of December 8, 2020 No. KR DSM-238/2020
About approval of Rules of rendering specialized, including high-technology medical care
According to Item 5 of article 124 of the Code of the Republic of Kazakhstan of July 7, 2020 "About health of the people and health care system" PRIKAZYVAYU:
1. Approve Rules of rendering specialized, including high-technology medical care according to appendix 1 to this order.
2. Recognize invalid some orders of the Minister of Health of the Republic of Kazakhstan according to appendix 2 to this order.
3. To provide to department of the organization of medical care of the Ministry of Health of the Republic of Kazakhstan in the procedure established by the legislation of the Republic of Kazakhstan:
1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;
2) placement of this order on Internet resource of the Ministry of Health of the Republic of Kazakhstan after its official publication;
3) within ten working days after state registration of this order submission to Legal department of the Ministry of Health of the Republic of Kazakhstan of data on execution of the actions provided by subitems 1) and 2) of this Item.
4. To impose control of execution of this order on the supervising vice-Minister of Health of the Republic of Kazakhstan.
Minister of Health of the Republic of Kazakhstan
to the Order of the Minister of Health of the Republic of Kazakhstan of December 8, 2020 No. KR DSM-238/2020
1. These rules of rendering specialized, including high-technology medical care (further - Rules) are developed according to Item 5 of article 124 of the Code of the Republic of Kazakhstan of July 7, 2020 "About health of the people and health care system" (further - the Code) and determine procedure for rendering specialized, including high-technology medical care in the Republic of Kazakhstan.
2. In these rules the following concepts are used:
1) high-technology medical care (further - VTMP) - the medical care which is part of the specialized medical care provided by profile specialists in case of the diseases requiring application of innovative and (or) unique methods of diagnostics and treatment with scientifically proved efficiency and safety and the technologies developed on the basis of achievements of medical science and allied industries of science and technology;
2) the guaranteed amount of free medical care (further - GOBMP) - the amount of medical care provided at the expense of budgetary funds;
3) medical products - products of medical appointment and medical equipment;
4) the organization of health care - the legal entity performing activities in the field of health care;
5) specialized medical care - the medical care provided by profile specialists in case of the diseases requiring ad hoc methods of diagnostics, treatment, medical rehabilitation including with use of means of remote medical services;
6) authorized body in the field of health care (further - authorized body) - the central executive body performing management and cross-industry coordination in the field of protection of public health of the Republic of Kazakhstan, medical and pharmaceutical science, medical and pharmaceutical education, sanitary and epidemiologic wellbeing of the population, drug circulation and medical products, qualities of rendering medical services (help);
7) fund of social medical insurance (further - FSMS) - the non-profit organization making accumulation of assignments and fees, and also performing purchase and fee of the subjects of health care providing medical care in amounts and on conditions which are provided by the agreement of purchase of medical services, and other functions determined by the laws of the Republic of Kazakhstan.
3. In out-patient and stationary conditions, depending on medical specialties, types of specialized medical care are subdivided into therapeutic, surgical, pediatric and obstetric and gynecologic profiles.
The therapeutic profile includes: therapy, allergology, gastroenterology, hematology, nephrology, cardiology, cardiorheumatology, pulmonology, endocrinology, psychiatry, psychotherapy, medical psychology, neurology, therapeutic stomatology, sexual pathology, rehabilitology, professional pathology, work therapy, narcology, phthisiology, gerontology geriatrics, girudoterapiya, toxicology, physiotherapy exercises, dietology, radiology, Su-dzhok-terapiyu, manual therapy, reflexotherapy, homeopathy, dermatovenereology, dermato-cosmetology, infectious diseases, immunology, leprologiya.
The surgical profile includes: surgery, heart surgery, neurosurgery, endoscopy, oncology, traumatology and orthopedics, Combustiology, urology, andrology, otorhinolaryngology, ophthalmology, proktologiya, mammology, surgical stomatology, orthodontic stomatology, orthopedic stomatology, maxillofacial surgery, transplantology, extracorporal detoxication, hyperbaric oxygenation, toxicology, anesthesiology resuscitation.
The pediatric profile includes: pediatrics, ftiziopediatriya, children's anesthesiology and resuscitation, children's surgery, children's neurosurgery, children's endoscopy, children's traumatology and orthopedics, children's Combustiology, children's transplantology, children's extracorporal detoxication, children's allergology, medical genetics, children's cardiorheumatology, infectious diseases at children, children's immunology, children's oncology, children's haemato-oncology, children's neurology, children's nephrology, children's endocrinology, children's psychiatry, children's psychotherapy, children's toxicology, children's hyperbaric oxygenation, children's pulmonology, children's gastroenterology, children's otorhinolaryngology, children's ophthalmology, children's stomatology, including orthopedics and orthodontics, children's maxillofacial surgery, children's urology, children's and teenage gynecology, children's dermatovenereology, teenage narcology, teenage therapy, children's rehabilitology, neonatology.
The obstetric and gynecologic profile includes: gynecology, obstetrics, neonatology, medical genetics, high reproductive technologies.
4. Specialized medical care it appear to the population depending on the level of the medical organization.
5. Specialized medical care is provided in type of the consulting and diagnostic help in out-patient conditions, the hospital-replacing and stationary help at the secondary and tertiary levels of delivery of health care.
6. Specialized medical care is provided to the population in out-patient conditions according to the procedure, determined according to the subitem 31) of article 7 of the Code.
7. At any level of rendering specialized medical care in case of difficulty in identifications of the diagnosis, including not transportability of the patient, the consultation with involvement of specialists, if necessary with involvement of the specialist from other medical organizations will be organized.
8. The services in rendering specialized medical care which are not entering the list of GOBMP appear in system of compulsory social medical insurance (further - OSMS) or on paid basis.
9. Specialized medical care is provided by the doctors having profile specialization and necessary qualification according to the legislation of the Republic of Kazakhstan.
10. The amount of specialized medical care, including laboratory and diagnostic methods of research, is determined by clinical protocols (further - the Protocol).
11. Children up to five years, and also the children of advanced age needing according to the conclusion of the doctor individual care are hospitalized with mother or other persons for implementation of such leaving.
12. Person performing child care, being on hospitalization, is free of charge provided with berth.
13. In hospital-replacing conditions specialized medical care in day hospitals is provided in out-patient and stationary conditions by the organizations of health care.
14. Specialized medical care in hospital-replacing conditions within GOBMP and the OSMS system is provided in the conditions of day hospital in the direction of the specialist of primary health care or other organization of health care with results of laboratory, tool researches and consultations of the profile specialists necessary for treatment of this patient.
15. The services in rendering specialized medical care in hospital-replacing conditions which are not entering the list of GOBMP appear in the OSMS system or on paid basis.
16. The specialized medical care to the population in stationary conditions provided in the direction of specialists of primary health care is included into GOBMP and OSMS.
17. In need of rendering specialized medical care to the patient he goes to the relevant profile (specialized) organization of health care.
18. Hospitalization of patients is carried out according to profile of department (beds).
19. The management of the organization of health care, independently makes the decision on planned hospitalization of the patient in the presence of medical indications for the social and unprotected national groups: children up to 18 years, pregnant women, veterans of the Great Patriotic War, disabled people, mothers the having many children, pensioners sick with socially important diseases within 15% of amount of planned hospitalization for the scientific organizations, 10% for the organizations of health care of district, city, regional levels irrespective of pattern of ownership.
For the pandemic caused by koronavirusny infection of the new COVID-19 type management of the organization of health care independently makes the decision on planned hospitalization of the patient in the presence of medical indications for the social and unprotected national groups: children up to 18 years, pregnant women, veterans of the Great Patriotic War, disabled people, mothers the having many children, pensioners sick with socially important diseases within 50% of amount of planned hospitalization for the scientific organizations, 30% for the organizations of health care of city, regional levels irrespective of pattern of ownership.
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