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Guaranteed Volume of Free Medical Care

26.09.2016, 20:56

On the Approval of the List of Guaranteed Volume of Free Medical Care

Resolution No. 2136 of the Government of the Republic of Kazakhstan dated December 15, 2009

In accordance with Subparagraph 7) Article 6 and Paragraph 1 Article 34 of the Code of the Republic of Kazakhstan dated September 18, 2009 “About Health of the People and Health Care System”, the Government of the Republic of Kazakhstan DECIDES the following:

1. to approve the enclosed list of the guaranteed volume of free medical care.

2. The Ministry of Healthcare of the Republic of Kazakhstan, mayors of regions, Astana and Almaty are required to take the necessary action resulting from this Resolution.

3. To recognize the Resolution No. 853 of the Government of the Republic of Kazakhstan dated September 28, 2007 "On Approval of the List of Guaranteed Volume of Free Medical Care for 2008-2009" (Collection of Acts of the President of the Republic of Kazakhstan and the Government of the Republic of Kazakhstan, 2007, No. 35, Art. 397).

4. This Resolution comes into effect on January 1, 2010 and is subject to official publication.

 

Prime Minister of the Republic of Kazakhstan                                                                         K. Massimov

Annex to  the Resolution No. 2136 of

the Government of

the Republic of Kazakhstan

dated December 15, 2009

List of the Guaranteed Volume of Free Medical Care

Note: The List is as in force of the Resolution No. 29 of the Government of the Republic of Kazakhstan dated 27.01.2014.

1. General Provisions

1. The guaranteed volume of free medical care (hereinafter - GVoFMC) is provided to citizens of the Republic of Kazakhstan and repatriates (oralmans) at the expense of budget funds and includes preventive, diagnostic and therapeutic medical services with the greatest proven efficacy.

2. The GVoFMC includes the following:

1) ambulance and sanitary aviation;

  2) outpatient polyclinical care, including:

primary medical care (hereinafter - PMC); 

advisory and diagnostic assistance (further - ADA) in the direction of a specialist of primary medical care and specialized professionals;

3) inpatient care in the direction of a specialist or PMC professionals within the planned volumes, determined by the authorized body in the field of healthcare (hereinafter - the authorized body), on emergency indications - regardless of direction;

4) hospital-replacing medical care in the direction of a PMC professional or specialized professionals;

  5) recovery treatment and medical rehabilitation;

6) palliative care and nursing care for the population categories, as determined by the Government of the Republic of Kazakhstan.

2. List of the GVoFMC

3. Ambulance under the GVoFMC includes:

 1) provision of medical care in emergency indications;

 2) delivery of patients to medical institutions for emergency indications;

3) health care events (social, mass cultural, sports, etc.) of district, regional, republican significance ​​in coordination with the authorized body in the field of healthcare or the local executive body.

4. Air ambulances within the GVoFMC includes:

1) provision of emergency medical care to the population in case of impossibility of providing the appropriate level of care because of the lack of resources in the medical organization at the place of the patient's residence;

2) delivery of qualified specialists to the destination or the patient's transportation to the appropriate medical organization by air transport and motor transport means. 

5. Outpatient polyclinical care under the GVoFMC includes PMC, ADA and is available in the volume according to the appendix to this list of the GVoFMC.

6. Medical care with highly specialized and new technologies is provided in the direction of a specialist of the outpatient polycnilical organization (hereinafter - APO) in accordance with the list approved by the authorized body in the field of healthcare (hereinafter - the authorized body).

7. Inpatient care under the GVoFMC is carried out without provision of additional services (TV, telephone, customized meals, etc.) in rooms determined by the authorized body of the standard.


8. The GVoFMC provided in the form of inpatient care, according to the types and volumes, approved by the authorized body, includes:

1) examinations, specialist consultations, including with the use of telemedicine communications;

  2) laboratory and instrumental tests in accordance with the healthcare standards;

3) medical services (except for paid ones), provision of medicines in accordance with medical forms for medical indications;

4) provision of blood products and its components based on medical indications;

5) provision of the opportunity for mother (father) or other person directly involved in caring for a child aged up to three years, as well as seriously ill elder children, who need additional care based on the decision of doctors to stay in the medical organization along with the issuance of a temporary disability statement;

6) provision of free meals in a medical institution for the whole period of childcare to the nursing mother of a child under one;

7) early and continued medical rehabilitation according to the medical care provision arrangement standards (hereinafter – the standard) approved by the competent authority, including the late one, for children and socially vulnerable categories of citizens;

8) creation of necessary conditions for games, recreation and educational work in children's inpatient healthcare organizations;

9) palliative care and nursing care for the population categories established by the Government of the Republic of Kazakhstan.

9. Hospital-replacing medical care within the GVoFMC includes:

 1) examinations, consultations with specialists;

 2) medical services (except paid ones), provision of medicines, according to the medicine forms based on medical indications;

 3) early and continued medical rehabilitation for all categories of citizens according to indications, including physiotherapy and exercise therapy, according to the standards.

 10. Pathologicoanatomic bureaus (departments) services within the GVoFMC include the following:

 1) autopsy;

 2) histological examination of biopsy and operational material;

 3) cytology.

 11. List of the GVoFMC includes treatment of citizens of the Republic of Kazakhstan abroad when indicated and in accordance with the procedures established by the Government of the Republic of Kazakhstan.

 12. Provision of medicine to provide GVoFMC is carried out in accordance with the medicine forms approved by medical organizations and agreed in the prescribed manner by the authorized body in the delivery of the following:

 1) ambulance / urgent / emergency medical assistance;

 2) rabies assistance in epidemiological indications at risk of infection;

 3) sanitary and preventive and sanitary and anti-epidemic aid based on indications;

4) immunization / vaccination;

 5) inpatient and hospital-replacing care.13. Medicine provision at outpatient level under the GVoFMC is carried out in accordance with the list of medicine and medical items, approved by the authorized body, for the free supply of certain categories of citizens with certain medical conditions (states) and specialized medical products based on indications and prescription of the PMC specialist.

  14. Medical assistance under the GVoFMC also includes therapeutic and diagnostic services using minimally invasive technologies.

Annex 

to the List of the Guaranteed Volume 

of Free Medical Care

Outpatient Polyclinical Assistance within the Guaranteed Volume of Free Medical Care

  1. Primary Medical and Sanitary Care 

Activities

Services

Periodicity of Services Provision

1

2

3

Admission and advice

Admission, advice (PMC specialists - general practitioner, local physician / pediatrician, health nurses / general practitioner nurse, medical assistant, obstetrician

Upon request

Provision of services at home by PMC specialists

Based on indications

Prevention

Advice on health protection and strengthening, healthy lifestyle formation, rational and healthy meals

Upon request and referral of specialists

Advice on family planning

Upon request and referral of specialists

Introduction / removal of IUD, contraceptive injection

Upon request and referral of specialists

Preventive medical examinations (screening tests) for target groups of population

With periodicity according to the procedure approved by the body authorized in healthcare (hereinafter – authorized body)

Sanitary-epidemiological (preventive) measures in the outbreak of infectious diseases

Based on indications

Immunization

According to the established periodicity under the National Calendar of Vaccinations and Epidemiological Indications

Training in preventive offices, health improvement  schools

Upon request and referral of specialists

Teaching patients and their families to have self-control, self-help and mutual assistance in accordance with the chronic disease management programs

Upon request and referral of specialists

Counseling persons with chronic diseases on the phone

Upon request and referral of specialists

Medico-social and psychological services

Based on indications

Patronage of children, including newborns

According to the periodicity established by the authorized body and based on indications

Patronage of pregnant women

According to the periodicity established by the authorized body and based on indications

Secondary prevention of diseases and its complications through dynamic follow-up of patients with chronic diseases

At intervals, in accordance with the standards approved by the authorized body

Teaching children to have sanitary and hygienic skills in regard to the care of teeth and oral mucosa

Once per year with preventive purpose

Preventive examinations of oral cavity in children at preschool educational institutions, students of secondary educational institutions, women who are on the record for pregnancy

Once per year with preventive purpose

Diagnostics

Measurement of acuity of hearing and vision

With preventive purpose, according to the established periodicity; in other cases – based on indications

Measurement of intraocular pressure

With preventive purpose, according to the established periodicity; in other cases – based on indications

Complete blood count with leukoformula, hemoglobin, erythrocytes, color index, leukocytes, ESR, platelets.

Urinalysis with the determination of protein and glucose

1 time per year when addressing with preventive purpose; in other cases – based on indications

Time of blood coagulation, blood for malaria parasites, urine analysis based on Nechiporenko method, bile pigments in the urine

Based on indications

Microreaction

1 time per year at request; in other cases – based on indications

Stool test

1 time per year at request; in other cases – based on indications

Sputum sampling for TB detection

Based on indications

Material sampling for microbiological studies

Based on indications

Blood sampling for HIV infection and Wasserman Reaction (RW)

In voluntary anonymous and (or) confidential medical examination at request; in other cases – based on indications

Sampling and biochemical analyses: cholesterol, triglycerides, blood glucose, including rapid methods using test systems

With preventive purpose, according to the periodicity established by the authorized body; in other cases – based on indications

Sampling and biochemical analyses:  glutamyl pyruvic transaminase, serum glutamic oxalacetic transaminase, total bilirubin, urea, creatinine

Based on indications

Tissue sampling for other analyses

Based on indications

Microscopy of vaginal smear and vaginal sanation

Once per year with preventive purpose at request; in other cases – based on indications

Immunochemical assay (Hemoccult Test by rapid method)

With preventive purpose, according to the periodicity established by the authorized body; in other cases – based on indications

Malaria parasite blood test

Based on indications

Electrocardiogram

With preventive purpose, according to the periodicity established by the authorized body; in other cases – based on indications

Mantoux test with 2 TE PPD-L for children from “at risk” groups (including for the purpose of BCG additional vaccination and revaccination) and in cases of suspected tuberculosis in children

With preventive purpose, according to the periodicity established by the authorized body; in other cases – based on indications

Fluorography for the age above 15

Once per year with preventive purpose at request; in other cases – based on indications

Treatment, manipulations and procedures

Providing emergency medical care

Based on indications

Immobilization (application of curing gauze bandages, splints)

Based on indications

Prescription of medical treatment

Based on indications

Conducting intravenous, intramuscular, subcutaneous injections

Based on indications

Provision of hospital-replacing care, including at-home care

Based on indications

Physiotherapy for children under 18 and massage for children under 1

Based on indications

2. Advisory and Diagnostics Care

Activities

Services

Periodicity of Services Provision

1

2

3

Admission and advice

Admission and advice provided by relevant experts, including using telemedicine communications, as well as consultation at home:

based on the appointment of primary care specialist;

based on the appointment of a relevant specialist for differential diagnosis, in case of any complications involving other organs and determination of further tactics of patient treatment

Based on indications

Medical and genetic counseling of pregnant women and children under 18 based on the appointment of a specialist

Based on indications

Diagnostics

Screening of target groups of population in accordance with the procedure established by the authorized body

In accordance with periodicity set by the authorized body

Laboratory and instrumental methods of analysis

Based on prescriptions of PMC specialists and relevant experts

General clinical tests

Based on indications and prescriptions of PMC specialists and relevant experts

Blood tests for HIV and Wasserman Reaction (RW)

Voluntary anonymous and (or) confidential medical examination at request; in other cases – based on indications

Hormonal examination based on the prescription of a specialist

Based on indications

Determination of immunno-suppressive drugs concentration in blood of patients after organs transplantation

Based on indications

Biochemical analyses

Based on indications and prescriptions of PMC specialists and relevant experts

Blood group and Rh factor for persons subject to admission to the hospital’s inpatient department for surgery

Based on indications

Microbiological analyses of the tissue (bacterial swab test)

Based on indications

Ultrasound, X-ray, fibrogastroduodenoscopy, sigmoidoscopy, duodenal intubation, colonoscopy, methods of functional diagnostics and other types of endoscopy with sampling of tissue for biopsy based on the prescription of the primary medical care specialists and relevant experts

Based on indications and when addressing with preventive purpose, not more frequently than once per year

Screening tests (enzyme immunoassay, polymerase chain reaction) for the diagnosis of viral hepatitis B and C:

children with blood diseases, malignant neoplasms, hemodialysis, those having surgeries, transfusion of blood and its components in their medical history;

adults with with blood diseases, malignant neoplasms, hemodialysis, those having surgeries, transfusion of blood and its components in their medical history, as well as medical workers with increased risk of infection with viral hepatitis B and C

In accordance with periodicity set by the authorized body

Medical examination on the subject of the use of psychoactive substances

In appointment of law enforcement authorities, investigation and inquiry bodies

Forensic drug testing

Based on the decision of judicial bodies

Forensic psychiatric examination

Based on the decision of judicial bodies

Expensive types of diagnostic tests for the socially vulnerable categories of the population (children under 18; pregnant women; participants of the Great Patriotic War, I, II, III groups disabled, mothers with many children awarded with "Altyn Alka", "Kumis Alka" pendants; recipients of targeted social assistance; senior pensioners; patients with infectious, socially significant diseases, as well as diseases dangerous to others) based on the prescription of a specialist:

Based on indications

1. Polymerase chain reaction

Based on indications

2. Immunophenotyping

Based on indications

3. Medico-genetic examination of pregnant (ultrasound screening assessment of fetal anatomy, invasive prenatal procedures, biochemical screening cytogenetic study) in the amount and terms set by the body authorized in the field of healthcare

Based on indications

4. Computed tomography

Based on indications

5. Magnetic resonance imaging

Based on indications

6. Positron emission tomography

Based on indications

7. Single photon emission computed tomography

Based on indications

8. Angiography

Based on indications

Treatment, manipulations and procedures

Surgical, gynecological, ENT, urology, ophthalmology and other outpatient procedures, including using medical items and medicine, at the expense of the patient or within voluntary medical insurance

Based on indications, based on prescription of PMC specialists and relevant experts

In Vitro Fertilization in accordance with the procedure approved by the authorized body

Based on indications, but not more than 2 cycles of IVF

Emergency dental care (acute pain) to socially vulnerable categories of the population: pain relief, preparation and tooth filling made of composite materials of chemical curing, extraction of a tooth with anesthesia, periostotomiya, abscesses opening

Based on indications

Routine dental care for children and pregnant women (except orthodontic and orthopedic) based on the prescription of a specialist, including extraction of teeth with anesthesia, preparation and tooth filling made of chemical curing composite materials

Based on indications

Orthodontic care for children with congenital pathology of maxillofacial part using an apparatus for removing dentoalveolar anomalies (orthodontic plate)

Based on indications

Early and continuous medical rehabilitation of socially vulnerable group of population according to the standards approved by the body authorized in healthcare

Based on indications


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