle and place of residence of the person [1, 2].
According to experts of the world health organization to cause more than a quarter of all preventable diseases in the world is the low quality of the environment (figure 1).
SOURCE; Schroeder, SA, (2007). We Can Do Better — Improving the Health of the American People. NCJM. 357:1221-3. Figure 1 - Share of individual risk factors in the population of health formation
Modern socio-economic conditions of life for the majority of the population of Kazakhstan in the early 21st century led to the deterioration of their health. The health-care reform, the formation of new economic relations, a gradual transition to the
system of mandatory social health insurance (MSHI) and private medicine called for the design of stabilization measures for the improvement of medical care [3, 4, 5] (figure 2).
BecmHUK Ka3HMy №4-2017
393
The Constitution of the Republic of Kazakhstan. Article 29
1. Citizens of the Republic of Kazakhstan have the right to health protection.
2. Citizens of the Republic are entitled to reoeive free of charge the guaranteed amount of medical assistance established by law.
3. Obtaining paid medical care in public and private medical institutions, as well as in private medical practice, is carried out on the basis and in the manner prescribed by law.
/
Institutional reforms of the Head of State: 100 concrete steps
80. INTRODUCTION OF MANDATORY SOCIAL HEALTH INSURANCE. Strengthening the financial attainability of the health system based on the principle of SOLIDARY
RESPONSIBILITY of the state, employers and citizens. Priority financing of primary health care (PHC). Primary care will be at the oenter of national health care for the prevention and early fight against diseases.
Since 2017, Kazakhstan will introduoe a mixed system of health care financing:
The state-guaranteed amount of free medical care (GFMP)
System of compulsory social health insurance (OSMS)
Voluntary medical
insurance and paid medical services
\
Figure 2 - Prerequisites for the implementation of the MSHI in the Republic of Kazakhstan
The child health and development child health are priority tasks of the government [6].
In the best interests of the child in the health is being maintained and improved free health care to children. Children under 18 years with certain diseases (States), including children with disabilities, according to testimony, free of charge on an outpatient basis, are provided with drugs and specialized
medical products according to the approved List of medicines and medical devices [6].
By improving social and economic conditions of life of Kazakhstan, in the country there is a trend to improve the basic health and demographic indicators. Thus, a decrease in mortality, increase in natural population growth [6].
Table 1 - Coefficients of natural movement of population (January-August 2014-2015) per 1,000 of population
№
Name areas
Natural increase
9 months 2014.
9 months 2015.
Fertility
9 months 2014.
9 months 2015.
Mortality
9 months 2014.
9 months 2015.
RK
15,41
14,98
23,13
22,69
7,72
7,71
Akmola
7,26
17,76
17,26
10,50
10,58
Aktobe
17,09
16,94
23,81
23,64
6,72
6,70
Almaty
17,98
18,06
24,85
25,39
6,87
7,33
Atyrau
22,35
21,08
28,46
27,13
6,11
6,05
East Kazakhstan
6,60
6,09
17,10
16,70
10,50
10,61
Zhambyl
19,91
18,75
26,87
25,48
6,96
6,73
West Kazakhstan
11,70
10,90
20,55
19,78
8,85
9
10
Karaganda
8,26
7.70
18,16
17,84
9,90
10,14
Kyzylorda
21,13
19,52
27,30
25,47
6,17
5,95
11 12
13
14
Kostanay
3,65
3,59
14,56
14,35
10,91
10,76
Mangistau
27,15
25,73
31,84
30,49
4,69
4,76
Pavlodar
7,29
6,89
17,37
16,94
10,08
10,05
North- Kazakhstan
1,98
2,17
14,28
14,50
12,30
12,33
15
South Kazakhstan
24,56
23,90
30,13
29,48
5,57
5,58
16 17
Astana city
24,32
25,25
28,57
29,78
4,25
4,53
Almaty city
12,22
12,08
19,46
18,73
7,24
6,65
According to the statistics Committee of the RK
7
8
Thus, the issues of infant, child and maternal mortality rates in the Republic remain relevant and are specially monitored [6]. Despite of this, currently the health system in the context of reforms to date cannot solve the basic problems of providing comprehensive, efficient and high-quality neurosurgical care to children. An aggravating factor is insufficient funding, obsolete equipment, high cost of drugs, personnel problems [7, 8]. In large cities the main institution providing primary health care to children remain of city and regional children's hospitals. However, optimizing the provision of neurosurgical care at this level has not been reached [9, 10].
Research on the integrated study of children's health, is currently still small. Moreover, research mostly relate to some of the problems or on certain areas of medico-social assistance. All of the above suggests that a provision of neurosurgical care to children living in a large city, require a more in-depth study and the development of appropriate programs for the preservation and strengthening of their health. Conclusion.
Considering all the above, we propose on the basis of comprehensive medical and social research to justify modern organizational forms of neurosurgical care to the children of a large city. To achieve this goal it is necessary to solve following
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Вестник КазНМУ №4-2017
tasks: to study the dynamics of medico-demographic indicators of Astana for 2016 - 2019; to assess the state of health of child population residing in a large city; to reveal the peculiarities of the organization of preventive and curative care for children's population of a large city; to explore the opinion of medical
professionals on medical and organizational features of the delivery of neurosurgical care to children living in a large city; to suggest ways of improving the work of health facilities providing neurosurgical help to children living in a large city.
REFERENCES
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2 Schepin О.P., Belov V.B. Shchepin, OP The role of health in the formation of public health // Problems of social hygiene, public health and history of medicine. - 2007. - №3. - P. 3-5.
3 Law of RK «On mandatory social health insurance» № 405 -V SAM on November 16, 2015: http://adilet.zan.kz/rus/docs/Z1500000405
4 Acharya A, Vellakkal S, Kalita S, et al. Do Social health insurance schemes in developing country settings improve health outcomes and reduce the impoverishing effect of healthcare payments for the poorest people? . Available at:
http://r4d.dfid.gov.uk/PDF/Outputs/SystematicReviews/FINAL-Q40-Social-Health-Insurance-Protocol-DFID-LSHTM.pdf. Accessed 18/04/16
5 Cutler, D. M. and R. J. Zeckhauser The Anatomy of Health Insurance // Handbook of Health Economics. - Newhouse. North Holland: Elsevier Science, 2000. - №1. - P. 563-643.
6 Report on the situation of children in the Republic of Kazakhstan [Electronic resource]. - Access mode: https://www.bala-kkk.kz/sites/default/files/upload/files/%20%204.12.2015.doc%2B%2B%2B%281%29.pdf.
7 Chicherin L.P. The further development and implementation of the principles of social pediatrics // Rossiyskiy pediatricheskiy zhurnal. -2013. - №6. - P. 28-30.
8 Al'bitskiy V.Yu., Ustinova N.V., Kulikov O.V., Kim A.V. et al. The order of organization of department of health and social care for children's clinic // Voprosy sovremennoy pediatrii. - 2013. - №4. - P. 12-16.
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10 Medvedeva O.V., Dmitriev A.V., Petrova E.I. Organization of health and social care for children in diffi cult situations // Saratovskiy nauchno-meditsinskiy zhurnal. - 2012. - №8(2). - P. 305-307.
А.А. Жайлганов, А.М. Арингазина, Е.С. Утеулиев, И.Т. Кентаева
«К,огамдъщ денсаулъщ сацтау жогарымектеб!» Цазацстандыцмедициналъщуниверситетi, Алматы ц.
БАЛА ЖАСЫНДАFЫ HAY^ACTAPFA НЕЙРОХИРУРГИЯЛЫК; К0МЕКТЩ МЕДИКО-¥ЙЫМДАСТЫРУШЫЛЬЩ
АМАЛДАРЫНЫН, НЕГ1ЗГ1 АСПЕКТ1ЛЕР1
TyW^ Жас балалардыц денсаулыгын коргау жэне балалык кргамдык; денсаульщ сактауды дамыту ap6ip елдщ басымшыл мшдеттершщ 6ipi болып калуда. Денсаулыкты крргау саласында балалардыц муддесш ец ттмд камтамасыз ету максатында балаларга тепн медициналык кызмет керсету жуйей тек сакталып кана коймай, api карай жетшдару устшде. Бул ретте нэрктелер, балалар мен ана елiмi мэселелей елiмiз ушш элi де езект болып кала отырып, эйресе, ipi кала жагдайында бала жасындагы наукастарга нейрохирургиялык кемек керсету ерекше бакылауда усталынады.
TYffiB^ сездер: Денсаулык сактау жуйеа, нейрохирургиялык кемек, мшдетт элеуметтш медициналык сактандыру, бала жасындагы наукастар, Казакстан Республикасы.
А.А. Жайлганов, А.М. Арингазина, Е.С. Утеулиев, И.Т. Кентаева
Казахстанский Медицинский Университет «ВШОЗ», г. Алматы
ОСНОВНЫЕ АСПЕКТЫ МЕДИКО-ОРГАНИЗАЦИОННЫХ ПОДХОДОВ НЕЙРОХИРУРГИЧЕСКОЙ ПОМОЩИ БОЛЬНЫМ ДЕТСКОГО ВОЗРАСТА
Резюме: Одним из приоритетнейших задач любого государства остается охрана здоровья детей и развитие детского здравоохранения. В целях наилучшего обеспечения интересов ребенка в области охраны здоровья сохраняется и совершенствуется система бесплатного медицинского обслуживания детей. При этом, вопросы младенческой, детской и материнской смертности для республики остаются актуальными и находятся на особом контроле. Особенно, нейрохирургической помощи больным детского возраста в условиях крупного города.
Ключевые слова: Система здравоохранения, нейрохирургическая помощь, обязательного социального медицинского страхования, больные детского возраста, Республика Казахстан.
