Resort Ukraine
Sanatorium-and-spa institutions
Sanatorium-and-spa treatment
Information for consumers
First of all it is necessary to determine the aim with which person is going for the resort or in the sanatorium – for rest, for health promotion and treatment, because not only the result will depend on it but also differences in approaches to the choice of the sanatorium and getting of a trip ticket.
The main aim of sanatorium-resort selection is based on improvement of treatment results and disease precaution, fixation of treatment results, intensification of sanatorium net effectiveness. At the time of sanatorium-resort selection it is necessary to take into account clinical exclusion of underlying and coexistent diseases, phase of development and peculiarities of disease duration, condition of a patient and expectative firm effect of sanatorium-resort treatment. It influences the choice of location and medical profile of sanatorium. It is recommended durative and seasonal sanatorium-resort treatment. Necessary releases and doctor recommendations of sanatorium are given. Follow up of direct results of sanatorium-resort treatment is made by the sanatorium doctor, and follow up of remote results (level of achievement and effectiveness of sanatorium-resort treatment) is made by the doctor according to the place of residence or working place of a patient after his coming from the sanatorium. Received facts are gathered, analyzed, and systematized for the further improvement of sanatorium-resort treatment and selection, which leads to improvement of sanatorium-resort section in general.
The main component of sanatorium-resort selection, according to the order from 16.05.1983 No.580 Ministry of Public Health of Ukraine, is establishment of indication to sanatorium-resort treatment according to the data of defined clinical diagnosis, underlying and coexistent diseases, results of medical care, fulfilled patient’s treatment, data of laboratory and clinical researches. Identified data help to determine the list of sanatorium-resort centers, which is correspond to the treatment tasks of a concrete patient in the highest degree. The table of general data to the sanatorium-resort treatment for adults you can observe in the appendix 3, for children in the appendix 4. Contraindications for the sanatorium-resort and recovery treatment are divided into general and special. General contraindications don’t depend on the concrete diagnosis of separate patient, who has indications for the sanatorium-resort treatment, and are definitive for all patients, who have one or another co-morbidity or condition. Special contraindications, as a rule, depend on the profile of concrete disease or patient’s condition. Some contraindications can be canceled in time in the case of patient’s condition change, and usage of modern treatment methods in sanatorium-resort practice constantly reduces the list of diseases, which are contradictions to sanatorium-resort treatment.
The table of general indications and contraindications to sanatorium-resort treatment for the adults you can observe in the appendix 5, for the children in the appendix 6.
Deciding the question of choice of one or another sanatorium-resort center, besides of the underlying diagnosis, it is necessary to take into account the phase of disease, presence or absence of coexistent diseases, the level of function dyspraxia of separate organs and systems, ability of a patient to spontaneous movement and self service, and there are taken into account not only treatment factors and climatic characteristics of sanatorium, but also condition of patient’s delivery to it (condition, kind of transport, transfers etc)
Effectiveness of sanatorium-resort treatment greatly depends on right selection and sending of patients to resorts and in sanatoriums. Treatment in sanatorium is one of the stages of medical help and it should be compared with prior and further medical and preventive arrangements. Before sending to sanatorium doctor prescribes all necessary diagnostic researches. If the doctor determined, that the patient is needed in sanatorium-resort treatment, he gives to the patient certificate according to established by Ministry of Public Health of Ukraine form, which contains recommendations according to the type of resort (sanatorium), kind of treatment (sanatorium, ambulatory) and season of the year. And also should be taken into account forms and phases of underlying disease, coexistent diseases, general condition of patient’s health. Selection of patients for the sanatorium-resort phase of medical rehabilitation is guided by the commission of Health Care Center as for the medical selection of patients in rehabilitation departments of sanatorium-resort centers (“Approximate statement about commission” in the appendix 8 according to Statements, with are agreed by administration of center, take patients for the treatment and by Ministry of Public Health of Ukraine (example of statement about sanatorium-resort selection in sanatorium-resort commission are given in appendix 7).
After the procedure of sanatorium-resort selection, patient receives the main document, which proves the need in sanatorium-resort treatment and it is one of the basis for the issue of sanatorium-resort cart and trip ticket to the patient – certificate for the getting of a trip ticket of No. 070/o form, which is noted in medical card of ambulatory patient. After getting it, patient, with the presence of sanatorium-resort trip ticket, should apply to Health Care Facility, which has given it according to sanatorium-resort card. The next phase after the selection is direction of patient on sanatorium-resort treatment, for which he should execute sanatorium-resort card of No.072/o form (example in given in appendix 9). When sending a patient with nervous-psychic disability in anamnesis to sanatorium-resort treatment - data of psychoneurological examination are compulsory. In the case, when sanatorium-resort trip ticket is bought by the person individually, directly in sanatorium, execution of sanatorium-resort card can be fulfilled in medical and preventive center (hospital, ambulatory) according to the location of sanatorium. In this case, patient will be able to pay by himself all necessary volume of diagnostic examination, which is mentioned in sanatorium-resort card. Sanatorium-resort card is given by the doctor after the presentation of trip ticket to sanatorium-resort treatment, without which trip ticket is not current.
In sanatorium-resort card doctor should put results of following examinations:
- Clinical analysis of blood and urine;
- For the patients or people, who are elder than 40 years old, who are sent to sanatorium-resort treatment according to the profile of heart-vessel diseases (or allied profiles, coexistent diseases),-data of electrocardiography;
- Photoroentgenography or roentgenological researches of chest organs (if the last examination was longer than 6 months ago);
- Under the diseases of digestion organs – data of ultrasound research of peritoneal cavity organs;
- If its necessary, for the improvement of diagnosis, additive researches are fulfilled: determination of rudimentary blood azote, examination of eye ground, gastric juice, liver, allergic batches etc;
- For women and pregnant- necessary are: consultative embedding of gynecologist (attendant- gynecologist) and metabolic card (for pregnant);
- Under underlying or coexistent diseases urological, otorhinolaryngological, skin, hematological etc- embedding of corresponding specialists.
Some sanatoriums provide sanatorium-resort services for a child (two children) with adult accompanying. In such a case adult should execute all necessary forms, which are noticed above, and sanatorium-resort card for children and teenagers is executed by the form No.76/o with fulfillment of all researches, with are provided by this form (appendix 10).
Besides, according to “order of children sending to the sanatorium-resort treatment” (look, appendix 11), for the every child should be given separate child trip ticket by the form 077/o.
Patients can be provided with sanatorium-resort trip tickets according to following variants:
· Acquisition individually for personal money;
· Supply at the expanses of social insurance funds;
· Acquisition at the expanses of enterprises, centers and organizations or expanses of their trade committees or their different financial structures, which were organized for the realization of concrete aims;
· Supply at the expanses of targeted funds of state budget;
· Supply at the expanses of center and authorities funds, which have on balance their own sanatorium-resort centers.
Acquisition of sanatorium-resort trip tickets in the order of personal request for personal money, as a rule, is fulfilled through the specialized tour agencies and companies or directly in sanatorium-resort center, which has for it corresponding department as for the realization of trip tickets or responsible employee. It should be noticed that such a way of trip ticket achievement doesn’t release the person from the necessity to execute sanatorium-resort card, without which trip ticket is considered to be illegal. Also, with the aim to rise sanatorium-resort treatment, it will not be odd to fulfill in a befitting way sanatorium-resort selection for the receive of corresponding recommendations of specialists according to the choice of sanatoriums according to individual indications/ contraindications, climatic zone, natural treatment factors, infrastructure and etc.
At the expenses of social insurance funds is fulfilled with trip tickets to sanatorium-resort and recovery treatment only persons, who according to legislation are considered to be assured. Services, which are connected with sanatorium-resort treatment, are given to assured persons only with the presence of medical indications.
According to the article 47 of Law of Ukraine “About compulsory for all state social assurance because of temporary lose of employability and expenses, which are conditioned by burial”, assured person and members of his family (and also the person, who studies in higher education establishment), have the right to achieve sanatorium-resort treatment at the expenses of social insurance funds by temporary lose of employability, health improvement in special health care centers (in child centers also) in order and under the conditions, which are determined by Fund administration. In this case, assured person is a hired man and other persons (citizens of Ukraine, foreigners, persons without citizenship and members of their families, which live in Ukraine, when other isn’t written in international agreement of Ukraine, it is agreed by Verkhovna Rada of Ukraine), in favor of them is fulfilled compulsory state social assurance because of temporary lose of employability and expenses, which are conditioned by burial, who in established by legislation order got sanatorium-resort trip ticket. Conditions of getting sanatorium-resort treatment by assured persons and members of their families, which are paid at the expenses of social insurance fund as for the temporary lose of employability, which are determined by statement of fund administration from 25.02.2009 No.12 “About affirmation of receive order by assured persons and members of their families of sanatorium-resort treatment, which is paid at the expenses of social insurance fund as for the temporary lose of employability”.
Essential role belongs to sanatorium-resort help in organization of medical rehabilitation of persons, which suffered from accidents on production and professional diseases. Supply with trip tickets for the sanatorium-resort treatment of injured people, who became handicapped people as a result of an accident on production or professional disease, at the expenses of social insurance fund from an accidents on production or professional diseases of Ukraine, which is described by Order about supply of injured in an accidents on production and professional diseases with trip tickets for sanatorium-resort treatment, which is established by the statement of authorities of social insurance fund from an accidents on production or professional diseases of Ukraine from 31.10.2007 No.49.
There is an order in
Persons, who suffered from Chernobyl accident, get sanatorium-resort trip ticket according to the Law of Ukraine ”About the status and social secure of citizens, who suffered in a result of
Order of providing ill citizens of
After the execution of a trip ticket for the concrete patient, some note is made in special registration book. When the patient got the trip ticket for the sanatorium-resort treatment, he goes to sanatorium according to the period of trip ticket validity. If there are some difficulties, which cause inability to come in time in sanatorium-resort center, it is necessary (preferably in written form) to notify administration or correspond employee (as for marketing and realization of trip tickets) about the situation. It is possible, that if there are free places, term of trip tickets will be postponed. The day of arrival and day of leave from sanatorium-resort center are included in term of sanatorium-resort treatment (term of trip ticket action).
Patient, who came to sanatorium, should be taken for the treatment irrespective of the time of arrival. In admission office or in registry patient gives to a nurse on duty or to a registrar the trip ticket and sanatorium-resort card, which is kept in medical card of in-patient (clinical chart). After the first examination by attending sanatorium doctor, patient gets sanatorium-resort book, where is written a diagnosis and indication of manipulating treatment. Sanatorium-resort book is given to patients in balneophisiotherapeutic and other treatment-diagnostic departments of sanatorium-resort center, where is noted a fulfilled treatment. It is necessary to note, that the main legal document about fulfilled treatment is a medical card of in-patient (clinical chart), where attending doctor notes prescriptions and realization of diagnostic-treatment complex, realization of consultations and examinations of the a patient (diaries), changes in prescribed treatment, in the presence of, refusal of a patient from prescribed treatment.
Resort (sanatorium), presence on which leads to worse health condition of a patient, is considered to be contraindicative. Under the establishment of contraindication, doctors should be ruled by established by Ministry of Public Health of Ukraine general contraindications, which exclude the possibility of patient’s indication to sanatorium-resort treatment, and it should be noticed in every distinct case not only the form and phase of disease, but also a phase of risk during the presence on resort (in sanatorium) for the patient and others.
In order to define the contraindication of patient’s presence in sanatorium-resort center, there is created doctorial-consulting counsel, where the head is the director of sanatorium, and the body consists of: deputy director of medical department, chief of department, attending doctor, and if necessary- specialized advisers. Counsel determines the presence of contraindications to sanatorium-resort treatment, and possibility to leave the patient in sanatorium for the climatic, medical and other treatment, necessity of his hospitalization (transfer in the hospital) or evacuation according to the place of living. It is necessary to give an attendant for the patient for the evacuation.
If contraindications to sanatorium-resort treatment are defined in patient, than doctorial-consulting counsel of sanatorium take formal notes in three copies, one of them is sent to the address of the highest health care institution (regional or city department of health care according to the patient’s place of living), the second to the address of medical center, which gave a sanatorium-resort card, in order to make an enquiry of every act in order to find the reasons of wrong selection and direction of patients to sanatorium-resort treatment and involvement of guilty to responsibility, the third copy of the act stays in sanatorium. In the case, when the patient was sent not at his own expenses, the copy of the act is sent on the address of working institution of organization, at which expenses was bought sanatorium-resort trip ticket. All data about patients with contraindications are noted in corresponding register, medical card of in-patient (clinical chart), sanatorium-resort book and in back talon of sanatorium-resort trip ticket.
The term of patient’s presence in sanatorium-resort center during contraindication establishment shouldn’t be longer than 5 natural days from the moment of arrival in sanatorium. Under evacuation of ill people from sanatorium-resort center, administration of sanatorium should maximally promote in his transfer (acquisition of tickets, delivery to transport terminals), and if it is necessary, in accordance with decision of doctorial-consulting counsel, to give an attendant.
Separate case of direction to sanatorium-resort treatment is a direction of patients for the medical rehabilitation in rehabilitation departments of sanatorium-resort centers. Peculiarity is concluded in the fact that the patient is sent by selective commission of the health care center directly from the in-patient department, because medical rehabilitation is one of the most important and necessary phases of in-patient treatment. Such an order of patient direction provides maintenance of the main principles of medical rehabilitation: early beginning of recovery treatment, its sequence and succession in medical help. In this case realizes the scheme of recovery treatment “in-patient - rehabilitation department - ambulatory” best of all, which helps to firm, reached in in-patient department, results of treatment, to fulfill further recovery of injured and compensation of lost because of disease functions, to predict the appearance of disease backsets. Besides, patients must, after the end of rehabilitation term, return the back talon of a trip ticket in commission, which gave it, which fulfills the estimation of effectiveness of medical rehabilitation by specialists, who decided to fulfill it.