tourism resort recreational sanatorium

Analysis demographic indicators region and its main cities and districts indicates a decrease in the structure of the child population, an analysis of morbidity indicates a catastrophic deterioration in the health of the child population. For the rehabilitation of children, there are only two sanatoriums related to municipal property. There is a need to expand the network of children's sanatoriums or, preferably, to open a Mother and Child sanatorium on the basis of one of the local sanatoriums. The development of rehabilitation programs could be undertaken by the Research Institute of Medical Climatology rehabilitation treatment.

Rational restructuring of the I&C infrastructure. It is necessary to create a variety of specialized rooms and clinics in specialized medical and health facilities, constantly conduct explanatory and advertising work in the form of lectures, schools - seminars, flyers, etc., promoting advanced rehabilitation technologies, advertising a pleasant environment, pleasure and usefulness from medical procedures.

To increase the flow of consumers, it is necessary to offer three types of voucher services without fixed terms: accommodation, food, treatment; accommodation and meals; accommodation only. All three types of vouchers must include a set of services (excursions, concerts, dances, sporting events, etc.).

The need for organizational and financial restructuring of sanatoriums. Financing of resorts of federal significance is carried out from the federal budget, funds from the budgets of the constituent entities of the Russian Federation, as well as from other sources of financing in accordance with the legislation of the Russian Federation; financing of population health programs - from state social insurance funds. Improving the economy of the industry is possible by increasing the efficiency of I&C activities, preferential taxation of I&C activities, and the use of intra-institutional mutual settlements as an economic tool for increasing the level of organization and efficiency of I&C activities.

Training, retraining and selection of personnel. IN educational programs Medical institutions have virtually no information about sanatorium-resort treatment; young specialists have a lack of knowledge in the field of rehabilitation therapy natural means. One cannot expect a rapid restructuring of curricula. It is necessary to create regional training centers for the training and retraining of specialists for I&C. It's not just about medical workers, but also to no less extent the workers of health and medical services providing services to patients (cooks, waiters, tour guides, workers of clubs, libraries, hairdressers, communications equipment, etc.). Training centers should be created on the basis of specialized research institutes and (or) educational institutions.

Development of new advanced medical technologies. There are ample opportunities for the development of new medical and health technologies in the Primorsky Territory. First of all, using the methodology and formula developed at the Institute of Medical Climatology and Rehabilitation, it is possible to identify medical and recreational areas and quantify their recreational potential, which is currently used within 5 - 10 percent of the maximum possible. The Primorsky Territory has significant medicinal natural potential, the basis of which is the monsoon climate of temperate latitudes, about 100 sources of mineral waters, deposits of marine sulfide silt and sapropel medicinal mud, large reserves of peat, sea and freshwater reservoirs, various exotic landscapes, and natural monuments. The natural resources of Primorye are sufficient to implement projects aimed at meeting the need for treatment, health improvement and recreation not only of the residents of the Primorsky Territory, but also of the entire Far East and part of Eastern Siberia.

Socio-economic transformations determine trends in health resort industry- increasing the share of short-term rest and treatment. In the off-season, the financial situation of sanatoriums can be improved due to congress and business tourism. This type of activity should pay attention, first of all, to suburban sanatoriums. World experience shows that 40 - 50 percent of corporate meeting organizers hold their events at resorts. Full board service with services under one roof has many adherents.

In the Primorsky Territory, standards for their activities have been developed for the purposes of licensing and accreditation of I&C companies. This made it possible to objectively assess the quality of treatment and preventive activities of institutions, increase efficiency and safety medical services. Three years of monitoring of ICUs after their licensing confirm this. In this regard, our region is ahead of other territorial entities of the Russian Federation. Solving the above-mentioned problems, as well as the development of the sanatorium and resort industry of Primorye, is impossible without improving the environmental situation of recreational areas, developing a set of measures to prevent the degradation of natural resources and restore recreational resources as a result of anthropogenic impact.

The developed set of measures should include:

• · monitoring system for the condition of medical and recreational areas;
• · removal from the sanitary protection zones of resorts of enterprises that are not related to the functioning of health and recreation institutions;
• · development and approval of sanitary protection zones and technological schemes exploitation of promising deposits of mineral waters and medicinal mud;
• · reservation of promising medical and recreational zones with a limited regime of environmental management in them;
• · development of legal regulations for users of natural resources.

The reorganization of the health resort industry should take place in the following areas:

• 1. Organizational measures of the sanatorium and resort industry, requiring coordination with federal and regional health authorities;
• 2. Structural and functional reorganization of medical and health institutions at the level of chief doctors of resorts and sanatoriums;
• 3. Scientific substantiation of new medical technologies at the level of research institutes.

Tourism is a complex socio-cultural, economic and psychological phenomenon, the versatility of which is characterized by the presence of a large number of definitions. Some of them are highly specialized in nature, reflecting certain aspects of tourism - economic, social, legal, etc. Others - essential definitions - characterize the subject as a whole, reveal the internal content of tourism, expressed in the unity of the entire diversity of properties and relationships. In the most general view Tourism can be defined from two sides:

• - firstly, this is a type of socio-cultural and leisure activity within the framework of the entire free movement of the population from their place of residence and work to another region (within a given country or abroad);
• - secondly, it is an industry that produces services necessary to satisfy the needs that arise during travel.

One of the specific types of tourism is health resort tourism. It has all the main features of tourism, on the one hand, and also specific features, with another.

The market for sanatorium-resort and tourist services consists of numerous and diverse sanatorium-resort institutions, travel companies, hotel enterprises, various organizations aimed at providing the necessary treatment, organizing recreational recreation, exciting tourist tours, excursion activities and a variety of delicious therapeutic nutrition vacationers.

The last two years have been marked by certain changes in the state of the sanatorium and resort business in Russia. More attention has been paid to this industry state level, while the resort and recreational system and its problems were considered in a single complex with tourism. This is especially important, since to this day there are still debates about whether sanatorium-resort organizations belong to tourism.

Historically, it happened that therapeutic holiday in Russia was and remains dominant. Sanatoriums and boarding houses with treatment, despite all the vicissitudes of the transitional hard times, maintain positive dynamics, which indicates the continued interest of the Russian population in maintaining health at resorts. Currently, there are over 4,000 health-related institutions with a total capacity of 761 thousand places, while only 158 tourist centers have survived, with a capacity of 27 thousand places. At the same time, the number of medical and health institutions (sanatoriums, sanatoriums and boarding houses with treatment (2232)) is still greater than just recreational institutions (2184).

From the point of view of the system of organizing treatment and recovery, Russian resorts are still among the best in the world. Russian resort technologies are quite modern and have significant commercial value, including export value. However, in targeted programs for sustainable tourism development, as a rule, there is not even a mention of resorts. From a scientific point of view, this is fundamentally incorrect, since sustainable development of recreation and tourism should be based on rational use all types of recreational resources, including natural healing resources.

Having realized the prospects for the development of tourism, specialized tourism management bodies (Committees, Directorates, Departments and even Ministries) began to be formed in the regions and pursue policies that support tourism and the forms of entrepreneurship associated with it. The resorts remained outside the scope of their attention and support. This leads to the fact that even in those regions where the resort business is the most developed form of the tourism industry, when developing concepts for tourism development, priority is given to other types of tourism activities.

The concepts of “resort services” and “tourist services” do not absorb each other, but due to the historically developing industry to meet the needs of the population for recreation, they function closely with each other. The resort industry cannot exist in isolation from tourism, if only because it belongs to the recreation system, where, in addition to therapeutic functions, there are sports and animation activities, as well as excursion programs. Now the choice of a resort is largely determined by the conditions of accommodation and entertainment that complement the treatment courses. And the treatment programs themselves, among combined types of aerotherapy, previously included not only walking on health paths, but also close-range tourism. Both tourist organizations (camp sites, ski and mountain resorts, yacht clubs, etc.) and sanatoriums use the same infrastructure (transport, communications, heat, power grids, services, etc.), as well as the same facilities sociocultural infrastructure (theatres, museums, cinema and concert halls, etc.); they are interested in their improvement.2

At the same time, the tourism industry itself can become a factor ensuring increased competitiveness of the Russian economy. Russia has great potential for development domestic tourism, and for receiving foreign travelers. It has everything you need - a huge territory, a rich historical and cultural heritage, natural attractions, and in some regions - untouched, wild nature. The report of the World Travel and Tourism Council notes that in the next decade the Russian Federation could become one of the leading countries in the field of travel and tourism.

However, the situation in the resort sector is not going well.

On the one hand, many health resort institutions, focusing on providing general services, began to pay less attention to the medical side of their activities. On the other hand, those regions that have at their disposal excellent natural healing mud, exceptional water quality, brines, gases, still leave much to be desired in terms of service.

It is necessary to balance this situation and learn to combine natural resources, enormous practical experience and European services so that people can not only relax, but also improve their health, undergo rehabilitation, and receive additional treatment.

A.S. Kolpakov, Administrative Officer of the President of the Russian Federation

Sanatorium-resort direction The Russian economy has traditionally been an integral part of state policy and an important section of the healthcare system, primarily its preventive component.

In his message to the Federal Assembly, President of the Russian Federation V.V. Putin emphasized that in accordance with the Concept for the development of healthcare in the Russian Federation until 2020, in order to ensure sustainable socio-economic development of the Russian Federation, the priority of state policy is to preserve and strengthen the health of the population through the revival of medical prevention and improvement health resort assistance, which makes it possible to purposefully and highly effectively improve the health of the population and carry out the rehabilitation of sick people. In addition, one of the priority objectives of the Concept is to create conditions, opportunities and motivation for the population to lead a healthy lifestyle.

Minister of Health of the Russian Federation V.I. Skvortsova also noted in her speeches that the most important tasks of the Ministry of Health of the Russian Federation is becoming a “global improvement” of prevention and recovery, where a large role will belong to sanatorium and resort care, and therefore dictates the need to improve the sanatorium and resort business in Russia and increase the efficiency of work sanatorium and resort institutions.

In the country's national health care system, an important place is given to sanatorium and resort treatment, which is a basic component of restoring and maintaining the health of citizens. The set of measures makes it possible to purposefully and highly effectively improve the health of the population and carry out the third stage of medical rehabilitation of patients, as reflected in the subprogram “Development of medical rehabilitation and sanatorium-resort treatment, including for children,” adopted as part of state program Russian Federation "Health Development".

IN modern conditions restoration of the sanatorium- spa treatment and health improvement, its accessibility for the bulk of the population, the revival of Russian resorts seems to be an important national task that can make a great contribution to improving the level of public health. In other words, further development of the sanatorium and resort complex is, first of all, an additional investment in the health of the Russian population.

Sanatorium-resort treatment is based on socially and scientifically substantiated progressive principles: preventive and rehabilitation orientation, continuity between outpatient diagnostic, inpatient and sanatorium-resort institutions, high qualifications and specialization of care provided. The significance of sanatorium-resort treatment is due to the persistence of unfavorable trends in the health of the population and the role played in overcoming them. resort business in the modern concept of development Russian system healthcare.

Domestic sanatorium- resort industry has a number of undeniable advantages: in Russian tourism, the resort sector was initially dominant due to a widespread network of institutions and a powerful material base. Traditionally, resorts have been differentiated into children's resorts, for children with parents and adults.

The results of many years of large-scale research and scientifically based methods of using medicinal natural and preformed factors for health improvement, prevention, spa treatment and medical rehabilitation are used everywhere. Russian resorts have a serious diagnostic base, and the scientific approach to both the study and protection of natural healing resources and the organization of the treatment process remains a distinctive feature of Russian sanatorium and resort institutions due to a personalized approach to each vacationer and the development of comprehensive treatment programs. There are programs for follow-up treatment of patients after surgical interventions, providing high-tech assistance patients. All this contributes to maintaining the high competitiveness of the Russian industry in the world and determines the development potential of the sanatorium and resort sector in the structure of the country’s economy.

Sanatorium and resort institutions, like any business entities in our country, operate in a market economy, therefore all the positive and negative aspects of market relations fully apply to relations in the resort business. A change in the form of ownership of resort organizations and a weakening of control over the use of natural medicinal resources in the period from the early 80s to the end of the 90s led to an increase in the cost and decrease in the availability of sanatoriums. resort services for the population, an unjustified reduction in the volume of use of natural healing factors in the practice of resorts.

In this regard, in the coming years, it is necessary to develop and carry out a number of large-scale measures to create a health-saving trend among the adult population with an established and established worldview to organize their own living space and reorient the population, which has decades-old stereotypes of poor nutrition, organization of work and leisure, and others. destructive patterns, for sanatorium-resort recovery and primary prevention of socially significant diseases.

The main priorities for the further development of the sanatorium and resort industry are also the sanatorium and resort health improvement of young children and school age, youth, strengthening the health of the working population and maintaining health in old age. Complex health-improving and preventive measures increase the level of health by 1.5 times, the use of healing resources of the sanatorium-natural complex and new low-cost, highly effective medical technologies based on them increases the efficiency of citizens’ health improvement by 25-30 %.

In this regard, the further development of the sanatorium and resort business in the Russian Federation should be an important component of the state socio-economic policy, which in modern conditions, on the one hand, should be focused on the implementation of wide accessibility for the population, especially for its socially vulnerable groups, services of sanatorium and resort organizations as an integral component of the healthcare system (providing disease prevention and post-hospital rehabilitation of citizens), and on the other hand, being a medical and health type of tourism, the sanatorium and resort industry should actively use effective tourism technologies (marketing, management, hospitality) and a variety of tourism services (excursion, congress, sports, environmental and others).

The primary objectives and directions for further development of the sanatorium and resort industry and state regulation in the resort sector should be:

1. Improving the system of providing sanatorium and resort treatment to weakly protected groups of the country’s population (children, disabled people, the elderly, participants in military operations and liquidators of man-made and natural disasters and other categories of persons determined by law), providing for the establishment of a maximum cost of social vouchers.

2. Restoration and development of the system government controlled, regulation and control of the activities of sanatorium and resort institutions; development and improvement of the necessary regulatory documents.

3. Development and implementation of scientific and practical programs on the use of medical and health tourism, including tourism for the disabled, for the purpose of improving health and primary prevention diseases; development and implementation of new treatment and health technologies for secondary prevention of diseases based on effective application natural and preformed physical factors.

4. Conservation and development of natural medicinal resources; environmental control over the condition of resort areas.

5. Improving the system of training personnel for sanatorium and resort activities.

6. Improving the material, technical, scientific and methodological base of sanatorium-resort and research institutions.

State policy in the resort business should be based on the priority of solving social problems of society, one of which is sanatorium and resort assistance to the population of the country, and be built on the following principles:

1. Availability of sanatorium and resort care to the population, regardless of the social status of citizens, their level of income and place of residence.

2. The priority of health and preventive measures in the field of resort business.

3. Support for balneology as a science that studies natural healing factors and develops effective methods for their medical use.

4. Consolidation of actions of executive authorities of all levels, organizations and citizens in the formation and implementation of comprehensive development programs for the resort complex of the Russian Federation.

5. A multi-level approach to the organization of health, treatment, preventive and rehabilitation activities at resorts, taking into account both the general needs of the country’s population as a whole, and the specific needs of the population of different regions, individual social, professional and age groups.

6. The unity of the entire resort system, regardless of territorial and departmental boundaries.

7. Unity of medical, preventive, health and economic efficiency of the resort system.

8. Promoting the transformation of the sanatorium and resort complex of the Russian Federation into a highly profitable and competitive sector of its economy.

Thus, the process of development of the sanatorium and resort industry within the framework of the healthcare system of the Russian Federation implies a set of measures aimed at improving the quality of the entire social, everyday and cultural sphere of Russian resorts, the creation of a modern industry of rehabilitation, medical and recreational activities and recreation.

In addition, at the state level it is necessary to pay more attention to research and production work in the field of exploration and use of natural medicinal resources, development and implementation of modern technological equipment into the practice of resort organizations. The rational use of the most valuable deposits of mineral waters and medicinal mud is very important.

In light of the resolution of these issues, the Government of the Russian Federation was asked to determine the role of the state in regulating the market of sanatorium and resort services, developing a mechanism for their financing, provision and consumption, and provide for the development of:

Proposals for improving the environmental management system at resorts,

The procedure and criteria for licensing medical activities and accreditation of sanatorium and resort institutions, as well as the system mandatory certification sanatorium and resort services,

Criteria for the formation of a state order for sanatorium and resort treatment of citizens and the establishment of the maximum cost of social vouchers,

Scientifically based standards for providing sanatorium and resort care for various categories of the population,

Fundamental research to study the mechanism of action of natural and preformed spa factors in the treatment of various diseases.

An effectively constructed system of specialized sanatorium-resort treatment will not only improve the level of health of the population and thereby make a significant contribution to the fulfillment of the state social task, but will also provide a stable flow of funding to the sanatorium, serve as an incentive for the development of their medical base, improving the conditions of temporary residence and services .

The organization of sanatorium and resort activities is closely related to personnel training, and therefore it is necessary to devote Special attention training programs not only for doctors, nurses, social support workers and other personnel of the sanatorium and resort sector, but also for teaching staff.

The basis for the further development of the resort business should be the so-called cluster principle of organizing resorts, which involves the integration of sanatorium-resort medical and scientific institutions with organizations of the tourism complex, that is, the widespread development of both the resort medical cluster and health and other types of tourism with the involvement of private capital.

This approach to solving problems associated with innovative development and the formation of the resort industry will allow us to quickly modernize the sanatorium and resort facilities, equip resorts with modern equipment, and more effectively solve the problems of rehabilitation and health improvement of the population of the Russian Federation.

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Posted on http://www.allbest.ru/

Chapter 1. Trends in the development of the sanatorium and resort sector in Russia

1.1 History of the development of sanatorium and resort business in Russia

1.2 Market of sanatorium and resort services: features of supply and demand

1.3 The place of sanatorium and resort business in the domestic tourism market

1.4 Chapter 1 Conclusions

Chapter 2. Sanatorium and resort potential of the Moscow region

2.1 Natural medicinal resources of the Moscow region

2.2 Sanatorium and resort network of the Moscow region

2.3 Analysis of the needs of the population of the Moscow region for medical recreation and treatment

2.4 Chapter 2 Conclusions

Chapter 3. Development Concept

3.1 Resort zoning of the territory

3.2 Strategy for the development of resort business in the Moscow region

3.3 Recommended conceptual model of management structure in the field of sanatorium recreation and treatment in Russia

3.4 Chapter 3 Conclusions

• List of references and sources

Chapter 1. Trends in the development of the sanatorium and resort sector in Russia

1.1 History of the development of sanatorium and resort business in Russia

The beginning of the development of resorts in Russia dates back to the 18th century, when, on the instructions of Peter I, the Marcial, or Konchezersky (near Petrozavodsk), and Lipetsk waters were opened for treatment. With the annexation of the Caucasus, Crimea and Central Asia, rich in medicinal areas, to Russia, the resort business began to develop more intensively. At the same time, domestic literature on balneology developed. At the end of the 18th century, a description of Russian resorts appeared. In the 19th century, the literature devoted to the description of resorts and their use for various diseases expanded significantly. Cabbage L.I. Marcial Waters. Pages of the history of the first Russian resort. - St. Petersburg: "Dmitry Bulanin", 2006. - 100 p..

The authors of works on the study of Caucasian mineral waters were doctors Tsed (1817), Conradi (1824), Nelyubin (1825) and Savenko (1827). The development of Russian clinical balneotherapy was greatly promoted by the work of major clinicians: S.P. Botkina, A.A. Ostroumova and others, and especially G.A. Zakharyin - the founder of domestic balneology. However, resorts in Russia developed slowly. The tsarist government showed almost complete indifference to the domestic resort business and did not create conditions for its development.

The poor amenities of the resorts and the associated inconveniences for patients led to the fact that the Russian bourgeoisie preferred to be treated at foreign resorts, while the working population did not have the financial opportunity to go to resorts.

For many years, resort factors were applied empirically, there was no scientific approach to study both indications and contraindications for treatment at resorts. Doctors who worked at the resorts sought to present their resorts as a panacea for all diseases, and those who worked away from the resorts either trustingly sent even hopeless patients there for treatment, or were skeptical about treatment at the resorts.

Scientific balneology began to be created in Russia at the end of the 19th century. Its development was facilitated by the work of the Russian Balneological Society in the Caucasian Mineral Waters, the Odessa Balneological Society, as well as balneologists A.A. Lozinsky and V.S. Sadikov in Kemeri and others. V.A. has great merits in the development of Soviet balneology. Alexandrov Vetitnev A.M., Kuskov A.S. Medical tourism. - M., 2010. - 592 pp.

Scientific balneology and the establishment of resort business in general in pre-revolutionary Russia cannot be compared with the enormous scope of resort construction and achievements in this area after the Great October Socialist Revolution, which is explained by the exceptional attention to resorts shown Communist Party and the Soviet government.

Our country has a widely developed network of resorts, sanatoriums and holiday homes. The planned socialist construction of resorts began with the signature of V.I. Lenin issued a historic decree on March 20, 1919 on the transfer of all resort business to the jurisdiction of the People's Commissariat of Health. The resort wealth of our country is great and diverse. Before the Great October Socialist Revolution in Russia there was no scientific institution specifically dealing with issues of balneology, but now in our country there are a number of institutes of balneology.

Issues of experimental balneology - the most important branch of balneology - were also dealt with by I.P. Pavlov. Back in 1923-1924. he specially sent his students to the Caucasian mineral waters (in Pyatigorsk) to organize an experimental laboratory and research therapeutic effect mineral waters on the body. An experimental laboratory created at that time, later reorganized into the experimental department named after I.P. Pavlova of the Pyatigorsk Balneological Institute, for many years carried out work, guided by the basic principles and ideas of I.P. Pavlov, whose attention to the work of this laboratory did not weaken until the end of his life.

The results of experimental work carried out in this laboratory to study the influence of mineral waters on the function of the digestive organs provided the basis for their scientific and effective therapeutic use for certain diseases. K.M. has done a lot to substantiate the effect of mineral waters on the body. Bykov and his employees (works of the Pyatigorsk and Zheleznovodsk clinics of the Balneological Institute).

Treatment of patients at resorts is mainly carried out in sanatoriums. In the Soviet Union there are also sanatoriums located outside the resorts. Of the 2,200 currently available sanatoriums, more than half are located outside the resorts of Kapusta L.I. Marcial Waters. Pages of the history of the first Russian resort. - St. Petersburg: "Dmitry Bulanin", 2006. - 100 pp. sanatorium resort medicinal natural

The Soviet government set the task of comprehensive development of sanatorium and resort care within the republic, region or group of regions (North, Central regions of the European part of the RSFSR, the Urals, Siberia, the Far East and the Central Asian republics). The sanatorium at the resort was a stationary medical and preventive institution that provided comprehensive treatment.

In the Soviet Union, it was formed and implemented centralized system planning and management sanatorium-resort complex, however, as in all other areas, which provided the conditions for its stable existence and development.

The distribution system, which ensures the employment of most sanatoriums, did not stimulate work to improve the quality of services provided. By the mid-80s. XX century The economy of the resort complex became completely stagnant, the equipment was not updated, and there were not enough funds for the expanded reproduction of health resorts. By the end of the 80s. XX century Centrally, money for many health resorts and sanatoriums ceased to be allocated at all; only departmental sanatoriums or those on the balance sheets of large enterprises remained operational. The rest were left to their own devices.

The level of comfort of many health resorts has long ceased to meet modern requirements in this area. The quality of service did not stand up to criticism. Many sanatoriums, especially those not located in the medical zone, began to repurpose themselves into other institutions or even abandoned R.M. Navodnichiy. Management of the development of the sphere of medical and health services in Russia // Abstract of the dissertation for the academic degree of Candidate of Economic Sciences. M.: 2011. - 26 p..

The reforms that began in 1991 destroyed the foundations of the previous system, including the system of functioning of the country's resort complex. But, instead, a new system was not created, and clear goals for the functioning and development of the industry in the near future were not outlined. Everything was left to chance. All government funding was stopped from trade unions, including the withdrawal of social insurance funds from management, which in connection with this lost the function of distributing sanatorium and health vouchers and compensating vacationers for part of their cost. Created government funds social insurance already had other functions and principles of financing, they stopped allocating any funds to recreational enterprises, especially those owned by enterprises and departments. Only the payment of the cost of vouchers was left within the competence of the funds. This deprived the health resorts of basic funds for expanded reproduction and reconstruction, not to mention capital expenditures to improve the quality of services (purchase of new equipment, staff training, etc.) and further development. The difficult economic situation of most entire industries National economy sharply reduced another source of financing for the resort complex - funds from the consumption funds of industrial enterprises, the main task of which was the struggle for survival. As a result, enterprises generally refused to finance sanatoriums and health centers. This could not but affect the condition of resort institutions; the statistical indicators of sanatorium and resort services sharply deteriorated.

The collapse of the USSR during this period led to the alienation of many important resorts and health resorts, especially Crimean and Caucasian ones.

In the period from 1990 to 1995, the crisis in the resort industry worsened: the number of resort visitors decreased by more than 3.6 times, the number of places in health resorts - by 34%. Economic reforms had a particularly strong impact on the functioning of tourist centers, which had the least comfortable accommodation conditions and the weakest material resources. The number of places in them has decreased over five years by 2.7 times, and the annual number of tourists - by 7.6 times. Only for the resort institutions of the Federation of Independent Trade Unions in 1993, the annual volume of capital investments decreased to 41.7 million rubles. compared to 185.8 million rubles. in 1990 Vetitnev A.M. Resort business. M.: KNORUS, 2012. - 528 pp..

In 1995, the standard service life of more than 1.5 thousand wooden buildings with 49 thousand beds expired, and 107 health resorts with 33.6 thousand beds needed complete reconstruction. The losses of the sanatorium-resort complex of trade unions amounted to 1 billion 365 million rubles in 1993, and the number of employees decreased by 23%.

Since many resorts were of national importance, they began to depend heavily on the seasonality of resort services, which became increasingly pronounced.

These changes led to the fact that the average annual occupancy of health resorts in Pyatigorsk, Kislovodsk, Anapa, Gelendzhik, and Sochi in these years did not exceed 60%. First of all, this is due to the high cost of air and train tickets, the unstable political situation, the proximity of these resorts to zones of armed conflicts, and the traditionally higher level of prices in resort areas for the main groups of consumer and food products compared to other regions of the country. In 1996, in the resort city of Sochi, with an average monthly occupancy rate of 40%, the third quarter accounted for 63.20% of the annual number of vacationers, 50.43% of the number of bed days and 57.97% of the annual revenue from the sale of vouchers. Every year the average number of “days of stay of vacationers” at the resort decreases. There is a reorientation of the main purposes of trips to all-Russian resorts from treatment to recreation Barchukov I.S. Sanatorium and resort business: textbook. A manual for university students studying in the areas of service and tourism / M.B. Barchukov. - M.: Unity-Dana, 2012. - 303 pp..

With the development of market reforms, the country's resort complex was reformed not only quantitatively, but also qualitatively. Major changes began to occur with changes in Russian legislation, privatization took place. Many “surviving” health resorts began to acquire new organizational and legal forms. Of the 2,416 stationary recreational enterprises (institutions) in the country, a little more than a third (35.5%) remained in the public sector; the remaining health resorts acquired the status joint stock companies(partnerships) or became resort branches of large enterprises.

Thus, recreational enterprises acquired economic independence and financial independence. Due to the end of the centralized distribution of vouchers and subsidies for them, an independent, unique market for vouchers began to be created. This market has shifted priorities to the supply of accommodation facilities, comfort, and quality of services provided.

Simultaneously with the formation of a new market, a new consumer began to form. The number of vacationers purchasing vouchers (tours) for full cost and presenting completely different (increased) requirements for the level of service and variety of resort services, i.e. demand has changed. Satisfying personalized demand has formed the institution of intermediaries between consumers of sanatorium and resort services and accommodation enterprises, represented by travel agents and tour operators, as well as various resort and health associations.

Changes in legislation, especially tax legislation, also contributed to the emergence of travel agents, tour operators and various associations and business formations. Thus, in the new economic conditions, the formation of a completely new market for sanatorium and resort services is observed.

Moreover, it should be noted the positive dynamics in the indicators of recreational services for 1999 - 2000, which indicates a certain adaptation of resorts to market conditions. This trend is confirmed by the volume of sanatorium and resort services provided, as well as an increase in their share in the overall structure of paid services to the population of the country.

However, the state presented the next “surprise” in 2001, when state funding was sharply reduced sanatorium treatment through social insurance. Since 2002 funding was stopped completely. The situation in the resort and sanatorium sector began to deteriorate again, although the occupancy rates of all-Russian resorts decreased by only 7-10%. On the other hand, this encouraged health resorts to take a more active part in the formation of the market for recreational services, especially those that have finally lost the support of the state Resort business: tutorial/ A.M. Vetitnev, L.B. Zhuravleva. - 2nd ed., erased. - M.: KNORUS, 2012.-528 p..

As a result, with Russia’s entry into market conditions, there was a gradual adaptation of the sanatorium and resort complex. The situation on the newly formed market of recreational services has stabilized, the number of sanatoriums and holiday homes in all-Russian resorts began to grow by 5 - 10% annually. However, the trend towards reducing the length of stay at resorts and the seasonality of their operation still persists. But this situation has begun to change in recent years.

1.2 Market of sanatorium and resort services: features of supply and demand

The health resort market for health services is going through difficult times. Created during the Soviet period, it had a hard time learning the lessons of a market economy. In the early 90s of the last century, during the period of transfer of financing for resorts from trade unions to social insurance, sales volumes of resort services sharply decreased. In 1999 - 2000, health resorts gradually adapted to new conditions and reached a stable operating mode. But since 2002, after the reform of the Social Insurance Fund and the curtailment of state financial support, the sanatorium and resort complex fully experienced the laws of the market. It turned out that many health resorts were not ready to move from a relatively quiet existence to fierce competition for vacationers. Medical tourism as a modern direction spa medicine in Russia / A.N. Razumov [and others] // Issues of balneology, physiotherapy and exercise therapy. - 2009. - No. 3. - P. 46..

According to its purpose and nature therapeutic work sanatoriums at resorts are divided into general therapeutic, specialized non-tuberculosis, for tuberculosis patients and children's.

Specialized sanatoriums are divided into cardiological sanatoriums, for patients with diseases of the digestive and metabolic organs, organs of movement and support, the nervous system, rheumatism, the consequences of polio, diseases of the female genital organs, etc.

Sanatoriums for patients with tuberculosis are divided into sanatoriums for treatment:

a) patients with active forms of pulmonary tuberculosis;

b) patients with bone tuberculosis;

c) patients with tuberculosis of the kidneys and urinary tract;

d) convalescents after tuberculous meningitis.

The following specialization has been established for children's sanatoriums:

1) for patients with active forms of pulmonary tuberculosis;

2) for patients with fading forms of pulmonary tuberculosis;

3) for patients with bone tuberculosis;

4) for convalescent children after tuberculous meningitis;

5) for patients with rheumatism;

6) for patients with rickets;

7) psychoneurological sanatoriums;

8) for patients who have had polio;

9) general therapeutic.

For outpatient patients, resort clinics and boarding houses Manshina N.V. have been organized at resorts. Spa therapy for everyone. For health, go to the resort. -M.: Veche, 2010. - 592 pp..

Much attention is paid to the selection of patients for treatment at resorts. The selection is made by attending physicians during long-term observation of the patient and after diagnosis. For proper selection, the doctor must know the basics of sanatorium-resort business and the indications and contraindications for referring patients to resorts. For each patient, the attending physician fills out a certificate of need for spa treatment, and after the patient receives a voucher, a sanatorium-resort card, which includes data from clinical laboratory, x-ray and inpatient examinations.

Treatment at the resort is indicated for patients in whom it can be assumed that permanent restoration of working capacity will occur. Indications are differentiated according to the seasons of spa treatment.

Local treatment and preventive institutions should monitor the patient upon his return from the resort and study the long-term results of treatment.

Many enterprises and institutions of the sanatorium and resort complex compete in the industry. All sanatoriums have different volumes of services, different organizational and legal forms, material and technical bases and staffing. There is no clear leader in the market. The market is relatively stable. In the 1990s, the sanatorium and resort complex, created during the Soviet period, experienced a period of sharp decline in sales of services. The main reasons were the removal of trade unions from the management of social insurance funds, the limitation of the fund’s ability to pay for sanatorium and resort treatment for workers and members of their families, a sharp decline subsidies to enterprises for resort treatment and rehabilitation. After the curtailment of state support for the sanatorium-resort complex, competition between enterprises for consumers intensified. Many sanatoriums have “left the race”. The remaining ones differ significantly from each other in the level of service provision, material and technical base and pricing policy. And they count on different target groups of consumers.

Most managers do not deal with this issue at all, believing that they can improve their health by buying vouchers at the expense of wages. Others pay a certain amount as compensation for a trip, both to a resort and a tourist one, at the employee’s choice. Under these conditions, the choice naturally falls either on a large resort with a “promoted” name, or on a trip to the warm sea. Often when choosing a resort establishment decisive factor It is not the quality of the service provided, but its cost. Individuals prefer holidays abroad or in the southern regions of the country.

Every year, competitions are held by the Social Insurance Fund for the improvement of health of persons registered with the authorities social protection. The requirements for health resorts are such that either large sanatoriums or those resort institutions where the material resources are very poor can win the competition. high level. The rest are doomed to extinction. Some health resorts are being converted into hotels, losing their main meaning - improving the health of the population Resort business: a textbook / A.M. Vetitnev, L.B. Zhuravleva. - 2nd ed., erased. - M.: KNORUS, 2012.-528 p..

The most popular areas of work are the development of SPA technologies: clients really like various types of massage, water treatments. Solariums have become less popular, and this is understandable - in the age of oncology, you need to be more careful with this procedure.

The main problems of the industry include insufficient attention to the sanatorium-resort complex from the authorities, the seasonality of the provision of recreational services, the imperfection of the animation and leisure component, the low level of management and material and technical base in a number of sanatoriums and, as a consequence, the low quality of the services provided. We cannot discount competitors from neighboring regions. Thus, in recent years, the health resort industry in Bashkortostan has been developing very intensively, and strong government support plays a big role here, which cannot be said about, for example, the Perm Territory.

Of course, the global financial crisis has had an adverse effect on the industry. Social programs aimed at improving the health of workers are being cut at enterprises. The solvency of the population has decreased, and, as a result, the flow of vacationers to sanatoriums has decreased. The industry requires large and long-term financial investments with low level returns, which adversely affects the possibility of lending, since banks are only interested in short-term financial investments. Promising is the emphasis not on treatment, but on health complexes, the development of specialized health programs, especially related to cosmetology and SPA technologies. The rapid development of medical technologies allows us to provide services at a fundamentally higher level. Those health resorts that, thanks to their competitive advantages, will be able to offer consumers something new will thrive.

Trends in the market of sanatorium and resort services fully correlate with the general ones in the country. Medical tourism as a modern direction of resort medicine in Russia / A.N. Razumov [and others] // Issues of balneology, physiotherapy and exercise therapy. - 2009. - No. 3. - P. 46. Thus, the government has long been trying to reduce costs: there was a project to reduce social security contributions from 5.4% to 3.4%. In 2003, the government submitted to the Duma a draft law that provided for a sharp, 3-fold reduction in funding for children's health care. But since 2010, the budget has been approved by deputies elected not from the people, but from parties. As a result, expenses for children's health, after-care, and medical examinations were reduced from the social insurance budget. These funds appear in the regional budgets.

But the average resident continues to receive treatment in Russian sanatoriums. At least in recent years there has even been an increase. We can conclude that the development of the resort business is hampered by:

1) withdrawal from the state market;

2) the absence of a middle class in the country. The rich are not interested in this, the poor are unable to bear it.

Currently, weak SCOs are continuing to leave the market, then absorption processes will follow (including by non-core structures), as required by the market, which is increasingly “managing” the sphere of sanatorium and resort services Vetitnev A.M. Resort business. M.: KNORUS, 2012. - 528 pp..

Full development of the sanatorium sector is impossible without government support. Its absence may lead to the fact that sanatorium-resort institutions will increasingly transform into ordinary hotel facilities. In the same case, if the industry begins to be developed more actively, it may become dominant in the country’s economy.

1.3 The place of sanatorium and resort business in the domestic tourism market

In the hotel business, which also deals with resort establishments, the main ones are hotels with a developed entertainment infrastructure: bars, discos, saunas, etc. and where the development of resort medicine is not necessary Volkov Yu.F. Introduction to hotel and tourism business: Textbook / Yu.F. Volkov. - Rostov-on-Don: Phoenix, 2013. - 348 p.. Russian resorts do not prioritize the development of the high-class hotel sector, but deservedly place emphasis on their main advantage - developed resort medicine, which allows for optimal use of resort resources for the improvement of people's health. Thus, spa medicine provides for the organization of work on the formation of a sanatorium-resort product, which is based on therapeutic or health-improving technology that improves the quality of life. The social significance of resort medicine lies in the creation of a significant part of the integral system of prevention and health care through the formation of the “rest” subsystem (for healthy people) Barchukov I.S. Sanatorium and resort business: textbook. A manual for university students studying in the areas of service and tourism / M.B. Barchukov. - M.: Unity-Dana, 2012. - 303 pp..

In this regard, the functioning of the resort industry requires the development of new structural and organizational forms, developed taking into account historical, regional and national characteristics resort business. In recent years, the very term “balneology” itself has been called into question. It quite fully covers the variety of contents of the subject, including balneology, balneology, hydrothermal medicine, landscape therapy, etc. The term “health resort therapy” reflects the therapeutic side of the spa business. More often in this context, the more formal phrase “sanatorium-resort treatment” is used.

In general, in domestic healthcare, a three-stage rehabilitation system was developed and effectively operated, where sanatorium and resort activities played a significant role Vetitnev A.M. Resort business. M.: KNORUS, 2012. - 528 pp..

Stage 1 - polyclinic involves the provision of primary care medical care at the place of residence for both children and adults. For these purposes, a network of children's and adult clinics has been deployed.

In addition, there are student clinics and medical and physical education clinics for those involved in physical education and sports, where high-quality athletes are observed and undergo training. medical examinations before competitions, as well as anti-tuberculosis, dermatoveneral, cardiological and other dispensaries. The tasks of the latter include early detection, prevention and treatment of patients, as well as long-term monitoring of them.

Stage 2 - clinical. At the outpatient or dispensary stages, up to 75-90% of all primary patients receive treatment, and patients with a complicated course, exacerbation chronic disease or in emergency cases referred for clinical treatment.

In a hospital setting, patients receive a course of medication or complex therapy, and according to indications, they undergo emergency or planned operations. Emergency surgical interventions include removal of a suppurating appendix (appendicitis), gallbladder (cholecystitis), removal of part of the stomach in case of peptic ulcer in case of bleeding, etc. Planned operations carried out after preparing the patient for surgical intervention on the heart (coronary bypass surgery), lungs (section resection for tuberculosis), vessels of the extremities (for varicose veins veins), etc. After surgical interventions, it is mandatory to prescribe rehabilitation treatment using physical therapy, massage, and physiotherapy.

The length of stay at the inpatient stage of treatment largely depends on the timely and complex application rehabilitation activities. On average, the inpatient stage in therapeutic clinics is 14-18 days, in surgical clinics 10-14 days. In cardiology (heart attack) departments, the length of stay reaches 30-45 days, which is due to the severity of the disease and the need for phased rehabilitation.

Stage 3 - restorative (supportive) occurs after discharge from the hospital. This stage of treatment is carried out under outpatient observation or sanatorium-resort treatment.

The greatest healing effect is observed with continuity of treatment and monitoring of patients. Restoring the patient’s physical and psychological activity in a local sanatorium or dispensary, usually located at the patient’s place of residence (in a suburban area), allows significant results to be obtained in 30-45 days.

According to indications and in order to consolidate the results of treatment, patients are referred to sanatorium-resort organizations. The choice of resorts depends on the availability of resort medicinal factors, such as mineral waters, medicinal mud, favorable climate, and other specific therapeutic factors (naftalan, kumis treatment, speleotherapy, etc.) Vetitnev A.M. Resort business. M.: KNORUS, 2012. - 528 pp..

Indications for spa treatment and seasonality of stay are determined by the attending physician. In this case, it is necessary to strictly adhere to medical instructions, failure to comply with which leads to a decrease in health-improving effectiveness, and in some cases causes exacerbation of the disease and even death of people, for example, in a post-infarction state, with micro-strokes, etc.

Domestic balneology has developed a comprehensive system of indications and contraindications for sanatorium-resort treatment and recovery for various diseases Barchukov I.S. Sanatorium and resort business: textbook. A manual for university students studying in the areas of service and tourism / M.B. Barchukov. - M.: Unity-Dana, 2012. - 303 pp..

Over time, rational schemes for comprehensive rehabilitation were introduced, taking into account the age, gender and professional characteristics of the body of vacationers. However, with Russia’s entry into a market economy, the conditions for the functioning of the resort industry have changed, and the need arose to develop new structural and organizational forms that take into account historical, regional characteristics and recreational and health-improving capabilities of resort factors. In addition, these forms should ensure increased profitability of the health resort industry, and therefore take into account business patterns and provide for the use of service quality management technology.

Restorative medicine is a system of knowledge and practical activities aimed at restoring a person’s functional reserves, reduced as a result of the adverse effects of environmental factors and activities or as a result of illness (at the stage of recovery or remission), through the use of predominantly non-drug methods.

2) secondary prevention.

The first direction - protection (preservation and restoration) of the health of healthy or practically healthy people, covers people with reversible functional disorders or pre-morbid disorders. The object of restoration impact in in this case are reduced reserve regulatory capabilities of the body, the goal is to restore impaired functions and lost health.

As an independent section of the first direction, we can highlight the formation and restoration of emerging health in children and adolescents.

The second direction - secondary prevention - involves medical rehabilitation of sick people and disabled people with somatic diseases and irreversible morphological changes in organs and tissues. Rehabilitation treatment in this case is aimed at increasing functional reserves, compensating for impaired functions, secondary prevention of diseases and their complications, restoring reduced work functions or returning limited capacity against the background of partial health insufficiency.

Protecting and promoting the health of healthy and practically healthy people is one of the priority problems of the Russian healthcare system, in accordance with which a fundamentally new direction of activity is being developed - the transition of priorities from a system focused on the treatment of the sick and rehabilitation of the disabled to a system based on the formation of a culture of health and aimed at preventing diseases Barchukov I.S. Sanatorium and resort business: textbook. A manual for university students studying in the areas of service and tourism / M.B. Barchukov. - M.: Unity-Dana, 2012. - 303 pp..

The protection of the health of a healthy person is understood as a set of measures of a political, spiritual, economic, legal, social, cultural, scientific, medical, sanitary and epidemiological nature, aimed at optimizing the conditions for the formation, active preservation, restoration and strengthening of health, ensuring a reduction in morbidity and an increase in population healthy and practically healthy people.

The protection and promotion of the health of healthy people is carried out in relation to citizens of the Russian Federation - both absolutely healthy (5-7%) and those with one or two diseases in a state of stable remission (55-70%). Among the latter, the most numerous part of the population with disadaptation phenomena, the condition chronic fatigue, phenomena of fatigue and overwork, decreased mental and physical performance. The named conditions with continued exposure to physical and social factors with a high probability lead to exacerbation of the underlying disease and the development of concomitant ones.

The need to solve this problem in Russia still remains very relevant due to the fact that, despite some positive trends, population health indicators and the state of national system health care in general are at an unsatisfactory level. This is manifested in extremely high morbidity and mortality rates, low birth rates, health status of mothers and children, quality of nutrition, especially for vulnerable segments of the population, and deepening social differentiation.

It should also be pointed out that Russian market The key difference between domestic tourism and outbound tourism is the lack of formed packages. All the same things are offered: hotels, transfers, Additional services at resorts, but there is no packaging with transportation Manshina N.V. Spa therapy for everyone. For health, go to the resort. -M.: Veche, 2010. - 592 pp..

This is due to the specifics of our transport services market. Russian Railways is a monopolist, and they have no interest in cooperating with operators. In the aviation market, there is an obvious tendency to redistribute the market by key airlines, which hold the bulk of all domestic traffic in Russia. As a result, they are also not interested in tour operators - selling a block for a regular flight to an operator at a low price, or, moreover, signing an agreement for charter transportation, is essentially creating unnecessary competition with your own hands for their sales of tickets for regular flights. Added to this is the lack of low-cost airlines on the Russian market. As a result - high prices for domestic flights and railway transportation, which significantly hinders the development of domestic tourism in Russia. It gets to the point of absurdity: for residents of a number of regions, the cost of moving to the resort exceeds the cost of a holiday at the resort by 2-3 times.

But, despite this, more than 30 million Russians annually vacation within the country. The reasons are different. Firstly, according to statistics, only about 10% of Russians have foreign passports. Secondly, more than half of the tourists are families with children, for them our resorts mean the absence of a language barrier, traditional familiar cuisine, the absence of significant cultural, religious and behavioral differences, psychological feeling security - I'm in my country. Many vacation in their region, due to the high cost of transportation; the vast majority of these regions have their own tourist resources - forests, lakes, rivers, mountains, natural healing factors Tourism, hospitality, service: Dictionary-reference book / G.A. Avanesova, L.P. Voronkova, V.I. Maslov, A.I. Frolov; Ed. L.P. Voronkova. - M.: AspectPress, 2012. - 422 pp..

If we talk about the preferences of tourists, the first place is taken by family holiday at the resorts of the Krasnodar Territory and Crimea. These are black seaside resorts are actively developing. In recent years, a sufficient number of modern hotels have appeared, focused on the Turkish format (all inclusive, animation, infrastructure for adults and children, SPA centers). The range of prices for accommodation during the high season in Ukraine is $40-70 per day with 3 meals a day, in Russia $50-150. The resort infrastructure is also developing - water parks, amusement parks, interactive museum areas are being built, and event tourism is developing.

The demand for health resort holidays is growing steadily. Firstly, it is now becoming fashionable to be healthy, as a result, the average client of health resorts has become much younger - if recently it was the age category from 45 to 70, now it is from 30 to 50 years. And this is the most active and solvent part of the population Volkov Yu.F. Introduction to hotel and tourism business: Textbook / Yu.F. Volkov. - Rostov-on-Don: Phoenix, 2013. - 348 pp. Secondly, the medical resorts themselves have recently begun to pay attention to updating their infrastructure. Private investors come, new sanatoriums are built, or old ones are completely reconstructed. Russia has powerful healing resources. There are only 18 unique resort areas, the healing factors of which have no analogues in the world. The traditions of our sanatorium treatment are more than 200 years old. Treatment methods are constantly being refined and developed thanks to advances modern medicine. Sanatoriums are creating new treatment programs, acquiring modern medical equipment. The quality of service is improving.

In third place in popularity is cultural and educational tourism, primarily tours to St. Petersburg, Moscow, and the Golden Ring. Interest in the countries of the post-Soviet space is being revived.

1.4 Conclusions from Chapter 1

The beginning of the development of resorts in Russia dates back to the 18th century, when, on the instructions of Peter I, the Marcial, or Konchezersky (near Petrozavodsk), and Lipetsk waters were opened for treatment. With the annexation of the Caucasus, Crimea and Central Asia, rich in medicinal areas, to Russia, the resort business began to develop more intensively. At the same time, domestic literature on balneology developed. At the end of the 18th century, a description of Russian resorts appeared. In the 19th century, the literature describing spas and their use for various diseases expanded significantly.

The reforms that began in 1991 destroyed the foundations of the previous system, including the system of functioning of the country's resort complex. The collapse of the USSR during this period led to the alienation of many important resorts and health resorts, especially Crimean and Caucasian ones.

During the reforms, recreational enterprises acquired economic independence and financial independence. Due to the end of the centralized distribution of vouchers and subsidies for them, an independent, unique market for vouchers began to be created. This market has shifted priorities to the supply of accommodation facilities, comfort, and quality of services provided. An institute of intermediaries has been formed between consumers of sanatorium and resort services and accommodation enterprises, represented by travel agents and tour operators, as well as various resort and health associations.

Simultaneously with the formation of a new market, a new consumer began to form.

Thus, in the new conditions, a completely new market for sanatorium and resort services is being formed, and the sanatorium and resort complex has also gradually adapted.

The health resort market for health services is going through difficult times. Created during the Soviet period, it had a hard time learning the lessons of a market economy. In the early 90s of the last century, during the period of transfer of financing for resorts from trade unions to social insurance, sales volumes of resort services sharply decreased. In 1999 - 2000, health resorts gradually adapted to new conditions and reached a stable operating mode. But since 2002, after the reform of the Social Insurance Fund and the curtailment of state financial support, the sanatorium and resort complex fully experienced the laws of the market. It turned out that many health resorts were not ready to move from a relatively calm existence to fierce competition for vacationers.

The structure of the market for consumers of health resort services has changed. The number of vacationers who bought tours at full price and have completely different requirements for service has increased sharply. At the same time, the number of so-called “guaranteed client flows” decreases every year. There is a trend toward a decrease in the average number of days vacationers stay in sanatoriums, an increase in demand for “shortened” health programs, and the widespread introduction of SPA technologies.

All health resorts in Russia are becoming multidisciplinary, and much attention is paid to service. Comfortable living conditions, food, and interesting leisure are the leading factors for the client when choosing a vacation spot.

In the past few years, the government's attention to legislative bodies The problem of developing tourism as a highly profitable sector of the economy was faced. A number of legislative programs were adopted on the development of tourism and tourism activities, the recreational sector, etc. The concept of tourism development adopted in Russia allocates a special place to medical tourism as “traditionally one of the main forms of tourist and recreational activity of the population.” The country's sanatorium and resort potential is considered as a material and technical base. Therefore, the development of medical tourism is a promising direction in the health resort industry.

In accordance with the modern Concept for the development of healthcare and medical science in the Russian Federation, new preventive direction, called "regenerative medicine".

Structurally, restorative medicine, as a branch of medicine, combines two main areas:

1) protecting the health of healthy and practically healthy people;

2) secondary prevention.

Protecting and promoting the health of healthy and practically healthy people is one of the priority problems of the Russian healthcare system, in accordance with which a fundamentally new direction of activity is being developed - the transition of priorities from a system focused on the treatment of the sick and rehabilitation of the disabled to a system based on the formation of a culture of health and aimed at preventing diseases.

The demand for sanatorium-resort holidays is growing steadily. Firstly, it is now becoming fashionable to be healthy, as a result, the average client of health resorts has become much younger - if recently it was the age category from 45 to 70, now it is from 30 to 50 years. And this is the most active and solvent part of the population. Secondly, the health resorts themselves have recently begun to pay attention to updating their infrastructure. Private investors come, new sanatoriums are built, or old ones are completely reconstructed. Russia has powerful healing resources. There are only 18 unique resort areas, the healing factors of which have no analogues in the world. The traditions of our sanatorium treatment are more than 200 years old. Treatment methods are constantly being refined and developed thanks to the achievements of modern medicine. Sanatoriums are creating new treatment programs and purchasing modern medical equipment. The quality of service is improving.

Chapter 2. Sanatorium and resort potential of the Moscow region

2.1 Natural medicinal resources of the Moscow region

In the Federal Law of February 23, 1995 N 26-FZ (as amended latest changes and additions dated June 25, 2012) “On natural healing resources, health-improving areas and resorts” a definition of natural healing resources is given, according to which they include mineral waters, healing mud, brine of estuaries and lakes, healing climate, and other natural objects and conditions used for the treatment and prevention of diseases and recreation http://base.garant.ru/10108541/1/#block_100.

A therapeutic and recreational area is a territory that has natural healing resources and is suitable for organizing the treatment and prevention of diseases, as well as for recreation of the population.

Based on these definitions, we will conduct a study of the natural medicinal resources of the Moscow region. Because, no matter how attractive sea resorts may look, it is preferable for a person living in central Russia to engage in health prevention in their area. Now the sanatoriums of the Moscow region have modern medical equipment, excellent recreation facilities, and the medical staff is fluent in modern treatment methods. Current state and prospects for developing the resort potential of the Moscow region / N.K. Dzhabarova [and others] // Issues of balneology, physiotherapy and exercise therapy. - 2007. - No. b. - pp. 46-47..

Sanatoriums in the Moscow region use the rich natural factors of Central Russia for treatment - the microclimate of forests, waters of mineral springs, therapeutic peat and sapropel mud, beaches of lakes, rivers and man-made reservoirs.

The Moscow region is located in the central part of the East European Plain, between the Volga and Oka rivers, in a zone of mixed forests. The terrain is mostly flat. In the east of the Moscow region there is the swampy Meshcherskaya lowland, and in the north and west there is the Smolensk-Moscow upland, the most high part, which reaches 285 m above sea level.

Forests occupy 50% of the territory of the Moscow region; The main species are spruce, pine, birch; in the south of the region there are oak and linden groves. The water axis of the Moscow region is the Oka and Moscow rivers (with tributaries Ruza, Istra, Yauza, Pakhra, etc.); lakes - Trostenskoye, Nerskoye, Chernok, etc. Within the Moscow region there is a network of reservoirs (Klyazmenskoye, Mozhaiskoye, Uchinskoye, Istrinskoye, Ikshinskoye) Mironenko N.S., Tverdokhlebov I.T. Recreational geography. - M.: MSU, 2011. - 208 p..

The basis of the natural resort resources of sanatoriums in the Moscow region are mineral waters. The Moscow groundwater basin, located in the center of the East European Plain, is one of the largest, forming a kind of underground sea.

The Moscow groundwater basin, located in the center of the East European Plain, is one of the largest, forming a kind of underground sea. In the middle of the 20th century, you could taste the “Moscow Mineral” from the pump room in the very center of Moscow, in the drinking gallery of the Research Institute of Balneology V.S. Nazarenko, O.V. Nazarenko, V.V. Nazarenko. Mineral healing waters and mud. - Rostov-on-Don, 2008. - 162 p..

The waters of the “Moscow Sea” flow into pump rooms and fill the swimming pools of sanatoriums near Moscow.

Low-mineralized waters (M 2.3 5.5 g/l) of the Upper Devonian horizons, lying at a depth of 335 to 520 m, the composition is predominantly sulfate and sulfate-chloride sodium (calcium-magnesium-sodium), known as "Moscow mineral water" . The mineral waters of the springs located near the cities of Dorokhovo, Ramenskoye and Monino are similar in composition to “Moskovskaya Mineral”.

In the deepest parts (from 1000 m) of the Moscow artesian basin there are brines of high concentration - from 50 to 270 g/l, the composition of the water is sodium chloride, often with a high bromine content.

Drinking and brine waters within Moscow were discovered by wells in the area of ​​New Arbat (RRC rehabilitation medicine and balneology), on the banks of the Setun River (KB No. 1 "Volynskaya" UDP of the Russian Federation), in the Losiny Island reserve (Svetlana sanatorium). Since the 1930s, there have been wells of brine water on Talalikhina Street, which fill the bowl of the Atlant swimming pool and are used in the Specialized Clinical Hospital for Rehabilitation Treatment, located in this area of ​​​​Moscow.

Many sanatoriums in the Moscow region have swimming pools with sea ​​water- brine waters of the Moscow underground sea diluted with fresh water Nazarenko V.S., Nazarenko O.V., Nazarenko V.V. Mineral healing waters and mud. - Rostov-on-Don, 2008. - 162 p..

Sanatoriums in the Moscow region widely use balneotherapy, magnetotherapy, mud therapy, laser therapy, therapeutic massage, speleotherapy, physiotherapy, physical therapy, reflexology, herbal medicine and a huge range of other types of treatment and wellness procedures.

On the territory of the Moscow region there are several deposits of medicinal peat and sapropel mud. About 65 sanatoriums use peat and sapropel mud from deposits in the Moscow region. Currently, many sanatoriums use imported mud; in the Dorokhovo sanatorium, peat mud from the Yukhnovskoye deposits is used for mud treatment; in the Tishkovo sanatorium, high-silt sapropels of Lake Dolgoye and blue clay are used for mud treatment. Sapropels from Lake Biserova in the Balashikha region and peats from the Tatishchevskoye deposit in the Dmitrov region are not currently used for medicinal purposes.

Internal intake of mineral water is the main method in the treatment of diseases of the digestive system. Mineral water is prescribed to patients with gastric and duodenal ulcers in the remission phase and in the unstable remission phase in the absence of pain; chronic gastritis with reduced and preserved secretion; chronic pancreatitis in the phase of stable remission; with diseases of the liver and biliary tract (gallbladder dyskinesia, chronic cholecystitis and hepatitis); diseases of the small and large intestines (irritable bowel syndrome; intestinal dyskinesia, etc.). Internal intake of mineral water also has a healing effect for diseases of the urinary system; for metabolic disorders ( diabetes, obesity).

...

Similar documents

Trends in the development of the sanatorium and resort sector in Russia. Analysis of the market for the services of the boarding house "Dolphin". Methodological support for the adoption of strategic management decisions. The main stages of forming an innovative development strategy for an enterprise.

thesis, added 02/24/2010


Natural medicinal resources of Russia as the basis of the state's resort industry, assessment of their reserves and prospects for production in the future, classification and varieties. Medical and health tourism in Russia, areas and features of the use of natural resources.

test, added 12/22/2010


Features of the development of tourism activities. Characteristics of the resource potential of Kazakhstan for sanatorium and resort purposes. Analysis current state sanatorium and resort activities in Kazakhstan. Ways to improve the transportation of tourists.

course work, added 12/02/2012


Justification of the principles and methods of investing in a recreational enterprise in the Tuapse region. The process of investment design of a sanatorium-resort base using the example of a holiday boarding house. Indicators of economic evaluation of an investment project.

thesis, added 09/06/2009


Study of the structure, essence and function of the region's health resort industry. Study of the methodology for economic analysis of the activities of a sanatorium. Analysis of the natural healing factors of the resort. Treatment of diseases various systems human body.

thesis, added 05/30/2015


The place and role of sanatorium and resort services in the provision of services to the population of the Russian Federation. Assessment of the sanatorium-resort appearance of the Karelian region according to groups of criteria: leisure activity programs, accommodation conditions, basic treatment programs.

test, added 01/25/2014


Development of the resort industry. The role of the resort industry in the economy of the Caucasian mineral waters. Competitive advantages of the region's resort industry. Problems of the resort industry in the region. The main directions of development of the resort industry of the Caucasian mineral waters.

course work, added 07/14/2011


Characteristics of the resort industry in the tourism system. Formation of the sanatorium and resort business in Russia. Organization of services in the sanatorium-preventorium "Beryozki". Analysis of types and methods of sanatorium treatment: antler baths, hirudotherapy, halotherapy.

course work, added 07/22/2010


Consideration of the features of effective management of a sanatorium-resort complex. Analysis of the effectiveness of the marketing and information client-oriented policy of the Rus sanatorium. Development of recommendations to improve operational efficiency.

thesis, added 06/29/2015


State regulation of sanatorium and resort activities. Financial support for sanatorium-resort treatment and recreation. Recreational infrastructure. Organizational and methodological support for control over the implementation of state guarantees.

Introduction

Appendix 2

Appendix 3

Appendix 4

Appendix 5

Figure 1 – Organizational structure of Sanatorium-Ural LLC

Introduction

On modern stage development, there is an increasing tendency for people to pay attention to their health, recreation and recuperation. Public interest in healthy image life, sports served as a jump in the popularity of the sanatorium-resort industry, and its emergence as one of the first plans in the tourism system. The emergence of new recreational needs of man and his requirements for the quality of recreation at resorts gradually led to the entry of the sanatorium and resort business into the resort and recreational system, the functions of which are to improve the quality and standard of living, improve the health and life expectancy of the population.

The peculiarity of the sanatorium and resort industry is that this industry is based not only on the practice of prevention and health improvement of the population, it affects animation and leisure activities, but also expresses interests in preserving natural areas, maintaining the environment and the rational use of natural healing factors. In this regard, studying this industry is of great importance.

Relevance of the graduation topic qualifying work lies in the need to study and research the sanatorium and resort industry of the region, in order to preserve the natural potential of climatic zones, form a new system of modern resort services, introduce services that can satisfy the needs of clients at the present stage of development of the tourism system. Currently, there are significant problems in the health resort industry, primarily expressed not only by the outdated material and technical base, but also by the degree of satisfaction with the infrastructure of the cultural and leisure needs of the population. The territory of the Orenburg region has an extensive network of sanatorium-resort institutions, natural-climatic zones with a rich content of therapeutic factors, but is significantly inferior to the sanatorium-resort zones of other regions in terms of the quality of service and the range of services provided, in connection with this, there is a need for a set of measures aimed at improvement of the resort service system.

The purpose of the final qualifying work is to develop measures to improve the areas of the sanatorium and resort industry in the region, using the example of Sanatorium Ural LLC.”

The main tasks that need to be solved to achieve the goal:

Consider the concept of “health resort industry”;

Study the structure, essence and functions of the health resort industry;

Consider the specifics of the activities of health resort industry facilities;

Study the methodology for economic analysis of the sanatorium’s activities;

Analyze the state of the health resort industry in the Orenburg region;

Conduct an analysis of the activities of Sanatorium Ural LLC;

Define promising directions development of Sanatorium Ural LLC;

Develop and justify improvement measures

activities of Sanatorium Ural LLC.

The structure of qualification work consistently solves the assigned tasks.

The object of study was a sanatorium-resort institution in the city of Orenburg - LLC Sanatorium Ural.

The subject of the study is the activities of LLC “Sanatorium Ural”.

Scientific novelty final work is as follows:

The understanding of the essence of the concept has been deepened and expanded and the functions of the health resort industry have been identified;

Based on the developed questionnaire, directions were identified and measures were proposed to improve the activities of Sanatorium Ural LLC.

The practical significance of the thesis lies in the possible introduction of practical activities into the customer service process of Sanatorium Ural LLC.

The final qualifying work was carried out on the basis of methods of collecting and processing information using a system integrated approach to solving the problem.

The main sources when writing the final thesis were scientific literature, articles in the open and specialized press, as well as the regulatory framework in the field of functioning of the sanatorium and resort industry.

When studying the topic of the thesis, special attention was paid to consideration the latest systems services used in other resort regions, and also assessed the possibilities of introducing these services into the activities of Sanatorium Ural LLC. Theoretical basis Research on the topic included the works of specialists in the field of sanatorium and resort business, economics and management of tourism enterprises, which were subsequently applied to the set goals and objectives of the qualifying work. The main sources for research and collection of materials for the thesis were the publications of the following authors: I.S. Barchukov, A.V. Babkin, O.V. Lysinova, M.A. Magomedov, V.V. Kiselev, T.A. Irisova and others.

1 Theoretical aspects of studying the activities of sanatorium and resort institutions

Sanatorium and resort industry: essence, functions, structure

The health resort industry is one of the most ancient types of tourism services. Since ancient times, people have mastered mineral springs and learned to use medicinal mud for recreational purposes. Over a long period of time, spa treatment has developed rapidly, resulting in it taking a leading place in the tourism industry market. At the present stage of development of the tourism industry, the sanatorium and resort business is becoming one of the most developing types, attracting not only a significant number of recreationists, but also creates interest for investors.

Recently, the importance of the health resort industry has been growing rapidly, which is associated with the need of tourists for high-quality and inexpensive resort and health services. The relevance of the resort theme lies in the fact that there are many unresolved problems in this field of activity.

The sanatorium, by its type of activity, belongs to medical and preventive institutions. These institutions are located in favorable natural areas, mainly outside cities. There are many definitions of the concept of “sanatorium”; let’s look at some of them.

According to the Great Medical Encyclopedia, a sanatorium is an institution medical type, which uses natural healing factors (mud, climate, mineral waters, etc.) in combination with physical therapy, a gentle, specially established regimen, and physiotherapy for recreational, therapeutic and preventive purposes.

A sanatorium is a medical institution specially equipped for the accommodation of persons who require constant medical supervision and adherence to a strict regime.

A sanatorium is a medical and preventive institution, the purpose of which is treatment with physiotherapy and natural factors (mineral waters, climate, mud), taking into account a strict regime and a special diet. Data medical institutions divided into sanatoriums general type and special (children's, tuberculosis, etc.).

Thus, based on the presented definitions, we can conclude that sanatoriums are specialized medical and preventive institutions that provide prevention and treatment of various diseases, accommodation facilities, as well as recreation without treatment, including the organization of leisure activities for vacationers.

Sanatoriums can be organized not only at resorts, but also in suburban areas with favorable natural conditions (climate, landscape, sanitary and hygienic conditions). Sanatorium institutions have a classification (Figure 1).

Figure 1 – Classification of sanatoriums

Sanatoriums for adults and children can be either single-disciplinary, specializing in the treatment and prevention of similar diseases, or multi-disciplinary, including several specialized departments. The main specialization of sanatoriums, taking into account the requirements of medicine, as well as the needs of the population in sanatorium and resort health, provides sanatoriums for vacationers with the following diseases:

Circulatory organs;

Digestive organs;

Respiratory organs (non-tuberculous);

Movement organs;

Organs of the nervous system;

Digestive organs responsible for metabolism;

Urinary canals and kidneys;

Gynecological diseases;

Dermatological diseases.

Along with multidisciplinary ones, there are narrow-profile sanatoriums; treatment in such sanatoriums is carried out in special areas and specially developed methods.

Also, there are specialized sanatoriums for the treatment of patients with a certain disease, these can be diseases bronchial asthma, respiratory organs (non-tuberculosis), diabetes. Depending on the established profile, the sanatorium is equipped with diagnostic and treatment rooms, and is also provided with doctors and specialists of certain qualifications.

Depending on the determining factor, sanatoriums are classified as follows:

Balneological sanatoriums – sanatoriums specializing in treatment with mineral waters;

Mud sanatoriums – sanatorium institutions using healing mud different types, V medical purposes;

Climatic – a type of sanatorium where beneficial combinations of natural environmental conditions are used as the main therapeutic factor.

Along with the concept of “sanatorium”, the concept of “resort” is often found. The Federal Law “On Natural Healing Resources, Medical and Health Areas and Resorts” contains the following terms and definitions:

Resort business is a combination of various types of scientific and practical activities for the organization and implementation of the prevention and treatment of diseases, through the use of natural healing factors;

Resort - developed and used in recreational, preventive, health and medicinal purposes a natural area under special protection, with natural healing factors, buildings and structures prepared for their exploitation, and infrastructure facilities, as well as meeting sanitary and environmental standards;

Natural healing resources are natural healing factors used for therapeutic and preventive purposes. The main natural healing resources include favorable climate properties, balneological factors, mineral waters and healing mud;

Medical and recreational area - a territory that has natural healing factors, suitable for organizing treatment and prevention of diseases, as well as for recreation of recreationists;

Spa treatment- type of medical care provided in health resort institutions based on the use of predominantly natural healing resources;

Sanatorium and resort services- services for the provision of sanatorium-resort assistance, food, organization of accommodation, leisure activities, as well as other service services provided in sanatorium-resort institutions.

Ushakov’s explanatory dictionary interprets that a resort is a natural area with recreational properties suitable for medicinal purposes.

Author of the Great Medical Encyclopedia A.V. Topolyansky notes that a resort is an area with natural healing resources (mud, climate, mineral waters and others), as well as necessary conditions for their use.

Thus, from all of the above we can conclude that the resort is a recreational facility that provides complete rest for people, that is, it is directly related to tourism. Resorts also have their own typology (Table 1).

Table 1 – Types of resorts and their characteristics

Resort type	a brief description of
Balneological mud resort	A type of resort that uses therapeutic mud and mineral waters as the main healing resources.
Balneoclimatic resort	A type of resort that uses climate and mineral waters as the main healing resources.
Balneological resort	A type of resort where mineral waters are used as the main healing resources (for external and internal use).
Mud resort	A type of resort that uses therapeutic mud as the main healing factors
Climatokumysalapeutic resort	A type of resort where climatic properties and kumis, a fermented milk drink made from mare's milk, are used as the main healing factors.
Seaside climatic resort;	Mountain climatic resort;

Depending on the level of therapeutic effectiveness of natural recreational factors, the degree of their development and improvement, resorts are divided into medical and recreational areas and resort areas of local, regional and federal significance.

Resort areas at the federal level include resort towns on the Black Sea coast Krasnodar region, Caucasian Mineral Waters, Belokurikha, Sergievsky Mineral Waters, the resort area of ​​St. Petersburg on the coast of the Gulf of Finland, seaside resorts of the Kaliningrad region, Nalchik.

Currently, all resorts of regional importance are under the jurisdiction of state authorities of the constituent entity of the Russian Federation. Resort areas of local importance are determined by local governments in favorable landscape and microclimatic conditions near large cities and industrial zones.

The Federal Law “On Natural Healing Resources, Medical and Health Areas and Resorts” provides the term “resort fund of the Russian Federation”.

So, according to the Federal Law, the Resort Fund of the Russian Federation is the totality of all identified and recorded natural healing resources, medical and recreational areas, as well as resorts and resort regions.

Depending on the objectives of the activity, the following functions of resorts are distinguished:

Spa treatment;

Medical recreation of patients;

Healthy recreation, prevention and treatment of diseases;

Cultural, educational and entertaining.

The first three functions presented represent spa therapy - the therapeutic use of natural recreational factors.

Under health-improving holiday, refers to the stay at resorts of practically healthy people who do not need special medical care, medical supervision and treatment. At the present stage, the main health-improving factors are physical culture and sports, tourism, natural healing resources used to restore the body, as well as cultural events.

Medical (therapeutic) tourism is a temporary departure from a permanent place of residence for medical, health and recovery purposes. Types of medical tourism include mountain, water, and ski tourism. Based on duration, they are divided into short-term (five to seven days) and long-term (more than seven days).

Resorts are located in health-improving areas - in areas with natural healing factors suitable for organizing the prevention and treatment of various diseases. For the most effective use such natural areas for medicinal and health purposes, it is necessary to have a resort infrastructure.

Figure 2 – Functions of the health resort industry

The functions of the resort and recreational system are a set of specific technologies that should have a comprehensive effect on the human body.

Therapeutic functions include therapeutic recreational factors, the priority of which is to expand health reserves, these include cycles of activities that increase spiritual health, as well as the moral guidelines of society.

However, in connection with the development of the sanatorium and resort industry, new directions are needed that can promote and implement the services of sanatoriums:

Resort marketing, a direction that will take into account the recreational and cultural needs of the population, and will also help to identify and expand the range of new services;

Drawing up forecasts for the development of resort and recreational systems at various levels, identifying promising ways to solve problems;

Development of the latest technologies in the field of use, as well as subsequent reproduction of natural recreational resources, and the development of methods of sanatorium and resort healing;

Advanced training and training of resort specialists for sanatoriums and tourism companies selling on the market of medical services;

Organization of joint activities of resort enterprises and travel companies.

Thus, having studied the concepts, essence, functions and tasks, we can conclude that the health resort industry is a system of material objects and activities for the provision of resort services to the population that promote health.

Each of the considered functions of the sanatorium-resort industry requires its own specific technologies, which should only be used comprehensively. In therapeutic functions, priority is given to natural healing factors and non-traditional methods aimed at expanding health reserves; In recreational functions, priority is given to cycles of activities that increase the spiritual health and moral guidelines of society.