[Some problems in assessing the quality of rendering medical assistance to people with multiple sclerosis]

To solve the problem of medical and social assistance to people with multiple sclerosis (MS) is possible in employing a system/ comprehensive approach which involves appropriate material basis and appropriate structures, systems, sub-systems with a definite area of their activities and functional interrelations between them. The quality of medical services is a complicated category that is defined by many characteristics. One needs certain equipment to manage in order to obtain the quality while based on the system approach. Experts in the area of quality management inform that, currently, the Russian healthcare is mostly characterized by primary level of quality, which is represented by unsystematic management of the quality and unsystematic (unstable) quality. The methodology of improving the quality is a multistage one. In accordance with the management cycle of Deming-Schuchart or the cycle of PDCA ('P' is for 'plan', 'D' is for 'deed', 'C' is for 'control' and checking the conformity of the result planned to that in the end, and, 'A' is for 'adjustment' of actions depending on the results achieved), the methodology comprises certain problems, an analysis of the system, an action plan development, testing proposed changes in pilot institutions, and practical application in the healthcare system. The article attempts to analyze basic problems and difficulties in setting up medical assistance for a resource-consuming group of patients, by the example of 382 patients with MS, taking into account the experience acquired in a test of application of management systems for medical assistance quality, which is based on international standards (ISO 9000), in order to find possible ways to overcome the existing negative processes and facts.