Hospital-based emergency care in the Russian Federation: a historical analysis of statutory regulations

The ongoing changes the system of emergency care (EC) in the Russian Federation (RF), especially its in-hospital component, require modifications of applicable laws. This paper analyzes past development and evaluates the current state of regulations pertinent to hospital-based EC in RF. We have reviewed and analyzed the regulatory statutes that governed hospital-based emergency care in Russia between 1735 and 2013. The study traces the development of past regulations (legal and normative acts) applicable to EC in RF. Main regulations currently in effect are characterized. At present, there already exists a body of laws supporting further modernization of hospital-based EC in Russia. Most recently, the legal foundation has been laid for previously novel concepts such as short-term observation, and for the creation of hospitalbased centers of EC. Work in progress involves active steps towards clinical recommendations and protocols for the envisioned new structure of EC in the RF. The paper will be of interest to professionals studying global emergency medicine development. It will help researchers and clinical practitioners in the fields of emergency medical care and healthcare management by understanding the link between regulatory deficiencies and barriers to improving emergency department operations.