Shevchenko M. V.

CONTENTS

Scentific article

Introduction. One of the basic ways of management and institution of health care is its legal regula- tion, which is presented by various types of regulatory legal acts. The significant place among these is occupied social norms and standards – indicators of necessary consumption of foodstuff, non-food products and services and provides educational, medical, housing-and-municipal, social and cultural services. Analysis of legislation of separate post-Soviet countries and references has shown that minimum social norms and regulations can include objects nomenclature presented in the form of lists of institutions, assortment or set of material goods and services. Therefore to social norms and regulations inclusion of specification of security by ambulatories of general practice/family medicine – centres divisions of primary medical (medicosanitary) care that is extremely actual at planning of outpatient clinics network development in regions of Ukraine for the period up to 2020 for achievement of equal availability of primary medical care and monitoring and evaluation of this process. The purpose – financial and economic substantiation of resources requirement for achievement of specifica- tions supply by network ambulatories – centres divisions of primary medical (medicosanitary) care in Ukraine. Object and research methods. Calculations are spent on the basis of data of medical equipment and stock cost according to the Approximate sheet of equipment of health care departments of health facilities providing primary care (medical and sanitary) assistance, which have been given by SE “Ukrmedpostach” MoH of Ukraine (as of 01. 01. 2013 ) (without expenses on acquisition of vehicles – car), data of regional health care departments on available number of ambulance stations in rural and urban areas, data on construction/reconstruction for covering of their requirement. Analytical, comparative and economic methods are used. Results of researches and their discussion. According to the current legislation ambulance station are created for the ensure population with primary health care by approach of place of rendering PHC to the places of residence of attached population, ensure the right of patients to choose a doctor providing such assistance and equal physi- cal availability of primary health care for the population. In countryside such ambulance station will provide primary care approximately 3,000 rural residents, in outpatient clinic 2 doctors who will serve on 1. 5 thousand population ( an equivalent of loading of 1. 25 rate) will work. Analysis of ambulance stations network supply has shown that proper standard achieved in Mykolayiv, Kharkiv (3. 7 per 10 thousand rural population), Sumy (3. 5 per 10 thousand population) regions and Sevastopol, therefore in calculations expenses on designing and building for these admin- istrative and territorial units were not considered. By calculations estimated expenditures necessary for designing and building of new ambulance stations for reach the provision standard offered by Ministry of Health of Ukraine at the level of 3. 3 per 10 thousand of rural population make 1,334,200,000 UAH, including for designing – 89. 2 million UAH, building – 1245. 0 million UAH. For provide of ambulatories of general practice/family medicine standard for the rural population services in general in Ukraine it is necessary to create in addition 1240 ambulance stations, estimated expenses on their maintenance according to the equipment sheet will amount 179. 5 million UAH. The standard of provision by ambulance stations of inhabitants of cities is determined taking into account resid- ing of the population depending on character of building and for the purpose of maintenance of walking distance (radius of service 0,5-1km). In particular, in microdistricts with low-rise building an ambulance station to cover ser- vice on the average over 4 thousand people (2 doctors to 2 thousand population on everyone) (standard of 2,5 ambulance stations per 10 thousand corresponding population). In microdistricts with multi-storeyed building – the ambulance station should be organised on the average on 6250 population (3-4 doctors) – standard of 1. 6 ambu- lance stations per 10 thousand corresponding population. Calculation of expenditure for ambulance station equipment by medical equipment and stock, communication facilities, computers will constitute 3,128,400,000 UAH, including necessary for equipment of new clinics in cities / cities microdistricts with predominantly low-rise building – 172. 7 million UAH Totally estimated settlement costs for designing and building of ambulance stations in cities will amount 2,642,700,000 UAH. Conclusions. For achievement of standards of security by ambulatories of general practice/family medicine – departments of primary health centers (medicosanitary) care in all administrative and territorial units of the country it is necessary 7. 2848 million UAH.

requirement, ambulatory, network, financial and economic substantiation

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«Bulletin of problems biology and medicine» Issue 3 part 1 (110), 2014 year, 387-390 pages, index UDK 616-082:336