of June 6, 2019 No. 254
About the Strategy of development of health care in the Russian Federation for the period till 2025
According to article 17 of the Federal Law of June 28, 2014 "About strategic planning in the Russian Federation" I decide No. 172-FZ:
1. Approve the enclosed Strategy of development of health care in the Russian Federation for the period till 2025.
2. To the government of the Russian Federation in 6-month time to approve the actions plan on strategy implementation of development of health care in the Russian Federation for the period till 2025.
3. Recommend to public authorities of subjects of the Russian Federation to be guided by provisions of the Strategy of development of health care in the Russian Federation for the period till 2025 when implementing the activities in the sphere of protection of public health, having provided introduction of necessary changes in the strategy of social and economic development of subjects of the Russian Federation.
President of the Russian Federation
Approved by the Presidential decree of the Russian Federation of June 6, 2019 No. 254
1. This Strategy is the document of strategic planning developed for the purpose of ensuring national security of the Russian Federation in the sphere of protection of public health, including assessment of condition of homeland security in this sphere, determining the purposes, the main objectives and the priority directions of development of health care in the Russian Federation and also the main stages expected results and mechanisms of realization of this Strategy.
2. The legal basis of this Strategy the Constitution of the Russian Federation, the Federal Laws of November 21, 2011 constitute No. 323-FZ "About bases of protection of public health in the Russian Federation", of June 28, 2014 No. 172-FZ "About strategic planning in the Russian Federation", presidential decrees of the Russian Federation of December 31, 2015 No. 683 "About the Strategy of homeland security of the Russian Federation", of May 7, 2018 No. 204 "About the national purposes and strategic tasks of development of the Russian Federation for the period till 2024" and of March 11, 2019 No. 97 "About Bases of state policy of the Russian Federation in the field of ensuring chemical and biological safety for the period till 2025 and further prospect".
3. This Strategy is directed to forming and realization at the federal, regional and municipal levels of the coordinated policy in the sphere of protection of public health.
4. This Strategy is basis for development of industry documents of strategic planning, state programs of the Russian Federation, state programs of subjects of the Russian Federation, and also the national projects "Health Cares" and "Demography".
5. From 2012 to 2017:
1) the remaining life expectancy in case of the birth grew by 2,5 of year and constituted 72,7 of year;
2) the indicator of general death rate decreased with 13,3 to case 12,4 on 1 thousand people, death rate of persons of working-age - on 15, percent (to case 484,5 on 100 thousand people of the corresponding age), infantile death rate - for 35 percent (to case 5,6 on 1 thousand children who were born live), maternal death rate - on percent 23,5 (to case 8,8 on 100 thousand children who were born live), number of abortions - on percent 26,7;
3) the level of occupational diseases decreased on percent 23,4 (to case 1,31 on 10 thousand workers), however at the same time timely identification of initial forms of occupational diseases when performing periodic medical examinations remains low because of deficit of pathologists, insufficient range of functional and laboratory researches. Insufficient interest of employers in preserving health of workers, including in passing by them of routine medical examinations and medical examination is noted;
4) the number of citizens to whom high-technology medical care is provided increased in 2,3 of time and constituted 1047,9 of one thousand people that demonstrates increase in its availability to the population;
5) the number of the citizens who received sanatorium treatment increased in time 1,3;
6) the number of rehabilitation beds increased in time 1,7, number of the patients who underwent rehabilitation - twice, however it does not provide fully need of patients for rehabilitation (in 2017 from 26 463,5 thousand cases of treatment medical rehabilitation is carried out only to 409,6 of one thousand cases (percent 1,5);
7) implementation of the state quality control and safety of medical activities, the state control (supervision) in the sphere of drug circulation, state control of the address of medical products allowed to reduce amount of counterfeited and substandard medicines almost twice (to percent 0,4);
8) expenses of citizens on acquisition of medicines and medical products grew with 713, 3 billion rubles to 1254, 1 billion rubles, from them by acquisition of medicines - with 598, 1 billion rubles to 1027, 2 billion rubles;
9) the quantity of diseases of the blood circulatory system grew by percent 20,4, number of patients with malignant new growths - on percent 14,5 that against the background of decline in mortality from these diseases demonstrates growth of the appeal of citizens to the medical organizations;
10) the number of persons infected with human immunodeficiency virus grew up and constituted 808,8 of one thousand people;
11) the illness rate diabetes increased by 23 percent. Prevalence of other alimentary and dependent diseases, including obesity is noted. In food allowance of adult population of number of subjects of the Russian Federation deficit of vitamins and minerals is observed;
12) the amount of paid medical services grew in 1,9 of time and made 626, 6 billion rubles (the share of paid medical services in the total amount of paid services grew from 16 to 20 percent).
6. Level of satisfaction of citizens with quality of medical care in 2017 constituted percent 39,9.
7. Expenses on delivery of health care in subjects of the Russian Federation within the program of the state guarantees of free rendering medical care to citizens increased from 2012 to 2017 by percent 45,4. At the same time there are imbalance and deficit of financing of territorial programs of the state guarantees of free rendering medical care to citizens within budgetary appropriations of budgets of subjects of the Russian Federation.
8. The insufficient quality level of primary health care and its availability to the population are noted. There are settlements which are out of zone of availability to citizens of primary health care.
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