Issue №1-89, 2019
The experience of organizing the department of the second stage of medical rehabilitation of patients with stroke
1 Bidenko M.A., 1 Bortnik O.V.
1 «Irkutsk City Clinical Hospital №1», Irkutsk, Russia
ABSTRACT
Given the high incidence and mortality from stroke, the issue of organizing medical rehabilitation in inpatient settings isextremely important. Medical rehabilitation should begin from the first hours of the patient entering the intensive care unitand continue the entire period of treatment of the patient in the hospital. After the end of the acute period of the stroke andthe intensive course of treatment, rehabilitation activities should be continued in the departments of medical rehabilitationof multi-purpose hospitals or rehabilitation centers. It is advisable to start treatment in such rehabilitation units immediatelyafter the end of the acute period of a stroke, if possible without a break. This article contains questions on the organizationof the provision of medical services for the rehabilitation of patients after stroke in Irkutsk city, an assessment of the needs ofthe adult population of Irkutsk region for medical rehabilitation in a hospital, and an analysis of the practical experience oforganizing a second-stage medical rehabilitation department on the basis of medical institution. An algorithm for organizingthe department of medical rehabilitation is presented, the economic feasibility and clinical efficacy of treating patientsat the second stage of medical rehabilitation assistance is investigated.
KEYWORDS: stroke, medical rehabilitation, clinical and statistical group, rehabilitation routing scale, Bartel scale, Functional Independence Measure, second stage of rehabilitation, the scope of state guarantees of free medical care.
References:
- Federal’nyj zakon ot 21.11.2012 № 323 «Ob osnovah ohrany zdorov’ja grazhdan Rossijskoj Federacii» // «Rossijskaja gazeta», № 5639, 23.11.11.
- Postanovlenie Pravitel’stva RF ot 15.04.2014 N 294 “Ob utverzhdenii gosudarstvennoj programmy Rossijskoj Federacii “Razvitie zdravoohranenija” // «So-branie zakonodatel’stva RF», vyp. №17, 2014, s. 2057.
- Postanovlenie Pravitel’stva Rossijskoj Federacii ot 19 dekabrja 2015 goda № 1382 «O Programme gosudarstvennyh garantij besplatnogo okazanija grazh-danam medicinskoj pomoshhi na 2016 god» // «Sobranie zakonodatel’stva RF», vyp. №52, 2015, s. 7607.
- Rasporjazhenie Pravitel’stva RF ot 17.11.2008 N 1662-r «O Koncepcii dolgosrochnogo social’no-jekonomicheskogo razvitija Rossijskoj Federacii na period do 2020 goda» // «Sobranie zakonodatel’stva RF», vyp. №47, 2008, s. 5489.
- Prikaz Minzdrava Rossii ot 29.12.2012 № 1705n «O porjadke organizacii medicinskoj reabilitacii» // «Rossijskaja gazeta», № 6066, 25.04.13.
- Prikaz Mizdravsocrazvitija Rossii ot 17.05.2012 № 555n «Ob utverzhdenii nomenklatury koechnogo fonda po profiljam medicinskoj pomoshhi» // «Ros-sijskaja gazeta», № 5805, 13.06.12.
- Bojcov S.A. [Prevention of noncommunicable diseases as a necessary condition for reducing mortality in the Russian Federation] // Materialy vserossijskoj nauchno-prakticheskoj konferencii «Sovershenstvovanie okazanija medicinskoj pomoshhi bol’nym s sosudistymi zabolevanijami». [Materials of the AllRussian scientific-practical conference “Improving the provision of medical care to patients with vascular diseases”]. - 2011. - S. 8-12.
- Danilova N.V. [Problems of providing specialized (rehabilitation) care in medical organizations] // Menedzher zdravoohranenija. - 2014. - № 10. - C. 33-38.
- Epifanov V.A., Epifanov A.V. Reabilitacija bol’nyh, perenesshih insul’t. [Rehabilitation of stroke patients]. Moscow: MEDpress-inform; 2013.
- Ivanova G.E. [Serious changes are coming up in the rehabilitation system] // Argumenty i fakty (Zdorov’e). - 2015. - №40.
- Kadykov A.S. Reabilitacija posle insul’ta. [Rehabilitation after a stroke.] Moscow: Miklos; 2003.
- Kadykov A.S., Chernikova L.A., Shvedkov V.V. Zhizn’ posle insul’ta. Populjarnoe prakticheskoe rukovodstvo po reabilitacii bol’nyh, perenjosshih insul’t. [Life after a stroke. A popular practical guide for the rehabilitation of stroke patients]. Moscow: Miklos; 2002.
- Prilipko N.S. [The need of the adult population of Russia for medical rehabilitation in a hospital.] // Zdravoohranenie Rossijskoj Federacii. - 2014. - № 1. - C. 11-19.
- Savchenko T.I. [The organizational component of the quality management of medical rehabilitation.] // Voprosy jekspertizy i kachestva medicinskoj pomoshhi.- 2014. - № 2.
- Skvorcova V.I. [Formation of a medical care system for patients with cerebral stroke in the Russian Federation] // Materialy vserossijskoj nauchno-prak-ticheskoj konferencii «Sovershenstvovanie okazanija medicinskoj pomoshhi bol’nym s sosudistymi zabolevanijami». [Materials of the All-Russian scientific-practical conference “Improving the provision of medical care to patients with vascular diseases.”].- 2011.- С. 13-35.
- Sokolova N.A. [Organization of medical rehabilitation in the Russian Federation: legal aspects] // Pravovye voprosy v zdravoohranenii. - 2013. - № 9. - C. 26-36.
- Stahovskaja L.V. ed. Insul’t: Rukovodstvo dlja vrachej. [Stroke: A Guide for Doctors]. Moscow: Medical Information Agency; 2013.
- Razumov A.N. Uchebnik po vosstanovitel’noj medicine. [Textbook on restorative medicine]. Moscow: “Regenerative medicine”; 2009.
- Itogi kruglogo stola 20 oktjabrja v Gosudarstvennoj Dume FS RF «O sostojanii i perspektivah razvitija sistemy okazanija reabilitacionnoj pomoshhi (v tom chisle detjam) v Rossijskoj Federacii» [Jelektronnyj resurs],- http://www.komitet2-2.km.duma.gov.ru/site.xp/052057124050051057054.html.
- Parlamentskie vesti: 27 nojabrja 2015 g. Materialy IA “Bajkal Info” [Jelektronnyj resurs], - http:// www.vsp.ru/parlament/paperpost/2015/11/27
- Preduprezhdenie infarktov i insul’tov/ Vsemirnaja organizacija zdravoohranenija [Jelektronnyj resurs], - http://www.who.int/publications/list/9241546727/ru
- Rezoljucija Pervogo nacional’nogo s#ezda vrachej Rossijskoj Federacii [Jelektronnyj resurs], - http://medportal.ru/mednovosti/news/2012/10/05/kreml.
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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.