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Level 3 hospital what. On approval of the levels of medical organizations in the provision of medical care to the population

29.03.2020 -
Fungus

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1

First level:

The first level organizations are intended for women with uncomplicated pregnancies and urgent physiological deliveries. In case of admission of non-core pregnant women and women in childbirth, ensure transfer to an organization of the appropriate level; in case of emergency, it is necessary to stabilize the condition, assess the degree of risk and call transport "to myself" from a maternity hospital of a higher level for the transfer of pregnant women and newborns.

If it is impossible to transfer non-core pregnant women, women in labor, the task of the first-level institution is to prevent, predict, diagnose threatening conditions in the fetus and newborn, timely resolve the issue of the method of delivery, provide a complex of primary resuscitation care to the child at birth or in the event of emergency conditions, conduct intensive and supportive therapy before the possibility of transfer to more high level, as well as nursing premature babies with stable respiratory and circulatory functions, if their weight exceeds 2000 grams.

First-level organizations, in addition to basic equipment, should have equipment for resuscitation of women and newborns, wards intensive care with equipment.

Second level:

Organizations of the second level are intended for women with uncomplicated pregnancy and childbirth, with preterm birth with a gestational age of 34 weeks or more, as well as pregnant women, women in labor and puerperas, according to the risks defined in Art.

In case of admission of non-core pregnant women and women in childbirth, ensure transfer to an organization of the appropriate level, and in case of emergency, it is necessary to stabilize the condition, assess the degree of risk and call for transport "on oneself" from a higher-level maternity hospital for the transfer of pregnant women, women in labor, puerperas and newborns.

If it is impossible to transfer a non-core woman in labor and the birth of a sick newborn or an infant weighing less than 1500 grams, the task of the second-level institution, in addition to the measures listed above, is to provide adequate medical care and intensive care in accordance with the protocols, with the exception of diseases requiring emergency surgical intervention ;

Second-level obstetric organizations, in addition to basic equipment, should have a resuscitation and intensive care unit for newborns with a full set for resuscitation, ventilation systems, CPAP, incubators, as well as clinical, biochemical and bacteriological laboratory. In the staffing table, provide for a round-the-clock post of neonatologists.

Third level

Organizations of the third level (Perinatal Centers, Regional Hospitals, etc.) are intended for hospitalization of pregnant women, women in childbirth and puerperas with the risk of perinatal pathology, premature birth with a gestational age of 22-33 weeks + 6 days.

In the organization of this level, women with uncomplicated pregnancy and childbirth can also be hospitalized.

The task of the institutions of the third level is to provide all types of medical care to pregnant women, women in childbirth, puerperas and sick newborns who need specialized obstetric and neonatal care, including premature newborns weighing 1500 g or less, transferred from an organization of a lower level.

Women who are shown highly specialized assistance should be sent to the republican centers of the NSCMID (Astana), NCAGiP (Almaty). Newborns in need of urgent surgical care should be referred to the republican centers of the NSCMD (Astana), the National Center for Children and Health (Almaty) or to the neonatal surgery departments of regional hospitals.

Obstetric organizations of the third level should be provided with highly qualified medical workers who own modern perinatal technologies and are equipped with modern medical and diagnostic equipment and medicines.

Organizations of the third level should have a round-the-clock neonatal post, a clinical, biochemical, bacteriological laboratory, a resuscitation and intensive care unit, as well as neonatal pathology and premature nursing departments.

    Illustrative material: presentations, slides

    Literature:

    Classification of the main nosological forms in pediatrics: a textbook. Recommended by UMO as study guide/ ed. prof. L.V. Kozlova. Smolensk, SGMA, 2007. - 177 p: ill.

    A practical guide to childhood illnesses. Under the general editorship of prof. V.F. Kokolina and prof. A.G. Rumyantseva. volume 3. Cardiology and rheumatology childhood. Edited by G.A. Samsygina and M.Yu. Shcherbakova. Medpraktika - M. Moscow - 2004.

    Guide to outpatient pediatrics / Ed. A.A. Baranova. - M.: GEOTAR-Media, 2006. - 608 p.

    Test questions:

    What periods are distinguished in the development of the child.

    What are the features of the course of diseases in childhood.

    What is the age of adolescence.

    What is the structure of morbidity in adolescence.

    Rendering features medical care pregnant.

Ilevel – healthcare institutions – legal entities providingspecialized medical care, including high-tech specialized assistance:

  1. City Clinical Hospital No.: 1 named after N.I. Pirogov, 4, 7, 12, 13, 15 named after O.M. Filatova, 19, 20, 23 named after Medsantrud, 24, 29 named after N.E. Bauman, 31, 36, 40, 50, 52, 57, 59, 64, 67, 68, 70, 81, S.P. Botkin, GKUB No. 47, MGOB No. 62, OKB.
  2. GVV Nos.: 1, 2, 3, Maxillofacial Hospital for War Veterans.
  3. Moscow City Scientific and Practical Center for Combating Tuberculosis.
  4. Moscow SPC of Otorhinolaryngology.
  5. Research Institute of Emergency Medicine named after N.V. Sklifosovsky.
  6. Scientific and Practical Center for Interventional Cardioangiology.
  7. Center for Speech Pathology and Neurorehabilitation.
  8. Center for family planning and reproduction.
  9. Central Research Institute gastroenterology.
  10. Scientific and Practical Center for Medical Assistance to Children with Malformations of the Craniofacial Region and congenital diseases nervous system.
  11. Research Institute of Emergency Pediatric Surgery and Traumatology.
  12. Children's City Clinical Hospital No. 9 named after G.N. Speransky.
  13. Morozov Children's City Clinical Hospital.
  14. Tushino Children's City Hospital.
  15. Children's City Clinical Hospital of St. Vladimir.
  16. Izmailovo Children's City Clinical Hospital.
  17. Children's Psychoneurological Hospital No. 18.
  18. Children's City Clinical Hospital No. 13 named after N.F. Filatov.
  19. Children's Infectious Diseases Hospital No. 6 of the UZ SAO of Moscow.

II level - health care institutions - legal entities providing specialized medical care (without high-tech medical care):

  1. City Clinical Hospital No.: 6, 11, 14 im. V.G. Korolenko, 45, 51, 53, 55, 60, 61, 63, 71, 79;
    GB No.: 3, 9, 17, 43, 49, 54, 56, 72;
  2. IKB No.: 1, 2, 3.
  3. TKB №№: 3 im. prof. G.A. Zakharyina, 7; TV No.: 6, 11.
  4. Design Bureau No.: 1 im. ON THE. Alekseeva, 4 im. P.B. Gannushkina, 12, 15;
    PB №№: 2 im. O.V. Kerbikova, 3 im. V.A. Gilyarovsky, 5, 7, 9, 10, 13, 14, 16;
    SKB No. 8 im. Z.P. Solovyova (Clinic of neuroses).
  5. NKB number 17.
  6. Moscow Scientific and Practical Center for Narcology.
  7. Center for Medical and social rehabilitation with a department of permanent residence for adolescents and adults with severe disabilities forms of cerebral palsy who do not move independently and do not serve themselves.
  8. Moscow Scientific and Practical Center for Sports Medicine.
  9. Centre restorative medicine and rehabilitation.
  10. Diagnostic center(Women's Health Clinic).
  11. Baby psychiatric hospitals №№: 6, 11.
  12. Children's City Rehabilitation Hospital No. 3.
  13. Children's City Hospital No. 19 named after. T.S. Zatsepin.
  14. Children's cardio-rheumatological sanatorium No. 20 "Krasnaya Pakhra".
  15. Children's pulmonological sanatorium No. 39.
  16. Children's tuberculosis sanatorium No. 64.
  17. Children's bronchopulmonary sanatorium No. 23.
  18. Children's sanatoriums №№: 44, 68.
  19. Maternity Nos.: 1, 2, 3, 4, 5, 6 named after A.A. Abrikosova, 8, 10, 11, 14, 15, 16, 17, 18, 20, 25, 26, 27, 32.

III level - health care institutions - legal entities providing specialized and primary health care (institutions on the basis of which there are mono-profile and multi-profile specialized inter-municipal centers):

  1. Station of ambulance and emergency medical care named after A.S. Puchkov.
  2. NPC emergency medical care.
  3. City Hospital № 8.
  4. Gynecological hospitals №№: 1, 5, 11.
  5. City Polyclinic № 25.
  6. City consultative and diagnostic center for specific immunoprophylaxis.
  7. Moscow City Center for the Rehabilitation of Patients with spinal cord injury and consequences of cerebral palsy.
  8. Manual Therapy Center.
  9. Family planning and reproduction centers No.: 2.
  10. Diagnostic clinical center No. 1; Diagnostic centers №№: 2, 3, 4, 5, 6.
  11. MSCH №№: 2, 6, 8, 13, 14, 15, 17, 18, 23, 26, 32, 33, 34, 42, 45, 48, 51, 56, 60, 63, 66, 67, 68.
  12. Rehabilitation clinics №№: 1, 2, 3, 4, 6, 7.
  13. PND No.: 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24.
  14. Narcological Clinical Dispensary No. 5;
  15. Tuberculosis clinical dispensaries №№: 4, 12, 21;
    PTD No.: 2, 5, 6, 7, 8, 10, 13, 14, 15, 16, 17, 18, 20.
  16. Oncological Clinical Dispensary No. 1,
    OD No.: 4.
  17. Endocrinological dispensary.
  18. Cardiology dispensary No. 2.
  19. Medical and physical education dispensaries №№: 4, 5, 6, 11, 13, 16, 17, 19, 27.
  20. First Moscow Hospice.
  21. Hospices ##: 2, 3, 4, 5, 6, 7, 8.
  22. Children's infectious diseases hospitals No. 4, 5, 8, 12, 21.
  23. Orphanages specialized for children with organic lesions of the central nervous system and mental disorders №№: 6, 9, 12.
  24. Specialized children's homes №№: 20, 21, 23.
  25. Tuberculosis sanatoriums No. 5, 58.
  26. Children's nephrological sanatorium No. 6.
  27. Children's bronchopulmonary sanatoriums No. 8, 15, 29.
  28. Children's tuberculosis sanatorium No. 17.
  29. Children's cardio-rheumatological sanatoriums: No. 20 "Krasnaya Pakhra", 42.
  30. Children's psycho-neurological sanatorium No. 30, 65, 66.

IVlevel - health care institutions - legal entities providing primary health care:

  1. HP No.: 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 64, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 179, 180, 181, 182, 183, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 211, 212, 213, 214, 215, 217, 218, 219, 220, 221, 222
  2. DGP No.: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42 (teenage center), 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150.
  3. SP No.: 2, 3, 4, 5, 7, 8, 9, 11, 12, 13, 14, 15, 19, 20, 22, 23, 24, 27, 31, 32, 33, 34, 35, 48, 49, 50, 51, 53, 55, 56, 57, 60, 61, 62, 64, 65, 66, 67.
  4. Chipboard No.: 1, 6, 10, 16, 21, 25, 26, 28, 29, 30, 36, 37, 38, 39, 41, 43, 44, 45, 46, 47, 52, 54, 58, 59, 63.
  5. LCD No.: 9.
  6. Children's sanatoriums №№: 9, 12, 13, 18, 19, 24, 25, 27, 33, 34, 45, 47, 48, 51, 56, 62, 67, 70.
  7. Orphanages ##: 2, 3, 4, 5, 13, 14, 15, 17, 19, 24, 25.
  8. Rehabilitation centers for children №№: 1, 3, 4, 5, 6, 7, 9.
  9. Rehabilitation center for children with bronchopulmonary pathology.
  10. Center for the organization of rehabilitation treatment of specialized psychoneurological care for children No. 2.

1. Review the project exemplary program modernization of health care in a constituent entity of the Russian Federation for 2011-2012 (see www.minzdravsoc.ru).

2. Prepare and submit information on Appendix 1 (not shown) (Tables 1.2, 2.2, 2.3, 2.4, 2.5, 2.6, 3.4, 3.5, 3.8.1, 3.8.2, 3.8.3, 3.10, 4):

- for filling in electronic form in the UAIS (Moszdrav) system, module "Health Modernization Program". Deadline: until 12.00 19.08.2010;

- on paper with the signature of the head and the seal of the institution to the Department of Health (4th floor, conference room) 18.08.2010 from 15.00 to 17.00; 08/19/2010 from 10 am to 12 pm.

When preparing information, be guided by the approximate Classification of healthcare institutions by levels of medical care (attachment to the order).

3. Questions on the draft exemplary Health Modernization Program should be sent by e-mail: [email protected]

First Deputy Head of the Moscow City Health Department, Chairman working group S.V. Polyakov

Appendix to the order of the Department of Health of the city of Moscow dated August 13, 2010 N 2-18-81

CLASSIFICATION OF HEALTH CARE INSTITUTIONS BY LEVELS OF MEDICAL CARE

Level 1 - healthcare institutions, legal entities providing specialized medical care, including high-tech specialized care:

1. GKB N 1 named after N.I. Pirogov, 4, 7, 12, 13, 15 named after O.M. Filatova, 19, 20, 23 named after Medsantrud, 24, 29 named after N.E. Bauman, 31, 33 named after prof. A.A. Ostroumova, 36, 40, 47, 50, 52, 57, 59, 62, 64, 67, 68, 70, 81, S.P. Botkin, GKUB N 47, GOKB N 62, OKB.

2. GVV N 1, 2, 3, Maxillofacial hospital for war veterans.

3. Moscow City Scientific and Practical Center for Combating Tuberculosis.

4. Moscow SPC of otorhinolaryngology.

5. Research Institute of Emergency Medicine named after N.V. Sklifosovsky.

6. Scientific and Practical Center for Interventional Cardioangiology.

7. Center for Speech Pathology and Neurorehabilitation.

8. Center for family planning and reproduction.

9. Central Research Institute of Gastroenterology.

10. Scientific and Practical Center for Medical Assistance to Children with Malformations of the Craniofacial Region and Congenital Diseases of the Nervous System.

11. Research Institute of Emergency Children's Surgery and Traumatology.

12. Children's City Clinical Hospital N 9 named after G.N. Speransky.

13. Morozov Children's City Clinical Hospital.

14. Tushino children's city hospital.

15. Children's City Clinical Hospital of St. Vladimir.

17. Children's psycho-neurological hospital N 18.

18. Children's City Clinical Hospital N 13 named after N.F. Filatov.

Level 2 - health care institutions - legal entities providing specialized medical care (without high-tech medical care):

1. GKB N 6, 11, 14 im. V.G. Korolenko, 51, 53, 55, 60, 61, 63, 71, 79;

GB N 3, 9, 10, 17, 43, 49, 54, 56, 72;

SKB of rehabilitation treatment.

2. IKB N 1, 2, 3.

3. TKB N 3 im. prof. G.A. Zakharyina, 7;

4. Design Bureau N 1 im. ON THE. Alekseeva, 4 im. P.B. Gannushkina, 12, 15;

PB N 2 im. O.V. Kerbikova, 3 im. V.A. Gilyarovsky, 7, 9, 10, 14, 16;

SKB N 8 im. Z.P. Solovyova (Clinic of neuroses).

6. Moscow Scientific and Practical Center for Narcology.

7. Center for medical and social rehabilitation with a permanent residence department for adolescents and adults with severe cerebral palsy who do not move independently and do not serve themselves.

8. Moscow Scientific and Practical Center for Sports Medicine.

9. Center for Restorative Medicine and Rehabilitation.

10. Diagnostic Center (Women's Health Clinic).

11. Children's psychiatric hospitals N 6, 11.

12. Children's City Rehabilitation Hospital N 3.

13. Children's city hospital N 19 named. T.S. Zatsepin.

14. Children's sanatoriums N 20, 23, 39, 44, 64, 68.

15. Maternity hospitals N 1, 2, 3, 4, 5, 6 them. A.A. Apricot, 8, 10, 11, 14, 16, 17, 18, 20, 25, 26, 27, 32.

Level 3 - health care institutions - legal entities providing specialized and primary health care (institutions on the basis of which there are single-profile and multi-profile specialized inter-municipal centers):

1. Station of ambulance and emergency medical care. A.S. Puchkov.

2. SPC for emergency medical care.

3. City hospital N 8.

4. Gynecological hospitals N 1, 5.

5. City consultative and diagnostic center for specific immunoprophylaxis.

6. Moscow City Center for the Rehabilitation of Patients with Spinal Cord Injury and Consequences of Cerebral Palsy.

7. Manual therapy center.

8. Centers for family planning and reproduction N 2, 3.

9. Diagnostic Clinical Center N 1;

diagnostic centers N 2, 3, 4, 5, 6.

10. MSCH N 2, 6, 8, 13, 14, 15, 17, 18, 23, 26, 32, 33, 34, 42, 45, 48, 51, 56, 58, 60, 63, 66, 67, 68.

11. Polyclinics of rehabilitation treatment N 1, 2, 3, 4, 6, 7.

12. KVKD No. 7, 8, 10, 23, 29;

HPC N 1, 3, 5, 6, 9, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 26, 27, 28, 30, 31.

13. PND N 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24.

14. Narcological clinical dispensary N 5;

narcological clinics N 1, 2, 3, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14.

15. Tuberculosis clinical dispensaries N 4, 12, 21;

PTD N 2, 5, 6, 7, 8, 10, 13, 14, 15, 16, 17, 18, 20.

16. Oncological clinical dispensary N 1;

17. Endocrinological dispensary.

18. Cardiology dispensary N 2.

19. Medical and physical education clinics N 4, 5, 6, 11, 13, 16, 17, 19, 27.

20. First Moscow Hospice.

21. Hospices No. 2, 3, 4, 5, 6, 7, 8.

22. Children's infectious diseases hospitals N 4, 5, 6, 8, 12, 21.

23. Orphanages specialized for children with organic damage to the central nervous system and mental disorders N 6, 9, 12.

24. Specialized children's homes N 20, 21, 23.

25. Tuberculosis sanatoriums N 5, 58.

26. Children's nephrological sanatorium N 6.

27. Children's bronchopulmonary sanatoriums N 8, 15, 23, 29.

28. Children's tuberculosis sanatoriums N 17, 64.

29. Children's cardio-rheumatological sanatorium N 20 "Krasnaya Pakhra", 42.

30. Children's psycho-neurological sanatoriums N 30, 44, 65, 66.

31. Children's pulmonological sanatorium N 39.

Similar changes are taking place in other districts, but we will tell about them in the next editions of the newspaper.

Long queues for appointments with doctors, difficulties in obtaining a coupon for narrow specialists, poor quality of medical care - all this, which has long become a byword, is a thing of the past. The measures taken by the Moscow City Health Department as part of the Moscow Healthcare Modernization Program make it possible to radically change the situation for the better.

Developed three-tier system provision of medical care, as a result of which each medical institution will be assigned to one of three levels.

First level: polyclinics, including children's, designed to provide primary pre-medical, medical assistance and some types of primary specialized health care.

Second level: outpatient centers, including children's, which provide primary pre-medical, medical care and primary specialized health care to clarify the diagnosis and determine the tactics of further patient management.

Third level: consultative and diagnostic centers and departments of hospitals, including children's, and scientific and practical centers, where they provide consultative and diagnostic assistance on an outpatient basis on prehospital stage and after discharge of patients from the hospital.

On the territory of the Northern District, 26 polyclinics for adults and 14 polyclinics for children will continue to operate. In addition, pediatric polyclinic departments of Children's Infectious Diseases Hospital No. 12 and City Polyclinic No. 193 will continue to work to provide outpatient care to children.

The contingent of patients is determined medical institutions 1st, 2nd and 3rd levels.

Polyclinics of the first level:

Healthy patients for preventive measures, dispensary examinations;

Patients with chronic diseases in remission to control the course of the disease and receive drug coverage;

Patients of a gerontologist;

Primary patients with acute pathology;

Patients observed at home;

Polyclinics of the second level - outpatient centers:

Patients with acute pathology referred from the outpatient department for additional examination and treatment;

Dispensary patients of working age registered with medical specialists;

Patients who are examined before being sent to third-level centers, before planned hospitalization, receiving high-tech medical care;

Day patient patients.

Medical institutions of the third level:

Patients in need of high-tech types of medical care;

Patients in need of advisory highly specialized assistance (for example: a deep mycosis center, a somnological room, a center for paroxysmal conditions, an arrhythmological service, and others);

Day patient patients.

The adult network organizes the work of four outpatient centers, each of which is assigned first-level polyclinics:

The outpatient center on the basis of City polyclinic No. 6 will serve patients of city polyclinics No. 21, 44, 93, 105, 142, 159, 164;

The outpatient center on the basis of the Consultative and Diagnostic Center No. 6 will serve patients of city polyclinics No. 138, 146, 155, 188, 193;

The outpatient center on the basis of the Medical Unit No. 51 will serve patients of the city polyclinics No. 28, 81, 108, 136, 154;

The outpatient center on the basis of the City Polyclinic No. 62 will serve patients of the city polyclinics No. 39, 62, 71, 113, 156, 157.

The children's network also organizes the work of four outpatient centers, each of which is assigned first-level children's polyclinics:

The outpatient center on the basis of the Children's City Polyclinic No. 39 will serve patients of the children's city polyclinics No. 19, 43, 22, 39, the polyclinic department of the Children's Hospital No. 12;

The outpatient center on the basis of the Children's City Polyclinic No. 86 will serve patients of the children's city polyclinics No. 79, 68, 86, the pediatric department of the city polyclinic No. 193;

The outpatient center on the basis of the Children's City Polyclinic No. 15 will serve the patients of the children's city polyclinics No. 15, 77, 76;

The outpatient center on the basis of the Children's City Polyclinic No. 133 will serve patients of the children's city polyclinics No. 37, 87, 45, 133.

If you, dear Muscovites, have any questions about the creation of outpatient associations, please address them to the website of the Moscow Department of Health - [email protected] mail.ru.

Press service of the GKU Directorate of Health of the SAO.



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