Participants in a Moscow Government Presidium meeting have passed resolutions on issuing grants to the city’s state-owned medical institutions. They will use them to pay bonuses to their employees that treat elderly people. “We have met with medical experts and agreed to issue additional grants for general practitioners (GPs) and experts who treat elderly people with chronic health problems,” Sergei Sobyanin noted.
The following medical personnel categories are to be eligible for grants:
- doctors and mid-level medical personnel involved in treating elderly patients with multiple chronic health disorders;
- general practitioners (family doctors).
Each doctor is to receive an additional 20,000 roubles per month, with each nurse getting 10,000 roubles, said Moscow Government Minister Alexei Khripun, Head of the City Department of Healthcare.
This year, the city will improve healthcare standards for elderly people at outpatient clinics. This programme stipulates new guidelines for general practitioners dealing with elderly patients, including women aged 55 and over, as well as men aged 60 and over and having three and more chronic health disorders. These health problems include arterial hypertension, coronary artery disease, cerebrovascular disease, chronic cardiac decompensation, atrium fibrillation and flutter, diabetes type 2, bronchial asthma, chronic obstructive pulmonary disease and chronic kidney disease.
Each outpatient clinic will create special sections for elderly patients with these health problems, which will be staffed with separate GPs who will treat no more than 450-500 people. Primary exams will last 40 minutes, and 20-minute secondary exams are also stipulated. GPs will compile individual treatment plans for each patient. If necessary, patients will be able to call their doctors or nurses to ask about medications. Doctors will also comment on their current condition.
Today, 250 doctors in this category work at outpatient clinics, and the number is to reach 400 before the year is out, Mr Khripun said. “They are specially trained and the best GPs working with each patient under an individualised programme. They receive patients longer, and they can speak with them any time, including by telephone,” he said.
Local adult clinics will set up sections staffed by GPs and family doctors. On 1 May, 650 general practitioners will start receiving patients, and an additional 1,500 doctors will step in from 1 September.
Over 3,000 doctors will be receiving these patients starting in 2018, Mr Khripun said. “A programme to regularly retrain general practitioners for these sections will make it possible to boost initial treatment quality, which is the most important thing,” Mr Khripun said. The results of a 2016 pilot programme at several outpatient clinics showed that patients’ condition had improved considerably.
The number of patients with stabilised blood pressure has soared from 26 to 74 percent, with the share of patients with normal cholesterol levels increasing from 35 to 60 percent. As compared to patients not involved in the programme, these elderly people summon ambulance teams nine percent less often. And the share of elderly patients satisfied with medical treatment quality has increased from 65 to 92 percent.