2019 № 7 Improving the system of organizing the psychiatric aid of the megapolis
Abstract. Currently, a restructuring of the psychiatric service is carried out in Moscow. The changes are implemented accordingto the concept of socially-oriented psychiatry based on a biopsychosocial approach. Reforms include the reductionof inpatient and the development of an outpatient unit of the psychiatric service. Psychiatric hospitals were merged with outpatient units on a territorial basis.
The aim of the study was a comprehensive analysis of the psychiatric service functioning in Moscow during the period of
A retrospective analysis of the demographic characteristics of the Moscow population and clinical and epidemiological
indicators characterizing the incidence of mental disorders, as well as an analysis of the functioning of inpatient and
outpatient units of the Moscow psychiatric service and its staff, was made. The evaluation of the conversion efficiency
indicators was made. A sociological survey about the reforms (questionnaire) of specialists and relatives of persons with mental disorders being carried out through questionnaires was also conducted.
During the transformation of the psychiatric service, the incidence of mental disorders, hospital mortality and the number of cases of disability decreased. The provision of the population with places in day hospitals, the number of places in day hospitals and patients who received assistance in day hospitals, the staffing level of outpatient rates, and the number of visits to district psychiatrists increased. The share of persons involuntarily examined and recognized as in need of inpatient treatment increased from 70% to 100%. According to a sociological survey, most of the heads of structural units of the psychiatric service, psychiatrists, and users of the service positively assess the reforms that have been carried out.
For a large city, the cluster-modular system of psychiatric service, currently organized in Moscow, is a priority.
Results of this work have found application in the organization of psychiatric care in Moscow, Vladimir, and Tula regions
and the city of Sevastopol, and can be put into practice in other major cities of the Russian Federation.
2013 № 8 Method of defining demands of adult population in medical rehabilitation (FSHM «Russian scientific center of medical rehabilitation and spa treatment» Ministry of Health Care of Russian Federation, Moscow, Russia; Federal Research Institute for Health Organization and Informatics of Ministry of Health Development of the Russian Federation, Moscow)
Annotation: Method of defining demands of adult population in medical rehabilitation is based on data concerning population's morbidity, generally in accordance to diseases classes as well as on few particular diseases. The basis of defining method for demand in medical rehabilitation was formed by indications and contraindications to its processing in outpatient and inpatient conditions. The development of medical organizations network, which provides aid for medical rehabilitation has to correspond with the real demand of the population. The following methodical recommendations permit to make a judgment regarding demands of concrete region in medical rehabilitation after processing the described calculations.