ORGANIZATION AND UNRESOLVED PROBLEMS OF PROVIDING MEDICAL CARE BY THE EMERGENCY DEPARTMENT TO SICK CHILDREN DO NOT NEED HOSPITALIZATION

Abstract

In recent years, the option of providing medical care in reception departments of hospitals to children do not need hospitalization has spontaneously developed in the country. Moreover, such conditions for providing outpatient care are not even implied in the normative documents of domestic health care. Aim: to improve the organization of medical care in the conditions of compulsory health insurance in hospitals for children who do not need hospitalization. Material and methods. The research was conducted from 2009 to 2019 on the basis of Children’s City Clinical Hospital № 8, Metallurgichesky district of Chelyabinsk, assigned contingent over the research period changed in the range of 23,4 thousand – 26,5 thousand children 0 to 17 years. Results and discussion. Over the decade, the number of treatments in emergency departments increased from 6,3 cases per 1,000 children in 2009 to 48,0 cases in 2018. The spontaneously established system of providing medical care in emergency departments in case of a sudden deterioration of children’s health, do not need hospitalization, many violations of existing regulations and requires a change of the system of settlements with the outpatient hospital, independent of providing medicine, changes in the procedure for recording morbidity and the schedule of work of the hospital diagnostic services. The reason for these drawbacks is the lack of legislative consolidation of the right to provide assistance to outpatients. Conclusion. It is necessary to make the additional formulation in the paragraph 2 of Article 32 of section 3 of Federal Law № 323 “…outpatient medical care is provided, including in emergency departments of the hospital… .”