Help at home

Help at home in the USSR - the system of medical care provided to the patient at home physicians and paramedical personnel outpatient polyclinics, medical stations, stations of ambulance and emergency care.
Patients are cared for at home, in some cases, you need only one visit for emergency aid or for the diagnosis and immediate hospitalization; in other cases require more or less long-term observation and treatment at home. In most cases, home care is provided by General practitioners, pediatricians. Home care have also doctors of other specialties - surgeons, neuropathologists, obstetricians-gynecologists, and other otorhinolaryngologists
Medical aid in-home - medical and paramedical personnel is provided according divisional principle. If necessary, the local doctor organizes in-home patient consultation of doctor-specialists, provides the necessary clinical diagnostics (laboratory, x-ray, ECG) research. In some cases, for this purpose transportable patients with special transport bring to the Clinic, and after conducting the necessary research brought home.
Visit to a patient by a doctor on the day of the call is required. All of re-visiting the sick, the doctor does in the manner of so-called active call, i.e., appoints the day of his Next visit.
In cases of any infectious disease doctors and nurses are taking Preventive measures to avoid reinfection: identify the persons who had contacts with the patient, and immediately reported to authorities.
The duties of nurses involved in the provision of health care at home under the direct supervision of a doctor is performing therapeutic and diagnostic procedures prescribed by the doctor. For these purposes, nurses, laboratory technicians or medical assistant provided dressing materials, medicines and other means necessary for injections and infusions, kits for blood, gastric juice and other Portable physiotherapy, electrocardiographic and other equipment. Nurses visit the sick, to clarify the living conditions, the control over performance of the appointed doctors, treatment and nutrition, teach caregivers for the sick, the rules of care. Give assistance to doctor-pediatrician, nurse, in addition to the medical doctor at home, the patient is also nursing responsibilities for healthy children: gives advice to mothers on care of children and the rules of feeding, monitors the timeliness of vaccination (see the Patronage).
The nurses who work independently under General guidance of the doctor in a rural area providing first aid, spends at home medical measures within the limits stipulated by the regulations on the items of medical service (health posts, health centres), with exemption in necessary cases from work for a limited period of time (up to three days). If necessary, the nurses causes a local doctor or refers the patient to a clinic, which includes an item of medical services.
An important element of care at home is the organization of patient care (see). Typically, this is done by the relatives of the patient. In some cases, provides patient care on the basis of so-called hospital at home. In these cases care are allocated nurses. To care for lonely ill be attracted activists of the red cross Society on a voluntary basis. Polyclinics allocate the family of the patient for temporary use care items (bed pans, the drinking bowl, mug esmarkha and so on). Clinics, combined with hospitals, there are the clothes that periodically in the course of the disease vary. At the instruction of doctors nurses who care for the lonely, sick, get in the kitchen hospitals power at the expense of the patient. Certain groups of patients on prescription; doctors dispense medication from pharmacies free (in the treatment of patients with tuberculosis, rheumatism, cancer patients and others, as well as children of the first year of life). Invalids of the great Patriotic war and some groups of pensioners will pay only 20% of the cost of medicines.
The urban population is able to use the medical home help of special dispensaries (tuberculosis, neurological).
Emergency care at home with a sudden illness at night and weekends have at polyclinics (one or more) of the area of special emergency. If necessary, the doctors of the emergency, take measures to hospitalization of patients.
Physical findings and recommendations on duty doctors of emergency entered in the out-patient medical history in succession in the observation. Cm. also Emergency medical care.

Home help provides the population with the medical staff of outpatient polyclinics, women's and children's clinics, ambulance stations and first aid, special dispensaries. Home help provide primary care physicians, pediatricians and physicians of other specialities. In rural areas, in addition to physicians to provide P. N. D. attracted by paramedics.
In the USSR, home help is available everywhere, is continuously improved and is now an important place in the system of out-of-hospital services.
Doctor on call to provide P. N. D. follows the principle of providing local service.
In primary healthcare clinics produce a record of the primary call of doctor on a house (by phone or in the course of personal accounts from relatives or neighbors in the apartment). Visitation of the sick on the day of the call is required. All of re-visiting the sick, the doctor does in the manner of so-called active call, when the doctor prescribes the day of his next visit.
If necessary, the local doctor organizes in-home patient consultation of doctor-specialists, direct to patient technicians to take the material for analyses or specialists for radiography or electrocardiography. Nurses perform at home in patients all assignments to your GP or specialist.
General practitioners provide cars for going on some calls.
In 1963 the USSR was made 90,3 million medical visits at home, which is 0.8 visits per urban resident per year; in 1964 was made 90,7 million medical visits at home. The increase in the number of visits to physicians at home ahead of the increase in the number of visits paid to physicians at the polyclinic. For three years (1960-1963) the number of visits paid to physicians at outpatient clinics and polyclinics in cities of the USSR increased by 7.4%, and the number of visits to the sick therapists at home grew by 16%.
For 1964 in Moscow doctors outpatient network Mosgorspravka was done 8 207 000 visits patients at home, which was on average 1.3 visit in order to help at home for 1 person, including therapists - 0,6, pediatricians - 0,5, emergency physicians - 0.1 and specialists (0,1 visit. During the decade (1955 -1964) the number of medical territorial areas in cities, providing care to adult population has increased by almost 100%, and the number of paediatric sites in these years has increased more than 100%.
II. common lodging-houses in the cities and rural areas of the USSR is not only medical, but also a preventive nature. In the order of the Minister of health of the USSR (L° 321, 1960) particularly emphasized the role of local doctors in the field of preventive work in providing care at home.
In the help to the pediatrician for care of sick children at home allocate nurses - visiting nurses who perform medical doctors directly in-home patients.
In cities organized a special types of assistance at home, of which the most widely presents special types of assistance psychiatric and tuberculosis.
Abroad in socialist countries - Bulgaria, Hungary, GDR, Poland, Romania, Czechoslovakia care at home, as in the USSR, it appears in the precinct territorial principle. In capitalist societies, P. N. D. have mostly privately practicing doctors. In Sweden, Norway, Denmark, France and some other countries, where the predominant system of health insurance, home care provided by General practitioners, consisting in the public service. Cm. also out-of-Hospital care, emergency and First aid.