The Moscow Government Presidium discussed the implementation of the Municipal Healthcare programme, which opened in 2014 to increase the life expectancy in the city.
“Considerable changes in municipal healthcare helped to strengthen the material resources, introduce an integration information system, introduce a system of mandatory medical insurance and implement structural changes,” Sergei Sobyanin said.
Alexei Khripun, the Moscow Government Minister and head of the Department of Healthcare, said that the life expectancy was 76.7 years in Moscow in 2014 (70.8 years across Russia in 2013), the mortality rate per 1,000 people was 9.7 people in Moscow (12 across Russia in 2013), infant mortality per 1,000 live births was 6.1 (8.2 across Russia in 2013) and the mortality rate from circulatory diseases per 100,000 people was 529.3 (698.1 across Russia in 2013).
“Life expectancy has grown to nearly 77 years, which is higher than the country’s average. At the same time, the mortality rate [in Moscow] is substantially lower than the average for Russia,” Mr Khripun said.
He added that the mortality rate from oncological diseases had increased.
He explained that this is due to the aging senior and elderly residents in Moscow, and the fact that Moscow houses three federal oncology centres.
The mortality rate from tuberculosis continues to decline.
“It is 80 percent lower than the country’s average despite the large number of labour immigrants in the city,” Mr Khripun said.
The main achievements in 2014 included infrastructure improvements such as construction and major repairs at healthcare centers, the introduction of modern diagnostics and treatment equipment, the provision of advanced medical training, the reduction of waiting time at outpatient clinics and the transition to per capita financing and development of the Integrated Medical Information and Analytical System, which includes online prescriptions and medical records, Mr Khripun said.
“What exactly has been achieved to improve the basic medical and demographic indicators? This can be divided into four blocks, starting with improved preventive measures, the operation of outpatient clinics and hospitals and the average ambulance response time,” Mr Khripun said.
He also said last year’s achievements were the result of considerable improvements to material resources. “In 2014, we built seven outpatient clinics, including in the Troitsky and Novomoskovsky administrative areas,” Mr Khripun said. “In all, we have opened 15 outpatient clinics since the start of the modernisation programme.”
The construction of seven outpatient clinics for 2,040 visits per shift has created over 400 jobs. Mr Khripun also noted the construction of two buildings at Communicable Diseases Hospital No 2 — a laboratory and pharmaceutical block and a maternity ward.
Also, the authorities built 35 multi-faceted medical centres in 2014, finished creating a cardiac system comprising 28 cardiovascular centres for acute myocardial infarction and stroke patients, increased the voulme of high-tech medical assistance, improved medical assistance for newborns, reduced the average ambulance response time and increase the range of ambulance services.
“All cardiovascular centres have modern medical equipment systems, including angiographs and equipment for thrombolytic therapy, which has greatly improved their performance. We can now save more AMI patients, whose mortality rate in 2014 was nearly three times lower than in 2011. Modern equipment, the growing professionalism of Moscow’s doctors and the development of new technology served as the basis for increasing the volume of high-tech medical assistance, which reached approximately 100,000 last year,” Mr Khripun said.
Efforts within the Municipal Healthcare programme included major repairs at 183 healthcare facilities, including reprofiling and the provision of modern medical equipment. In particular, surgery blocks at Hospitals No 56 and No 29 have been overhauled and the outpatient and hospital buildings of the Maxillofacial Surgery Hospital for War Veterans have been upgraded.
The programme included buying over 2 million units of vital medical equipment for healthcare institutions. In 2014, Moscow’s healthcare system performed 207,600 MRIs and 574,000 computed tomography scans, with the average waiting time of
The number of Muscovites who received high-tech medical care increased by 25 percent compared with 2010 to 98,200.
“Work is underway to improve doctors’ professional qualifications, both through regular professional growth courses at our leading medical schools, and through international internship programmes, which have been attended by about 600 doctors and nurses,” Mr Khripun said.
Overall in 2014, 8,100 doctors took part in professional growth training (up 36% from 2010) and 18,600 nurses (up 20%). Meanwhile, 611 healthcare professionals were trained at foreign clinics in Switzerland, Israel, Belgium, Italy, and South Korea where they learned innovative diagnosis and treatment methods.
The revenues of Moscow doctors continued to increase. According to Mr Khripun, their average monthly salary has reached almost 75,000 roubles, while nurses now make an average monthly salary of 52,000 roubles.
The Moscow Department of Healthcare now includes a monitoring centre established to improve accessibility to healthcare services.
The centre monitors the availability of Moscow clinics through the United Medical Information and Analytical System (EMIAS) system on a daily basis and works to improve the accessibility of services by adjusting doctors’ schedules and organising appointments with physicians.
In February 2015, the share of patients who failed to make an appointment with a physician for a date closer than three days beforehand was no more than 2.3%.
“While in 2014, only 60%-70% of Muscovites got appointments with a general practitioner or pediatrician for a date that was close enough, their number reached almost 98% by early 2015. This means these services have become dramatically more accessible thanks to EMIAS operating at full capacity, which enables us to monitor almost around the clock each clinic and even each physician’s practice at a clinic,” he said.
There are a total of 7.3 million unique patients registered with EMIAS, and 250,000 get their doctor appointments through it daily.
According to Mr Khripun, the EMIAS system’s functionality is unique and used around the clock. “In particular, we are working together with the Department of Information Technology to introduce other additional services, such as electronic prescription (now, 78% of Moscow clinics are involved in the project), digital outpatient medical records, laboratory services, stenting-related services, standard physical exams, and others.”
The project to establish 35 multidisciplinary hospital centres has increased the quality of care and ensured the more efficient use of hospital beds.
In 2014, the number of patients treated in community hospitals increased by 6% compared with 2010 to 1.9 million people.
The hospital mortality rate dropped to 2.5%, down 11% from 2010.
“We began to construct a number of facilities that are critical for the development of pediatric and obstetric care — a new building at the Morozov Hospital and a perinatal centre. These clinics will meet the highest standards, and the construction is being implemented quite rapidly,” Mr Khripun said.
He noted that the Moscow authorities intend to continue modernising the healthcare system.
“By 2020, we will come close to the standards used in developed economies,” he said.
The plan includes improving the quality of care provided in hospitals and clinics, and further updating of equipment and expanding training courses for physicians.
Other plans also include anti-cancer programmes.