Do the operations make rhinoplasty in the policy. Inclusion of plastic operations in the OMS policy: myth or reality of the future? How to get medical assistance in the Policy of the OMS within the framework of the Moscow Regional MSM program in the hospitals of Medsi
Dear friends! Today I would like to disassemble important moment - The cost of rhinoplasty. Some patients, addressing the clinic of aesthetic medicine about the plastic of the nose, are surprised by its value, high, in their opinion. It would seem, this is not neurosurgery or cardiology - what can be expensive here? Let's figure it out, whether the cost of rhinoplasty is overestimated, how it is formed, and in what cases you can make rhinoplasty for free.
Technical factors for the formation of Riplasty price
Despite the seeming simplicity, rhinoplasty is one of the most difficult operations in aesthetic surgery. First, the slightest inaccuracy can lead to a catastrophic result, when it is not just a goal of the operation remains unreadable, but there is a deterioration external view patient. Secondly, it is important to maintain or restore the basic function of the nose - respiratory, which is sometimes very difficult to combine with the aesthetic requests of the patient (see the face analysis before rhinoplasty).
A considerable share in the pricing of rhinoplasty falls on the payment of the anesthesiologist. To perform this operation, a rather complicated type of anesthesia is needed - endotracheal - which requires special professionalism and responsibility of a specialist. Also important to carry out successful rhinoplasty the level of equipment of the operating and clinic as a whole. Modern medical equipment, without which rhinoplasty cannot do, is very expensive.
Therefore, private clinics simply cannot afford to offer patients with free rhinoplasty, because the performance of an experienced doctor must be paid according to his qualifications.
However, it is possible to make rhinoplastics for free: if there is a compulsory health insurance policy, it is performed in many state medical institutions. But at the same time it must be remembered that free rhinoplasty is not performed according to aesthetic indications. Such an operation is most often carried out to eliminate problems with the nasal breathing arising from the injury of the nose. But even if functional problems With breathing eliminated, the aesthetic result of free rhinoplasty, as a rule, rarely suits the patient. This lies the reason for the frequent circulation of patients in the clinics of plastic surgery for re-ropelasty.
The cost of re-ropelasty is significantly higher than the cost of primary, since its duration is also affected on the price. Even the most simple rhinoplasty lasts at least an hour, in the case of a re-operation, the plastic surgeon works intensively in the operating room several hours. Therefore, free rhinoplasty ultimately costs many patients very expensive.
And one more important factor in the formation of the cost of rhinoplasty is the duration of the rehabilitation period, after which only one can talk about the final result of the operation. The patient is under the supervision of a surgeon for about a year after the operation, and this observation is already included in the cost of the operation (rehabilitation after rhinoplasty).
Moral and ethical and psychological factors
The nose largely determines the appearance of a person. He occupies the central area of \u200b\u200bthe face and immediately attracts attention to others, especially if he is not aesthetic. Rhinoplasty, like any other operation, carries the risks of complications or the accuracy of the desired result. The surgeon takes responsibility and considerable. Naturally, it can not be free.
Another important factor affects not even at the very cost of the operation, but to the perception of its potential patients of the aesthetic clinic. For some reason, the woman is ready to lay out a very round sum for an increase in the breast for three sizes, but the price of a minor (in her opinion) change the nose in the price of the clinic seems to be overstated. In fact, the first operation is much easier than the second - both by itself and in terms of rehabilitation.
Speaking about the cost of rhinoplasty, I want to repeat the well-known saying: "Sir at the root!" And then there will be no doubt about its validity.
Mandatory Faming is a component of the insurance services system provided at the state level. It is needed to provide equal opportunities in terms of providing qualified medical care patients of different social categories. Polis OMS includes wide spectrum services, including expensive surgical operations. What directions of interventions are included in mandatory insurance, how to get them for free, and when the failure is usually provided and the operation is not made, then.
What is an OMS policy - definition
OMS is mandatory medical insurance, the most important component. Thanks to this policy, all citizens of the Russian Federation receive equal access to medicinal and medical care (this becomes possible by attracting). The procedure for the provision and list of services is indicated in No. 326-FZ of 29.11. 2010 "On compulsory medustry in the Russian Federation."
Free assistance is provided in the country in the amount registered in the basic program, and at the place of residence - in the volumes specified in the territorial rules.
The basic program develops and approves the Government of the Russian Federation, territorial - official representations of subjects (regions). Medical assistance in the framework of the action policy is provided by those organizations that are included in the register of the OMS Territorial Fund.
What is included in free policy service read.
What includes a basic package
The program of state guarantees is clearly registered with a list of preferential services that must be granted free to citizens of the Russian Federation. Paying them at the expense of budgets of different levels (urban, regional, federal) and from the funds of the OMS Foundation.
Treatment and under what conditions it is provided
For free of charge, you have the right to undergo treatment in the following areas:
Where you can get a medical policy Read.
In accordance with the provisions of the current state program, citizens of the Russian Federation may freely undergo the treatment of most diseases.
List of preferential services for ambulance and polyclinic care
Source and Polyclinic Services outpatient care included in. This also includes conducting diagnostic, therapeutic events in day hospital, in a clinic or at home.
Drug Equipment In the course of treatment in the outpatient office, the OMC program is not included.
What services are included in the program within the system of state insurance
Within the framework of the state insurance system, fixed assistance is provided for free at:
- Genera, abortions, pathologies of pregnancy.
- Injuries in need of intensive therapy, poisoning, exacerbations chronic diseases, the need to treat pathologies in acute form, isolation by epidemiological indications.
- Planned hospitalization in the framework of therapy and rehabilitation programs, including when permanent medical observation is needed.
The list of additional paid inpatient services is registered in the order of the Health Committee.
On a paid basis (voluntary or) during stays in the medical institution can be provided with the following services:
- stay in the ward increased level comfort, other individual service;
- examination, treatment for related diseases in the absence of exacerbations;
- observation, examination, treatment at home (except when the patient has no physical opportunity to visit the medical institution independently);
- anonymous services (except for free AIDS diagnostics);
- helping persons who do not have the right to highlight the use of the territorial state program;
- medical care with the use of alternative (but necessarily permitted at the state level) technologies, treatment methods;
- consulting on the personal initiative of citizens.
Read also about how to arrange for a newborn.
Free do not make preventive vaccinations at the request of citizens, do not conduct homeopathic treatment, dental prosthetics, some.
Cosmetology services, sexologic therapy is carried out only for a fee.
What free operations do in the policy and who pays them - a list of the main directions in surgery
A number of surgical operations within the framework of the Policy of the OMS is performed free of charge. The main directions for which they operate:
- Gynecology and obstetrics.
- Abdominal surgery.
- Treatment of severe burn lesions.
- Transplantation.
- Traumatology, orthopedics.
- And others - organ surgery chest, vessels, hearts, rheumatology, ophthalmology, hematology, etc.
About MRI for free by policy read.
Thus, as part of the action policy of the OMS, most of the surgical operations are performed for free. Rehabilitation activities are also available at no rate (list of exceptions you will find below).
If you are forced to pay for the operation, which should be done for free, call the hotline of the FOMS.
How to arrange a coupon for surgical intervention - sign up for a planned operation
Free operations are conducted via coupon. To obtain it, to start operating, you need to collect a full package of documents:
- An extract from the protocol of the Commission of Doctors.
- Issument and medical card with the justification of the need for treatment.
- Passport, copy, statement from a citizen who wants to use the service.
- Polis Oms and copy.
- Certificate of disability (for those who have it).
- With a copy (if any).
How to get a direction to hospitalization in the clinic and start to be operated
The direction on the planned or emergency hospitalization can be taken from the attending physician - it will also issue the necessary documents. It is sent to the Ministry of Health or a specific medical institution within three days if the commission approves the request, the patient will receive a coupon.
Can the patient choose the clinic? No, but the right to express their wishes - if possible, they will be taken into account.
We draw your attention to the fact that the list of free operations is updated annually and depends on the region. At the moment, on the Policy of the OMS, you can spend for free and sign up for free:
- Endocrine surgical interventions are the operational treatment of parachitoid glands, adrenal glands, thyroid gland.
- Cardiovascular, cardiac operations - on peripheral arteries, including vertebrates and sleepy.
- Urological treatment - endoscopic interventions in adenoma prostatic gland, urolithiasis, reconstruction of the pelvic bottom organs during their omission, urinary incontinence.
- Neurosurgical interventions - on the spine.
- General surgical operations - laparoscopy in the hernias of the abdomen, biliary disease, groove, umbilical henioplasty, etc.
- Oncological treatment - Combined techniques are used.
- Auxiliary reproductive operations - by extracorporeural fertilization.
- Gynecological interventions - plastic when omitting the vagina, removal of misa or mioma with conservation of uterus, hysterectomy, laparskopia, operations in uterine appendages, plastic of genital organs of the third category.
- Coloproctology - removal of hemorrhoidal nodes, excision of epithelial cleaned stroke, perianal tissue with fistula.
- Otoidolaryngological operations - septoplasty, polypotomy, tonsilectomy, endoscopic geimerotomy.
- Laser vision correction is not cosmetic operations for the treatment of myopia, cataracts, astigmatism.
In these cases, interference for the OMS policy owner will be free, he pays for medicines himself. If the examination of the Russian production lens, which is proposed as part of the patient, does not suit it, it has the right to order imported, but already at his own expense.
In what cases may refuse to operate
In carrying out a free surgical operation, even if it enters the list of mandatory services, it can be denied. Main reasons:
- The patient can be cured without interfering.
- Indications for therapy with high-tech methods.
- The limit of benefits in the Ministry of Health for a year has been exhausted.
If you have received a refusal because of the exhaust limit of benefits, find out what medical institutions have budget places. If they are not at all, make up the coupon and quota.
Read about how to restore the policy at the loss.
When there are no free places, and the operation is urgently needed, it is better to do it on paid reasons, and then apply for compensation.
You can also get a refusal for free rehabilitation. It is issued with anemia in heavy forms, postoperative complications, disability of the patient, venereal diseases, hypertension, drug addiction, alcoholism, heavy mental disorders, oncology.
If you think that you are wrongfully refused to rehab at the expense of budget funds, call the FOMS - and the specialist will help clarify the situation.
Video
conclusions
At the Policy of the OMS, you can get a large list of medical services at no cost. Please note that some treatment services in the hospital are charged additionally, and in the operation can be denied if the limit of budget places is exhausted, or the patient can be cured without surgery. For any controversial issues, you can call the FOM HOT line.
The services of a plastic surgeon should be accessible to every citizen of Russia, is convinced by the main freelance specialist - the plastic surgeon of the Ministry of Health of Russia Natalia Manturova. At the same time, it is only about the services that should be provided on medical reasons. "We have created a nomenclature of medical services on plastic surgery and now conduct reasoned negotiations with the main representatives of medical specialties on the positions that must be carried out exclusively to plastic surgeons. In our opinion, these are congenital and acquired defects of soft tissues, burns, scar changes," the expert explained . At the same time, she did not exclude that this list can be much wider.
Head of the Department of Plastic Surgery and Cosmetology of the South Ural State Medical University Sergey Vasilyev noted that plastic surgery technologies are already implemented in the existing clinical practice. "There is no lines" plastic surgery "in OMS, but there is a" high-tech medical care ", which, for example, provides for a one-time or delayed reconstruction after the oncological operation, but in the structure general treatment Oncological patient. That is, a plastic surgeon today can perform a reconstructive plastic surgery as a guest specialist, but only if the possibility of providing such a service is provided for as high-tech medical care, "he said. However, Vasilyev added, currently existing order allows plastic reconstructive operations and attending Doctors who have no certificate of a plastic surgeon - for example, when treating oncology, an oncologist can be held such an operation.
What types of medical services are expensive, what document does this document and what is the rationale for the assignment of plastic surgery to complex operations? The answer to this and other practical questions - in "Base of Legal Consulting Knowledge
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"As a specialty" Plastic Surgery "can not yet log in to OMS, since the relevant clinical and statistical groups have not yet been developed and the nomenclature of medical services is not approved," Vasilyev stressed. Nevertheless, Natalia Manturova is confident that I voiced the initiative will be supported: "Professandard plastic surgeon is now being formed and a nomenclature has already been developed. In addition, we argue the inclusion of the specialty" plastic surgeon "into the system of the OMS of its surgical technique, participation in adjacent medical Communities, conferences. I am sure that we will receive support. The Ministry of Health of Russia is aware of our initiative, and he will not remain aside. "
At the same time, it mentioned that the implementation of this initiative would not entail the burden on the budget: "Now there are a lot of positions performed by adjacent specialists, but which are legally the privilege of plastic surgery." "Plastic reconstructive operations are already paid by OMS, but payment occurs within the framework of other specialties. The main problem is exactly how to combine patients with a plastic surgeon and improve the quality of assistance provided to him. There are no additional costs here, this is an exclusively organizational question." Supported Sergey Vasilyev.
The importance of this initiative experts substantiates the fact that today the activity of the plastic surgeon has become socially significant. "If patients immediately fall into the hands of a plastic surgeon, a modern doctor performs two tasks at once: solves a physical question (restores damaged organs and tissues necessary for the person to feel physically healthy and active) and aesthetic nature (normalizes patient psychostatus, Restoring it in the social environment of society), "said Natalia Manturova. And at the present time, she believes, the social role of man is no less significant than his health, which is why it is so important that the plastic surgeon be sure to be among other medical staff in state medical institutions.
Today in the cabinets of the Federal Ministry of Health, there are discussions. Officials and medical professionals decide whether to include "plastic surgery" specialization in the list of services provided by the population free of charge within the framework of the Mandatory Medical Insurance system (OMS). The fact that this current issue is discussed at the highest level, it became known at the other day in Moscow, the Scientific Congress "Plastic Surgery, Aesthetic Medicine and Cosmetology". What is the situation today, our portal spoke to. M. N., Plastic surgeon Dmitry Nadelson.
Plastic surgery includes a reconstructive and aesthetic direction. The latter, naturally, to enter the OMS system will not be - just in case we clarify that this category includes breast enlargement operations, liposuction and so on. But the reconstructive direction is very relevant. After all, many patients need in rehabilitation operations after strong burns, injuries, mastectomy (breast removal operations), congenital defects that affect both the physical and psychological health of a person. Surgeons endors the initiative to include specialization in OMS.
In percentage ratio, the number of aesthetic plastic operations exceeds the number of reconstructive interventions: approximately 70 to 30 in favor of the first. But it should be noted that the aesthetic operations cost cheaper than reconstructive. Given this fact, the last direction is worth creating in state medical centersAnd aesthetic surgery will develop in parallel in commercial clinics. This is talking about the plastic surgeon Dmitry Nadelson and adds:
All profile specialists have long realized that reconstructive surgery must be submitted to the OMS system. The fact is that the result of the plastic surgery depends on the set of factors, ranging from the qualification of specialists there and ending with the equipment used. We all understand that similar high level Not all private clinics can support.
Also, a specialist believes that a number of clinics reduce the cost of plastic operations, using inexpensive materials, for the quality of which the manufacturer cannot always vouch. This, in turn, leads to re-interventions, since the patient requires correction after the poorly done work. These are the main problems of the industry.
You can only solve them in the inclusion of specialization in the OMS system, because in this case you will have to develop the quality of the work of doctors in aesthetic medicine. In addition, you will need to change and improve the system for the preparation of future plastic surgeons. This is an extensive part of the entire industry, and it will have to be changed. However, experts argue that the positive effect of the entry of plastic surgery in the OMS is possible only if the state can financially ensure this step. After all, today from those who need to reconstruct the breast of women, only 10% can make operations - these are those who could independently pay this procedure.
Nevertheless, the beginning is already supposed. The Ministry of Health has already completed the development of official terms of plastic surgery. At this stage, a list of medical hospitals has been created in the department. After approval of the nomenclature, the Russians may already hope for the translation of plastic surgery into the OMS system. Well, and then follows the inclusion of plastic surgeons to state medical centers.
As the services of plastic surgeons are provided regarding reconstructive operations in Moscow, the head of the organizational and analytical department of the city fund OMS Julia Bulavskaya says:
Today, these services can be obtained in the direction of the attending physician. Last year, plastic surgeons in the Russian capital conducted an operation for breast reconstruction 274 patients. The technique included the use of endoprosthesis and microsurgical techniques. All this was paid by the state.
Numbers
- The All-Russian industry market is estimated at 5 billion rubles.
- Every year the number of plastic operations in Russia increases by 12%, while the experts consider these figures low.
- 90% of the total number of plastic operations are held in Moscow.
- According to the latest data, the number of clinics operating in the capital exceeds 100 medical centers.
Rating
Well, in conclusion, you note the most sought-after plastic operations in the world in 2016:
- Removal Komkov Bisha. Thanks to this operation, you can get high cheekbones, because in the course of surgical intervention, the rubber volume decreases. Victoria Beckham, Angelina Jolie and Natalie Portman made this correction.
- Rhinoplasty. Operation for the correction of the shape and size of the nose was required by Jennifer Aniston, Scarlet Johansson and Blake Lavli.
- Glutheoplasty. Plastic Operation to increase the buttocks using implants. Did you gues that such changes in our appearance chose Kim Kardashian?
