The Ministry of Health and Social Development of the Republic of Kazakhstan Republican Center for Health Development Development of a network of health care organizations Republic of Kazakhstan November 2015 Strategic Directions Message from the President of the Republic of Kazakhstan Nursultan Nazarbayev to the people of Kazakhstan 2014 "Strategy" Kazakhstan2050 ": a new policy established state" Our main goal - by 2050 to become one of the 30 most developed countries State Program for Development of Health of the Republic of Kazakhstan "Salamatty Kazakhstan" for 2011-2015 The purpose 5.4. Creating an efficient and accessible health care system Draft State Program of Health of the Republic of Kazakhstan "Densaulyk" for the years 2016-2019 Objective: To strengthen health and longer life of Kazakhstan to sustainable socio-economic development Approaches to planning Determination of needs of the population in the quality of care Increased patient satisfaction with medical care Social and economic development, geographical location, environment, health and demographic indicators The proposed standards inpatient care: Level 1 - the Republican Hospital; 2nd-level multidisciplinary District Hospital (city, district); Level 3 - Distribution Hospital (multi-level); Level 4 - republic and scientific organizations; the development of rehabilitation centers, hospitals, palliative care outpatient care: Register Stuck populations, territory and the remoteness of residence, the development of general practice The implementation The development The definition of Further of the planned of general Standard economic improvement and Providing the measures for the practice, equipment of efficiency of the implementation of Staffing population with restructuring of expansion of the basic hospital sector high technologies medical staff equal access to the hospital hospital replacing medical and ambulatory applied in by function health care sector and the technologies, equipment and polyclinic developed development of ambulatory medical devices organizations countries primary health surgery care Levels of hospital care (In accordance with international experience) Level 4: National Centre, research institutes, republican hospital, holding > 1 million. Population, multidisciplinary + tertiary care + research Level 3: regional hospitals 300,000 -1,000,000. Population, including multidisciplinary, oncological, and others. + Tertiary care Level 2: inter-district (regional, multidisciplinary) Hospital Level 1: district hospitals 50 000 - 300 000 population. Basic specialty + specialized beds (cardiology, neurology, endocrinology and others.) . 20 000 - 50 000 population. 4 basic specialties: internal medicine, surgery, obstetrics and pediatrics. With a population of less than 20 000 or, in the absence within a radius of 60-120 minutes RB created Sat not reviewed Taken into account in longterm plans, taking into account the proposals of the Master Plan The master plan for the development of primary health care The master plan for the restructuring of the hospital sector (16 regions) The master plan for the improvement of laboratory service (16 regions) Future plans for the development of a network of health care organizations in the regions 2015-2025 years, taking into account the proposals of the Master Plan for the restructuring of the hospital sector, the development of primary health care and laboratory services (16 regions) The network of health care organizations Availability of beds per 10 thous. Population the Ministry of Health and Social Development other ministries and agenciesа private 34 больницы с 3011 койками (2,8%) АПО - 69 729 больниц с 95555 койками (90,8%) АПО - 2174 148 больниц с 6653 койками (6,4%) АПО-921 USA 33 United Kingdom 39 Australia 40 Canada 34 organization for economic cooperation and development 49 Kazakhstan 53,3 -2014 г. 50,0 - к 2020 г. Existing and recommended rates of attachment of the population to primary health care facilities by population type recommendations of the master plan Medical station 300-1200/1500 2000 Medical general practice 1200/1500 Family clinic 10,000 > Family Health Center 3,000/4,000 Family clinic 30,000 The regional center of general practitioners \ family health 4,000-30,000 (+Family Health Care Centre) Family clinic 30,000 The city center of general practitioners / family health 30,000 - 150,000 (+Family Health Care Centre) type State norm МРБП 50-800 МS Paramedic obstetric point outpatient clinic 50-800 800-2000 State standard of the network of health care organizations • Based on the recommendations on the structure of the network of health care organizations, developed by Sanigest Internacional Ministry of Health and Social Development has been initiated by the adoption of new government regulations network of Health of the Republic of Kazakhstan, approved by the Government of the Republic of Kazakhstan dated February 19, 2014 №114. • New government regulations included the following items: • main hospital sector became general hospitals (for both adults and children); • introduced a fundamentally new type of hospital - interregional multidisciplinary hospital to serve the population in areas inhabited by at least 100 thousand people; • specialized hospitals (infectious, drug treatment, psychiatric, dermatological and venereal) remain only at the level of the regional center, allowed the transformation of the regional infectious diseases hospital in the department at the regional hospital multidisciplinary; • introduces a requirement for the opening of rehabilitation beds in hospitals or offices, and the establishment of a rehabilitation center was valid only if the population served in a quantity of not less than 150 thousand people; • first introduced the requirement to open a hospice beds in hospitals or offices, as well as the opening of nursing homes with a population of not less than 400 thousand people. Activities planned in the long-term plans of development of the network of healthcare organizations of Kazakhstan for 2015 - 2025 years. (according to the state standard of the network of organizations of Health) The existing network of primary health care 6026 measures for the reorganization of primary care network ВА в СП СП в ВА ВА в МП и ФАП ФАП и МП в ВА 8 3 137 63 The existing network of hospitals 729 measures for the restructuring of the hospital sector an assoc iatio n 150 Preliminary results of the Perspective plan of activities for 9 months of 2015 70 60 Redirecting МБР/ РБ РЦ хос пис БСУ 70/ 131 14 20 4 63 Closing / Translati ons into primary health care 82 61 45 50 40 30 20 10 18 10 2 8 5 10 8 0 реструктуризация ЦРБ в МРБ закрытие нерентабельных больниц планирование на 2015 год объединение больниц исполнено закрытие МП реорганизация ПМСП Actualization and realization of perspective plans for development of a network of health care organizations in the region during 2015-2025, taking into account the recommendations of the master plan for the restructuring of the hospital sector and the development of primary health care Conclusion of the Memorandum with akimats regions, cities of Astana and Almaty with the inclusion of commitments to the implementation of the planned activities on implementation of long-term plans of development of the network of medical institutions in the current year Monitoring of the implementation of measures of long-term plans the network of medical institutions in the coming 3 years, taking into account the budget planning for 2015-2017 years Prevention of social tension in the restructuring of the hospital sector: - The distribution of flows of patients (in-patient level, day care or other beds around the clock); - Retraining and employment of redundant staff; - Preparation of new technologies in the event of conversion of the medical organization; - The use of vacated buildings and other tangible assets; - Work with the public and the media.