Organization of provision of medical equipment to the military level by wholesale pharmaceutical organizations and opportunities for its improvement

Full Text

Medical support of the Armed Forces within the military district (fleet) is implemented on a territorial basis within the territorial medical support system of the TSMO.
TSMO provides for the creation of responsibility zones within the borders of the military district, within which functional unification is carried out and coordination of actions located in the immediate vicinity of military medical units, units and organizations is ensured.
The general management of the TSMO of the military district is entrusted to the head of the medical service of the military district.
By order of the Commander of the military district (fleet), the territory of the military district is divided into zones of responsibility. In each of the areas of responsibility, a basic military medical organization is determined (regardless of subordination), which is entrusted with the organization and conduct of medical support measures for personnel on a territorial basis.
Measures to provide troops (forces) with medical equipment are directly carried out by: the Center of Pharmacy and Medical Equipment of the Ministry of Defense of the Russian Federation, centers for providing medical equipment and property of military districts and departments (departments) of medical supply, pharmaceutical centers, pharmacies, gas supply units, departments of operation of medical equipment of military medical organizations, medical supply departments (pharmacies) of military medical organizations and units (hereinafter referred to as medical supply units).
In order to ensure the availability of medical care and an even distribution of the burden on military medical organizations within each area of responsibility, the areas of medical responsibility are approved by the order of the commander of the military district and senior medical chiefs of the areas of medical responsibility are appointed.
In order to achieve the goal and solve the tasks, special emphasis was placed on the drug provision of medical units providing assistance at the first level of medical evacuation measures.
The first level is represented by units of the military medical service. Alexander Yakovlevich Fisun, Major General of the medical service, Honored Doctor of Russia, Doctor of Medical Sciences, professor points out that in order to "increase the effectiveness of medical evacuation and preventive measures in military units and formations, the staff structure of the forces and means of the medical service has been optimized.
In particular, in motorized rifle battalions, officer positions of medical platoon commanders have been introduced, which are subject to recruitment by doctors, and for the provision of pre-medical care in motorized rifle companies, the positions of paramedics have been introduced. In the future, it is planned to expand the list of positions, primarily in relation to military units stationed in remote garrisons, as well as expand the list of positions of officers with higher pharmaceutical education" [1].
To receive medical equipment, each military unit (ship) regularly submits an application report on form 14/MED once a year, on the basis of which the property is issued from the TSOMTI.
After preparing for the issuance of medical equipment for a military unit (ship), the TSOMTI forces make a selection of the missing property, and as the missing property is received, each military unit (ship) is sent to the TSOMTI. In case of urgent (combat, training and combat activities) provision of missing property, the head of the TSOMTI makes a report to the medical service of the district (fleet) in order to make a decision on providing the missing property.
The head of the medical service, having considered the list of missing property, decides on the possible issuance of medical property from other medical institutions and medical supply units of the district (fleet). If this property is not available, then the chief of the medical service of the district (fleet) prepares an order to include the missing property in the procurement plan.
To date, district (naval) military medical organizations (hospitals) are engaged in the purchase of medical property to a greater extent, since they are second-level budget recipients and can make purchases in accordance with current legislation. They carry out the procurement procedure in accordance with the procurement plan for the year in order to provide the hospital complex with non-giving medical equipment that does not arrive in a centralized manner, mainly according to the nomenclature of the hospital link in accordance with the form of medicines of the medical service of the Armed Forces of the Russian Federation. In case of receiving an order from the head of the medical service to include medical equipment for military units (ships) in the procurement plan, the contract service of the hospital performs the procurement procedure.
The purchase of medical equipment for military units (ships) should be carried out according to the nomenclature of the military link, which causes certain difficulties, since the contract service of the hospital develops technical specifications and makes purchases according to the nomenclature of the hospital link.
In accordance with the TSMO, a larger number of military units (ships) receive medical equipment and are on allowance in the TSOMTI.
TSOMTI , in accordance with the legislation of the Russian Federation , are classified as pharmaceutical organizations .
A pharmaceutical organization is a legal entity, regardless of its organizational and legal form, carrying out pharmaceutical activities (organization of wholesale trade in medicines, pharmacy organization).
All the main activities of TSOMTI are licensed by the Federal Service for Supervision in the Field of Healthcare of the Russian Federation .
The centers for providing medical equipment and property of the district (fleet) are not included in the nomenclature of medical organizations, and accordingly, the allocation of funds for the procurement procedure under the article healthcare cannot be carried out, it is necessary to consider the inclusion of TSOMTI in the nomenclature of medical organizations.
Most of the TSOMTI of the district (fleet) do not have their own personal accounts and there is no financial authority in their states, therefore, TSOMTI does not have the right to make purchases in accordance with the current legislation.
Due to the absence of its own financial authority in the CMTI, the registration of primary accounting documents for the issuance (receipt) of medical property takes place in the financial authority to which the CMTI is attached, which in turn leads to an increase in the time of document circulation.
In order to ensure the most complete and timely provision of medical equipment for military personnel, it is advisable to consider the issue:
* allocation of an independent personal account in the Treasury by the TSOMTI;
* introduction of a financial body and a contract group (procurement department) to the staff of the CMTI.
The introduction of these changes in the structure of the TSOMTI of the district (fleet) would allow for the purchase of medical equipment at a higher quality level, namely the nomenclature of medical equipment of the military level. This will increase the efficiency and completeness of the provision of military units (ships) standing on allowances in the TSOMTI of the district (fleet), as well as reduce the burden on the procurement group of the hospital, since there will be no need to include in the procurement plan of the hospital the nomenclature of medical equipment of the military link.
For the high-quality organization of decentralized procurement, delegate the functions of the recipient of budget funds to the TSOMTI of districts (fleets) [2].
In each district (fleet) periodically, in order to perform combat tasks by military units (ships), it becomes necessary to issue medical equipment to military units as soon as possible and unscheduled.
In this connection, it is necessary to provide a strategic reserve of medical equipment according to the norms of supply of medical equipment to the military level, since military units, unlike hospitals, do not have the possibility of purchasing missing medical equipment. It is most rational to keep this stock in the TSOMTI of the district (fleet) and issue it by order of the chief of the medical service of the district (fleet).

About the authors

Alexandr V. Dobrovol’skiy

Military Medical Academy

Author for correspondence.
Email: alex.com.sev@mail.ru
SPIN-code: 4636-3070

Lecturer at the Department of Organization of Provision of Medical Equipment to Troops (Forces)

Russian Federation, 6, Akademika Lebedeva str., Saint Petersburg, 194044

Viktor V. Koidan

Military Medical Academy

Email: koydan1952@mail.ru
SPIN-code: 7849-2093

Ph.D. (Military), Associate Professor, Senior Lecturer, Department of Organization of Provision of Medical Equipment to Troops (Forces)

Russian Federation, Saint Petersburg

Il’ya A. Likhogra

Military Medical Academy

Email: lihilya1@yandex.ru
SPIN-code: 4798-1812

Ph.D. (Pharmaceuticals), Lecturer at the Department of Organization of Provision of Medical Equipment to Troops (Forces)

Russian Federation, Saint Petersburg

Sergey V. Samarin

Military Medical Academy

Email: Svsamarin@mail.ru
SPIN-code: 8358-9759

Senior Lecturer, Department of Organization of Provision of Medical Equipment to Troops (Forces)

Russian Federation, Saint Petersburg

References

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