二战后苏联的儿童医疗改革

Valerii Y. Albitskiy, S. A. Sher
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摘要

文章介绍了反映二战后儿童保健改革问题的历史和医学研究成果。研究的目的是介绍战后十年(1946-1956 年)苏联儿童保健改革的问题。研究的现实意义在于,有必要研究我国战后最困难时期儿童保健改革的历史经验,以便从过去的经验中汲取重要教训,并将其进一步用于成功实施 "发展儿童保健,包括为儿童提供医疗保健建立现代化基础设施 "的联邦项目。为了解决这一问题,我们研究了俄罗斯联邦国家档案馆保存的苏联卫生部和苏联医学科学院已发表和未发表的文件,以及医学杂志、科学文集和专著中的出版物。研究分析表明,战后最初几年开始的国家卫生改革中最重要的部分是将成人医院和诊所、妇产医院和妇科诊室、儿童医院和儿童诊室以及门诊诊所合并在一起。战后改革促进了住院和门诊医疗质量的提高,医院作为所有联合设施的组织和领导中心的作用日益增强。儿童医院与会诊和门诊的结合,以及根据由单一儿科医生为出生至 16 岁儿童提供医疗和预防保健服务的制度组织初级儿科保健,显示出初级保健医生和医院工作的继承。卫生工作者的资质得到提高,专业医疗类型得到发展,医疗和预防保健的质量得到改善。儿童保健改革促进了疾病的及时诊断和早期住院,加强了初级保健医生和护士与儿童家庭的联系,降低了儿童发病率和死亡率。
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Reforming Children’s Health Care in the Soviet Union after the World War II
The article presents the results of historical and medical research reflecting the issues of reforming children’s health care after the World War II. The aim of the study is to present the problems of reforming children’s health care in the USSR in the post-war decade (1946–1956). The study relevance is defined by necessity to examine the historical experience of reforming children’s health care during the most difficult for our country post-war period so we can learn crucial lessons from the past and use them further for the successful implementation of the federal project “Development of children’s health care, including the creation of modern infrastructure for medical care provision for children”. Published and unpublished documents of the USSR Ministry of Health and the USSR Academy of Medical Sciences, stored in the State Archive of the Russian Federation, as well as publications from medical journals, scientific collections, monographs were studied to cover this issue. The analysis of this study has shown that the most significant part in the state health reform started in the first post-war years was the merger of hospitals and clinics for adults, maternity hospitals with women’s consultations, children’s hospitals with children’s consultations and outpatients’ clinics. The post-war reform has contributed to the improvement of the quality of inpatient and outpatient medical care, to the increasing role of the hospital as the organizing and leading center of all united facilities. The integration of children’s hospitals with consultations and outpatients’ clinic, as well as the organization of the primary pediatric care according to the system of medical and preventive care provision for children aged from birth to 16 years by single pediatrician, have shown succession in the work of primary care doctors and hospitals. The increase in the health workers qualifications, the development of specialized types of medical care, the improvement in the quality of medical and preventive care were observed. The reform of children’s health care contributed to the diseases’ timely diagnosis and early patients’ hospitalization, strengthening the connection of the primary care doctor and nurse with the child’s family, and decreasing of child morbidity and mortality.
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