Theoretical foundations and practical implementation of monitoring the accessibility state of facilities and services in the field of health care
- Authors: Ishutina I.S.1, Shabanova O.A.1, Khodakovskii M.D.1, Vladimirova O.N.2, Kantemirova R.K.1,3
-
Affiliations:
- Federal Scientific Center for the Rehabilitation of the Disabled named after G.A. Albrecht
- Saint-Petersburg Institute for Advanced Training of Medical Experts
- St. Petersburg State University
- Issue: Vol 103, No 5 (2022)
- Pages: 841-850
- Section: Social hygiene and healthcare management
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/77392
- DOI: https://doi.org/10.17816/KMJ2022-841
- ID: 77392
Cite item
Open Access
Access granted
Abstract
Background. By decision of the Commission under the President of the Russian Federation for the Disabled, the Ministry of Labor of Russia was entrusted with monitoring the implementation of federal and regional action plans “road maps” to increase the accessibility of facilities to people with disabilities.
Aim. Monitoring the implementation by state authorities of the constituent entities of the Russian Federation of action plans (“road maps”) to increase the values of accessibility indicators for disabled people in healthcare facilities.
Material and methods. The indicators of accessibility for disabled people of facilities in the healthcare system based on the results of implementation of action plans by executive authorities of 85 constituent entities of the Russian Federation in the field of healthcare, obtained as a result of monitoring the achieved values in the indicators of accessibility for disabled people of facilities in 2019 and 2020, were analyzed. The availability of facilities was calculated on the basis of information from the state authorities of the constituent entities of the Russian Federation, prepared in accordance with the recommendations of the Ministry of Labor of Russia, using the analysis and generalization of the received materials, using the method of comparing absolute and relative indicators.
Results. The accessibility of medical organizations for the disabled is created in two ways — from the standpoint of “universal design” (inclusion of measures to organize the accessibility of facilities and services for the disabled when designing and building new facilities, as well as during reconstruction and major repairs) and using the principle of “reasonable accommodation” for existing facilities (before their overhaul and reconstruction). Ranking the indicators of the e150 domain (design, nature of design, construction and arrangement of buildings for public use) on the basis of a unified assessment scale of the International Classification of the Functioning of Disabilities and Health made it possible to identify regions of the Russian Federation with varying degrees of accessibility of healthcare facilities: absolutely accessible — in 10 (11.8%) regions of the country; with a significant level of accessibility — in 53 (62.4%) regions; with a moderate level of accessibility — in 8 (9.4%) regions; with a low or insignificant level of accessibility — in 9 (10.6%) regions of the Russian Federation; with a very low level of accessibility of healthcare facilities — in 5 (5.8%) regions of the Russian Federation, respectively.
Conclusion. According to the monitoring of the state of accessibility of facilities for the disabled in the healthcare sector in the constituent entities of the Russian Federation, the level of accessibility varied from 100% to 0.5%. The planned indicators of increasing the availability of facilities in the healthcare sector have reached 100% in 52 constituent entities of the Russian Federation.
Full Text
About the authors
Inna S. Ishutina
Federal Scientific Center for the Rehabilitation of the Disabled named after G.A. Albrecht
Email: in.ishutina@yandex.ru
ORCID iD: 0000-0002-6640-904X
M.D., Cand. Sci. (Med.), Head, Depart. of medical early care and support, Institute of early help and support
Russian Federation, St. Petersburg, RussiaOksana A. Shabanova
Federal Scientific Center for the Rehabilitation of the Disabled named after G.A. Albrecht
Email: expert-oksana@mail.ru
ORCID iD: 0000-0002-8019-8963
M.D., Cand. Sci. (Med.), Leading Researcher, Depart. of medical early care and support, Institute of early help and support
Russian Federation, St. Petersburg, RussiaMatvei D. Khodakovskii
Federal Scientific Center for the Rehabilitation of the Disabled named after G.A. Albrecht
Author for correspondence.
Email: hodak200@yandex.ru
ORCID iD: 0000-0001-6953-5191
junior researcher, Depart. of medical early care and support, Institute of early help and support
Russian Federation, St. Petersburg, RussiaOksana N. Vladimirova
Saint-Petersburg Institute for Advanced Training of Medical Experts
Email: vladox1204@yandex.ru
ORCID iD: 0000-0001-6692-2882
M.D., D. Sci. (Med.), Rector
Russian Federation, St. Petersburg, RussiaRaisa K. Kantemirova
Federal Scientific Center for the Rehabilitation of the Disabled named after G.A. Albrecht; St. Petersburg State University
Email: terapium@yandex.ru
ORCID iD: 0000-0002-1287-486X
M.D., D. Sci. (Med.), Prof., Head, therapy department; Depart. of Hospital Therapy
Russian Federation, St. Petersburg, Russia; St. Petersburg, RussiaReferences
- Federal Law No. 419-FZ of December 1, 2014 “On Amendments to Certain Legislative Acts of the Russian Federation Regarding the Social Protection of Disabled Persons in Connection with Ratification of the Convention on the Rights of Persons with Disabilities”. Konsul'tant Plyus. http://www.consultant.ru/document/cons_doc_LAW_171577/ (access date: 01.07.2021). (In Russ.)
- United Nations. Convention on the Rights of Persons with Disabilities. Adopted by General Assembly resolution 61/106 of 13 December 2006. https://www.un.org/ru/documents/decl_conv/conventions/disability.shtml (access date: 01.07.2021). (In Russ.)
- Mintrud Rossii. Report on the implementation and assessment of the effectiveness of the state program of the Russian Federation “Accessible Environment”. https://mintrud.gov.ru/docs/mintrud/handicapped/1353 (access date: 01.07.2021). (In Russ.)
- Federal Law “On Social Protection of Disabled People in the Russian Federation” from 24.11.1995 No. 181-FZ. Konsul'tant Plyus. http://www.consultant.ru/document/cons_doc_LAW_8559/ (access date: 01.07.2021). (In Russ.)
- Decree of the Government of the Russian Federation No. 599 of 17 June 2015 “On the Procedure and Timeframe for the Development by Federal Bodies of Executive Power, Bodies of Executive Power of Constituent Entities of the Russian Federation, and Local Government Bodies of Measures to Improve Values of Accessibility Indicators for Disabled People of Facilities and Services in Established Areas of Activity”. Ofitsial'nyy internet-portal pravovoy informatsii. http://pravo.gov.ru/proxy/ips/?docbody=&nd=102374010 (access date: 02.07.2021). (In Russ.)
- Order of the Ministry of Health of the Russian Federation No. 802n of November 12, 2015 “On Approval of the Procedure for Ensuring Accessibility for Disabled Persons of Infrastructure Facilities of State, Municipal and Private Health Care Systems and Services Provided in the Area of Health Care, as well as Providing them with the necessary Assistance”. GARANT — Zakonodatel'stvo. https://www.garant.ru/products/ipo/prime/doc/71172330/ (access date: 02.07.2021). (In Russ.)
- Order of Roszdravnadzor No. 5974 dated 10.07.2020 “On Approval of Administrative Regulations of the Federal Service for Healthcare Supervision on the Implementation of State Control of the Quality and Safety of Medical Activities”. Konsortsium kodeks. https://docs.cntd.ru/document/565471721 (access date: 02.07.2021). (In Russ.)
- Federal Law No. 323-FZ of November 21, 2011 “On the Fundamentals of Public Health Protection in the Russian Federation”. Konsul'tant Plyus. http://www.consultant.ru/document/cons_doc_LAW_121895 (access date: 01.07.2021). (In Russ.)
- Code of the Russian Federation on Administrative Offences from 30.12.2001 No. 195-FZ. Konsul'tant Plyus. http://www.consultant.ru/document/cons_doc_LAW_34661/ (access date: 01.07.2021). (In Russ.)
- Decree of the Cabinet of Ministers of the Republic of Tatarstan from 28.09.2015 No. 716 “On approval of the Action Plan (road map) to improve the indicators of accessibility for disabled people to facilities and services in the Republic of Tatarstan for 2015–2030”. Konsortsium kodeks. https://docs.cntd.ru/document/430649350?marker=19OD05N§ion=text (access date: 03.07.2021). (In Russ.)
- Decree of the Government of the Russian Federation No. 363 of 29.03.2019 “On Approval of the State Program of the Russian Federation “Accessible Environmen”. Konsul'tant Plyus. http://www.consultant.ru/document/cons_doc_LAW_322085/ (access date: 02.07.2021). (In Russ.)
- Order No. 627 of the Russian Ministry of Labor dated December 25, 2012 “On Approving Methods to Objectify and Systematize the Accessibility of Facilities and Services in Priority Areas of Life Activities for Persons with Disabilities and Other Low Mobility Groups, with the Ability to Consider Regional Specifics” [Together with GOST R 51079-2006 (ISO 9999:2002). Group P20. National Standard of the Russian Federation. Technical means of rehabilitation for people with disabilities (OCS 11.180 OKP 94 0100) (extracts)]. Konsul'tant Plyus. http://www.consultant.ru/document/cons_doc_LAW_150687/ (access date: 02.07.2021). (In Russ.)
- O’Ferrall E. Accessibility of products and services following a design for all approach in standards. In: Advances in Intelligent Systems and Computing. 20th Congress of the International Ergonomics Association, IEA 2018. 2019;1543–1552. doi: 10.1007/978-3-319-96071-5_158.
- Accessibility of buildings and structures for people with low mobility. SNIP 35-01-2001-SP 59.13330.2016. Konsortsium kodeks. https://docs.cntd.ru/document/456033921 (access date: 03.07.2021). (In Russ.)
- Vladimirova ON, Ishutina IS. Methodology for creating a barrier-free environment for people with disabilities and other low-mobility groups of the population. Dostupnaya sreda. 2020;(1):10–15. (In Russ.)
- UN Committee on the Rights of Persons with Disabilities. Concluding remarks on the original report of the Russian Federation of 09.04.2018. Mintrud Rossii. https://mintrud.gov.ru/docs/mintrud/handicapped/272 (access date: 03.07.2021). (In Russ.)
- Vladimirova ON, Ishutina IS, Khodakovskiy MD. A programme for the automated collection of data and the compilation of information from the constituent entities of the Russian Federation and the evaluation of the achieved values of the indicators and indicators of the regional roadmaps for increasing the values of the indicators of accessibility for persons with disabilities to facilities and services. Certificate of state registration of computer programmes No. 2021614505. Bulletin issued at 25.03.2021. (In Russ.)
- The Federal State Statistics Service. The total number of people with disabilities by disability group. https://rosstat.gov.ru/folder/13964 (access date: 02.07.2021). (In Russ.)
- Federal Law of 30.12.2009 No. 384-FZ (ed. on 02.07.2013) “Technical Regulations on the Safety of Buildings and Structures”. Konsul'tant Plyus. http://www.consultant.ru/document/cons_doc_LAW_95720/ (access date: 03.07.2021). (In Russ.)
- Order of the Ministry of Labor of Russia from 10.05.2017 No. 420 (revised on 01.08.2019) “On approval of methods for calculating the indicators of the state program of the Russian Federation “Accessible Environment” for 2011–2020”. Konsortsium kodeks. https://docs.cntd.ru/document/551623157 (access date: 02.07.2021). (In Russ.)
- Mezhdunarodnaya klassifikatsiya funktsionirovaniya, ogranicheniy zhiznedeyatel'nosti i zdorov'ya (MKF). (International Classification of Functioning, Disability and Health (ICF) (with changes and additions as of 2016): project). Saint-Petersburg: Chelovek; 2017. 262 p. (In Russ.)
Supplementary files
