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Bularkiev E.A., Sagymbaye M.A., Kyrgyz Scientific Research Institute of Balneology and Recovery Treatment E-mail: ebularkieva@mail.ru
NEW PATHS OF DEVELOPMENT OF MEDICAL REHABILITATION AND SANATORIUM-RESORT SERVICES IN THE KYRGYZ REPUBLIC
Abstract: Primary objective of the study is to develop a complex, integrated and stable system of restorative medicine, aimed at health maintenance and promotion, as well as at decrease in population disability level of the Kyrgyz Republic. Achieving this objective presupposes solving the following tasks: improvement of legislation, development and implementation of regulatory and legal framework for sanatorium-resort assistance; provision of good quality and availability of medical and rehabilitation services for all social strata; creation of a chain of medical and rehabilitation institutions; development of professional training and retraining systems, regular rehabilitation service personnel development; arranging scientific research, development and implementation of effective forms and methods of sustainable utilization of natural curative resources.
Keywords: restorative medicine, curative resources, sanatorium-resort assistance, medical and rehabilitation institution, quality of life, health center.
1. Introduction
1.1. A relevant objective of a modern stage of sanatorium-resort complex development of the country is enhancement of efficiency and quality of its activity (Resort Bulletin. 2004; No. 6. P. 2-16). To achieve this objective, it is required to provide a justification for a systemic methodological approach for estimation of the results of sanatorium-resort therapy (SRT), using objective informative criteria, cohesively reflecting various aspects of the process of SRT (Savchenko, V.M. 2000, P. 12-15., Sokolov, A.V. 2004, P. 7-11). An approved Strategy of Development of a Sanatorium-Resort Sector should represent a fundamental document for the upcoming medium-term period for the period until 2020 and for a subsequent period. Work to improve regulatory and legal framework will be continued. It seems to be relevant to create a classification system for sanatorium-resort institutions, which should provide for
an accurate description of requirements and norms, in accordance with which one or another category is assigned or verified, depending on the level, scope and quality of rendered medical services. In its turn, medical and rehabilitation departments of family practice centers (FPC), territorial and district hospitals ofpublic health organizations of the Republic, as well as separate medical and rehabilitation institutions represent a medical and rehabilitation service in Kyrgyzstan, namely:
1. Kyrgyz Scientific Research Institute of Balneology and Recovery Treatment has 561 beds (310 state-funded beds and 251 pay beds) with an affiliated branch in Bishkek.
2. South Regional Center of Medical Rehabilitation Kochkor-Ata - 105 beds.
3. Chuy District Specialized Center of Medical Rehabilitation for Children and Adolescents with disabilities, Maksat - 70 beds.
4. Jalal-Abad Regional Children's Center for Medical Rehabilitation, Bakyt - 120 beds.
5. Osh Municipal Children's Center for Rehabilitation Treatment - 100 beds.
6. Bazar-Korgon Interdistrict Children's Center for Medical Rehabilitation - 50 beds.
7. Children's Psychoneurological Sanatorium "Rodnichek" - 50 beds.
8. Ak-Suu Specialized Children's Department of Rehabilitation Treatment - 40 beds as part of Issyk-Kul District Combined Hospital.
9. Kochkor Speleocenter of Medical Rehabilitation - 20 beds.
A total of 164 institutions function throughout the Republic, out of which SRT - 28, rest houses - 9, recreation and retreat centers - 62, children's health complexes - 34, out of which 28 function all year round.
Table 1. Number of sanatorium-resort and health and recreation institutions throughout the Republic
Institutions Number of enterprises Private State 2015 2016
Number of people visiting Number of people visiting
Sanatorium 15 10 5 56385 56237
Children's Sanatorium 6 0 6 4726 5906
Sanatorium-Preventorium 10 10 0 13467 7912
Sports and Fitness camp 5 3 2 4806 10061
Children's Health Complex 29 14 15 23599 15979
TOTAL: 65 37 28 10298 96095
In the service of medical rehabilitation, the total of 166 physicians are employed, 59 of them are physiotherapists. There are 1166 beds in medical and rehabilitation institutions throughout the Republic.
2. Methods
Methods of estimation and control of correspondence of health resort institutions to classification requirements were applied.
2.1. SRT with a certain category is supervised to confirm its compliance with the requirements, set for this category. An authorized body from the field of healthcare performs estimation of SRT correspondence to categories.
2.2. In order to estimate SRT compliance with the requirements set for SRT of various categories, the following basic control methods are used: visual, analytical, measuring, expert evaluation of the quality and safety of health resort services, sociological (in the form of a questionnaire to be filled by visitors of SRT).
3. Results
3.1. As a result of estimation of condition of 102 health resort institutions and recreational institutions (RI), the following was established:
1. Among SRT and RI of the Kyrgyz Republic, private institutions (72%) and institutions with the status of local institutions (64%) prevail.
2. Only 10% of SRT and RI are licensed to carry out realize medical activities, and 52% are certified.
3. SRT and RI of our Republic practically have categories and profilizations (84%), and function primarily in summer (86%).
4. A part of medical staff working at the estimated SRT and RI constituted 12%, 40% of which possess categories.
5. The majority of chief executives of SRT and RI (75%) do not pay attention to the issues of cli-matotherapy.
6. Local mineral water and local therapeutic mud are rarely used in the analyzed SRT and RI (5%).
7. Instrumental physiotherapy, mud treatment and thermotherapy are used in 82% of health resort institutions.
8. Balneotherapy in the form of various baths, ablution, underwater traction and massage are used in approximately half of the analyzed SRT and RI (48%).
9. Methods of laboratory and functional diagnostics are applied in 25% SRT.
10. Almost all SRT have sports and fitness facilities, as well as infrastructure facilities.
11. At the majority of SRT and RI (75%), parents with children (56%) and children without parents (19%) undergo treatment and recreate.
12. Generally, three meals are provided daily (89%), rarely - dietetic nutrition (10%).
13. Duration of stay in SRT and RI is primarily 5-10 days.
14. Rooms in SRT are primarily for 2 (33%), 3 (36%), 4 people and more (31%).
15. Cost of one day of stay in a private SRT is twice as large as in a state one.
4. Discussion
Therefore, analysis and estimation of the present-day condition of health resort institutions and recreational institutions has revealed the necessity of taking a range of immediate measures, including both legislation and regulations, and measures for preparation of skilled staff, use of natural curative resources, attracting investments and innovation. Diagnostic and physiotherapy equipment was relatively
new, if compared to the 90s. Young skilled workers are expected to enter the industry, since currently professional employees at SRT are generally at their preretirement age.
5. Conclusion
The designed concept of development of restorative medicine service and sanatorium-resort sector in the Kyrgyz Republic in the next few years will allow to:
• improve medical and economical effectiveness of Centers and departments of medical rehabilitation, health resort institutions, health centers;
• create foundations for the system of health maintenance and promotion, developing a chain of rehabilitation offices;
• create a system of formation, active maintenance, rehabilitation and promotion of health;
• create prerequisites for reduction of premature mortality levels, disease incidence, levels of disability, increase of life expectancy;
• satisfy consumer demand for accessible and high-quality medical and rehabilitation assistance and health resort services.
Generalizing the obtained results, it can be stated that we need to continue conducting more in-depth studies both in the field of balneotherapy (studying natural curative resources in particular) and in the field of restorative medicine with the focus on implementation of new health-maintaining medical and rehabilitation technologies.
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