[Problems of updating the procedures for the provision of medical care used in diseases of the ear and mastoid, throat and nose].

Unlabelled: The procedures for the provision of medical care in otorhinolaryngology and audiology-otorhinolaryngology contain a large number of requirements. The actualization of the orders has not been carried out for a long time, which is due to the lack of methodological formalized approaches for the formation of hypotheses regarding expedient changes. The article proposes an analysis of the results of state control, which will allow the formation of specific proposals for assessment by experts in the framework of the process of updating the procedures for the provision of medical care.

Purpose Of The Study: To analyze the effectiveness of the formalized mechanism for updating the Procedures for the provision of medical care to the population in the field of otorhinolaryngology, approved by the orders of the Ministry of Health of Russia.

Material And Methods: In this work, an analysis has been carried out, during which the provisions of the regulatory enactments of the Procedures for the provision of medical care in the field of otorhinolaryngology were investigated for the compulsory implementation and duplication. The analysis of 72 acts of inspections of state control in relation to medical organizations providing assistance (licensed) in the field of otorhinolaryngology was carried out.

Results: The analysis showed that only a small number of the foreseen requirements regulate the activities of medical organizations and can be subject to control. For the most part, these are requirements regarding the availability of equipment (medical devices). At the same time, the results of state control demonstrate that licensees violate the same provisions of the Procedures for the provision of medical care, including repeatedly. This circumstance should be considered as a trigger for the expert method of researching these provisions, in particular for their redundancy and a real contribution to the availability, quality and safety of medical care.

Findings: Today there is no formalized mechanism for updating the procedures for the provision of medical care. One of the possible triggers starting this process and guiding it is the analysis of the results of state control: 1) the absence of at least one single detection of violations of the rules and stages can alert from the point of view of the formulation of requirements - are they not recommendatory or declarative; 2) the presence of repeated violations in terms of the lack of identical positions of the equipment standards may indicate excessive requirements and should be evaluated and interpreted by experts with a decision to change the provisions of the procedure for the provision of medical care.