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The Ministry of Health is considering the future of clinics The question is to be or not to be?

Currently, there is a large network of dispensaries offering endocrinological, oncological, cardiological, TB, dermatovenereological, psychoneurological, narcological services.

Dispensary of each specializationis available in almost every region. It is not the first time that the future of these institutions is under question. This issue has been on the agenda since the decision of setting up diversified medical centers for children and adults in the regions was made in 2008. The question arises as the consequence of the need for further optimization and unification of medical care. Until now, the upheld position was for preservation of the institutions. But time will show, how it will be this time. This issue was discussed by the correspondent of Uzbekistan Today with Said Ismail Chief Endocrinologist of the Ministry of Health and the Director of the Republican Specialized Scientific and Practical Medical Center of Endocrinology.

“There are currently14 endocrinological dispensaries,” said SaidIsmailov.“We, the doctors, especially endocrinologists, favor maintaining dispensaries.”

How would you describe the current epidemiological situation of endocrinological diseases?

- The 1st place is occupied by thyroid disease, 2nd place - diabetes, 3rd place - diseases of the genital glands, 4th place - pathology of hypothalamic-pituitary system, to date. Comparing the results for the last three years revealed a decrease in the number of cases among patients with thyroid gland disease, which is the result of mass prevention, achieved by saturating the market with iodized salt. The number of patients decreased from 949.3 to 835.1 per 100 thousand by 2014. There has been an increase in the number of patients in other pathologies in our country, as well as around the world due to population growth. On another note, we now have the equipment necessary for the diagnosis of diabetes in almost all rural health centers. By the way, the incidences of diabetes have increased from 455.9 to 511.3 per 100 thousand in three years. Thus the actual number of people with diabetes is much higher, since we still face difficulties with diagnosis of the disease.

What is the role of endocrinological dispensaries inpatient assistance on the ground?

- Huge, they make specialized care easily available to people and it is convenient. Importantly, dispensaries contribute to early detection of the diseases. The treatment becomes more affordable and more effective, if the disease is diagnosed at an early stage. It is much harder to save the patient when the diagnosis is made at a later stage with severe complications.

Dispensaries take care of all the routine work with most of the endocrinological patients and that allows us - the Republican Specialized Scientific and Practical Center of Endocrinology- to focus on the development of the service and improve medical and high-tech care. We tend to concentrate on patients with severe cases of the disease and offer high-tech help. In recent years, we have opened the neurosurgery department, which deals with pituitary tumors, dialysis department that supports the diabetic patients, whose kidneys are almost not functioning.

In case the dispensaries are closed down, who will treat such huge numbers of patients?

- In any case, patients will not be left without attention. In place of the dispensaries, there will come specialized departments as part of multidisciplinary medical centers. It is possible to increase the number of rooms in endocrinology clinics in the field, today the country operates 502 endocrinological rooms, and 179 of them are for children.However, we are deeply convinced that the endocrinology department as part of a multi-disciplinary hospital - is not the best option, although it is the case for many other countries. And we have presented our conviction in writing to the management. Chief physician and staff of endocrinology clinics can and are doing more for endocrine patients because they are focused on the solution of their problems. The quality of endocrinological care does not just depend on the maintenance of institutions, where one can get help, it is also important to organize preventative measuresand detect diseases at an early stage.

And what was the attitude of the Ministry of Health regarding dispensaries?

- Dispensaries were given the highest priority. Over the past two or three years, most clinics have been renovated and redecorated, and new buildings were constructed. In particular, we have built a new modern building convenient for Surkhandarya regional clinic, and in Khorezm we constructed a new wing to the building. We also addressed issues with the equipment. A great emphasis was placed on vertical expansion in the organization and improvement of the quality of medical care. Our Republican Center for specialists holds conferences and workshops regularly; our experts go into the field to conduct inspections and training of experts in the framework of "directly from the workplace” approach.

I can only say my opinion. The maintenance and development of clinics is essential. I am not the one to make the decision. So I cannot predict the outcome, time will show.

 In your opinion, what will be the decision on this issue?

I can only say my opinion. The maintenance and development of clinics is essential. I am not the one to make the decision. So I cannot predict the outcome, time will show. 

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