Improving the organization of medical care for patients in the specialty of medical rehabilitation in the Tomsk oblast

Abstract

More than a third of the total population of the planet needs medical rehabilitation and the need will increase in the future. The prospective increase in life expectancy by the middle of the 21st century will be accompanied by an increase in the share of malignant neoplasms and diseases of the circulatory system in the morbidity structure, and the level of injuries will remain unchanged. These factors will negatively affect a person’s functional capabilities and will contribute to an increase in disability, increasing the relevance of medical rehabilitation. In Russia, according to the current procedure, there is a three-stage organization of medical rehabilitation. The implementation of these stages is carried out within the regional territorial programs of state guarantees (TPSG) of free medical care to citizens, which limits the financial accessibility of the completed cycle of medical rehabilitation for patients, due to budgetary allocations and the compulsory health insurance program, negatively affecting the quality of care provided. The article assesses the volume of medical rehabilitation provided in inpatient settings in the TPSG of the Tomsk oblast for the period of 2019–2022. Currently, three medical organizations in the region of different forms of ownership provide medical rehabilitation. In total, over a four-year-period, 8,804 cases in the specialty of medical rehabilitation were completed in the amount of 378.9 million rubles. An underfulfillment of the volume and costs of medical care during medical rehabilitation approved by the TPSG was recognized, as well as an outflow of patients for treatment to other regions (1,864 people during the study period). The most popular clinical and statistical groups (CSG) for which residents of the Tomsk oblast need rehabilitation measures have been identified, and organizational ways to improve the profile of this medical care have been substantiated.