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Health care reform in the russian empire, the attempts of conversion of management of the medical and sanitary sector (1886–1916)

[History of medicine]
Irina Valentinovna Egorysheva; Alexey Vyacheslavovich Morozov;

The article describes the attempts of the government in the late XIX – early XX centuries to implement health care reform in Russia. The government commissions established under the Ministry of Interior based the draft laws on the establishment of an independent Central health management body, tighter control over the medical and sanitary activities of local selfgovernment health authorities and departmental medicine, and streamlining of medical legislation. The medical community, fearing the bureaucratization of medical and sanitary assistance to the population, did not support the projects of the commissions. The Commission headed by academician G. E. Rein worked most effectively, as a result of which in 1916 the Main Department of public health was created – the world’s first Ministry of health.

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References:
1. Zhurnaly uchrezhdennoj pri Medicinskom sovete komissii po voprosu ob uluchshenii sanitarnyh uslovij i umen’sheniyu smertnosti v Rossii. – Magazines of the Commission established at Medical Council on improvement of sanitary conditions and reduction of mortality in Russia. Spb., 1886. (In Russ.).
2. Prilozhenie k zhurnalam uchrezhdennoj pri Medicinskom sovete Komissii po voprosu obuluchshenii sanitarnyh uslovij i umen’shenii smertnosti v Rossii. Appendix to the journals of the Commission established by the Medical Council on improving sanitary conditions and reducing mortality in Russia. Spb. 1886;(1):146-179. (In Russ.).
3. Zakonodatel’noe zayavlenie 83 chlenov Gosudarstvennoj Dumy (st. 55 uchr. Gos. Dumy) o proekte novogo zakona ob uluchshenii obshchegosudarstvennogo sanitarnogo sostoyaniya v Rossii. Legislative statement of 83 members of the State Duma (art. 55 hr. state. Duma) on the draft of a new law on improving the state sanitary condition in Russia. Trudy Vysochajshe uchrezhdennoj mezhduvedomstvennoj komissii po peresmotru vrachebno-sanitarnogo zakonodatel’stva. – Proceedings of the most Highly established interdepartmental Commission for the revision of medical and sanitary legislation. Spb. 1913;(2):91-100. (In Russ.).
4. Frejberg N. G. Spravka po voprosu o pereustrojstve upravleniya vrachebno-sanitarnoj chast’yu v Rossii. – Freiberg N. G. Reference question of the reorganization of the management of medical-sanitary part of Russia. Spb., 1910. (In Russ.).
5. Istoricheskaya spravka o komissiyah i soveshchaniyah po voprosu o pereustrojstve vrachebno-sanitarnoj chasti v Imperii. Historical information on commissions and meetings on the reorganization of the medical and sanitary part of the Empire. Trudy Vysochajshe uchrezhdennoj mezhduvedomstvennoj komissii po peresmotru vrachebno-sanitarnogo zakonodatel’stva. – Proceedings of the most Highly established interdepartmental Commission for the revision of medical and sanitary legislation. Spb. 1913;(1):3-8. (In Russ.).
6. Zhurnal Osobogo soveshchaniya po obsuzhdeniyu nedostatkov dejstvuyushchej v Imperii organizacii vrachebno-sanitarnogo dela i po ustanovleniyu obshchih osnovanij pereustrojstva etoj organizacii. Trudy Vysochajshe uchrezhdennoj mezhduvedomstvennoj komissii po peresmotru vrachebno-sanitarnogo zakonodatel’stva. – Journal of a Special meeting to discuss the shortcomings of the organization of medical and sanitary Affairs operating in the Empire and to establish the General grounds for the reorganization of this organization. Proceedings of the most Highly established interdepartmental Commission for the revision of medical and sanitary legislation. Spb. 1913;(2):101-123 (In Russ.).
7. Еgorysheva I. V. Znachenie trudov Komissii G. Е. Rejna dlya zdravoohraneniya Rossii. Problemy social’noj gigieny, zdravoohraneniya i istorii mediciny. – Problems of social hygiene, health care and medical history. 2013;(2):54-57. (In Russ.).
8. Istoricheskaya spravka o komissiyah i soveshchaniyah po voprosu o pereustrojstve vrachebno-sanitarnoj chasti v Imperii. Trudy Vysochajshe uchrezhdennoj mezhduvedomstvennoj komissii po peresmotru vrachebno-sanitarnogo zakonodatel’stva. – Historical information about the commissions and meetings on the reconstruction of the medical and sanitary part of the Empire. Proceedings of the most Highly established interdepartmental Commission for the revision of medical and sanitary legislation. Spb. 1913;1:4. (In Russ.).
9. Ustav zdravoohraneniya i uchrezhdeniya, vedayushchie vrachebno-sanitarnym delom. Proekt. The Charter of health care and institutions in charge of medical and sanitary Affairs. Draft. Vysochajshe uchrezhdennaya mezhduvedomstvennaya komissiya po peresmotru vrachebno- sanitarnogo zakonodatel’stva. – Тhe most highly established interdepartmental commission for the revision of medical and sanitary legislation. Pg., 1916. (In Russ.).
10. Shidlovskij K. O novom ministerstve gosudarstvennogo zdravoohraneniya. About the new Ministry of public health. Obshchestvennyj vrach. – Public physician. 1917;(1-3):49. (In Russ.).
11. Еgorysheva I. V. N. G. Frejberg – soratnik G. Е. Rejna i N. A. Semashko. Problemy social’noj gigieny, zdravoohraneniya i istorii mediciny. – Problems of social hygiene, health care and history of medicine. 2001;(6):53-55. (In Russ.).

Keywords: health care management in pre-revolutionary Russia, health care reforms, medical and sanitary legislation, consolidated by the Imperial Court interdepartmental Commission for the revision of medical and sanitary legislation (G. E. Rein Commission)


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