How to get a quota for prostate cancer surgery

My dad was diagnosed with T2 prostate cancer

Good afternoon. My dad was diagnosed with T2 prostate cancer. He is 82 years old. We live in Novokuznetsk

Respectfully, Vadim.

Dear Vadim, ultrasonic ablation of the prostate or Hi-Fu technique, which consists in thermal ultrasonic treatment of the prostate gland. As a result, necrosis (death) of prostate cells and replacement with connective tissue is assumed. Given the pronounced swelling of the prostate after manipulation, immediately before ultrasound ablation, endoscopic removal of the inner part of the prostate (adenomatous) is performed, which helps to quickly restore urination after the operation.

The technique is an alternative and is performed today if other, more radical, methods of treatment are not applicable. The technique has proven itself well in the older age group (from 75 and above). As a rule, these are patients with clinically significant prostate cancer, but with a high operational and anesthetic risk. Perhaps your dad falls into this group. Contraindications may be severe cardiovascular and other somatic diseases, operations on the rectum. With a properly technically performed operation, there are no special complications. The first time after the operation may be somewhat difficult to urinate.

Everything will depend on the degree of readiness, the speed of obtaining a quota and the queue to the department for hospitalization. As a rule, all patients, especially oncological ones, are hospitalized within 10-14 days. The scope of the examination may be determined during a face-to-face meeting.

Thanks for the provided answer. Two more questions. How can one get such a quota? Is a paid operation possible without a quota? If so, how much will it cost and how can I book an operation?

The administration of the clinic sends a request to the local health department. All you need is a passport, compulsory health insurance policy, pension insurance certificate.

Regarding your question about paid medical services, the cost of high-frequency ultrasound ablation with preliminary transurethral resection of the prostate is approximately 150,180 thousand.

If for some reason you prefer such treatment, then this is your right. But beforehand, all the same, we need to make sure that it is shown to your dad. Good luck.

How to get a GMP quota?

Discovery of a disease that requires high-tech surgical intervention is a common story. Such an intervention can be performed using the method of minimally invasive surgery using the da Vinci robotic platform. The basis of the method is surgery using point punctures in tissues or through natural physiological openings, which avoids large postoperative traces.

It may seem to you that it is extremely difficult to get funding from the budget for high-tech assistance, nevertheless, there is a chance, and the number of operations performed under the quota is growing every year. According to official data, the cost of VMP is growing annually by 20%, and the number of transactions completed over the past 10 years has increased 15 times.

Speaking at SPIEF-2018, Minister of Health Veronika Skvortsova announced the increase in the availability of high-tech medical care (HTMC): "We have significantly increased the volume of high-tech medical care, starting from 60 patients 10 years ago, and now it is more than 1 million according to the results of the past year", - said the Minister

Surgery using the da Vinci robotic platform is expensive, but any patient in need is eligible to receive a state quota for such an operation.

We bring to your attention answers to questions that arise from applicants.

Who is eligible for a free high-tech surgery?

This document is accepted annually.

Which institutions deal with the issue of quotas?

All issues of obtaining financing for High-Technological Medical Assistance (HMP) from the federal budget are regulated by the Ministry of Health.

What diseases fall under the quota program?

View the types of assistance that can be provided with the da Vinci robot here.

Which institutions are eligible to provide High-Tech Medical Care (HICH)?

A medical institution providing high-tech medical care under state quotas must have an appropriate license. All the clinics on our list that have the da Vinci robotic system in their arsenal have such a document.

Is there an age limit for the patient?

There are no age restrictions for minimally invasive surgery using the da Vinci robot.

What are the steps involved in obtaining a quota for an operation that meets the gold standard of surgery?

Step 1. Contact your doctor.

First of all, the patient should contact the attending physician to obtain a referral for hospitalization, draw up the necessary documents and send them for consideration to the competent organization. The attending physician of the medical organization in which the patient is being diagnosed and treated determines the presence of medical indications for the provision of HTMC and, if there are medical indications, issues a referral for hospitalization. The presence of medical indications is confirmed by the decision of the medical commission of the medical organization, which is drawn up in a protocol and entered into the patient's medical documentation. If there are medical indications, the attending physician issues a referral for hospitalization.

Requirements for issuing a referral for hospitalization:

The referral must be completed on the letterhead of the referring medical organization legibly by hand or in print, certified by the personal signatures of the attending physician and the head of the medical organization, as well as the seals of the attending physician and the medical organization and contain the following information:

• Name patient, date of birth, registration address;
• CMI policy number and the name of the medical insurance organization;
• certificate of obligatory pension insurance;
• code for the diagnosis of the underlying disease in accordance with the international classification of diseases;
• profile and name of the VMP type;
• name of the medical organization to which the patient is referred;
• Name

Attached to the referral:

• an extract from medical records indicating the diagnosis of the disease, the code of the disease according to the international classification of diseases, information about the state of health, the results of special medical studies. The extract must be certified by the personal signatures of the attending physician and the head of the medical organization;
• copy of patient ID or copy of birth certificate (for children under 14);
• copy of compulsory medical insurance policy;
• copy of compulsory pension insurance certificate (if available);
• Consent to the processing of personal data.

The head of the referring medical organization or another employee of the medical organization authorized by the head sends a referral for hospitalization:

To the receiving medical organization, if the VMP is included in the basic CHI program (clause 15.1 of the Procedure);

Important: The patient or his legal representative has the right to submit the completed package of documents on his own. This will speed up the collection and submission of the documentation necessary for obtaining the VMP.

Step 2. It is necessary to wait for the registration of the coupon for the VMP.

There are 2 options for coupon design:

• If the patient is referred for the provision of HTMC included in the basic CHI program, then the receipt of the coupon with the attachment of the set of documents specified in step 1 is provided by the receiving medical organization.

The HMO Commission decides on the presence or absence of indications for referring the patient to the receiving medical organization within 10 working days from the date of receipt of the full package of documents. The decision of the HMO commission is drawn up in a protocol, which should contain a conclusion on the indications for referral to the VMP or on the need for additional examination.

Note: An extract from the protocol of the decision of the HMO commission is sent to the sending medical organization, and is also given to the patient (his legal representative) upon a written application or sent to the patient (his legal representative) by postal and (or) electronic communication.

Step 3. It is necessary to wait for the decision of the commission of the medical organization providing HTMC.

The commission makes a decision on the presence (absence) of medical indications or the presence of medical contraindications for hospitalization of the patient within seven working days from the date of issuance of the coupon for the provision of HTMC.

The decision is drawn up in a protocol containing a conclusion on the presence of medical indications and the planned date of hospitalization of the patient, on the absence of medical indications for hospitalization, on the need for an additional examination, on the presence of medical indications for referring the patient to a medical organization for specialized medical care, on the availability medical contraindications for hospitalization of a patient in a medical organization providing high-tech medical care.

Step 4. After completing the HTMC, receive recommendations.

Based on the results of the provision of HTMC, medical organizations make recommendations for further observation and (or) treatment and medical rehabilitation with the relevant records in the patient's medical records.

What do da Vinci robotic surgery quota applicants need to consider?

The number of quotas is disproportionately less than the number of patients in need of surgery.The classic direct route to getting quotas usually stretches over time.

Where can I find out if there are quotas for High-Tech Medical Care?

The Ministry of Health annually approves the number of quotas for HTMC and other types of treatment. All quotas are distributed among medical institutions licensed to provide such care. Information about how many quotas are left can be obtained from two sources. One of them is the Department of Health, the other one is the clinic where you want to get a VMP.

In any clinic that provides treatment under government quotas, there must be a person responsible for quotas, or there may even be a whole quota department. This is where you need to contact for questions about the availability of quotas.

How many high-tech operations with the help of the da Vinci robot are performed per year, is there any chance of getting help?

In 2017, a total of 2421 operations were performed using a robotic system. Of these, only 5% was paid by private individuals, the rest was financed by quotas.

If a medical center is equipped with the da Vinci system, does this mean that all types of operations can be performed at the medical center?

The use of a robotic system allows for the most complex interventions in urology, general surgery, gynecology, thoracic surgery, colorectal surgery and on the organs of the head and neck. Although the list of operations is quite wide, 70% of all interventions take place in Urology, and robot-assisted prostatectomy is the gold standard in the world in the treatment of prostate cancer. It is important to understand that each clinic develops separate directions. There are multidisciplinary centers where surgical interventions using da Vinci are carried out in different directions, and there are centers specializing in one thing. For example, GBUZ MO "MONIIAG" specializes in gynecology, and all operations are carried out only in this area.

A list of medical institutions that perform surgery using the da Vinci robot is presented on our website, in the "Clinics" section

Urology: Radical prostatectomy, A denomectomy, Kidney resection; autotransplantation; allotransplantation, Nephrectomy, Adrenalectomy, Cystectomy, Bladder resection, LMS plasty, Ureteroanastomosis; Ureterocystoanastomosis, A bdominal testicular resection, Pyelolithotomy, Varicocelectomy.

Abdominal surgery: Hepatectomy, Liver resection, Pancreatectomy, Fundoplication, Cardiomyotomy, Adrenalectomy, PDR (Pancreatoduodenal resection), Cholecystectomy, Selective arterial embolization or partial pancreaticoduodenectomy, Gastrectomy, Nissen fundoplication, Tupe fundoplication, Gastroastrotomy , Abdominal aortic aneurysm replacement.

Colorectal surgery: Rectal resection (anterior and low anterior), BAR (Abdominal anal resection), Hemicolectomy (left, right), Sigmoidectomy, Colectomy.

Thoracic surgery: Segmentectomy, Lobectomy, Bilobectomy, Marginal resection, Mediastinal resection.

Head and neck: Glossectomy, Thymectomy, Theriodectomy, Hemithyroidectomy, Resection of the isthmus of the thyroid gland.

How to get and apply for a quota for oncology treatment in 2018-2019

The state provides assistance to citizens suffering from deadly ailments. So, for the treatment of oncological diseases, a quota is allocated that allows you to get (VMP).

This service is available only to certain categories of people who are unable to pay for expensive treatment. How to get a quota for oncology treatment and what documents are needed, we will consider further.

What is a quota and who is entitled to it

The concept of "quota" refers to a service, which is the provision of medical care to a patient free of charge with the provision of a place in a hospital. People suffering from serious diseases that threaten their lives apply for assistance.

There is a special federal list of diseases for which benefits are allocated. The list includes dozens of items, and cancer is one of them.

The quota for cancer treatment is funded from the federal and local budgets. The procedure for granting benefits is regulated by order of the Ministry of Health 1248n.

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How to get the service

The amount of financial assistance from the state is strictly limited. In addition, benefits for free treatment should be distributed among clinics throughout the country. How to get a quota for oncology treatment?

First of all, it is worth finding out how many quotas are allocated for the current year. You can contact the Department of Health for this. Also, information on the availability of benefits is provided at the medical institution itself that provides services under the quota.

Quite often there are situations when benefits end, and a person is deprived of the opportunity to receive qualified assistance for a whole year. Do not despair - perhaps the quotas remained in another medical institution.

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Where to start

To receive a quota for cancer treatment, the patient must contact the attending physician. The specialist is obliged to prepare an extract from the patient's outpatient card, attaching the results of the studies performed to it.

A similar document can be provided by an oncologist or therapist. The patient can apply both to the local doctor from his polyclinic at the place of residence, and to the specialist of the medical institution of interest to him.

If it was decided to conduct an initial examination with an oncologist, then you should decide on the clinic, prepare a passport and a medical policy. If the patient has already taken any tests, the results will also be useful to him.

Having established an accurate diagnosis, the doctor will make an extract from the medical history and prepare a referral for a quota.

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Required Documents

In order to receive benefits, an oncologist's patient will need more paperwork in addition to the discharge and referral.

If the patient is under the age of 14, they will need a birth certificate and a copy of their mother's or father's passport to receive benefits.

Where to contact

All subsequent actions depend on whether the VMP required by the patient is included in the basic CHI program. N 1403.

If the required type of assistance is included in the list, the documents are sent to the medical facility (federal center) where the treatment will take place.

Documents are sent by a polyclinic or an oncologic dispensary within three days.

If necessary, the patient is sent for further examination.

I assign a registration number to each coupon, which allows you to track the state of the queue for receiving high-tech medical services.

Do not forget that the benefit provided for medical care does not relieve the patient from the queue for hospitalization at the medical institution of their choice.

If all the places in the hospital are occupied, the patient is placed on a waiting list. But, thanks to modern technologies, anyone can view the status of the queue for hospitalization and for receiving VMP on the Internet online.

What to do if you are not given a referral

The attending physician may refuse to issue a referral to a patient for various reasons. In this case, the patient can independently apply to the selected federal center for assistance. You need to bring with you:

• medical documents confirming the diagnosis;
• extracts from specialists;
• results of conducted studies (analyses).

The quota committee of the selected center makes a decision based on all the documents. If the outcome is positive, the patient applies to the department of the Ministry of Health of his region for a coupon for receiving VMP.

You can contact the Ministry of Health directly in the following cases:

Due date for quota

The quota for cancer treatment is provided according to a special coupon, which is issued to a person when registering as a cancer patient. The term for receiving medical services on the coupon is not defined.

After receiving the quota, the medical center makes a decision on the hospitalization of the patient within 7 days.

The date of hospitalization depends on several conditions:

• the patient's condition and the need for urgent surgery;
• the availability of budget (preferential) places.

If you don't currently have a cancer treatment benefit, you may be able to get it in the future when benefits become available again. This is the rule - benefits are provided on a first-come, first-served basis.

If the patient needs urgent care and treatment, he can pay for medical services on his own. Having then presented certain documents to responsible persons in the Department of Health, the citizen will be able to compensate for his expenses.

We describe typical ways to resolve legal issues, but each case is unique and requires individual legal assistance.

To quickly resolve your problem, we recommend contacting qualified lawyers on our site.

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