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The Krasnodar Region’ Health Care System

 

In 2009, the health service of the region continued to work on building effective health system, primarily in terms of increasing access to health care and improvement of its quality. The year 2009 was marked as the “Year of Youth”; a lot of attention was paid to the strengthening of wealth and preventive orientation among young people, issues of healthy way of life, involving implementation of activities of the demographic development Concept of the country and the region, federal and regional task programs, as well as the National Project of “Health”. 

In 2009, some 349 medical institutions operated in the region, out of which 209 were separate municipal and 119 public health facilities, as well as 21 public health facility under federal control. 

As of January 1, 2010, in the Krasnodar Region the in-patient care was provided by 125 different types of hospitals and 56 specialized clinics, with in-patient departments. 

Primary health care was provided by 71 independent ambulatory clinics (66 of them are those of the municipal authority), 96 - parts of the hospitals and 34 dental clinics, including 27 (79.4%) - for treatment of the adult population, 6 (17.7%) - for treating children and a clinic of GOU VPO KSMU. 

In the rural areas there are 16 independent and 41 ambulatory units, being parts of hospitals. First aid is provided at 733 FAPs (First-aid-midwife stations).

There is a rapid development of the technologies for hospitalization care substitution, those of medical aid arrangement, which implementation, into activities of the out-patient service, has enabled increase of the number of places at the day hospitals of the ambulatory clinics by 13.3% and the availability of places at the day hospitals - by 12.0%, since the year 2005. 

The average length of patient’s stay in bed was reduced at the round-the-clock hospitals up to 11.4 days, which resulted in the bed turnover increase. 

In the region there is some improvement of the number of medical departments, in comparison with 2008: the number of therapeutics departments has increased by 2% (mostly due to reduction of the small-sized ones by 60% and those of the complex ones - 20%), the number of pediatric departments increased by 0.3%, general practitioners - by 5%: 

There has been some increase in the number of specialists of ambulatory-policlinic category, which was also facilitated by the beginning of implementation of the priority national project “Health” activities: for the period of 2005-2009 - a significant (2.8 fold) increase in the number of general practitioners and district therapeutists (24% ). The increase of the number of district therapeutists has made up 11%. 

The availability of the primary medical care for the population of the region should be positively affected by the growth in staffing of physicians who provide primary health care. 

Every day health institutions are attended by more than 100 thousand patients due to some medical or diagnostic purposes, 1,000 surgeries and 4.5 thousand ambulance calls are made. 

The health of the population of Kuban had improved markedly. It is characterized with a significant, compared to the previous years, decrease of the number of exacerbations of the majority of diseases that affect mortality. Despite the worsening of the age structure of the population (an increase of the number of elderly persons), the measures, undertaken by health care system of the region continue to improve the demographic situation: 

-Fertility increased: in 2009, there were born 11,443 children more than in 2005.; increase of the birth rate made up 20.4%; 

-Total mortality decreased by 12.2% (2005 – 15.6; 2009 – 13.7), the differences in mortality among urban and rural population decreased, in 2009 the index of the region was lower than the average rate in Russia as a whole (14.2) 3.5%; 

   -Mortality rate has declined practically from almost all major causes of death, except for deaths from neoplasms; 

- A 22.1% mortality decrease of those at the working age (in 2005 – 6.8 per 1,000 resp. population, in 2009 – 5.3); 

- The population aged 5-64 years: mortality from preventable causes decreased by 19.3%; 

-Infant mortality over the past 5 years has decreased by 31.4% (2005 – 8.6; 2009 – 5.9), and throughout the whole period it is lower than the national average level, in 2009 - by 28.0% (RF – 8.2); 

-Maternal mortality has decreased by 1.8 times (2005 – 17.2; 2009 – 9.4) moreover, it is below the national average level; 

- In comparison with 2005 the natural population decline has decreased by more than 4 times (2005 – 5.3; 2009 – 1.3), and it is almost 1.5 times better than the average national level.

Since 2005, the estimated life expectancy of the region’s population increased by 2.2 years and made up 69.7 years as of the beginning of 2009, which is by 1.8 years higher than in Russia on average. According to preliminary data, by 2010, the estimated life expectancy, at birth, is to make up 70.1 years in the region. 

Activities on improvement of the demographic situation will continue to be pursued, the focus will be primarily made on reduction of premature deaths from preventable causes (from diseases of the blood circulation system, primarily associated with increased blood pressure, as well as the ones caused by malignant tumors), fighting against TB and HIV infection, reducing deaths from road accidents, especially in the most active working age, as well as promoting healthy lifestyles. 

Among the entire population of the Krasnodar Region in early 2010 some 5.8 million of various diseases were registered, amongst which a significant part belongs to respiratory diseases, blood circulation system, digestive apparatus and neoplasms. In comparison with 2005 prevalence of diseases among the region's population decreased by 2.7%. To a certain extent this is due to the introduction of a more effective system of prophylaxis and prevention of diseases. Simultaneously, the rate of regular medical check-up of the region’s population has risen by 2.1%, including the patients with diseases of the blood circulation system, diseases with high blood pressure, and coronary heart disease.

The Ministry of Health Care and Social Development of the Russian Federation and Administration of Krasnodar Region signed an agreement on June 26, 2009 regarding the implementation of measures aimed at promoting a healthy lifestyle among the citizens of the Russian Federation in 2009, including reduction of alcohol and tobacco consumption, according to which 13 Health Centers were created and began to work in the Krasnodar Region since 01.12.2009: in Krasnodar - two Health Centers - based on GUZ Tsentr Meditsinskoy Profilaktiki (Center of Medical Prophylaxis) and in the structure of City Hospital № 2 KMLDO; one health center in each place as follows: Novorossiysk , Anapa, Slavyansk-na-Kubani, Sochi, Armavir, Yeisk, Labinsk, Korenovsk Belorechensk, in the villages of Kanevskaya and Vyselki. 

Other municipalities, in the same area, are assigned to the Health Centers in such a way that all citizens of Kuban can be screened and consulted in regard to the preservation and improvement of health. 

The website of the Department of Health Care of Krasnodar Region: www.kubanzdrav.ru

The portal of the Department of Health Care of Krasnodar Region, “Medicine of Kuban”: www.kubandoktor.ru