Healthcare
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In 2009 healthcare institutions’ activity in the Autonomous Okrug was aimed to realize events on quality and availability improvement in the sphere medical assistance rendered to the population, provision process optimization of some categories of citizens of the Autonomous Okrug with medicines, sanitary and epidemiological welfare provision, improvement of demographic situation in the region, etc. In 2009 medical assistance was rendered to the population of the Autonomous Okrug by 144 prevention and treatment facilities (73 hospitals, 40 outpatient policlinic establishments which comprise 67 village first-aid stations and 73 health posts; 17 health centres, 14 independent stomatologies). Besides, 5 Emergency Call service stations, 4 blood transfusion station, 4 centers of medical prophylaxis, 2 centers of emergency medicine, 1 forensic psychiatric examination station, 2 sanatory institutions, 1 child care center operate on the territory of the Autonomous Okrug. Approximately 47.0 thousand people, including 7.5 thousand doctors, 20.7 thousand of paramedical workers are engaged in healthcare system. Dual jobholding index (number of positions which fall at one employee) is 1.30 over the Okrug (1.33 in 2008). Dual jobholding index among doctors is 1.55 (1.57 in 2008), among paramedical workers – 1.28 (1.09 in 2008). Approximately 80 kinds of paid services as follows are rendered by institutions of healthcare of the Autonomous Okrug: medical exams of drivers, lab services, stomatology, gynaecological, heart surgeon services, etc. The largest quota in the total volume of paid services falls at dentoprosthetic rehabilitation (26%) and periodic health examination (22%). In January-December 2009 the volume of paid services income accounted for over 1450 mln. rub. Proceeds are distributed as follows: 60% fall at payroll, 1.0% - at technologies upgrading, 12% - at material and technical basis provision, 1.0% - specialists' qualification upgrading, 26-% - other expenses. In 2009 realization of the childbirth certificates program was continued, departments of State institution of RF Social Insurance Fund over the Autonomous Okrug transferred over 212.9 million rubles to healthcare institutions, increased by 9.7% to the comparable period a year earlier. 19 directions of high-tech medical assistance are successfully developed in the Autonomous Okrug (except transplantation operations). Methods as follows are skilled and successfully used as planned: all kinds of cardiological & x-ray angio operations, surgical intervention in spinal column and other orthopedic operations for arthropathy, ophthalmological assistance using microinvasive & laser surgery, etc. Telemedical consultations are held by regional information system comprising 52 medical and preventive treatment institutions of the Autonomous Okrug. Totally over 1550 telemedical consultations were held in 2009. Despite of expensive implementing methods, direct and indirect expenses on medical service for the population decrease significantly. Main reasons of this process are as follows: active usage of in-patient hospitals’ opportunities; reduce of disability period and rehabilitation time; reduce of disability, mortality index; growth of working age citizens; expenses reduce of private finances and Okrug budgetary means for examination and medical care out of the Okrug. Within the framework of agreement between St. Petersburg and Khanty-Mansiysk Autonomous Okrug – Ugra «On Cooperation», specialists of the Autonomous Okrug undertake an internship on the basis of medical institutions of St. Petersburg (municipal hospitals, health centers, research institutes of emergency call service named after A.A.Dzhanelidze and others). Cooperation among healthcare institutions of the Autonomous Okrug and Research institute of Tocogynecology named after D.O.Ott of the Russian Academy of Medical Sciences, St. Petersburg, is continued. In 2009 realization of the innovative project «Ugra-kor» owing to which the system of early detection and disease treatment for blood circulation organs, is continued. In January-December 2009, 738 patients were treated at the Centers for intervention cardiology, 452 of them – by interdermal coronal intervention; 565 patients – by CABG. Realization of the program «Development of subsidiary reproductive technologies» in the Okrug allowed to provide perinatal centers of Khanty-Mansiysk and Surgut with up-to-date medical equipment, prepared by specialists, to form a basis for qualitative rendering of diagnostic assistance to families having different forms of agenesia, using subsidiary reproductive technologies. In 2009, 20 children were born at 17 married couples after extracorporal fertilization in Khanty-Mansiysk hospital. Preventive medical check-up of working people (in January-December 2009, over 62.0 thousand people passed medical check-up) is an effective measure, using of which allows to reveal the most widely-spread abnormality and to carry out diagnostic maneuver. Standard medical examination of working people is directed to improve healthy lifestyle motivation of the population. System of regional and municipal policy coordination in the sphere of Ugra healthcare is formed in the Autonomous Okrug. Expert group (Council of chief physicians) on quality control of medical assistance, coordination of healthcare activity of the Autonomous Okrug, operate at the Government of the Autonomous Okrug. Pre-licensing supervision and licence requirements and conditions control is carried out by Monitoring and supervision control service in the sphere of healthcare of the Khanty-Mansiysk Autonomous Okrug – Ugra. It helps to reduce the list of unfair licensees and improves the quality of rendered services in the sphere of healthcare. 375 inspections of healthcare and pharmacy organizations are made. On the results of inspections 34 administrative offence reports were written. In January – December 2009, total penal sanctions amounted to 711.0 thousand rubles. Under conditions of budget revenue side reducing of the Autonomous Okrug, the measures on current expenses optimization in the sphere of healthcare are held. A retrenchment of 1450 vacancies was made, in-patients service was reduced by 471 berths, expenses on communication, security, others were reduced as well. Despite of finances reducing in the Autonomous Okrug:
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