The procedure for providing medical care to dental patients. Provision of medical care to the adult population

carious, non-carious and other lesions of the teeth;

acute, chronic and specific inflammatory diseases, acute and chronic trauma, acquired defects and deformities, oncological diseases of the periodontium, oral mucosa, tongue, salivary glands, jaws, face and head;

anomalies and defects in the development of teeth, jaws, face and head, their prerequisites and consequences.

ambulance medical care;

primary health care;

specialized, including high-tech, medical care.

dentists (dentists) general practice), dentists-therapists, dentists-surgeons, dentists-orthopedists, orthodontists, maxillofacial surgeons (hereinafter - doctors dental profile), dentists, dental hygienists, dental technicians;

When there are signs of dental disease medical workers specified in paragraph 3 of this paragraph, after taking measures aimed at eliminating life-threatening conditions and eliminating pain, the patient is sent to medical organization for the provision of medical care by dentists.

Medical care for the adult population dental diseases in a hospital, it turns out to be doctors of a dental profile, or other doctors - specialists of the departments where the patient is hospitalized, with the participation of doctors of a dental profile.

In the presence of medical indications to high-tech types of medical care, such assistance is provided to the adult population with dental diseases in accordance with the established procedure for providing high-tech medical care.

For dental clinics of the state and municipal health systems headcount medical and other personnel is established taking into account the recommended staffing standards for medical and other personnel in accordance with Appendix No. 6

examination room;

department (office) of general practice, including mobile dental offices;

treatment-and-prophylactic department, including, among other things, dental offices in educational institutions secondary, higher and postgraduate vocational education, recruiting offices, enterprises and organizations;

branch (office) therapeutic dentistry with rooms for periodontics, endodontics and treatment of diseases of the oral mucosa;

department (office) of surgical dentistry;

department (office) of orthopedic dentistry;

orthodontic department (office);

department (office) of anesthesiology and resuscitation;

X-ray department (office);

physiotherapy room (department);

hygiene room;

cabinet functional diagnostics in dentistry;

registry;

organizational and methodological office;

centralized sterilization department (block);

dental (dental) laboratory;

office of medical statistics;

administrative and economic part;

technical services;

other departments that meet the statutory goals of the medical organization (including the service department, the software, legal department).

organization and conduct of preventive medical examinations and sanitation of the mouth of the adult population in institutions of secondary, higher and postgraduate professional education, recruiting offices, enterprises and organizations;

emergency dental care for adults acute diseases and injuries of the maxillofacial region;

provision of primary health care and (or) specialized dental care to the adult population with dental diseases;

organization dispensary observation for the adult population with dental diseases with an assessment of the level of dental health;

direction to in due course adult population with dental diseases hospital treatment to specialized maxillofacial and (or) dental departments;

conducting orthopedic treatment adult population with congenital and acquired defects of teeth, dentitions, alveolar processes, jaws and face;

conducting a comprehensive orthodontic treatment adult population with dentofacial anomalies and deformities;

examination of temporary incapacity for work, issuance of certificates of incapacity for work and recommendations for rational employment, referral to medical and social expert commissions of persons with signs of permanent disability;

analysis of dental morbidity in the adult population and development of measures to reduce and eliminate the causes that contribute to the occurrence of diseases and their complications;

carrying out sanitary and educational work among the population, including with the involvement of paramedical personnel of medical organizations, using the media;

accounting and reporting medical records and submission of reports on activities, collection of data for registers, the maintenance of which is provided for by the legislation of the Russian Federation.

For medical organizations of the state and municipal health care systems, the staffing of medical and other personnel is established taking into account the recommended staffing standards for medical and other personnel in accordance with Appendix No. 7 to the Procedure for providing medical care to the adult population in case of dental diseases, approved by this order.

organization of the treatment and diagnostic process for dental diseases;

organization and holding preventive examinations and sanitation of the mouth of the attached contingent, including in educational institutions of secondary, higher and postgraduate professional education, recruiting offices, at enterprises and organizations;

dispensary observation of patients with pathology dental system and analysis of its effectiveness with an assessment of the level of dental health;

identification of patients with dentofacial anomalies, deformities and the prerequisites for their development, defects in the crowns of the teeth and dentition, with their subsequent referral to the department of the dental clinic of the appropriate profile;

in the presence of medical indications, referral of patients for inpatient treatment to the departments of dentistry and (or) maxillofacial surgery multidisciplinary hospital, as well as in specialized medical organizations;

implementation modern methods prevention, diagnosis and treatment of dental diseases of the maxillofacial area;

manufacturing of dentures, maxillofacial prostheses and orthodontic appliances;

conducting sanitary and hygienic education of the population, including with the involvement of paramedical personnel (dental hygienist);

maintaining approved forms of accounting and reporting medical documentation and submitting reports on their activities in the prescribed manner, collecting data for registers, the maintenance of which is provided for by the legislation of the Russian Federation.

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT

RUSSIAN FEDERATION

ON THE APPROVAL OF THE ORDER

Article 37 federal law dated November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" (" Russian newspaper", N 263, 11/23/2011) I order:

Approve the procedure for providing medical care to the adult population in case of dental diseases in accordance with the appendix.

T.A.GOLIKOVA

Application

to the order of the Ministry

health and social

development of the Russian Federation

PROVIDING MEDICAL CARE TO ADULTS

FOR DENTAL DISEASES

doclvs: ; ; ;

1. This Procedure establishes the rules for the provision of medical care to the adult population in case of dental diseases by medical organizations, regardless of their organizational and legal form.

2. The provision of medical care to the adult population is carried out with dental diseases of the teeth, periodontium, oral mucosa, tongue, salivary glands, jaws, face and head, including:

  • carious, non-carious and other lesions of the teeth;
  • acute, chronic and specific inflammatory diseases, acute and chronic trauma, acquired defects and deformities, oncological diseases of the periodontium, oral mucosa, tongue, salivary glands, jaws, face and head;
  • anomalies and defects in the development of teeth, jaws, face and head, their prerequisites and consequences.

3. Medical assistance to the adult population in case of dental diseases is provided in the form of:

  • emergency medical care;
  • primary health care;
  • specialized, including high-tech, medical care.

4. Medical assistance to the adult population in case of dental diseases provides for the implementation of the necessary preventive, diagnostic, therapeutic and rehabilitation measures and is provided in accordance with established standards of medical care.

5. Medical assistance to the adult population in case of dental diseases and life-threatening conditions is provided in an emergency form.

6. Within the framework of emergency, including emergency specialized, medical care, medical care for the adult population in case of dental diseases is provided by paramedic mobile ambulance teams, medical mobile ambulance teams in accordance with the order of the Ministry of Health and Social Development of Russia dated 01.11.2004 N 179 "On Approval procedure for providing emergency medical care" (registered by the Ministry of Justice of Russia on November 23, 2004 N 6136).

When providing emergency medical care, if necessary, medical evacuation is carried out.

7. Primary health care adult population with dental diseases in outpatient settings turns out:

dentists (general practitioner dentists), general dentists, dental surgeons, orthopedic dentists, orthodontists, maxillofacial surgeons (hereinafter referred to as dental profile doctors), dentists, dental hygienists, dental technicians;

paramedics and doctors of other specialties.

If signs of a dental disease are detected by the medical workers specified in paragraph 3 of this paragraph, after taking measures aimed at eliminating life-threatening conditions and eliminating pain, the patient is sent to a medical organization for medical care by dentists.

8. Prevention of dental diseases is carried out by medical organizations providing medical care to the adult population with dental diseases, and includes preventive actions, including preventive medical examinations which are recommended to be carried out once a year.

9. Medical care for the adult population with dental diseases in a hospital is provided in dental departments, departments of maxillofacial surgery and other specialized departments of medical organizations.

Medical care for the adult population with dental diseases in a hospital is provided by dentists or other doctors - specialists of the departments where the patient is hospitalized, with the participation of dentists.

10. In the event of a dental disease in a patient who is being treated in a hospital in medical organizations with diseases of a different profile, dental care is provided by invited dentists.

11. Specialized, including high-tech, medical care for the adult population with dental diseases is provided in stationary conditions and in a day hospital by dentists.

If there are medical indications for high-tech types of medical care, such assistance is provided to the adult population with dental diseases in accordance with the established procedure for providing high-tech medical care.

12. Medical organizations providing medical care to the adult population in case of dental diseases carry out their activities in accordance with Annexes No. 1-14 to this Procedure.

13. If during the provision of medical care to the adult population with dental diseases, symptoms of oncological disease are detected, medical assistance to the patient is provided in accordance with the Procedure for the provision of medical care to oncological patients, approved by order of the Ministry of Health and social development of the Russian Federation dated December 3, 2009 N 944n (registered by the Ministry of Justice of Russia on December 15, 2009 N 15605).


Attention! information on the site is not medical diagnosis, or a guide to action and is for informational purposes only.

Order of the Ministry of Health and Social Development of the Russian Federation of December 7, 2011 N 1496n
"On approval of the procedure for providing medical care to the adult population in case of dental diseases"

Registration N 23035

The procedure for providing medical care to the adult population in case of dental diseases has been approved. It is provided by medical organizations, regardless of their organizational and legal form. the following diseases. These are carious and other lesions of the teeth, acute, chronic and specific inflammatory diseases. Oncological diseases periodontal, oral mucosa, tongue, salivary glands, anomalies and defects in the development of teeth, jaws, etc.

Ambulance (including specialized) medical care is provided by feldsher or medical mobile ambulance teams. Primary health care - dentists, dental technicians, paramedics and doctors of other specialties.

Prevention of dental diseases is recommended once a year.

Regulations on the organization of the activities of dental clinics, laboratories, offices, including a mobile dental office and a surgical maxillofacial and dental department of a hospital, were approved.

Order of the Ministry of Health and Social Development of the Russian Federation of December 7, 2011 N 1496n "On approval of the procedure for providing medical care to the adult population with dental diseases"

The presence of a compulsory medical insurance or VHI policy gives the patient entitlement to free dental care. It should be noted that such assistance cannot be called truly “free” due to the fact that when a medical organization provides medical care to one person (patient), payment for the medical service provided by this medical organization is made by another person (the state or a third party). The law also defines situations in which medical care should be provided free of charge even if the person does not have any insurance policy. This article will talk about all this in more detail.

For the purposes of this article, “patient” refers to someone in need of dental care. individual, as well as the concept of “patient” includes the concept of “insured person”, provided for by Federal Law No. 326-FZ of November 29, 2010 “On Compulsory Medical Insurance in the Russian Federation” (hereinafter Law No. 326-FZ). OMS - mandatory health insurance, VHI - voluntary health insurance in declension, conjugation depending on the context.

Free medical care under the VHI policy

It is not uncommon for an employer to issue a VMI policy for its employees and members of their families (hereinafter referred to as the “employee”). This means that from an employee there is no charge for providing medical care and the employer:

  • Independently chose one or more medical organizations providing dental services;
  • Independently determined the scope of medical care (list medical services), which can be provided to an employee under the VHI policy and the period of time during which medical assistance can be received under the VHI policy;
  • Signed a contract on my own behalf;
  • From its own funds made payment under this agreement;
  • He handed over to the employee a VHI policy with relevant information about the medical organization and the volume of medical services.

The scope of rights and obligations in the provision of medical care under the policy of VHI

If there is a VHI policy, the employee, who is also the patient, has almost all the rights of the patient, and the medical organization and the attending physician providing medical care have the obligations provided for in the Federal Law of November 21, 2011 No. ”(hereinafter “Law No. 323-FZ).

The exceptions are the following:

  • An employee-patient has the right to choose a medical organization and an attending physician only from those proposed by the employer (according to the VHI policy);
  • An employee-patient can receive medical assistance only to the extent agreed and paid for by the employer (according to the VHI policy);
  • The waiting time for medical care will depend on the workload of the doctors of this medical organization, taking into account the terms of the contract concluded by the employer;
  • An employee-patient pays for travel to and from a medical organization on his own (unless otherwise provided by local regulations of the employer).

However, this does not exclude the right of the worker-patient to expand the scope of medical services received. But payment for medical care in excess of the VHI policy will have to be made at their own expense.

Free dental care under the CHI policy

In order to ensure the constitutional rights of citizens of the Russian Federation to free medical care, the Government of the Russian Federation approves the Program of State Guarantees for the Free Provision of Medical Care to Citizens. For 2017 and for the planning period of 2018 and 2019, such a program was approved by Decree of the Government of the Russian Federation No. 1403 dated December 19, 2016 (hereinafter referred to as “Resolution No. 1403”).

The program of state guarantees establishes that in case of diseases of the digestive system, including diseases of the oral cavity, salivary glands and jaws (with the exception of dental prosthetics) citizen has the right to free dental care.

According to Law No. 326-FZ, in order for a citizen to receive dental care under the state guarantees program (that is, free of charge), he must have a compulsory medical insurance policy ( compulsory medical insurance policy) (clause 1 clause 1 article 16 of Law No. 326-FZ). The compulsory medical insurance policy is presented when applying for medical care, with the exception of cases free emergency dental care, because to eliminate the threat to the life of the patient, medical care is provided immediately and without charging a fee (Article 11 of Law No. 323-FZ).

According to order No. 1496n, in order to receive dental care for the adult population, it is necessary to contact:

  • Dental polyclinic of a medical organization providing medical care to patients with dental diseases on an outpatient basis;
  • Department (office, laboratory) of dental profile in medical organizations providing outpatient medical care;
  • Dental office in educational institutions of secondary, higher and postgraduate professional education, recruiting offices, enterprises and organizations;
  • Mobile dental office which is organized outside the stationary premises of a medical organization, including in remote and hard-to-reach settlements taking into account the territorial characteristics and needs for medical care for dental diseases;
  • Surgical maxillofacial and dental department(with a dressing room, operating room and dental office) of a hospital of a medical organization, which is organized to provide primary health care and (or) specialized, including high-tech, medical care to patients with dental diseases;
  • Hospital - in the event of a dental disease in a patient who is on treatment in a hospital setting;
  • paramedical field brigades ambulance, medical mobile ambulance teams within the ambulance, including.

Dentistry at home

According to the law, certain categories of citizens can get dental care at home. So, for example, the Order of the Department of Health of the City of Moscow dated July 7, 2009 No. 783 established a list dental services provided to people with severe disabilities at home. In addition, data normative act a list of general somatic hospitals for administrative districts Moscow for the hospitalization of disabled people with severe disabilities in order to provide comprehensive dental care. Such dental care in Moscow is provided free of charge.

Free dental care in commercial medical organizations

Not all patients are aware that free dental care can be provided in paid (commercial) medical organization, which is included in the List of medical organizations participating in the implementation of the Territorial Program. If such a medical organization is not included in the List, then all services provided by it are subject to payment at the expense of the patient.

You can find out whether a specific, chosen by the patient, medical organization will provide dental care under the MHI policy for free or not, in various ways:

  • Contact this commercial medical organization;
  • Apply to the territorial fund of obligatory medical insurance;
  • Contact the insurance medical organization that issued the CHI policy to the citizen;
  • Find information about this medical organization in the List of medical organizations participating in the implementation of the Territorial Program.

For example:

  • For the city of Moscow, the specified List of medical organizations is given in Appendix No. 11 to Resolution No. 935.
  • For the Moscow region, in Appendix No. 6 to the Decree of the Government of the Moscow Region dated December 22, 2016 No. 982/47 “On the Moscow regional program state guarantees of free provision of medical care to citizens for 2017 and the planning period of 2018 and 2019”.

The scope of medical care for dental diseases

For all medical organizations providing medical services in the profile "dentistry"(free for the patient or paid by the patient) the scope of medical care for dental diseases of the teeth, periodontium, oral mucosa, tongue, salivary glands, jaws, face and head is determined, including (clause 2 of Order No. 1496n):

  • Carious, non-carious and other lesions of the teeth;
  • Acute, chronic and specific inflammatory diseases;
  • Acute and chronic trauma;
  • Acquired defects and deformities;
  • Oncological diseases of the periodontium, oral mucosa, tongue, salivary glands, jaws, face and head;
  • Anomalies and defects in the development of teeth, jaws, face and head, their prerequisites and consequences.

We also note that in case of dental diseases, the following is provided for (clause 4 of Order No. 1496n):

  • preventive measures;
  • diagnostic measures;
  • medical measures;
  • rehabilitation activities.

Children's right to free dental care

For children (aged 0 months to 18 years) from the date of birth until the expiration of thirty days from the date of state registration birth also provides for compulsory health insurance in the insurance medical organization in which his mother or other legal representative is insured. Consequently, little patient It has the right to receive a full range of free dental care guaranteed by the state.

In order for a child to receive state-guaranteed medical care after 30 days from the date of state registration of birth and until reaching the age of majority (before acquiring full legal capacity), parents or another legal representative must choose an insurance medical organization and issue a CHI policy (Article 16 Law No. 326-FZ).

Prior to obtaining their own compulsory medical insurance policy, a newborn must be served under the policy of the mother or another legal representative. This means that medical organizations operating in the field of CHI, are obliged to provide medical care to newborns before issuing a compulsory medical insurance policy, and the refusal to provide such medical care will be illegal.

Where do children get dental care?

According to Order No. 910n, for receiving free dental care for children, you must contact:

  • Children's dental office, which is created for the implementation of advisory, diagnostic and medical care children;
  • Dental office in institutions of preschool, general education (primary general, basic general, secondary (complete) general education), primary and secondary vocational education, which is created to provide advisory, diagnostic and therapeutic assistance to students and pupils of educational institutions;
  • Children's dental clinic (department), which is created to provide preventive, advisory, diagnostic and therapeutic assistance to children, which does not provide for round-the-clock medical supervision and treatment;
  • Children's department of maxillofacial surgery for the implementation of preventive, advisory, diagnostic and therapeutic care for children.

Medical care for children with acute pain turns out to be in (clause 17 of Order No. 910n):

  • Children's dental clinic;
  • Dental department of a children's polyclinic (department);
  • Dental office in an educational organization;
  • Medical organizations providing medical care to children with dental diseases.

What is still free, and what is for a fee

The attending physician must inform the patient about what specific manipulations and methods of treatment should be provided free of charge in accordance with the State Guarantee Program for the treatment of this patient.

Also, the patient has the right to independently apply to a medical organization in which he plans to receive medical dental care, or insurance medical organization that issued him the MHI policy and clarify the information on how much medical care he should be provided free of charge.

Example: according to Decree No. 935, dental orthopedic services are not included in the territorial CHI program in Moscow, the provision of dental care using dental implants carried out at the expense of the patient's personal funds (for all categories of citizens).

Materials covered by the CHI policy

When providing medical care, the attending physician can use (we combine them under common name"materials"):

  • Consumables (syringes and needles for them, dressings, cotton wool, etc.);
  • Medications;
  • Materials required for filling;
  • And other materials.

When providing medical dental care, materials are also provided free of charge. But not any materials that the patient would like, but only those approved by the relevant commission at the level of the subject of the Russian Federation. However, this does not mean that the patient does not have the right to request the use of other materials. It has, but only the patient will have to pay for them on their own.

Terms of medical dental care

If a patient needs medical attention, it is not unimportant for him duration of medical care. Moreover, both the waiting period for this medical care and the duration of its provision. The specified terms are prescribed in the State Guarantees Program, currently established by Decree No. 1403.

Also, the terms for the provision of medical care can be established in the Territorial Program.

More details about the timing of the provision of medical services can be found in the article: “”.

Emergency medical care

In various regions of the Russian Federation, a list of persons with the right to receive medical care out of turn. For example, for the city of Moscow, Appendix No. 8 to Decree No. 935 refers to such persons: disabled people of the Great Patriotic War, combat disabled, Heroes Soviet Union, rehabilitated persons, citizens awarded with badges “Honorary Donor of Russia” or “ Honorary Donor USSR” and other categories of citizens.

In the event that you are denied free medical assistance and / or provided medical care for money, guaranteed free of charge, lawyers will help restore your right, including in court. For this you may need help of specialists who have experience and knowledge not only in the field of law, but also in medicine, which will allow you to comprehensively analyze your situation and protect your rights as much as possible.

Below we have selected some of the legal acts.

Appeal ruling of the Novgorod Regional Court dated December 17, 2014 in case No. 2-5839 / 33-2699

Demand: On the recovery of jointly and severally material damage, compensation for non-pecuniary damage.

Circumstances: The treatment provided to the plaintiff at the dental clinic was clearly misdirected.

Decision: The claim was denied, since the plaintiff did not provide evidence indicating the presence of shortcomings in the dental services (health damage) provided to him by the defendants, the facts of refusal to provide medical care. The court did not establish the facts of refusal to provide medical assistance to R. within the framework of the territorial program of state guarantees for the provision of free medical care to the population.

Appeal ruling of the Oryol Regional Court dated August 12, 2014 in case No. 33-1798

Satisfying the claim for contesting the decision and inaction of officials, collecting monetary compensation for dental prosthetics was rightfully denied, since no evidence was presented confirming that the plaintiff was sent by an authorized person for treatment, and also that the current regulatory legal acts do not provide for the payment of compensation to reimburse the costs of medical care directly to the serviceman or a member of his family.

The plaintiff had the opportunity to receive free medical care in accordance with the procedure established by Article 16 of the Federal Law of the Russian Federation “On the Status of Military Personnel”, but did not use her right. Plaintiff O.O.O. on own initiative applied to the BUZ Oryol region“Oryol regional dental clinic”, where she was provided with paid medical services.

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