Institutional Regulation of the Healthcare System in the Context of Spreading COVID-19 in the Russian Federation
Keywords:health care, coronavirus (COVID-19), response strategy, risk-based approach, medical care, government regulation
The modern era of globalization creates specific socio-ecological conditions for the existence of the world human community, which, in turn, determine the singularity of the epidemiological behaviour of many infectious diseases. The year 2020 has challenged the humanity with a pandemic that is rapidly spreading around the world. Global relationships are fraught with global epidemiological problems. Such manifestations of globalization as intensified international migration of population, roaring international trade in agricultural products, domestic and wild animals and birds, food, raw materials and goods, development of high-speed transport, turn the world into a single global socio-ecological epidemiological system, in which all processes are interconnected and mutually dependent. The purpose of this research is to study and analyse the system of institutional regulation of the health system in the context of a pandemic. The study used such methods as the analysis method, analogies, comparisons, observations, as well as statistical methods to analyse various indicators necessary for research. Using the above methods, a large amount of literature, legislation, regulatory and institutional regulations on this issue was analysed, some existing indicators were summarized, and a conclusion was made about the process of institutional regulation in an unfavourable epidemiological situation. As a result of the study based on a large number of official documents, it was concluded that measures were taken in the Russian Federation to counteract the active spread of a new coronavirus infection. Implementation of the state policy on preventing the spread of the pandemic resulted in no high mortality rate from new coronavirus infection compared to other world states. It should be noted that due to the federal structure of the country, the heads of regions independently decide on the regulation of mechanisms to counter the spread of infection on the territory of the subject. In this regard, it is not possible to promptly update information on the effectiveness of the measures taken. Currently, the risk-based approach described in the article is a mechanism for studying the epidemiological situation, which allows determining the risk factors that affect it and, on this basis, to rank epidemiological problems by their degree of importance. Due to the fact that the pandemic as a new virus was an unexpected risk, the clinical picture remains blurred, but the institutional form of state regulation is fused to protect the rights of citizens to health care under conditions of the pandemic.
ALFA.RU (2020). Reshenie Soveta EEK ot 08.04.2020 № 38 "O vnesenii izmeneniya v Reshenie Soveta Evrazijskoj ekonomicheskoj komissii ot 16 marta 2020 g. N 21" [Decision of the EEC Council dated 08.04.2020 No. 38 "On Amending the Decision of the Council of the Eurasian Economic Commission dated March 16, 2020 No. 21"]. https://www.alta.ru/tamdoc/20sr0038/ [in Russian].
Cherkasskiy, B.L. (2007). Risk v epidemiologii [Risk in Epidemiology]. Moscow: Prakticheskaya meditsina – Practical medicine. [in Russian].
Cherkasskiy B.L. (2008). Global’naya epidemiologiya [Global Epidemiology]. Moscow: Prakticheskaya meditsina – Practical medicine. [in Russian].
Khripun, A. (2020, May 18). Covid-19 Deaths in Moscow: The Government’s Account. The New York Times. Retrieved from https://www.nytimes.com/2020/05/18/opinion/letters/coronavirus-russia-moscow.html
KonsultantPlus. (2020). Pis'mo Minzdrava Rossii ot 17.05.2020 N 16-3/I/1-3061 „Ob osushchestvlenii vyplat stimuliruyushchego haraktera za vypolnenie osobo vazhnyh rabot medicinskim i inym rabotnikam, neposredstvenno uchastvuyushchim v okazanii medicinskoj pomoshchi grazhdanam, u kotoryh vyyavlena novaya koronavirusnaya infekciya COVID-19” [Letter of the Russian Ministry of Health N 16-3/I/1-3061 of 17 May 2020 “About the implementation of incentive payments for performing particularly important work to medical and other employees directly involved in providing medical care to citizens who have been diagnosed with a new COVID-19 coronavirus infection] Retrieved from http://www.consultant.ru/document/cons_doc_LAW_352690/#dst0 [in Russian].
KonsultantPlus. (2008). Federal'nyj zakon "O zashchite prav yuridicheskih lic i individual'nyh predprinimatelej pri osushchestvlenii gosudarstvennogo kontrolya (nadzora) i municipal'nogo kontrolya" ot 26.12.2008 N 294-FZ [The Federal Act No. 294-FZ of 26 April 2008 “About the Protection of the Rights of Legal Entities and Individual Entrepreneurs in the Exercise of State Control (Supervision) and Municipal Control”]. Retrieved from http://www.consultant.ru/document/cons_doc_LAW_83079/ [in Russian].
Ministry of Health of the Russian Federation. (2020, April 28). Profilaktika, diagnostika i lechenie novoj koronavirusnoj infekcii (COVID-19) Versiya 6 utverzhdena Minzdravom RF. [Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 6" approved by the Ministry of Health of the Russian Federation]. Moscow: Ministry of Health of the Russian Federation. Retrieved from https://minzdrav.midural.ru/uploads/COVID_method_view.pdf [in Russian].
National Institute for Quality. (2020). Chek-listy dlya organizacii i provedeniya vnutrennego kontrolya po razdelu „Epidemiologicheskaya bezopasnost'” v period pandemii koronavirusa COVID-19. [Checklists for organizing and conducting internal control under the section "Epidemiological safety" during the COVID-19 coronavirus pandemic]. Retrieved from http://nasci.ru/?id=10746 [in Russian].
Official Internet Resources of the President of Russia. (2020a). Perechen' poruchenij po voprosam protivodejstviya rasprostraneniyu novoj koronavirusnoj infekcii (COVID-2019) v regionah Rossijskoj Federacii N 665 ot 15.04.2020 [List of instructions on countering the spread of a new coronavirus infection (COVID-2019) No 665 of 15 April 2020]. Retrieved from http://kremlin.ru/acts/assignments/orders/63206 [in Russian].
GARANT.RU. (2020). Prikaz Ministerstva zdravoohraneniya RF ot 19 marta 2020 g. № 198n "O vremennom poryadke organizacii raboty medicinskih organizacij v celyah realizacii mer po profilaktike i snizheniyu riskov rasprostraneniya novoj koronavirusnoj infekcii COVID-19" [Order of the Ministry of Health of the Russian Federation of March 19, 2020 No. 198n "On the temporary procedure for organizing the work of medical organizations in order to implement measures to prevent and reduce the risks of the spread of a new coronavirus infection COVID-19"]. Retrieved from https://www.garant.ru/products/ipo/prime/doc/73669697/ [in Russian].
Official Internet Resources of the President of Russia. (2019). Ukaz Prezidenta Rossijskoj Federacii ot 06.06.2019 g. № 254 „O Strategii razvitiya zdravoohraneniya v Rossijskoj Federacii na period do 2025 goda” [Decree of the President of the Russian Federation of 06.06.2019 No. 254 “On the Strategy for the development of healthcare in the Russian Federation for the period up to 2025”]. Retrieved from http://www.kremlin.ru/acts/bank/44326 [in Russian].
RGRU. (2010). Federalnyi zakon "Ob obrashchenii lekarstvennyh sredstv" ot 12.04.2010 N 61-FZ [The Federal Act No. 61-FZ of 12 April 2010 “About Circulation of Medicines]. Retrieved from https://rg.ru/2010/04/14/lekarstva-dok.html [in Russian].
The Official Internet-Portal of Legal Information. (2020a) Federalnyi zakon ot 01.04.2020 N 99-FZ "O vnesenii izmenenij v Kodeks Rossijskoj Federacii ob administrativnyh pravonarusheniyah" [The Federal Act No. 99-FZ of 1 April 2020 “About the Amendments to the Russian Code of Administrative Offences”]. Retrieved from http://publication.pravo.gov.ru/Document/View/0001202004010076 [in Russian].
The Official Internet-Portal of Legal Information. (2020b). Postanovlenie Pravitel'stva Rossijskoj Federacii ot 21.03.2020 N 323 "Ob avansirovanii gosudarstvennyh kontraktov na osushchestvlenie Ministerstvom promyshlennosti i torgovli Rossijskoj Federacii zakupok apparatov iskusstvennoj ventilyacii legkih i ekstrakorporal'noj membrannoj oksigenacii, vklyuchayushchih raboty i uslugi po ih dostavke v medicinskie organizacii v sub"ektah Rossijskoj Federacii" [Decree of the Government of the Russian Federation of March 21, 2020 No. 323 "On advancing government contracts for the procurement of artificial ventilation devices and extracorporeal membrane oxygenation by the Ministry of Industry and Trade of the Russian Federation, including works and services for their delivery to medical organizations in the constituent entities of the Russian Federation"]. Retrived from http://publication.pravo.gov.ru/Document/View/0001202003230004 [in Russian].
The Official Internet-Portal of Legal Information. (2020c). Postanovlenie Pravitel'stva Rossijskoj Federacii ot 30.04.2020 № 630 "O vnesenii izmeneniya v postanovlenie Pravitel'stva Rossijskoj Federacii ot 24 dekabrya 2019 g. № 1803 i o priostanovlenii dejstviya otdel'nyh polozhenij nekotoryh aktov Pravitel'stva Rossijskoj Federacii" [Resolution of the Government of the Russian Federation of April 30, 2020 No. 630 "On Amending the Resolution of the Government of the Russian Federation No. 1803 of December 24, 2019 and on the Suspension of Certain Provisions of Certain Acts of the Government of the Russian Federation"]. Retrieved from http://publication.pravo.gov.ru/Document/View/0001202005030003 [in Russian].
The Official Internet-Portal of Legal Information. (2020d). Rasporyazhenie Pravitel'stva Rossijskoj Federacii ot 27.03.2020 № 748-r [Order of the Government of the Russian Federation dated March 27, 2020 No. 748-r]. Retrieved from http://publication.pravo.gov.ru/Document/View/0001202003300026 [in Russian].
The Official Internet-Portal of Legal Information. (2020f). Postanovlenie Pravitel'stva Rossijskoj Federacii ot 02.07.2020 № 974 "O vnesenii izmenenij v nekotorye akty Pravitel'stva Rossijskoj Federacii" [Resolution of the Government of the Russian Federation dated 02.07.2020 No. 974 "On Amending Certain Acts of the Government of the Russian Federation"]. Retrieved from http://publication.pravo.gov.ru/Document/View/0001202007100028 [in Russian].
World Health Organization. (2020, April 16). Certification and Classification (Coding) of Covid-19 as Cause of Death. Geneva, Switzerland: World Health Organization. Retrieved from https://www.who.int/classifications/icd/Guidelines_Cause_of_Death_COVID-19.pdf?ua=1
World Health Organization. (2020a). Retrieved from https://www.who.int/
World Health Organization. (2020b, April 14). COVID-19 Strategy Update. Geneva, Switzerland: World Health Organization. Retrieved from https://www.who.int/docs/default-source/coronaviruse/covid-strategy-update-14april2020.pdf?sfvrsn=29da3ba0_19