16 October 2013

You have the right…

We recommend that you first look at the end of the article, and then, if you want, read from the beginning about how it should ideally be – VM.

Patient rights: how to get to an expensive operation for free

Anna Dobryukha, RAPSIMany are sure that if you need heart surgery, endoprosthetics or transplantation, you will have to take an unaffordable loan, sell an apartment, or contact charitable foundations.

Meanwhile, according to the law, the state guarantees all of us high-tech medical care at the expense of the budget.

What expensive operations a Russian citizen has the right to get to for free and how to do it in practice – in the next issue of our column "Legislation".

In Moscow, it takes longer to wait, in the regions – faster First of all, there are several important nuances that, as the practice of recent years has shown, significantly increase the chances of getting free high–tech treatment in a reasonable time, "without waiting for peritonitis."

Since 2009, an information system has been operating in our country, where all medical centers providing VMP (high-tech medical care) and the availability of places in them with online updates are indicated. This database is at the disposal of the health authorities who send it to the VMP, and thanks to the clear overall picture with operational changes, it is now often possible to provide patients with a choice. "You may be offered, say, surgical treatment at the most popular institution in the country – the Burdenko Neurosurgery Research Institute with a longer waiting period, or surgery at a new neurosurgical center in Tyumen in a shorter time," the Department of the Ministry of Health, which is in charge of high–tech medical care, says.

At the same time, many of us traditionally believe that the most modern methods of treatment and the best equipment are concentrated in the capital. Aspiring to prestigious Moscow clinics, patients often end up in long queues and, in the end, fearing "not to live" before the operation, they begin to collect money. However, not only officials, but also doctors themselves, including in informal confidential conversations, admit: today, medical centers have been created and are operating in many regions, not inferior to the well-promoted metropolitan ones. For example, a unique brain surgery using a 3D camera, recently performed for the first time in Russia, took place at the Tyumen Neurosurgical Center.

Therefore, a tip: do not immediately dismiss the options for conducting an operation in another region. Make inquiries about the proposed clinic, read the responses on the Internet. Keep in mind: all data on surgical intervention, as well as recommendations for further treatment and rehabilitation will be entered into the specialized information system of the Ministry of Health. Accordingly, this important information will be received by a specialized hospital or polyclinic at the patient's place of residence. Thus, on the one hand, continuity of treatment is maintained, and, on the other, doctors have the opportunity to contact their colleagues to clarify the necessary nuances.

Where to start The procedure for sending Russian citizens to high-tech treatment, effective today, is defined in Order No. 1689n of the Ministry of Health and Social Development of the Russian Federation dated December 28, 2011.

The path to the VMP begins with the attending physician in the polyclinic or hospital at the place of residence. The doctor must issue an extract from the patient's medical history. This document specifies the diagnosis, the examinations and treatment carried out, data on the state of health in general, as well as a recommendation on the need to refer the patient to high-tech treatment. The results of tests and examinations confirming the diagnosis are attached to the statement.

Further, the recommendation of the attending physician is considered by the medical commission (VC) of the polyclinic or hospital. Within three working days, a decision is made: whether the referral to the VMP is justified. If the verdict is positive, then within the next three working days a package of documents is being prepared, which includes:

  • extract from the protocol of the VC decision on the referral of the patient to the VMP;
  • application of the patient (or his legal representative or proxy) with full name, address, passport series and number, postal address, contact phone number and e-mail address (if available);
  • written consent of the patient to the processing of his personal data.

Also attached are copies of: passport (birth certificate for children under 14 years old), compulsory medical insurance policy (if available), certificate of compulsory pension insurance (if available), the statement of the attending physician about the patient's health status, certified by the signature of the head physician of the polyclinic (hospital), the results of examinations confirming the diagnosis.

From commission to commission The package of documents is sent to the regional Commission for the selection of patients for the provision of VMP.

Such a "consultation" is formed by the health management body of each region, you can find out the coordinates (actual and email address, phone numbers) in the local help desk or on the website of regional authorities. The order allows you to transfer documents both by regular mail and by e–mail - in the form of scanned copies. The Ministry of Health says that more and more regions are switching to "advanced" electronic forwarding. However, in any case, the patient or his legal representative has the right to personally take the documents to the Selection Commission for the provision of VMP (paragraph 10 of the Procedure for sending citizens to VMP, approved by the aforementioned order of the Ministry of Health No. 1689n).

The Regional Commission within 10 working days decides on the availability (absence) of medical examinations for the VMP. The protocol indicates the medical institution where it is planned to send the patient for high-tech treatment. An extract from the protocol is given to the patient in his hands or sent by mail – electronic or regular.

In case of a positive decision, within the next three working days, the Commission draws up an accounting form No. 025/u-VMP "Coupon for the provision of VMP" for the patient. This coupon is generated electronically in the specialized information system of the Ministry of Health and immediately goes to the commission of the medical institution where the patient is supposed to be hospitalized for surgery. The results of previous analyses and examinations are also sent here by e-mail.

The medical commission of the clinic, in turn, reviews the documents within 10 working days and, finally, makes a final verdict indicating the date of the intended hospitalization. The corresponding protocol is drawn up on paper in one copy and remains for storage in the clinic itself, and is also attached electronically to the coupon for the provision of VMP. The patient, as stated in the order, is only informed of the final decision.

On a note
At first glance, there are so many approvals planned that my head is spinning. However, in practice, most of these stages take place without the patient's participation and quite quickly, since electronic technologies are increasingly being used. The developers of the order specify: everything about everything – from the moment of issuing a recommendation by the attending physician to the appointment of the date of hospitalization should take no more than 26 days.

A fly in the ointment from the editors
:(this is a first-hand story, not an urban legend):
A resident of St. Petersburg, in need of knee replacement, performed all the listed procedures and came to the doctor hooch, who explained to her that, of course, she was given both a prosthesis and an operation for free, but only after exactly the same amount was put in the pocket of this robe as the prosthesis costs, and an operation for a paid patient.
The lady cried-cried, collected a lot of money and ... went to a Finnish clinic, where she was operated on cheaper and in much better (at least household) conditions.
And I only regretted that I lost time: the queue for such a "free" operation in St. Petersburg is 1.5–2 years.

Portal "Eternal youth" http://vechnayamolodost.ru16.10.2013

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