MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION
ORDER
on December 20, 2012 N 1213n
ON APPROVAL OF THE STANDARD
PRIMARY HEALTH CARE WITH PNEUMONIA
In accordance with Article 37 of the Federal Law dated November 21, 2011 N 323-FZ "On the basis of public health protection in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724; 2012, N 26, Art. 3442, 3446), hereby:
To approve the standard of primary health pneumonia aid according to the application.
Minister
V.I.SKVORTSOVA
application
to the order of the Ministry of Health
Russian Federation
on December 20, 2012 N 1213n
STANDARD OF PRIMARY HEALTH CARE IN THE PNEUMONIA
Age category: adults, children
Gender: any
Phase: all
Stage: all
Complication: No complications
Kind of care: primary health care
Terms of care: outpatient
The form of care: emergency
Average treatment time (number of days): 15
ICD code X and disease entities
J15.9 Bacterial pneumonia, unspecified
J18.8 Other pneumonia, pathogen neutochnen
J18.9 Pneumonia unspecified
J18.0 Bronchopneumonia, unspecified
J16.0 Pneumonia caused by Chlamydia
J15.7 Pneumonia caused by Mycoplasma pneumoniae
J22 Acute respiratory infection of the lower respiratory tract, unspecified
1. Medical interventions to diagnose the disease, condition,
| Reception (examination, consultation), a specialist doctor | |||
| Code of medical services | Name of medical services | The average incidence rate of <1> | The average index of the multiplicity of application |
| B01.031.003 | Reception (examination, consultation) pediatrician precinct primary | 0,5 | 1 |
| B01.037.001 | Reception (examination, consultation), pulmonologist doctor primary | 0,1 | 1 |
| B01.047.003 | Reception (examination, consultation) Physician adolescent primary | 0,1 | 1 |
| B01.047.005 | Reception (examination, consultation) Physician of the district primary | 0,4 | 1 |
<1> The probability of medical services or prescribing for medical applications (medical devices) included in the standard of care that can take values from 0 to 1, where 1 indicates that the event is held 100% Patients who met the model and the figures at least 1 - specified in the standard of care the percentage of patients with appropriate medical indications.
| Laboratory Methods | |||
| Code of medical services | Name of medical services | The average rate of frequency | The average index of the multiplicity of application |
| A26.09.001 | Microscopic examination of sputum smears to Mycobacterium tuberculosis (Mycobacterium tuberculosis) | 0,4 | 1 |
| B03.016.003 | Total (clinical) blood test detailed | 1 | 1 |
| B03.016.004 | Biochemical analysis of blood Obshcheterapevtichesky | 0,1 | 1 |
| B03.016.006 | Urinalysis total | 1 | 1 |
| Instrumental methods of research | |||
| Code of medical services | Name of medical services | The average rate of frequency | The average index of the multiplicity of application |
| A05.10.006 | electrocardiogram | 0,2 | 1 |
| A06.09.006 | chest X-ray of lungs | 0,3 | 1 |
| A06.09.006.001 | Lung digital fluorography | 0,3 | 1 |
| A06.09.007 | radiography | 0,2 | 1 |
| A06.09.007.002 | Digital radiography | 0,1 | 1 |
| A12.09.005 | Pulse oximetry | 0,6 | 1 |
2. Medical services for the treatment of diseases, conditions and monitor treatment
| Reception (examination, consultation) and specialist doctor supervision | |||
| Code of medical services | Name of medical services | The average rate of frequency | The average index of the multiplicity of application |
| B01.031.004 | Reception (examination, consultation) pediatrician divisional re | 0,5 | 4 |
| B01.037.002 | Reception (examination, consultation), pulmonologist doctor repeated | 0,1 | 3 |
| B01.047.004 | Reception (examination, consultation) Physician teenage re | 0,1 | 3 |
| B01.047.006 | Reception (examination, consultation) Physician of the district re | 0,4 | 3 |
| B01.054.001 | Inspection (consultation) vracha physiotherapist | 0,6 | 1 |
| B01.054.001 | Inspection (consultation) vracha physiotherapist | 0,6 | 2 |
| B01.055.001 | Reception (examination, consultation), a TB doctor primary | 0,1 | 1 |
| Observation of patient care and health care workers with an average (primary) professional education | |||
| Code of medical services | Name of medical services | The average rate of frequency | The average index of the multiplicity of application |
| A11.02.002 | Intramuscular administration of drugs | 0,2 | 7 |
| A11.05.001 | Taking blood from a finger | 1 | 2 |
| A11.12.009 | Taking blood from a peripheral vein | 0,7 | 2 |
| A12.26.002 | Alopecia sample tuberculin | 0,1 | 1 |
| Laboratory Methods | |||
| Code of medical services | Name of medical services | The average rate of frequency | The average index of the multiplicity of application |
| A09.09.010 | Sputum cytology | 0,1 | 1 |
| A26.06.016 | Determination of antibody classes A, M, G (IgA, IgM, IgG) to Chlamydia pneumonia (Chlamidia pheumoniae) Blood | 0,05 | 1 |
| A26.06.048 | Determination of antibody class M, G (IgM, IgG) to human immunodeficiency virus HIV-1 (Human immunodeficiency virus HIV 1) in the blood | 0,3 | 1 |
| A26.06.049 | Determination of antibody class M, G (IgM, IgG) to human immunodeficiency virus HIV-2 (Human immunodeficiency virus HIV 2) in the blood | 0,3 | 1 |
| A26.06.057 | Determination of antibody class M, G (IgM, IgG) to mycoplasma pneumonia (Mycoplasma pheumoniae) Blood | 0,05 | 1 |
| A26.09.001 | Microscopic examination of sputum smears to Mycobacterium tuberculosis (Mycobacterium tuberculosis) | 0,6 | 2 |
| B03.016.003 | Total (clinical) blood test detailed | 0,8 | 1 |
| B03.016.004 | Biochemical analysis of blood Obshcheterapevtichesky | 0,1 | 1 |
| B03.016.006 | Urinalysis total | 0,5 | 1 |
| Instrumental methods of research | |||
| Code of medical services | Name of medical services | The average rate of frequency | The average index of the multiplicity of application |
| A04.09.001 | Ultrasound examination of the pleural cavity | 0,02 | 1 |
| A05.10.006 | electrocardiogram | 0,1 | 1 |
| A06.09.001 | X-ray of lungs | 0,1 | 1 |
| A06.09.005 | Computed tomography of organs thoracic cavity | 0,05 | 1 |
| A06.09.005.002 | Computed tomography of the chest with intravenous contrast bolus | 0,01 | 1 |
| A06.09.006 | chest X-ray of lungs | 0,2 | 1 |
| A06.09.006.001 | Lung digital fluorography | 0,2 | 1 |
| A06.09.007 | radiography | 0,2 | 1 |
| A06.09.007.001 | Sighting chest X-ray | 0,01 | 1 |
| A06.09.007.002 | Digital radiography | 0,2 | 1 |
| A06.09.008 | imaging of lung | 0,05 | 1 |
| A07.09.003 | lung scintigraphy | 0,01 | 1 |
| A12.09.005 | Pulse oximetry | 0,1 | 2 |
| Drug-free methods of prevention, treatment and medical rehabilitation | |||
| Code of medical services | Name of medical services | The average rate of frequency | The average index of the multiplicity of application |
| A17.09.004 | Exposure to ultra-high frequency currents in diseases of the lower respiratory tract | 0,2 | 5 |
| A17.30.007 | Exposure to electromagnetic radiation in the centimeter range (SMV-therapy) | 0,2 | 5 |
| A17.30.019 | Exposure to an alternating magnetic field (AMF) | 0,2 | 5 |
| A17.30.020 | Exposure to microwave electromagnetic field | 0,2 | 5 |
| A19.09.001 | Therapeutic exercises in diseases of respiratory system | 0,3 | 5 |
| A19.09.002 | Breathing exercises draining | 0,3 | 5 |
| A21.30.005 | Chest compressions | 0,2 | 6 |
3. The list of drugs for medical use, registered on the territory of the Russian Federation, with an indication of the mean daily dose courses
| The code | Terapevtichesko- anatomical chemical classification | Name of the drug | The average rate of frequency | Units | MIC | SKD |
| J01CA | Broad-spectrum penicillins | 0,2 | ||||
| amoxicillin | g | 1,5 | 10,5 | |||
| J01CR | Combinations of penicillins, including combination with inhibitors of beta-lactamase | 0,6 | ||||
| Amoxicillin + (clavulanic acid) | g | 6,25 | 12,5 | |||
| Amoxicillin + (Sulbactam) | mg | 750 | 5250 | |||
| J01DD | Cephalosporins of third generation | 0,15 | ||||
| ceftriaxone | g | 2 | 14 | |||
| J01FA | macrolides | 0,2 | ||||
| azithromycin | mg | 500 | 3500 | |||
| josamycin | mg | 1000 | 7000 | |||
| clarithromycin | mg | 1000 | 7000 | |||
| J01MA | fluoroquinolones | 0,3 | ||||
| gemifloxacin | mg | 320 | 2240 | |||
| levofloxacin | mg | 500 | 3500 | |||
| moxifloxacin | mg | 400 | 2800 | |||
| J07AX | Other vaccines against bacterial infections | 0,6 | ||||
| lysates of bacteria | mg | 7 | 70 | |||
| The vaccine antigens of opportunistic microorganisms polycomponent | g | 750 | 7500 | |||
| M01AE | Propionic acid | 0,05 | ||||
| ibuprofen | g | 2,4 | 7,2 | |||
| N02BE | anilides | 0,05 | ||||
| Paracetamol | g | 4 | 12 | |||
| R03BB | anticholinergics | 0,1 | ||||
| ipratropium bromide | g | 160 | 1600 | |||
| R05CB | Mucolytic drugs | 0,31 | ||||
| karbotsistein | g | 2,7 | 27 | |||
| Ambroxol | mg | 90 | 900 | |||
| acetylcysteine | mg | 600 | 6000 | |||
| R05FB | Other antitussives in combination with expectorants | 1 | ||||
| Ambroxol + Sodium + glycyrrhizinate creeping thyme herb extract | ml | 40 | 600 | |||
| V07AB | Solvents and diluents, including irrigation solutions | 1 | ||||
| Sodium chloride | ml | 800 | 4000 |
The International Statistical Classification of Diseases and Related Health, the X revision.
International nonproprietary or chemical name of the drug, and in their absence - the trade name of the drug.
The average daily dose.
Average course dose.
Remarks:
1. Medicinal products for medical use, registered on the territory of the Russian Federation shall be appointed in accordance with the instructions for use of the drug for medical use and for pharmacotherapeutic group Anatomical Therapeutic Chemical Classification System, recommended by the World Health Organization, as well as the route of administration and application of the drug. When assigning of medicaments for the medical use children dose is determined taking into account the mass body age in accordance with the instructions for use of the drug for medical application.
2. Purpose and use of drugs for medical use, medical devices and specialized clinical nutrition products are not included in the standard of care, allowed in the case of medical indications (individual intolerance, for health reasons) by the decision of the medical commission (Part 5 of Article 37 of the Federal Law of November 21, 2011 N 323-FZ "On the basis of public health protection in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724; 2012, N 26, Art. 3442, 3446)).
3. Citizens, who in accordance with the Federal Law of 17.07.1999 N 178-FZ "On state social assistance" (Collection of the Russian Federation, 1999, N 29, Art. 3699; 2004, N 35, Art. 3607; 2006, N 48, Art. 4945; 2007, N 43, Art. 5084; 2008, N 9, Art. 817; 2008, N 29, Art. 3410; N 52, p. 6224; 2009, N 18, Art. 2152; N 30, p. 3739; N 52, p. 6417; 2010, N 50, p. 6603; 2011, N 27, Art. 3880; 2012, N 31,
