[Influence of computer tomography diagnostics on the treatment in state health care system]

The presented paper is a continuation of the widely debated topic on the role of radiation technologies, including computed tomography (CT), in municipal medicine, which has been earlier raised on the pages of the Vestnik. The main objective of the paper is that by using the results obtained from the use of CT in a near-Moscow health care facility that is typical of Russia's municipal health care service, the author attempted to provide evidence that it is necessary to extensively introduce this technique into the most mass link of Russian public health care--municipal medicine. As an evidence basis, the author analyzed changes occurring in the organization of a therapeutic-and-diagnostic process the municipal health care facility from a great variety of organ and system pathology that is particularly important from the practical point of view. The data obtained before and after introduction of CT into the municipal diagnostic algorithms on specific, the most critical clinical situations are compared. Moreover, objective analytical data are confirmed by a battery of brilliant diagnostic images. The author elucidates the readiness of municipal clinicians for virtually complete use of CT data for their purposes. By using several nosological entities, he shows the CT-induced transfer of some therapeutic procedures from the regional to municipal area of practice. In addition, arguments are advanced in favor of the thesis that some therapeutic technologies now in use are not up to world standards and municipal health care cannot be in compliance with civilized standards without its effective diagnostic support. Prominent in the paper is the description of changes in the continuity of diagnostic medicine at the municipal and regional levels after inclusion CT into the day-to-day activities of a municipal facility. It is concluded that the population needs for CT: one 24-slice unit per 50,000 dwellers of an area under service of a municipal facility.