Quotas for children in need of neurosurgical treatment are sorely lacking

He noted that after the adoption of the WHO standard on live births in 1994, the implementation of relevant protocols and standards, mortality among very premature infants in the country began to decline. Thus, in Moscow, this figure decreased for newborns weighing up to 1000 g – from 96.5 to 27.3%, from 1000 to 1500 g – from 48 to 15.6%, from 1500 to 2000 g – from 30.4 up to 1.9%.

“But with each of our successes in saving lives, the question begins to sound more insistently and louder: what quality of life can we provide to the saved children? Over the last 6 years alone, the number of disabled people in the country has increased from 570 to 670 thousand,” Dmitry Zinenko expressed concern.

He complained that against the backdrop of the successes of domestic functional neurosurgery in pediatrics, a paradoxical situation has developed: the state finances the purchase of baclofen pumps, but does not allocate money for refills, for programming neurostimulators, for preoperative studies. The effectiveness of treatment depends on the duration of the disease, and children with a 10-year medical history are referred to neurosurgeons.

Spreading quotas across clinics is also harmful to business, the specialist believes: “This year, the Moscow Department of Health decided to distribute quotas – 3-5 per clinic, and this discredits the methods and wastes money. You often hear at conferences that they installed 7-10 pumps, but they don’t work, the technique is bad. How did they install it, where, who programmed it?”

Dmitry Zinenko also complained about the catastrophically small number of quotas, emphasizing that it is much more profitable for the state to treat a child than to support him for the rest of his life: “We say that functional surgery can help the majority of children with cerebral palsy and epilepsy. But this is also beneficial to the state, because an unoperated child is much more expensive.” According to specialist estimates, direct costs (monthly child benefit, wheelchair, apparatus, corsets, consumables, replacement kits, etc.) amount to 2–3 million rubles. per year per disabled person.

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