Aleksandrov M.A. Center for the Study of Health Problems

The article discusses the goals, structure, directions and timing of the implementation of the state program Russian Federation“Health Development”, approved by Decree of the Government of the Russian Federation of December 26, 2017 N 1640.

The State Program of the Russian Federation "Health Development" (hereinafter referred to as the Program) is a strategic document for the development of the industry. It defines the goals and main directions Russian healthcare until 2025. The Ministry of Health of Russia was approved as the responsible executor of the Program.

For the first time, the federal Health Program was developed in accordance with the new “Rules for the Development, Implementation and Evaluation of the Effectiveness of Certain State Programs of the Russian Federation”, approved by Decree of the Government of the Russian Federation of October 12, 2017 N 1242.

Program Goals

The main objectives of the Program are:

1) increase by 2025 life expectancy at birth to 76 years;

2) reduction by 2025 of the mortality rate of the working-age population to 380 per 100,000 population;

3) reduction of mortality from diseases of the circulatory system to 500 per 100,000 population by 2025;

4) reduction by 2025 of mortality from neoplasms (including malignant ones) to 185 per 100,000 population;

5) increase by 2025 the satisfaction of the population with the quality medical care up to 54 percent.

The effectiveness of the Program depends on the achievement of quantifiable indicators of the planned goals. As you can see, the planned indicators of life expectancy and mortality are very optimistic. However, it is not entirely clear what Russians will die from closer to 2025, because it is with an increase in life expectancy that the share of diseases of the circulatory system and neoplasms, the main causes of death, increases in the structure of morbidity. If people continue to live up to the same oncology, then the death rate from cancer will only increase. This trend is observed in all developed countries with an aging population. All indicators of the objectives of the Program are calculated per 100,000 population, and not per gender and age groups. In this regard, there are questions to the calculation of the real effectiveness of the Program.

Increasing satisfaction of the population with the quality of medical care

Quantitative indicators of goal No. 5 “Improving the satisfaction of the population with the quality of medical care” with a detailed breakdown by years also raise questions. We all know about the quality of sociological surveys conducted in healthcare, including through compulsory health insurance. The existing methods of collecting and processing information do not fully meet the modern requirements for conducting sociological research. The biggest problems arise with the collection of primary data. When organizing surveys, the requirements of anonymity are often not observed, the goals and objectives of the survey are not explained, an inconvenient time and place for conducting the survey is chosen, and the procedure for filling out questionnaires is not explained. The representativeness of the sample by sex and age composition, reasons for contacting a medical institution, nosologies, etc. is not determined.

The quality of ongoing sociological research in the health care system can be judged by the results of surveys already conducted. We can recall the case when in 2013 the website of the Ministry of Health of Russia published the results of a study of population satisfaction with medical care in 2011-2012 in the context of the constituent entities of the Russian Federation. The total number of respondents was more than 1.5 million people. Satisfaction was assessed according to such indicators as: waiting time at the registry office, for an appointment with a doctor, when making an appointment for laboratory and instrumental studies, the unavailability of some specialist doctors, satisfaction with the work of doctors, the level of technical equipment medical institutions and duration of hospitalization.

It was also reported that independent surveys conducted by insurance medical organizations in 3537 hospitals and 6459 institutions providing medical care on an outpatient basis showed that during the implementation of regional healthcare modernization programs, the satisfaction of the population with the medical care provided to them increased significantly from 53% in 2011 to 72% by the beginning of 2013.

It is known that public opinion has inertia, therefore, for such a significant change in such a short period of time, serious changes in the healthcare system were needed, which was not the case.

In general, the reliability of primary sociological data depends on many factors: the professional training of organizers and performers of a sociological survey, the quality of methodological support, including the preparation of a research program, determining the representativeness of the sample, developing questionnaires and instructions for filling them out, ensuring the anonymity of the survey, etc. The reliability of the data may also be affected by the fact that the satisfaction of the population medical care is included in the system of indicators for evaluating the activities of regional authorities.

At that time, the Novgorod Region (an increase of 2.22 times, an increase of 121.9%), the Republic of Sakha (Yakutia) (an increase of 2.07 times, an increase of 107.3%) and the Vologda Oblast became the champions in terms of increasing the indicators of satisfaction with medical care. region (an increase of 1.93 times, an increase of 92.7%). The best indicators of population satisfaction with medical care in 2012 were in the Khabarovsk Territory (96%) and Moscow (95%). Not much behind with their 94% Altai Territory, Primorsky Territory and Novosibirsk Region. There is no point in commenting on these figures.

It turns out that we have already achieved and even exceeded all indicators of public satisfaction with the quality of medical care planned in the Program. It should be noted that the methodology for conducting sociological research in health care, approved by the Ministry of Health of Russia and the Federal CHI fund, have not changed much since then. It is interesting that the Special Communications and Information Service of the Federal Security Service (FSO) of Russia, whose data is posted on the website of the Russian Ministry of Health, is also involved in questions of satisfaction with the quality of medical care. However, we do not know anything about the methodology for conducting these studies. By the way, the results of the research conducted by the FSO are more consistent with the indicators of public satisfaction with the quality of medical care planned in the Program - population satisfaction with medical care according to the FSO in March-July 2015 was 40.4% (the sample was 90 thousand respondents).

Financing of the Program

The total amount of financing of the Program will be 34910398190.4 thousand rubles, including:

for 2018 - 3875167871.3 thousand rubles;

for 2019 - 3958918478.1 thousand rubles;

for 2020 - 4142170871 thousand rubles;

for 2021 - 4300148194 thousand rubles;

for 2022 - 4434248194 thousand rubles;

for 2023 - 4577248194 thousand rubles;

for 2024 - 4729248194 thousand rubles;

for 2025 - 4893248194 thousand rubles.

The money will go in 9 main areas (subprograms):

1. Improving the provision of medical care, including disease prevention and the formation healthy lifestyle life.

2. Development and implementation of innovative methods of diagnostics, prevention and treatment, as well as the foundations of personalized medicine.

3. Development of medical rehabilitation and sanatorium treatment, including for children.

4. Development of human resources in health care.

5. Development international relations in the field of health care.

6. Expertise and control and supervisory functions in the field of health protection".

7. Health care certain categories citizens.

8. Information technology and industry development management.

9. Organization of compulsory health insurance citizens of the Russian Federation.

Russian Federation
"Health Development"

Rules
providing and distributing subsidies from federal budget budgets of constituent entities of the Russian Federation for one-time compensation payments medical workers (doctors, paramedics) who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people

With changes and additions from:

1. These Rules establish the goals, conditions and procedure for granting and distributing subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation in order to co-finance the expenditure obligations of the constituent entities of the Russian Federation to make lump-sum compensation payments to medical workers (doctors, paramedics) who arrived (moved) to work in rural areas. settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people (hereinafter referred to as subsidies).

2. Subsidies are provided within the limits budget commitments brought to the Ministry of Health of the Russian Federation as a recipient of federal budget funds for the provision of subsidies for the purposes specified in paragraph 1 of these Rules.

3. The criteria for selecting a subject of the Russian Federation to provide a subsidy are:

a) the availability of a list of vacant positions approved by the authorized executive body of the constituent entity of the Russian Federation in the field of healthcare (hereinafter referred to as the authorized body) medical workers in medical organizations and their structural divisions, upon replacement of which one-time compensation payments are made for the next financial year (program register of positions), developed on the basis of an approximate list of positions of medical workers in medical organizations and their structural divisions providing primary health care, upon replacement which are made lump-sum compensation payments for the next financial year (program register of positions), approved by the Ministry of Health of the Russian Federation;

b) the presence of an application from the highest executive body of state power of the constituent entity of the Russian Federation for participation in the event, containing information on the planned number of participants in the event (doctors, paramedics).

4. The subsidy is provided on the basis of an agreement on the provision of a subsidy concluded between the Ministry of Health of the Russian Federation and the highest executive body of state power of a constituent entity of the Russian Federation, prepared (formed) using the state integrated information system management of public finances "Electronic budget" in accordance with the standard form approved by the Ministry of Finance of the Russian Federation (hereinafter referred to as the agreement).

5. The conditions for granting a subsidy are:

a) the procedure for the provision of lump-sum compensation payments to medical workers (doctors, paramedics) who are citizens of the Russian Federation and who do not have unfulfilled financial obligations under a targeted training agreement approved by a regulatory legal act of a constituent entity of the Russian Federation (with the exception of medical organizations with a staffing level of less than 60 percent), arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements, or cities with a population of up to 50 thousand people and concluded an employment contract with medical organization, subordinated to the executive authority of the constituent entity of the Russian Federation or local government, on a full-time basis with the duration of working hours established in accordance with Article 350 of the Labor Code of the Russian Federation, with the performance of a labor function in a position included in the program register of positions provided for in clause 3 of these Rules, in the amount of:

2 million rubles for doctors and 1 million rubles for paramedics who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements located on the territory of the Far Eastern Federal District, in the regions of the Far North and equivalent areas , the Arctic zone of the Russian Federation;

1.5 million rubles for doctors and 0.75 million rubles for paramedics who arrived (moved) to work in rural areas, or workers' settlements, or urban-type settlements located in remote and hard-to-reach areas. The list of remote and hard-to-reach territories is approved by the highest executive body of state power of the constituent entity of the Russian Federation;

1 million rubles for doctors and 0.5 million rubles for paramedics who arrived (moved) to work in rural settlements, or workers' settlements, or urban-type settlements (with the exception of those indicated in paragraphs two and three of this subparagraph), or cities with a population of up to 50 thousand people;

b) the presence in the budget of the subject of the Russian Federation budget appropriations provided for the financial support of the expenditure obligations of the subject of the Russian Federation, for the purpose of co-financing of which a subsidy is provided, in the amount necessary to fulfill these obligations, including the amount of the subsidy planned to be provided;

c) conclusion of an agreement in accordance with paragraph 10 of the Rules for the formation, provision and distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation, approved by Decree of the Government of the Russian Federation of September 30, 2014 N 999 "On the formation, provision and distribution of subsidies from the federal budget to the budgets of the constituent entities Russian Federation" (hereinafter - the Rules for the formation, provision and distribution of subsidies).

6. A one-time compensation payment is provided by the authorized body to a medical worker from among the medical workers specified in paragraph 1 of these Rules (hereinafter referred to as medical workers), once on one of the grounds specified in subparagraph "a" of paragraph 5 of these Rules. The authorized body has the right to make a decision to provide a medical worker with a lump-sum compensation payment:

a) if he has obligations related to targeted training (targeted training), provided that he concludes employment contract with a medical organization, the staffing of which is less than 60 percent;

b) provided that the medical worker who has fulfilled the obligations related to targeted training (targeted training) continues to work in the same medical organization located in a rural settlement, or a working settlement, or an urban-type settlement, or a city with a population of up to 50 thousand people. Human.

7. A medical worker who has concluded an agreement with a medical organization on the provision of a one-time compensation payment (hereinafter referred to as the agreement), assumes the obligations:

a) perform labor duties for 5 years from the date of conclusion of the contract for positions in accordance with the employment contract, subject to the extension of the contract for the period of non-fulfillment of the labor function in full (except for the rest time provided for by the Labor Code of the Russian Federation);

b) return to the budget of the constituent entity of the Russian Federation a part of the lump-sum compensation payment calculated in proportion to the unworked period from the date of termination of the employment contract until the expiration of the 5-year period (except in cases of termination of the employment contract on the grounds provided for in paragraph 8 of part one of Article 77 and paragraphs 5 - 7 part one of Article 83 of the Labor Code of the Russian Federation), as well as in the case of transfer to another position or admission to training under additional professional programs;

c) return to the budget of the subject of the Russian Federation a part of the lump-sum compensation payment, calculated in proportion to the unworked period from the date of termination of the employment contract, in case of dismissal due to conscription for military service(in accordance with paragraph 1 of part one of Article 83 of the Labor Code of the Russian Federation) or extend the term of the contract for the period of non-performance functional duties(at the choice of a medical worker).

8. The total amount of the subsidy (S total) is determined by the formula:

S total = S 1i + S 2i + S 3i ,

S li - the amount of the subsidy to the budget of the i-th constituent entity of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules, insofar as it concerns medical workers who arrived (moved) to work in rural settlements or workers' settlements , or urban-type settlements (with the exception of medical workers specified in paragraphs 10 and these Rules), or cities with a population of up to 50 thousand people;

S 2i - the amount of the subsidy to the budget of the i-th constituent entity of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules, insofar as it relates to medical workers who arrived (moved) to work in rural settlements or workers' settlements , or urban-type settlements located on the territory of the Far Eastern Federal District, in the regions of the Far North and equivalent areas, the Arctic zone of the Russian Federation;

S 3i - the amount of the subsidy to the budget of the i-th constituent entity of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules, insofar as it relates to medical workers who arrived (moved) to work in rural settlements or workers' settlements , or urban-type settlements located in remote and hard-to-reach areas.

9. The amount of the subsidy to the budget of the i-th constituent entity of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules (S 1i ), insofar as it relates to medical workers who arrived (moved) to work in rural areas, or workers' settlements, or urban-type settlements (with the exception of medical workers specified in paragraphs 10 and these Rules), or cities with a population of up to 50 thousand people, is determined by the formula:

S 1i = (V 1plani 1 + F 1plani 0.5) L i ,

V 1plani - the number of doctors to whom it is planned to provide lump-sum compensation payments, in i-th subject the Russian Federation in the respective financial year;

1 - the amount of a one-time compensation payment provided to a doctor, equal to 1 million rubles;

F 1plani - the number of paramedics who are planned to be provided with lump-sum compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

0.5 - the amount of a one-time compensation payment provided to a paramedic, equal to 0.5 million rubles;

paragraph 13

10. The amount of the subsidy to the budget of the i-th constituent entity of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules (S 2i ), insofar as it relates to medical workers who arrived (moved) to work in rural areas, either workers' settlements or urban-type settlements located on the territory of the Far Eastern Federal District, in the regions of the Far North and equivalent areas, the Arctic zone of the Russian Federation, is determined by the formula:

S 2i = (V 2plani 2 + F 2plani 1) L i ,

V 2plani - the number of doctors who are planned to be provided with lump-sum compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

2 - the amount of a one-time compensation payment provided to a doctor, equal to 2 million rubles;

F 2plani - the number of paramedics who are planned to be provided with lump-sum compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

1 - the amount of a one-time compensation payment provided to a paramedic, equal to 1 million rubles;

L i - the maximum level of co-financing of the expenditure obligation of the i-th subject of the Russian Federation from the federal budget, determined in accordance with paragraph 13 of the Rules for the formation, provision and distribution of subsidies.

11. The amount of the subsidy to the budget of the i-th subject of the Russian Federation participating in the corresponding financial year in the implementation of the activities provided for in paragraph 1 of these Rules (S 3i ), insofar as it relates to medical workers who arrived (moved) to work in rural areas, either workers' settlements or urban-type settlements located in remote and hard-to-reach areas is determined by the formula:

S 3i \u003d (V 3plani 1.5 + F 3plani 0.75) L i,

V 3plani - the number of doctors who are planned to be provided with lump-sum compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

1.5 - the amount of a one-time compensation payment provided to a doctor, equal to 1.5 million rubles;

F 3plani - the number of paramedics who are planned to be provided with lump-sum compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

0.75 - the amount of a one-time compensation payment provided to a paramedic, equal to 0.75 million rubles;

L i - the maximum level of co-financing of the expenditure obligation of the i-th subject of the Russian Federation from the federal budget, determined in accordance with paragraph 13 of the Rules for the formation, provision and distribution of subsidies.

12. The volume of budget allocations for financial support of the expenditure obligations of the constituent entity of the Russian Federation for the implementation of one-time compensation payments to medical workers, for the purpose of co-financing of which a subsidy is provided, is approved by the law of the constituent entity of the Russian Federation on the budget of the constituent entity of the Russian Federation (determined by the consolidated budget breakdown of the budget of the constituent entity of the Russian Federation) based on the need to achieve the results of the use of the subsidy established in the agreement - the share of medical workers who are actually provided with lump-sum compensation payments in the total number of medical workers who are scheduled to receive these payments.

The amount of a subsidy to the budget of a constituent entity of the Russian Federation in a financial year cannot exceed the amount of funds for the fulfillment in the financial year of the expenditure obligations of a constituent entity of the Russian Federation related to the implementation of measures provided for in paragraph 1 of these Rules, taking into account the maximum level of co-financing of the expenditure obligation of a constituent entity of the Russian Federation from the federal budget, determined in accordance with paragraph 13 of the Rules for the formation, provision and distribution of subsidies.

13. The subsidy is transferred in the prescribed manner to the account opened for the territorial body Federal Treasury in an institution Central Bank of the Russian Federation to account for operations with budget funds of a constituent entity of the Russian Federation.

14. To assess the results of using the subsidy, an indicator is used - the share of medical workers who are actually provided with lump-sum compensation payments in the total number of medical workers who are scheduled to receive the specified payments (percentage) (I i ), calculated by the formula:

V facti - the number of doctors who were actually provided with one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

F facti - the number of paramedics who were actually provided with one-time compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

V plani - the number of doctors who are planned to be provided with lump-sum compensation payments in the i-th subject of the Russian Federation in the corresponding financial year;

F plani - the number of paramedics who are planned to be provided with lump-sum compensation payments in the i-th subject of the Russian Federation in the corresponding financial year.

15. The assessment of the effectiveness of the use of the subsidy is carried out by the Ministry of Health of the Russian Federation based on a comparison of the value of the results of the use of the subsidy established in the agreement and the value of the results of the use of the subsidy actually achieved at the end of the reporting year, provided for in paragraph 14 of these Rules.

16. The procedure and conditions for the return of funds from the budgets of the constituent entities of the Russian Federation to the federal budget in the event of a violation of the obligations stipulated by the agreement, as well as the grounds for exempting the constituent entities of the Russian Federation from the application of financial liability measures are established by paragraphs 16 - 18 and the Rules for the formation, provision and distribution of subsidies.

17. Control over the implementation by the constituent entities of the Russian Federation of the measures provided for in paragraph 1 of these Rules is carried out Federal Service for health care supervision.

18. Control over compliance by the constituent entities of the Russian Federation with the conditions for granting subsidies is carried out by the Ministry of Health of the Russian Federation and authorized bodies of state financial control.

35 trillion rubles - this is how much the Russian leadership intends to spend until 2025 on the development of healthcare. All expenses, all responsible persons, as well as indicators and deadlines are indicated in a separate document: “The State Program for the Development of Healthcare”. This is the third edition of the state program and, presumably, not the last. We talk about the program, understand what parts the state program for the development of healthcare in the Russian Federation consists of and what it helped to achieve.

History of the state health program

The Russian government approved the first state health program at the end of 2012. In fact, it was a kind of reform. Just worded more delicately. Indeed, from the word "reform" many in Russia since the 90s began to "distort".

The state program was not declarative in nature. It became a document whose provisions were spelled out in the budget of Russia. In other words, the document answered not only the question: “What needs to be done”, but also provided for the solution of these tasks specific budget funds for the current year and several planned ones. The document was developed by the Ministry of Health.

You can view and download the text of the Resolution below. The download is available to registered users.

Initially, the state program identified three main priorities: prevention disease, healthy lifestyle and early diagnosis.

The program started on January 1, 2013. The first step is the introduction of uniform requirements for organization of quality medical care.

In 2014 the government adopted new edition state health programs, where the tasks and amount of funding were adjusted. In particular, the task of increasing the satisfaction of the population with public medical services, expanding access to them, ensuring the full supply of the industry qualified personnel.

The failure of the state health development program

Nevertheless, very soon it became clear that the state program was leading healthcare "somewhere in the wrong direction."

The Accounts Chamber in a special report reported in 2015: “The “optimization” envisaged by the reform already in 2014 led to a reduction in medical personnel by 90 thousand people, which, with an increase in the number of consumers of services by 152.7 thousand people, worsened the quality of medical care and significant (by 24%) growth in the volume of paid services”.

Rural areas and small towns were particularly affected. The total reduction in hospital beds reached almost 34,000. This led to an increase in mortality to 3.7%.

Sociology also began to record acute dissatisfaction with the healthcare sector in society. If in January 2015 only 5% of residents considered this area to be problematic, then according to the results of the VTsIOM study, at the beginning of 2017, healthcare was in 5th place (15%) in the list of the most serious problems, and a year later this problem took the lead. 30% of the population believed that healthcare is the main problem in Russia.

At the same time, the report of the Ministry of Health reported on serious achievements and even ahead of schedule. Thus, maternal mortality decreased from 47.7 per 100 thousand born in 1990 to 7.3 in 12 months. 2017. At the same time, according to plans, by 2020 this figure should have reached 15.5.

The same goes for infant mortality. In 2017, it was 5.5 cases per 100,000. The target for 2020 was 6.4. By diseases: mortality from diseases of the circulatory system decreased by 4.8% and amounted to 584.7 per 100 thousand of the population. The plan for 2020 was 622.4.

The "failure" of the state program is associated with an attempt to "optimize" processes without taking into account local specifics.

For example, feldsher points were located in villages with a certain number of inhabitants. In small villages, they closed, the rates of employees were reduced. It was assumed that residents from there would travel to neighboring villages. And if in the central part of Russia these distances are not so significant, then for the Urals and Siberia, where villages can be located at a distance of tens of kilometers from each other, this circumstance has become critical.

Or bought a modern equipment, where there was simply no one to work - a shortage of personnel.

State program for the development of healthcare until 2020

In many ways, this is why in December 2017 the development of healthcare reached a new planned horizon. The government canceled the state health program until 2020 and developed a new one: for 2018-2025.

The purpose of the new state program is consonant with the previous one: to ensure the availability of medical care, increase the efficiency medical services. The total amount of funding will be 35 trillion rubles.

IN new program the number of areas of work has been reduced, only 9 subprograms remain. Among the top priorities: improving the provision of medical care, including disease prevention, the introduction and development of new diagnostic methods, the development of medical rehabilitation, and so on.

The values ​​of key indicators have changed. For example, the revised indicator mortality reduction from diseases of the circulatory system. From 622.4 per 100,000 people by 2020 to 500 per 100,000 by 2025. Similarly for oncology: from 190 to 185 cases per 100,000 people.

The future of the state program of the state program for the development of health care

Currently, the “fine-tuning” of the state program continues. Thus, in December 2018, the Ministry of Health came up with a proposal to again change the state program for the development of healthcare and radically change the very approach to the implementation of measures in the field of health protection.

"The state program will consist of a project part, which includes a national project, and a process part - current activities to ensure financing of medical care," the Ministry noted.

This is largely due to the new emphasis in this area, which was made by the President of Russia in February of this year in his annual Address to the Federal Assembly. In particular, the task was set to ensure the availability of medical care in all settlements. To do this, in a year and a half, it will be necessary to build 1,590 medical outpatient clinics and FAPs.

By 2021, it is necessary to transfer all children's clinics to - this is a new standard for the provision of medical services.

Accelerate implementation information technologies, to strengthen work with personnel in connection with the expansion of the Zemsky Doctor program, as well as a separate emphasis is placed on the fight against oncology. A trillion rubles will be directed to this direction.

Attention is paid to oncology due to the slow achievement of targets. For example, the 2017 report states that mortality from cancer decreasing by 2% annually. This is clearly not enough.

It is also worth noting the growing attention to the prevention of diseases among the working population. For example, last year a law was passed that provides employees with a separate day off in order to bypass all doctors. Therefore, the likelihood of adjusting the current state health development program remains high.

in the Russian Federation until 2020 (extracts)

In order to ensure sustainable socio-economic development of the Russian Federation, one of the priorities of state policy should be to preserve and strengthen the health of the population through the formation of a healthy lifestyle and increasing the availability and quality of medical care.

Goals development of health care are the formation of a healthy lifestyle of the population, including a decrease in the prevalence of tobacco use by up to 25% and a decrease in alcohol consumption to 9 liters per capita per year.

tasks development of health care are the creation of conditions, opportunities and motivation of the population of the Russian Federation for a healthy lifestyle.

For formation of a healthy lifestyle it is necessary to introduce a system of state and public measures to:

improvement of medical and hygienic education and upbringing of the population (especially children, adolescents and youth) through the media and the mandatory introduction of appropriate educational programs in preschool, secondary and higher education institutions.

Within the framework of this direction, it is necessary to provide training in hygienic skills in compliance with the rules of occupational health, work (including study) and rest, diet and structure of nutrition, timely seeking medical help and other norms of behavior that support health;

creation of an effective system of measures to combat bad habits (alcohol abuse, smoking, drug addiction, etc.).

The system should include educating and informing the public about the consequences of tobacco and alcohol use, promoting the reduction of tobacco and alcohol use, regulating and disclosing the contents of tobacco and alcohol products, and providing full information on the contents on the package, protecting non-smokers from exposure to tobacco smoke, limiting use alcohol in public places, regulating the placement of places for the sale of alcoholic beverages, tobacco and the procedure for their sale, as well as price and tax measures;

creating a system to motivate citizens to lead a healthy lifestyle and participate in preventive measures.

This should be ensured by popularizing the way of life and lifestyle that contributes to the preservation and strengthening of the health of citizens of the Russian Federation, the formation of a fashion for health, especially among the younger generation, the introduction of a system of medical care for healthy and practically healthy citizens; conducting explanatory work on the importance and necessity of regular prevention and medical examination of citizens;

creating a system to motivate employers to participate in protecting the health of workers by establishing benefits on insurance premiums for compulsory medical and social insurance, encouraging working teams to lead a healthy lifestyle;

prevention of risk factors for non-communicable diseases (blood pressure, malnutrition, physical inactivity, etc.);

creation of a system to motivate the heads of institutions of the school education system to participate in the protection of health and the formation of a healthy lifestyle for schoolchildren.

To form a healthy lifestyle

the following tasks will be solved:

conducting applied scientific and epidemiological research to justify the improvement of legislation and methodological base;

ensuring interdepartmental cooperation and the functioning of the coordination mechanism (including the organization of the activities of the federal resource center);

development of modern approaches and provision of conditions for training specialists, improvement of curricula, development of the infrastructure of federal scientific and educational institutions;

organization and development of medical and preventive care through the introduction of modern medical and preventive technologies;

organizational and methodological support for the activities of regional preventive organizations (centers of medical prevention), as well as primary health care institutions;

development and implementation of federal information and communication campaigns;

organization of a vertical of interaction between medical prevention centers and prevention cabinets in primary care;

organization of health schools according to the main risk factors;

development of conditions for maintaining a healthy lifestyle, including ensuring monitoring and a modern level of control (supervision) over the compliance of products intended for humans, as well as human environmental factors, with the requirements of current legislation.

The development goals of this direction are:

Formation of the ideology of a healthy lifestyle among the population, strengthening the physical and spiritual health of the population.

Development of health-saving technologies, primary medical prevention and social medicine.

Reducing the likelihood and risks of primary morbidity and morbidity in the population.

Direction tasks:

Organization and development of Health Centers based on health care institutions.

Improving activities in the practical field of primary medical prevention and monitoring of population health indicators.

Development and practical implementation of the main directions of development and improvement of the regional preventive medicine service.

4. Implementation of medical and social programs aimed at preventing the spread of socially related diseases.

5. Improvement and implementation of the methodology of health protection and the formation of a healthy lifestyle for all population groups.

6. Improving the health status of the population and socio-psychological rehabilitation of the population.

7. Creation of a network of social interaction and partnership, interdepartmental interaction.

8. Support effective initiatives in municipal health care, education, business and the public sector.

In order to ensure the objectives of the formation of a healthy lifestyle, the implementation of the following activities is envisaged:

– creation of mechanisms for interdepartmental interaction of the program executor;

- ensuring comprehensive sectoral measures aimed at increasing the level of knowledge of the population about a healthy lifestyle, organizing educational activities to promote a healthy lifestyle;

– creation and implementation of interdepartmental projects aimed at promoting a healthy lifestyle and improving the health of the population, developing a system of medical prevention;

- increasing the role of primary health care in the formation of a healthy lifestyle of the population through measures to increase the involvement of the population in physical education, sports and tourism;

– improvement of the regulatory legal, material and technical, organizational and managerial base;

– providing support in the organization of rational nutrition for children in educational institutions,

- monitoring the implementation of the program, conducting sociological research among the population, using systems for monitoring activities;

- organization of a prevention system through the development of Health Centers, medical prevention rooms, rooms for a healthy child;

- ensuring the availability of public knowledge about the state of health, measures to strengthen it, and prevent diseases;

- training the population to control their own health and the implementation of personal programs to strengthen it;

– development of a model and indicators of individual and public health, design of a system for monitoring the main indicators of health.

It is planned to evaluate the effectiveness of the above measures according to the following target indicators:

indicator of primary incidence of alcoholism;

overall mortality rate of the population;

mortality rate from cardiovascular diseases in working age;

indicator of the primary exit to disability among people of working age.

(as amended by Decrees of the Government of the Russian Federation of March 31, 2017 N 394,

dated 05/07/2017 N 539, dated 08/12/2017 N 964)

• Passport of the state program of the Russian Federation "Health Development"
• Passport of subprogram 1 "Disease prevention and promotion of a healthy lifestyle. Development of primary health care" of the state program of the Russian Federation "Health Development"
• Passport of subprogram 2 "Improving the provision of specialized, including high-tech, medical care" of the state program of the Russian Federation "Health Development"
• Passport of subprogram 4 "Protection of maternal and child health" of the state program of the Russian Federation "Health Development"
• Passport of subprogram 5 "Development of medical rehabilitation and sanatorium treatment, including for children" of the state program of the Russian Federation "Health Development"
• Passport of subprogram 6 "Palliative care, including for children" of the state program of the Russian Federation "Health Development"
• Passport of subprogram 7 "Personnel support of the healthcare system" of the state program of the Russian Federation "Health development"
• Passport of subprogram 8 "Development of international relations in the field of health care" of the state program of the Russian Federation "Health development"
• Passport of subprogram 9 "Expertise and control and supervisory functions in the field of health care" of the state program of the Russian Federation "Health Development"
• Passport of subprogram B "Medical and sanitary provision of certain categories of citizens" of the state program of the Russian Federation "Health Development"
• Passport of subprogram G "Management of the development of the industry" of the state program of the Russian Federation "Health development"
• Passport of subprogram D "Organization of compulsory medical insurance for citizens of the Russian Federation" of the state program of the Russian Federation "Health Development"
• Passport of the subprogram I "Development of emergency medical care" of the state program of the Russian Federation "Health development"
• I. Priorities and goals of state policy, including general requirements for state policy of the constituent entities of the Russian Federation
• III. General characteristics of the participation of the constituent entities of the Russian Federation in the implementation of the Program
• Appendix N 1. Information on indicators (indicators) of the state program of the Russian Federation "Health Development", subprograms of the state program of the Russian Federation "Health Development" and their values
• Appendix N 2. List of the main activities of the state program of the Russian Federation "Health Development"
• Annex N 3. Information on the main measures of legal regulation in the field of implementation of the state program of the Russian Federation "Health Development"
• Appendix N 4. Resource support for the implementation of the state program of the Russian Federation "Health Development" at the expense of the federal budget and the budgets of state non-budgetary funds of the Russian Federation
• Appendix N 5. Plan for the implementation of the state program of the Russian Federation "Health Development" for 2017 and for the planning period of 2018 and 2019
• Appendix N 6. Rules for the provision and distribution of subsidies from the federal budget to the budgets of the constituent entities of the Russian Federation and the city of Baikonur for the implementation of certain measures of the state program of the Russian Federation "Health Development"
• Annex N 7. Rules for the provision of subsidies from the federal budget within the framework of the state program of the Russian Federation "Health Development" to the budgets of the constituent entities of the Russian Federation for co-financing of capital investments in facilities state property constituent entities of the Russian Federation, which are made from the budgets of the constituent entities of the Russian Federation, or for the purpose of providing appropriate subsidies from the budgets of the constituent entities of the Russian Federation to local budgets for co-financing of capital investments in objects of municipal property, which are carried out from local budgets
• Appendix N 8
• Appendix N 9
• Annex N 10. Information on the need for capital construction of healthcare facilities in the Far East for 2017 - 2020
• Annex N 11. Information on the target indicators (indicators) of the state program of the Russian Federation "Health Development" in the Far East
• Annex N 12. Information on the resource support for the implementation of measures of the state program of the Russian Federation "Health Development" in the Far East at the expense of the federal budget
• Appendix N 13 Far East

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