scholarly journals The experience, results, and possible perspectives of organizing the optimally accessible primary medical care for the rural population of Zaporizhzhia region

Author(s):  
O. H. Aleksieiev ◽  
V. V. Taranov ◽  
V. P. Petrykhin

Nowadays, the assessment of the activity of the domestic healthcare system is an important and actual issue, especially against the background the active reformation of this industry. One of the important elements of the assessment is studying the availability of primary healthcare to the rural population. The aim of this work is to study the territorial accessibility of primary healthcare, the adequacy and effectiveness of the principles of forming a network of primary care facilities in the rural areas of Zaporizhzhia region that enables to address issues and optimize the location of primary care facilities in the rural areas. Materials and methods. The materials of the research were the data of the official statistical reports for the past 20 years, which characterize the state of health and the degree of medical care accessibility to the rural population. During the research, the technique of complex social and hygienic research was applied, with the use of historical, sociological, sanitary and statistical methods, organizational experiment and others. Results. The article presents the main results of studying the current state of primary healthcare organization for the rural population of Zaporіzhzhia region against the background of active reforming processes. According to the research results, the main elements forming the system of accessibility are territorial, medical, social and economic. The main factors of impact on territorial accessibility are identified. These are: the nature of the settlement of rural residents (density, compactness, service-area radius, the proportion of the rural population, the distance between villages, the distance from a household to a healthcare facility); quality of roads; transport connections between settlements and healthcare facilities; availability of communication means. Conclusions. As a result of the research, the following conclusions were drawn. Such factors as population density, compactness of its location, service-area radius, distance between villages, distance from a household to a healthcare facility, condition and quality of roads, transport connections between settlements and healthcare facilities are important during forming or improving the network of healthcare facilities in rural areas. These factors must be considered for the rational placement of primary care facilities in rural areas.  

2019 ◽  
Vol 63 (3) ◽  
pp. 122-128
Author(s):  
Tatiana M. Bogdanova ◽  
A. S. Demin ◽  
A. A. Lopatkina ◽  
A. V. Kosareva ◽  
M. A. Zankin

The analysis of the quality of medical care for the rural population has been taken in the «Ustinskaya Regional Hospital» of the Kalmyk Republic (further on referenced as «URH»). Analysis goal. To investigate the basic principles of medical care for the rural population and determine the major open issues regarding healthcare, considering URH as an example. Assessment methods. Two examination phases have been conducted: 1. Assessment of disease structure, equipment level, and overall work efficiency of URH 2. Analysis of the voluntary patient survey The investigation covered 653 respondents of both genders, aged between 20 and 70 with an average of 47,5 years [23,2; 68,1] Results - the principles of medical care at Ustinsky Region of Kalmyk Republic has been considered as satisfactory. The whole population of the Ustinsky Region makes 9958 people (including 8178 adults and 1780 kids). The population is divided into 3 therapeutic and 2 pediatric departments, according to the actual standards. From the nosology perspective, regional clinical examination covers 95.3% of the respiratory system diseases and 91% of cardiovascular system pathologies. In 2016 more than 95% of the survey respondents mentioned positive changes in the treatment level of URH. Own health level was considered as “good” by 96% of respondents. About 16% of patients were listed in the dispensary, but only 75% of them were screened annually. The complications with receiving preferential medicines were experienced by 46% of patients. The commute to the regional hospital takes 30 minutes for 58% of respondents, and over 60 minutes for 18% of them. Medical staff, conducting prophylactic measures has been spotted by 49% of respondents. Discussion. Dispensary observation has been properly focused on prophylaxis only in 2016. Conclusions. The overall level of medical care for the rural population of the assessed regional center has been considered as satisfactory.


1997 ◽  
Vol 78 (6) ◽  
pp. 464-465
Author(s):  
E. V. Karpukhin

The main feature of the system of medical care for the rural population created in our country is its phased nature, starting from feldsher-midwife stations to regional, territorial and republican institutions. Due to the peculiarities of rural population settlement, large distances to medical institutions, poor roads, lack of regular transport communication, low technical availability of communication facilities, as well as a number of social, economic and geographical factors, there are problems in the organization of medical care for this contingent.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Changle Li ◽  
Zhuo Chen ◽  
M. Mahmud Khan

Abstract Background With economic development, aging of the population, improved insurance coverage, and the absence of a formal referral system, bypassing primary healthcare facilities appear to have become more common. Chinese patients tend to visit the secondary or tertiary healthcare facilities directly leading to overcrowding at the higher-level facilities. This study attempts to analyze the factors associated with bypassing primary care facilities among patients of age 45 years or older in China. Methods Random effects logistic models were used to examine bypassing of primary health facilities among rural-urban patients. Data from 2011 to 2015 waves of the China Health and Retirement Longitudinal Study were used. Results Two in five older patients in China bypass primary health centers (PHC) to access care from higher-tier facilities. Urban patients were nearly twice as likely as rural patients to bypass PHC. Regardless of rural-urban residence, our analysis found that a longer travel time to primary facilities compared to higher-tier facilities increases the likelihood of bypassing. Patients with higher educational attainment were more likely to bypass PHCs. In rural areas, patients who reported their health as poor or those who experienced a recent hospitalization had a higher probability of bypassing PHC. In urban areas, older adults (age 65 years or older) were more likely to bypass PHC than the younger group. Patients with chronic conditions like diabetes also had a higher probability of bypassing. Conclusions The findings indicate the importance of strengthening the PHCs in China to improve the efficiency and effectiveness of the health system. Significantly lower out-of-pocket costs at the PHC compared to costs at the higher tiers had little or no impact on increasing the likelihood of utilizing the PHCs. Improving service quality, providing comprehensive person-centered care, focusing on family health care needs, and providing critical preventive services will help increase utilization of PHCs as well as the effectiveness and efficiency of the health system.


2020 ◽  
Author(s):  
Andrio Adwibowo

AbstractOne of the main challenges in dealing with the current COVID 19 pandemic is how to fulfill the healthcare facility demands especially for the residents living in the rural areas that have restricted healthcare access. Correspondingly, this study aims to record the daily COVID 19 cases and continue with the forecasting of the average daily demand (ADD) of healthcare facilities including beds, ICUs, and ventilators using ARIMA model. The forecasts were made for 3 rural populations located in the southern Amazon. The model shows that the healthcare ADD was different in each population. Likewise, the model forecasts that in a rural population that has the highest daily case with projected average cases equal to 67 cases/day (95%CI: 24, 110), that population has to fulfill healthcare ADD consisting of 57 beds/day (95%CI: 21, 93), 8 ICUs/day (95%CI: 2, 14), and 2 ventilators/day (95%CI: 2, 3). To conclude, the ARIMA model has addressed critical questions about ADD for beds, ICUs, and ventilators for rural residents. This ARIMA model based healthcare plan will hopefully provide versatile tool to improve healthcare resource allocations.


Author(s):  
Yuliya M. Beglyakova ◽  
◽  
Aleksander S. Shchirskii ◽  

The article analyses the accessibility of medical facilities in rural areas of modern Russia and the specifics of their organization and development. The authors reveal causes why rural residents have much less opportunities to seek quality medical care than urban ones, what leads to a disparity between the inhabitants of the city and the village. The thesis is substantiated that state programmes that should make health services accessible to the rural population to a greater extent do not cope with the task at hand. An attempt is made to highlight the public’s response to the existing disparity in the health services of the villagers compared to urban dwellers. Such a reaction can be considered an outflow of people from rural areas, and an increase in self-medication among rural people as a result of the difficulty in obtaining health services. The decrease in the number of treatment facilities in rural areas leads to a deterioration in the medicine situation in rural areas. That, according to the authors of the article, justifies the need to study the issues associated with the provision of medical care to the rural population.


2020 ◽  
Author(s):  
Jamie Murdoch ◽  
Robyn Curran ◽  
Ruth Cornick ◽  
Sandy Picken ◽  
Max Bachmann ◽  
...  

Abstract Background: Despite significant reductions in mortality, preventable and treatable conditions remain leading causes of death and illness in children in South Africa. The PACK Child intervention, comprising clinical decision support tool (guide), training strategy and health systems strengthening components, was developed to expand on WHO’s Integrated Management of Childhood Illness programme, extending care of children under 5 years to those aged 0-13 years, those with chronic conditions needing regular follow-up, integration of curative and preventive measures and routine care of the well child. In 2017-2018, PACK Child was piloted in 10 primary healthcare facilities in the Western Cape Province. Here we report findings from an investigation into the contextual features of South African primary care that shaped how clinicians delivered the PACK Child intervention within clinical consultations.Methods: Process evaluation using linguistic ethnographic methodology which provides analytical tools for investigating human behaviour, and the shifting meaning of talk and text within context. Methods included semi-structured interviews, focus groups, ethnographic observation, audio-recorded consultations and documentary analysis. Analysis focused on how mapped contextual features structured clinician-caregiver interactions. Results: Primary healthcare facilities demonstrated an institutionalised orientation to minimising risk upheld by provincial documentation, providing curative episodic care to children presenting with acute symptoms, and preventive care including immunisations, feeding and growth monitoring, all in children 5 years or younger. Children with chronic illnesses such as asthma rarely receive routine care. These contextual features constrained the ability of clinicians to use the PACK Child guide to facilitate diagnosis of long-term conditions, elicit and manage psychosocial issues, and navigate use of the guide alongside provincial documentation. Conclusion: Our findings provide evidence that PACK Child is catalysing a transition to an approach that strikes a balance between assessing and minimising risk on the day of acute presentation and a larger remit of care for children over time. However, optimising success of the intervention requires reviewing priorities for paediatric care which will facilitate enhanced skills, knowledge and deployment of clinical staff to better address acute illnesses and long-term health conditions of children of all ages, as well as complex psychosocial issues surrounding the child.


2017 ◽  
Vol 4 (1) ◽  
pp. 8-17
Author(s):  
Robita S

Manipur lives in villages. The rural population contributes to about 76.12% of the total population. Enhancement in the quality of life of the economically weaker section of the society has been one of the basic objectives of development planning of the State. Rural development, by empowering the rural masses through economic self-reliance, is one of the priority areas of the Central and State Govts. To bring about development in rural areas, the govts. and banks/financial institutions have formulated various programmes and schemes. Micro Finance is one such scheme adopted for the development of rural people.


2016 ◽  
Vol 126 (1) ◽  
pp. 8-12
Author(s):  
Daria Przybylska ◽  
Piotr Przybylski ◽  
Bartłomiej Drop ◽  
Krzysztof Czarnocki ◽  
Wojciech Przybylski ◽  
...  

Abstract Introduction. Family medicine remains the primary type of medical services in Poland and it is supposed to treat both individual patients and the society as a whole. Due to the growing commercialization of the health service, most primary healthcare centers have transformed into non-public healthcare facilities. The public ones (called SPZOZ in Polish) account only for a small fraction of the whole number of primary healthcare facilities. The quality of medical services provided by such facilities, as patients see it, remains one of the key elements determining the development of family medicine centers. Aim. The aim of this paper was to assess patient satisfaction levels regarding the healthcare services they received in two primary healthcare institutions, both of the NZOZ and SPZOZ type, in a small town located close to Lublin. Material and methods. An anonymous survey was filled out by 30 patients of both a public and non-public healthcare center located in Niemce (Niemce Commune, Lublin District). The quality of services was assessed using an original questionnaire in the form of a poll. Results. The results obtained indicate a clear relationship between one’s trust to the physician, diagnosis accuracy and visiting the particular center again, in order to continue the treatment. For older subjects, it was nurses’ kindness and politeness that was the most important. The elderly appreciated the kindness and politeness of the nurses in particular. No significant differences were found between the institutions in respect of the overall perception of satisfaction with services. In terms of infrastructure assessment, the majority of positive feedback was provided for NZOZ. Conclusions. The findings above suggest that it is essential to conduct surveys on a regular basis, in order to check patients’ assessment of the service quality in various institutons.


Author(s):  
Jane M. Gould

A unique feature of most pediatric healthcare facilities is that they provide opportunities for both inpatients and outpatients to participate in play with developmentally appropriate toys during their medical care. Reasons for play in hospitalized pediatric patients may include providing mechanisms to educate children about their particular medical conditions, providing stress reduction during frightening procedures, assisting in the development of coping strategies, and attempting to maintain a sense of normalcy during long hospitalizations. Although toys and playroom environments provide a vital psychosocial and quality-of-life function, however, they are also known to contribute to the transmission of infectious agents. This chapter provides guidance on minimizing transmission of pathogens in hospital-based playrooms and classrooms: pathogens that are commonly found in pediatric healthcare facilities. This chapter also discusses the transmission challenges with pet therapy programs for children, and suggests approaches for safe implementation of these programs. Sample policies are included.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e027296 ◽  
Author(s):  
Nóra Kovács ◽  
Orsolya Varga ◽  
Attila Nagy ◽  
Anita Pálinkás ◽  
Valéria Sipos ◽  
...  

ObjectivesThe objectives of our study were (1) to investigate the association between gender of the general practitioner (GP) and the quality of primary care in Hungary with respect to process indicators for GP performance and (2) to assess the size of the gender impact.Study designA nation-wide cross-sectional study was performed in 2016.Setting and participantsThe study covered all general medical practices in Hungary (n=4575) responsible for the provision of primary healthcare (PHC) for adults. All GPs in their private practices are solo practitioners.Main outcome measuresMultilevel logistic regression models were used to analyse the association between GP gender and process indicators of PHC, and attributable proportion (AP) was calculated.Results48% of the GPs (n=2213) were women in the study. The crude rates of care provided by female GPs were significantly higher for seven out of eight evaluated indicators than those provided by male GPs. Adjusted for practice, physician and patient factors, GP gender was associated with the haemoglobin A1c (HbA1c) measurement: OR=1.18, 95% CI (1.14 to 1.23); serum creatinine measurement: OR=1.14, 95% CI (1.12 to 1.17); lipid measurement: OR=1.14, 95% CI (1.11 to 1.16); eye examination: OR=1.06, 95% CI (1.03 to 1.08); mammography screening: OR=1.05, 95% CI (1.03 to 1.08); management of patients with chronic obstructive pulmonary disease: OR=1.05, 95% CI (1.01 to 1.09) and the composite indicator: OR=1.08, 95% CI (1.07 to 1.1), which summarises the number of care events and size of target populations of each indicator. The AP at the specific indicators varied from 0.97% (95% CI 0.49% to 1.44%) of influenza immunisation to 8.04% (95% CI 7.4% to 8.67%) of eye examinations.ConclusionFemale GP gender was an independent predictor of receiving higher quality of care. The actual size of the gender effect on the quality of services seemed to be notable. Factors behind the gender effect should receive more attention in quality improvement particularly in countries where the primary care is organised around solo practices.


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