Dispensaries identify patients in the early stages of diseases through systematically organized mass preventive and targeted examinations of the population; registering those in need of treatment; thorough examination and provision of qualified and special medical care them; active dynamic monitoring (patronage) of the health status of those registered; a detailed study of the working conditions, living conditions of patients and, together with sanitary and epidemiological stations, the elimination of factors that adversely affect the health of those taken for medical examination and those around them - family members, as well as those living and working with them.
Types of dispensaries
Dispensary structure
The structure of a dispensary, as a rule, includes an outpatient department, a hospital, and diagnostic units (laboratory, treatment room, etc.). In order to more rationally organize medical care for the population, it is advisable to transform low-power dispensaries, which employ 2-4 doctors, into specialized departments (offices) of central district hospitals and city clinics.
From the history
The first dispensaries in Moscow opened at the beginning of the 20th century for patients suffering from tuberculosis. So, in 1904, the “Ladies' Guardianship of the Poor” opened a tuberculosis dispensary at the St. Sophia hospital. Over the next 9 years " Russian society for the Protection of Public Health has already organized four similar dispensaries in Moscow. First venereal dispensary in Russia its history dates back to 1921, when it was allocated a building on Petrovka. It is interesting that in Moscow in 1924 the world's first dispensary for the treatment of mental diseases was opened (in 1928 it was renamed the Research Institute of Neuropsychiatric Prevention) [
dispenso “distribute”) - a special treatment and preventive medical institution that provides medical care to certain groups of the population and carries out systematic observation for their state of health.Dispensaries identify patients in the early stages of diseases through systematically organized mass preventive and targeted examinations of the population; registering those in need of treatment; thorough examination and provision of qualified and special medical care to them; active dynamic monitoring (patronage) of the health status of those registered; a detailed study of the working conditions, living conditions of patients and, together with sanitary and epidemiological stations, the elimination of factors that adversely affect the health of those taken for medical examination and those around them - family members, as well as those living and working with them.
Types of dispensaries
In Russia there are the following types of dispensaries:
- anti-tuberculosis
- oncological
- trachomatous
- goitrous
- medical and physical education
- endocrinological
- drug treatment
- cardiological
- orthopedic
- ophthalmological
Dispensary structure
The structure of a dispensary, as a rule, includes an outpatient department, a hospital, and diagnostic units (laboratory, treatment room, etc.). In order to more rationally organize medical care for the population, it is advisable to transform low-power dispensaries, which employ 2-4 doctors, into specialized departments (offices) of central district hospitals and city clinics.
From the history
The first dispensaries in Moscow opened at the beginning of the 20th century for patients suffering from tuberculosis. So, in 1904, the “Ladies' Guardianship of the Poor” opened a tuberculosis dispensary at the St. Sophia hospital. Over the next 9 years, the Russian Society for the Protection of Public Health has already organized four similar dispensaries in Moscow. The first venereal dispensary in Russia dates back to
Dispensary(English: distribute, care) - this is the main specialized institution that provides medical and preventive care to patients of a certain profile and is an organizational and methodological center for the fight against certain diseases in a specific territory; This is an independent institution of a legal entity that has the rights of a legal entity, a seal, an account, a charter, and internal rules. Manages the dispensary chief physician, states depend on the size of the population served, the level of morbidity, and the epidemic situation. The work is based on a territorial principle.
The tasks of the dispensary and their role in improving the quality of specialized care:
Providing qualified, specialized medical, advisory and diagnostic assistance
Carrying out clinical examination of patients and organizing clinical observation of them in medical institutions
Organizational and methodological management of the activities of territorial medical institutions of the general medical network
Registration of patients, analysis of morbidity, disability, mortality, registration of patients, development of preventive and organizational measures
Organization and holding of seminars and conferences in order to increase the level of knowledge on the relevant pathology
Conducting mass preventive medical examinations
Introduction of new methods of diagnosis, treatment and prevention in healthcare facilities
Dissemination of knowledge among the population, hygienic training and education.
The dispensary also turns out to be social help for patients (resolving employment issues, guardianship of incapacitated patients, resolving housing issues, etc.)
Dispensary structure:
1. Outpatient department (conducts specialized outpatient care)
2. Diagnostic department (laboratories, radioisotope diagnostics room, radiology diagnostics and etc.)
3. Hospital
4. Organizational and methodological department
Types of dispensaries by profile (the number in the Republic of Belarus is indicated as of 1997):
Skin and venereal disease clinics – 35
Anti-tuberculosis dispensaries – 30
Psychoneurological dispensaries – 14
Oncology dispensaries – 11
Narcological clinics – 10
Endocrinological dispensaries – 5
Cardiovascular dispensaries – 5
Specialized dispensaries for victims of the Chernobyl nuclear power plant – 2
In total, in 1997 there were 113 dispensaries in the Republic of Belarus.
By localization dispensaries can be republican, regional, city, inter-district.
Interrelation in the work of the dispensary and clinic: the clinic, according to indications, refers patients to dispensaries of the appropriate profile for therapeutic, diagnostic and rehabilitation measures; the dispensary transmits documentation about examined and treated patients to the clinic, provides organizational and methodological management of the work of clinics in its profile, conducts seminars, conferences, etc. to improve general level doctors’ knowledge on a specific pathology, introduces new diagnostic and treatment methods, etc.
Organizations of sanitary and epidemiological service. Center of Hygiene and Epidemiology. Management, tasks, structure of the regional center of hygiene and epidemiology. Preventive and current sanitary supervision. Interaction in the work of the Center for Hygiene and Epidemiology with treatment and preventive organizations.
Organization of sanitary and epidemiological service.
The management structure of the state sanitary supervision service of the Republic of Belarus is represented by a system of bodies and organizations carrying out state sanitary supervision. The service is headed by the Deputy Minister of Health, the Chief State Sanitary Doctor of the Republic of Belarus, appointed by the Minister of Health of the Republic of Belarus.
The system of bodies and organizations of the Ministry of Health carrying out state sanitary supervision includes:
Department of the Ministry of Health in charge of state sanitary supervision issues
Republican Center for Hygiene, Epidemiology and Public Health
Regional centers hygiene, epidemiology and public health
Minsk City Center for Hygiene and Epidemiology
Centers for hygiene and epidemiology in the districts of Minsk
City centers of hygiene and epidemiology
Regional centers of hygiene and epidemiology, etc.
In addition, this service includes a disinfection and sterilization center, preventive disinfection centers, a health center, research institutes, an examination and testing center in the Zoological Zone, hygienic departments of medical universities and BelMAPO, and the Center for Hygiene and Epidemiology of other ministries and departments.
TsGiE– the main institution of the sanitary and epidemiological service.
Structure of the district Center for Hygiene and Epidemiology:
a) in areas with a population of up to 30 thousand people: Sanitary and Epidemiological Department (disinfection department, microbiological laboratory, chemical and radiological laboratory, administrative and economic personnel)
b) in areas with a population of 30-60 thousand people:
1. Sanitary and hygienic department (departments of municipal hygiene, food hygiene, occupational hygiene, hygiene of children and adolescents)
2. Epidemiological department (disinfection department, microbiological laboratory, physicochemical and radiological laboratory, administrative and economic personnel)
c) in areas with a population of over 60 thousand people:
1. Sanitary and hygienic department (departments of municipal hygiene, food hygiene, occupational hygiene, hygiene of children and adolescents, radiation hygiene, department of sanitary and hygienic monitoring, risk assessment and public health)
3. Sanitary and hygienic laboratory with laboratory research units physical factors, physical-chemical, toxicological research methods and radiation monitoring
The district Center for State Hygiene and Epidemiology is managed by the Chief State Sanitary Doctor of the district, appointed by the Chief State Sanitary Doctor of the Republic of Belarus in agreement with the relevant local executive and administrative authorities.
Tasks of the district Center for Hygiene and Epidemiology:
1 - ensuring timely hygienic assessment of everything new introduced into the national economy
2 - control over maximum permissible concentrations harmful substances
3 - organization and control over the implementation of measures and recommendations to improve working conditions, living conditions, training, education and recreation of the population
4 - supervision of compliance with legal and individuals sanitary and hygienic legislation, sanitary norms, rules and hygienic standards, as well as the organization and implementation of measures to prevent and reduce morbidity among the population
5 - organization of measures for sanitary protection of the territory of the Republic of Belarus from the introduction and spread of quarantine and other infectious diseases
6 - organization of state supervision over compliance with radiation safety standards, sanitary rules when working with sources ionizing radiation, participation of the sanitary and epidemiological service in eliminating the medical consequences of the Chernobyl disaster
7 - organization of supervision of compliance with the requirements of sanitary rules during the design, construction and reconstruction of facilities
8 - interaction with other organizations of the Ministry of Health in terms of ensuring sanitary and epidemiological well-being, on issues of departmental sanitary supervision and industrial sanitary control carried out by them
The activities of the SES are based on preventive and ongoing sanitary supervision.
Preventive sanitary supervision is carried out in three areas:
1. during design, construction and reconstruction - carried out in the form of:
Issuance of sanitary conditions for construction design
Accounting for all designed, constructed or reconstructed facilities
Approval of the allotment land plot for construction
Drawing up a hygienic report
Approval of the construction (reconstruction) project of the facility
2. for the protection of atmospheric air, water bodies, water supply, soil - carried out in the form of:
Accounting for all objects that pollute air, water sources, and soil
Laboratory control
Studying the sanitary and hygienic condition of these areas and their impact on the morbidity of the population
Development and presentation of sanitary plans and tasks for health-improving activities
3. when establishing sanitary and hygienic norms and rules – includes:
Establishment of sanitary and hygienic norms and rules, requirements state standards for all industrial products for technical and household use, food products
Hygienic assessment and assessment of GOST standards for new types of chemical raw materials and materials
Current sanitary supervision carried out by examining the sanitary condition of public utility facilities, industrial enterprises, food objects, preschool, school and other institutions, sources of radioactive substances and ionizing radiation. For current sanitary supervision, methods of raid inspections of objects, sanitary and hygienic descriptions are used as per certain species objects, and in the region and city as a whole.
Current sanitary supervision assumes:
Study of sanitary and hygienic working conditions, hygienic assessment of the working environment
Laboratory control of controlled objects
Detection and elimination of sanitary-hygienic, anti-epidemic violations
Study of morbidity and injury
Organization of preventive examinations of the population
Control physical development children and teenagers
Monitoring hygienic learning conditions and regime for school and preschool institutions
Monitoring the condition of the air environment, water supply, soil
Population health surveillance
Development of tasks and proposals for elimination sanitary violations and improving the sanitary condition of facilities
Organization and control of sanitary educational work
Application of sanctions, disciplinary action, fines, confiscation of products, suspension of facility operations, removal from work, etc.
Control over the organization rational nutrition population, etc.
Communication between the Center for Hygiene and Epidemiology and the clinic- solves the following issues:
1- control over the implementation preventive vaccinations
2- joint work on medical examination of the population
3- accounting and reporting on infectious diseases
4- control over the implementation of medical primary anti-epidemic measures
5- medical observation of the source of infection
6- carrying out deworming
7- analysis of morbidity and relationship with environment(social and hygienic monitoring)
8- hearing at medical councils of materials on compliance with the sanitary and epidemiological regime
9- work on the formation of a healthy lifestyle
10- participation in joint medical examinations of workers at industrial enterprises
Communication between the Center for Hygiene and Epidemiology and the hospital:
Monitoring the sanitary and epidemiological regime and timely detection of infections:
a) periodic examination of personnel
b) periodic closure for disinfection
Accounting and reporting infectious diseases
Listening to materials on anti-epidemic measures in hospitals, checking them by the Center for State Hygiene and Epidemiology
Dispensary(English: distribute, care) is the main specialized institution that provides medical and preventive care to patients of a certain profile and is an organizational and methodological center for the fight against certain diseases in a specific territory; This is an independent institution of a legal entity that has the rights of a legal entity, a seal, an account, a charter, and internal rules. The dispensary is managed by the chief physician; staffing levels depend on the number of people served, the level of morbidity, and the epidemic situation. The work is based on a territorial principle.
The tasks of the dispensary and their role in improving the quality of specialized care:
– provision of qualified, specialized medical, advisory and diagnostic assistance
– carrying out clinical examination of patients and organizing dispensary observation of them in medical institutions
– organizational and methodological management of the activities of territorial medical institutions of the general medical network
– registration of patients, analysis of morbidity, disability, mortality, registration of patients, development of preventive and organizational measures
– organizing and conducting seminars and conferences in order to increase the level of knowledge on the relevant pathology
– conducting mass preventive medical examinations
– introduction of new methods of diagnosis, treatment and prevention in healthcare facilities
– dissemination of knowledge among the population, hygienic training and education.
The dispensary also provides social assistance to patients (resolving employment issues, guardianship of incapacitated patients, resolving housing issues, etc.)
Dispensary structure:
1. Outpatient department (conducts specialized outpatient care)
2. Diagnostic department (laboratories, radioisotope diagnostics room, radiation diagnostics room, etc.)
3. Hospital
4. Organizational and methodological department
Types of dispensaries by profile (the number in the Republic of Belarus is indicated as of 1997):
– skin and venereal disease clinics – 35
– anti-tuberculosis dispensaries – 30
– psychoneurological dispensaries – 14
– oncology dispensaries – 11
– drug treatment clinics – 10
– endocrinological dispensaries – 5
– cardiovascular dispensaries – 5
– specialized dispensaries for victims of the Chernobyl nuclear power plant – 2
In total, in 1997 there were 113 dispensaries in the Republic of Belarus.
By localization dispensaries can be republican, regional, city, inter-district.
Interrelation in the work of the dispensary and clinic: the clinic, according to indications, refers patients to dispensaries of the appropriate profile for therapeutic, diagnostic and rehabilitation measures; the dispensary transmits to the clinic documentation about examined and treated patients, provides organizational and methodological management of the work of clinics in its profile, conducts seminars, conferences, etc. to increase the general level of knowledge of doctors on a specific pathology, introduces new methods of diagnosis and treatment, etc.
Clinical examination is a method of medical care for certain populations, which is based on early active detection of diseases, differentiated recording, dynamic observation and timely treatment identified patients, carrying out public and personal disease prevention activities.
In the specialized organization system medical care For the population, an important role is played by the network of dispensaries, which are intended for the development and implementation of the complex preventive measures, as well as active identification of patients with certain diseases on early stages, their treatment and rehabilitation. In accordance with the nomenclature of healthcare institutions, the following types of dispensaries are distinguished: medical and physical education, cardiology, dermatovenerological, drug addiction, oncology, anti-tuberculosis, psychoneurological, ophthalmological and endocrinological. The dispensary provides assistance to both adults and children and, as a rule, includes a polyclinic (dispensary) department and a hospital. The role of dispensaries is leading in the provision of specialized treatment and preventive care for socially significant diseases.
Oncology Center.
The system of providing oncological care to the population includes oncology clinics, hospices or departments palliative care cancer patients, examination and oncology rooms of the APU. The main tasks of these institutions are to provide specialized medical care to patients malignant neoplasms(ZNO), carrying out dispensary observation of such patients, targeted (screening) medical examinations, as well as sanitary and educational work on the prevention and early detection of cancer.
In the system of providing specialized oncological care, the leading role belongs to oncology dispensaries, which, as a rule, are organized at the level of a constituent entity of the Russian Federation (republic, territory, district, region). The work of the dispensary is headed by the chief physician, who is appointed and dismissed by the head of the relevant health care management body. The main goal of the dispensary is to develop strategies and tactics for improving oncological care to the population, providing qualified oncological care to the population of the assigned territory. In accordance with this goal, the dispensary solves the following tasks:
Providing qualified specialized medical care to cancer patients;
Analysis of the state of oncological care for the assigned population, the effectiveness and quality of preventive measures, diagnosis, treatment and follow-up of cancer patients;
Maintaining a territorial cancer registry;
Development of territorial target programs to combat oncological diseases;
Training and advanced training of oncologists, doctors of basic specialties and paramedical workers on the provision of oncological care to the population;
Introduction of new medical technologies for providing medical care to cancer patients and patients with precancerous diseases;
Coordination of the activities of health care institutions of the general medical network on the issues of prevention, early detection of cancer, dispensary observation and palliative treatment of cancer patients;
Organization and conduct of sanitary and educational work among the population on the formation healthy image life, cancer prevention.
In addition to the outpatient and inpatient departments that are traditional for most dispensaries, the oncology dispensary includes: a palliative care department, radiation therapy, chemotherapy, boarding house, etc.
Psychoneurological dispensary
The leading institution in the system of providing specialized psychiatric care to the population is the psychoneurological dispensary, which solves the following tasks:
Providing outpatient psychiatric and psychotherapeutic care to patients suffering from mental disorders, and dispensary observation after them;
Inpatient care for patients suffering from non-psychotic types mental illness;
Conducting preventive examinations, examinations, forensic psychiatric, military medical and medical and social examinations;
Social and labor rehabilitation of patients with mental illness;
Urgent psychiatric care, including when emergency situations;
Participation in resolving issues of guardianship over incapacitated patients;
Providing consultative specialized psychoneurological care to patients in somatic hospitals and APU;
Psychohygienic, sanitary and educational work among the population.
The structure of the dispensary, as a rule, includes a treatment and diagnostic department with offices of local psychiatrists, a day hospital for short-term stay of patients suffering from non-psychotic types of mental illnesses, a department of child and adolescent psychoneurology, a department of mental health prevention and psychohygiene, a “Helpline” department, a social services office. -psychological assistance, etc. In addition, the psychoneurological dispensary may include state medical and industrial enterprises for occupational therapy, training in new professions and employment of people suffering from mental disorders, including people with disabilities. The dispensary can organize psychoneurological departments (offices) at general clinics to provide specialized psychoneurological care to the population.
Drug Dispensary
The drug treatment clinic is the main link in the organization of drug treatment assistance to the population, carries out work on the prevention and early detection of mental and behavioral disorders associated with drug use. psychoactive substances(alcoholism, alcoholic psychoses, drug addiction, substance abuse, etc.), provides specialized care and medical examination for these patients. Main tasks narcological clinic are:
Widespread anti-alcohol and anti-drug propaganda among the population and, above all, students educational institutions;
Early detection, dispensary registration, provision of specialized outpatient and inpatient care patients with alcoholism, drug addiction, substance abuse;
Study of the incidence of alcoholism, drug addiction and substance abuse in the population, analysis of the effectiveness of the preventive, therapeutic and diagnostic care provided;
Development of territorial target programs to combat drug addiction diseases;
Participation together with authorities social protection in providing social and domestic assistance to patients with alcoholism, drug addiction and substance abuse who are under dispensary observation;
Carrying out medical examination, examinations of alcohol intoxication, other types of examinations;
Methodological guidance in organizing pre-trip inspections of vehicle drivers;
Organizational, methodological and advisory assistance to drug treatment rooms that are part of other health care institutions;
Providing advisory specialized drug treatment to patients in somatic hospitals and emergency medical services;
Training and advanced training of doctors and paramedical personnel on the provision of drug treatment to the population.
The work of the dispensary is based on the local principle. The optimal organizational and functional structure of a drug treatment clinic includes the following divisions: offices of local psychiatrists-narcologists, adolescent office, examination of alcohol intoxication, anonymous treatment, anti-alcohol propaganda, specialized offices (neurologist, psychologist, therapist), inpatient departments, day hospital, organizational and methodological department . The dispensary also includes a laboratory, an office functional diagnostics, hypnotarium, room for reflexology, electrosleep, etc. The dispensary may have specialized transport equipped with equipment for conducting, together with traffic police officers, an examination of alcohol intoxication.
TB Dispensary
The basic principles of organizing specialized care for tuberculosis patients have been determined Federal law“On preventing the spread of tuberculosis in Russian Federation" A specialized healthcare institution providing anti-tuberculosis care to the population in the assigned territory is an anti-tuberculosis dispensary, which is assigned the following tasks:
Systematic analysis of the epidemiological situation regarding tuberculosis and the effectiveness of anti-tuberculosis measures in the jurisdictional territory, including in institutions of the penitentiary system;
Planning together with the Centers for Hygiene and Epidemiology, institutions of the general medical network for vaccination, BCG revaccination and organizational and methodological guidance for their implementation;
Hospitalization of bacterial pathogens and isolation of newborns from bacterial pathogens (for the period of formation of post-vaccination immunity);
Implementation of preventive measures for persons in contact with bacteria-releasing agents (regular dispensary monitoring of them, ongoing disinfection of outbreaks, revaccination, chemoprophylaxis, etc.);
Conducting, together with institutions of the general medical network, Centers for Hygiene and Epidemiology, enterprises, medical examinations of the population using fluorographic, immunological, bacteriological and other research methods;
Providing specialized inpatient and outpatient care to patients with tuberculosis, referring them to sanatorium-resort institutions;
Carrying out a set of measures for social and labor rehabilitation of tuberculosis patients;
Conducting an examination of the temporary disability of tuberculosis patients and, if necessary, referring them to medical examination;
Dispensary registration and dynamic observation of patients with tuberculosis (timely examination, treatment, chemoprophylaxis).
The structure of an anti-tuberculosis dispensary, as a rule, includes the following departments: dispensary department (for adults and children), hospital, sanatorium, occupational therapy workshops, clinical diagnostic and bacteriological laboratories, X-ray, endoscopic, physiotherapy rooms, patient rehabilitation department with post-tuberculosis changes and nonspecific respiratory diseases, a functional diagnostics room, a day hospital, etc. Anti-tuberculosis dispensaries work on a local basis. IN major cities with a population of more than 500,000 people, as well as in municipal areas of a subject of the Russian Federation, if there are two or more dispensaries, one of them is assigned the functions of an interdistrict anti-tuberculosis dispensary.
Dermatovenerological dispensary
The dermatovenerological dispensary is an independent specialized medical institution designed to provide preventive, therapeutic and diagnostic assistance to the population for diseases of the skin, subcutaneous tissue and infections that are predominantly sexually transmitted (STIs), as well as to carry out a set of anti-epidemic measures to prevent them. Taking this into account, the main objectives of the dispensary are:
Providing specialized advisory and therapeutic and diagnostic dermatovenerological care to the population in outpatient clinics and inpatient conditions;
Development of territorial targeted programs to combat STIs;
Carrying out, together with the Centers for Hygiene and Epidemiology, monitoring of STIs and contagious skin diseases;
Providing organizational, methodological and advisory assistance to institutions of the general medical network on the issues of prevention, diagnosis and treatment of patients suffering from STIs and contagious skin diseases;
Participation in the work of licensing and expert commissions of healthcare authorities, mandatory funds health insurance, insurance medical organizations, to monitor the medical activities of commercial structures and private practitioners providing dermato-venereological, gynecological, urological care;
Introduction into the practice of dermatovenerological institutions of modern medical technologies for the prevention, diagnosis and treatment of STIs and dermatoses;
Propaganda among the population, together with medical prevention centers, of knowledge on the prevention of infectious diseases skin diseases and STIs, etc.
A dispensary may have the following divisions in its structure: outpatient department, inpatient department, organizational and methodological department (office), departments primary prevention and periodic medical examinations, clinical diagnostic, bacteriological, immunological laboratories, cosmetology department (office), etc.
Related information.
