MEDICAL SERVICES OR MEDICAL CARE – AN URGENT ISSUE FOR PUBLIC HEALTH INSTITUTIONS

Purpose. To consider the relationship between the concepts of “medical service” and “medical care” in the work of public medical institutions, based on the analysis of normative legal documents of the modern period.

Materials and methods. In the course of the research, more than 18 legal and regulatory documents that were published during the period from 1990 to 2017 were analyzed, an analysis of judicial practice and related literature sources (periodicals) was carried out.

Results. The analysis made it possible to distinguish the stages in the development of the organizational and legal framework for the provision of paid medical services in the Russian Federation and the dynamics of the relationship between the terms “medical care” and “medical service”. It was revealed that the concept of “medical services” appeared much later and was associated with the development of paid medical services and the need to establish legal aspects of health care. The provision of medical assistance is regulated mainly by public law, and the provision of medical services is governed by private law. The term “medical care” is broader than the “medical service” from the standpoint of the social aspect. At the same time, the concept of “medical service” can be considered more widely than medical care in cases when it is not only about measures aimed at treating the patient, but also about providing additional services to the patient in the process of receiving medical care.

Conclusion. Thus, we concluded that the categories of medical care and medical services should not be identified, but also not completely different concepts, but rather enter into a partial intersection relationship. The need to distinguish between the concepts of “medical care” and “medical service” is dictated not only by the category relations or opinion of the population and the medical community, but also by the need for legal support for the process of providing paid medical services with state-owned establishments.

1. Golyshev AYa, Nosyreva OM. Kontseptsiya sozdaniya sistemy upravleniya kachestvom v lechebno-profilakticheskikh uchrezhdeniyakh. Medico.ru. Available at: URL: http://www.medico.ru/articles/management/article_001.htm (In Russian).

2. Yakovlev G. I. Medical care or service? MedLinks.ru [Internet]. Available at: http://www.medlinks.ru/article.php?sid=40123 (In Russian).

3. Tokarev O. Neprotorennaya doroga, ili koe-chto o meditsinskom prave. Meditsinskaya gazeta. 17.07.98; № 57. (In Russian).

4. Decision of the Plenum of the Supreme Court of the Russian Federation «On the practice of consideration by courts of cases on protection of consumers’ rights» of September 29, 1994, No. 7. — has lost its force. Available at: http://www.consultant.ru/document/cons_doc_LAW_5032/(In Russian).

5. Explanations «On some issues related to the application of the Law of the Russian Federation on the Protection of Consumer Rights»: approved by the order of the Ministry of the Russian Federation on Antimonopoly Policy and Support of Entrepreneurship from 01.01.01 № 000. Available at: http://www.consultant.ru/document/cons_doc_LAW_21455/(In Russian).

6. Decision of the Plenum of the Supreme Court of the Russian Federation «On consideration by courts of civil cases on disputes on the protection of consumers’ rights» of June 28, 2012 No. 17. — item 9. Available at: http://www.consultant.ru/document/cons_doc_LAW_131885/(In Russian).

7. Melyanchenko N. The quality of medical care. Clarify the meaning of familiar concepts MedLinks.ru [Internet]. Available at: http://www.medlinks.ru/article.php?sid=43191 (In Russian).

8. Federal Law No. 323-FZ of November 21, 2011 (as amended on 03.07.2016) «On the fundamentals of protecting the health of citizens in the Russian Federation» (as amended and supplemented, effective from 03.10.2016.). — Art. 2 paragraph 4. Available at: http://www.consultant.ru/document/cons_doc_LAW_121895/(In Russian).

9. Federal Law No. 323-FZ of November 21, 2011 (as amended on 03.07.2016) «On the fundamentals of protecting the health of citizens in the Russian Federation» (as amended and supplemented, effective from 03.10.2016). — Art. 2 paragraph 3. Available at: http://base.garant.ru/57499516/(In Russian).

10. Drozdova AV. Ponyatie meditsinskoi uslugi kak grazhdansko-pravovoi kategorii. Siberian Law Herald. 2004; 3: 42–46. (In Russian).

11. Shtern KV. Meditsinskaya usluga s pozitsii opredeleniya ponyatiya meditsinskoi pomoshchi. Medicine in Kuzbass. 2007; 4: 3–6. (In Russian).

12. Antonov SV. Civil responsibility for causing harm to health in the provision of paid medical services. Diss. 12.00.03. Kiev, 2006, 204 p. (In Russian).

13. Tikhomirov AV. Problems of legal qualification of harm to health in the provision of medical services. Diss. Мosocw, 2008, 24 p. (In Russian).

14. GK RF ot 26.01.1996 № 14-FZ. — section. 779. Available at: http://fzrf.su/kodeks/gk-2/st-779.php

15. Tikhomirov A. V. Problematika delikta pri okazanii meditsinskoi pomoshchi na osnovanii dogovora. Head-Doctor: Economy and Law. 2007; 4: 2–9. (In Russian).

16. Decree of the RF Armed Forces «Fundamentals of the RF Legislation on the Protection of Health of Citizens» of 22.07.1993 No. 5487–1. Available at: http://www.consultant.ru/document/cons_doc_LAW_2413/(In Russian).

17. The letter of the Ministry of Finance of the Russian Federation «On the approval of forms of strict reporting documents» dated April 20, 1995 No. 16–00–30–35, on the basis of the letter of the Ministry of Health and Social Protection of Russia from 09.07.95 № 147–16–86. Available at: http://www.consultant.ru/document/cons_doc_LAW_8670/(In Russian).

18. Resolution of the Government of the Russian Federation «On Approval of the Rules for the Provision of Paid Medical Services to the Population by Medical Institutions» of 13.01.1996 No. 27. Available at: http://base.garant.ru/105880/(In Russian).

19. The Order of the Ministry of Public Health of Russia «Rules for the granting of a license» dated April 18, 1996 No. 148: Approved by Resolution of the Government of the Russian Federation No. 350 of March 25, 1996. Available at: http://base.garant.ru/106069/(In Russian).

20. Federal Law «On licensing of certain types of activities» from 25.09.1998 № 158-FZ. Available at: http://www.consultant.ru/document/cons_doc_LAW_20392/(In Russian).

21. Instruction on the calculation of the cost of medical services (temporary): approved by the Ministry of Health No. 01–23/4–10 and the Russian Academy of Medical Sciences No. 01–02/41 of 10.11.1999. Available at: http://www.consultant.ru/cons/cgi/online.cgi?req=doc&base=EXP&n=290985#0 (In Russian).

22. The order of the Ministry of Health of Russia «On the order of admission of patients by public health institutions of federal subordination» of December 20, 2000 N 445/77. Available at: http://www.consultant.ru/document/cons_doc_LAW_29879/(In Russian).

23. Resolution of the Government of the Russian Federation «On approval of the list of medical services for diagnosis, prevention and treatment provided to the population, the sale of which regardless of the form and source of their payment is not subject to value added tax» of 20.02.2001 № 132. Available at: http://base.garant.ru/12122095/(In Russian).

24. Order of the Ministry of Health and Social Development of Russia «On the implementation of the Industry Classifier Simple Medical Services» of April 10, 2001, No. 113; The Order of the Ministry of Health and Social Development of Russia «On the implementation of the Industry Classifier» Complex and Complex Medical Services» of July 16, 2001, No. 268. Available at: http://www.consultant.ru/document/cons_doc_LAW_115841/(In Russian).

25. Law of the Russian Federation «On Protection of Consumer Rights» of 07.02.2002 No. 2300–1. Available at: http://www.consultant.ru/document/cons_doc_LAW_305/(In Russian).

26. Decree of the Government of the Russian Federation «On the development and financing of the fulfillment of tasks for ensuring state guarantees for the provision of free medical care to citizens of the Russian Federation and control over their implementation» of 06.05.2003 No. 255. Available at: http://www.consultant.ru/document/cons_doc_LAW_119521/(In Russian).

27. Federal Law «On Compulsory Medical Insurance in the Russian Federation» of November 28, 2010 N 326-FZ. Available at: http://www.consultant.ru/document/cons_doc_LAW_107289/(In Russian).

28. Federal Law «On the Fundamentals of Health Care of Citizens in the Russian Federation» of November 21, 2011 N 323-FZ (as amended on 03.07.2016). Available at: http://www.consultant.ru/document/cons_doc_LAW_121895/(In Russian).

29. Resolution of the Government of the Russian Federation «On approval of the rules for the provision of paid medical services by medical organizations» of October 4, 2012 No. 1006. Available at: http://base.garant.ru/70237118/(In Russian).

30. Resolution of the Government of the Russian Federation «On the Program of State Guarantees of Free Medical Assistance to Citizens for 2016» dated December 19, 2015 N 1382. Available at: http://base.garant.ru/71289846/(In Russian).