Organization of primary health care and specialized medical care for patients with prostate cancer in the Nizhny Novgorod Region

2021 ◽  
pp. 20-31
Author(s):  
Egor Aleksandrovich Perevezentsev ◽  
Maya Andreevna Kuzmina ◽  
Dariya Dmitrievna Vasina ◽  
Denis Igorevich Volodin
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Medical Personnel ◽  
Malignant Neoplasms ◽  
Medical Organization ◽  
Primary Health ◽  
High Level ◽  
Nizhny Novgorod Region

At present, the quality and availability of medical care are the aspects to which close attention is paid in the system of organizing medical care. One of the ways to achieve a high level of quality and accessibility of medical care is building up human resources, i.e. the presence of highly qualified general practitioners, sub-specialties and middle medical personnel in sufficient numbers in a medical organization. Currently, the oncological service of Russia has been assigned tasks to fulfill the instructions from the State Program for the Development of Health Care. The results of the work should lead to a decrease in mortality and an increase in the quality of life of the population. To address the issue of reducing mortality from malignant neoplasms, in particular from prostate cancer, a three-level system of oncological care has been created on the territory of the Nizhny Novgorod Region, including 1 regional center, 2 interdistrict cancer centers, 88 primary oncology rooms and 96 examination rooms. The tasks set to reduce morbidity and mortality from oncological diseases can be realized only with close interaction of the oncological service with the primary health care sector, in which the prevention should be the priority direction of work.

ANALYSIS OF THE IMPLEMENTATION OF A NEW MODEL OF A MEDICAL ORGANIZATION PROVIDING PRIMARY HEALTH CARE IN CHILDREN'S STRUCTURAL UNITS

2021 ◽  
pp. 117-127
Author(s):  
Владимир Петрович Косолапов ◽  
Наталья Николаевна Чайкина ◽  
Галина Владимировна Сыч ◽  
Ольга Николаевна Черных
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Medical Organization ◽  
Structural Units ◽  
New Model ◽  
Primary Health ◽  
Voronezh Region ◽  
Pediatric Service ◽  
The Creation

Вопросы улучшения оказания первичной медико-санитарной помощи детскому населению всегда выступали в качестве приоритетных при оптимизации деятельности службы охраны материнства и детства и вызывали особое внимание организаторов здравоохранения. Одним из значимых решений по повышению качества оказания медико-санитарной помощи, в том числе и детям, является проект по реализации «Новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» в детских структурных подразделениях. Одной из основных задач педиатрической службы Воронежской области является реализация мероприятий региональной программы «Развитие детского здравоохранения Воронежской области, включая создание современной инфраструктуры оказания медицинской помощи детям», которой предусмотрено достижение целевых показателей и выполнение определённых задач. В данной статье рассматриваются вопросы организации деятельности педиатрической службы Воронежской области в плане реализации новой модели медицинской организации, оказывающей первичную медико-санитарную помощь в детских структурных подразделениях. Определяются направления развития детского здравоохранения, включая создание современной инфраструктуры оказания медицинской помощи детям. Приводятся данные по достижению в детских поликлиниках и детских поликлинических отделениях Воронежской области организационно-планировочных решений внутренних пространств, создание условий для внедрения принципов бережливого производства и комфортного пребывания детей и их родителей при оказании первичной медико-санитарной помощи, с акцентом на воплощении идей оптимизации первичной медико-санитарной помощи путем использования принципов и методов бережливого производства в части реализации регионального проекта «Развитие системы оказания первичной медико-санитарной помощи» Нацпроекта «Здравоохранение» в рамках создания и тиражирования «Новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» The issues of improving the provision of primary health care to the children's population have always been a priority in optimizing the activities of the maternal and child health care service and have caused special attention of health care organizers. One of the significant decisions to improve the quality of health care, including for children, is the project to implement the "New model of a medical organization providing primary health care" in children's structural units. One of the main tasks of the pediatric service of the Voronezh region is the implementation of the activities of the regional program "Development of children's health care of the Voronezh region, including the creation of a modern infrastructure for the provision of medical care to children", which provides for the achievement of targets and the implementation of certain tasks. The article deals with the organization of the activities of the pediatric service of the Voronezh region in terms of implementing a new model of a medical organization that provides primary health care in children's structural units. The directions of development of children's health care, including the creation of a modern infrastructure for the provision of medical care to children, are determined. The data on the achievement in children's polyclinics and children's polyclinic departments of the Voronezh region of organizational and planning solutions of internal spaces, the creation of conditions for the introduction of the principles of lean production and a comfortable stay of children and their parents in the provision of primary health care, with an emphasis on the implementation of ideas for optimizing primary health care through the use of principles and methods of lean production in terms of implementation regional project "Development of the system of primary health care" of the National Project "Healthcare" in the framework of the creation and replication of the "New model of a medical organization providing primary health care"

scholarly journals Evaluation of Austrias first PHC: What lessons can be learned?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Fröschl ◽  
K Antony ◽  
S Ivansitis ◽  
B Piso
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Outpatient Care ◽  
High Performance ◽  
Control Group ◽  
Multiprofessional Team ◽  
Primary Health ◽  
High Level ◽  
Point Of Service

Abstract Issue/problem The Austrian health care system regularly shows high performance. While about 99.9% of the population is covered by the compulsory health insurance system, the system is highly fragmented with shared responsibilities for inpatient and outpatient care. Description of the problem Primary health care in Austria is mainly provided by general practitioners (GP) in solo practises with average opening hours of 16-20 hours a week. This leads to high frequencies in outpatient care departments of hospitals and secondly to inefficiencies due to a high level of uncoordinated care. Thus in June 2014, the Federal Target-Based Governance Commission adopted a new concept for providing primary Health Care in an integrative, quality-assured manner and steering patients to the Best Point of Service. PHC centres are providing care in a multiprofessional approach (psychologists, nutritionists, and nurses) and have significantly longer opening hours with 45 hours per week. Results In 2015, the State Target-Based Governance Commission of Vienna commissioned the Austrian Public Health Institute (Gesundheit Österreich GmbH) with the evaluation of these pilot centers. The evaluation results of the first two years of the first PHC center shows a high level of satisfaction with the services provided by PHC and high level of utilisation, indicating an improvement in the service offered. PHC patients show a significantly higher level of utilisation of general medical care and at the same time a lower level of utilisation of specialist medical care than patients of the control group. Furthermore PHC patients have a significantly lower frequency of contacts in general emergency outpatient clinics. Lessons Changes in structural conditions such as the expansion in the range of services and the provision of care by a multiprofessional team results in advantages for patients, the team and the utilization of services at the best point of service. Key messages PHC centers can lead to a lower utilization of outpatient departments and thus to an improvement in the coordination of care. Cooperation in multi-professional teams can lead to a relief of the physicians and a higher job satisfaction.

ANALYSIS OF ORGANIZATIONAL DIRECTIONS TO CREATE A NEW MODEL OF PRIMARY HEALTH CARE

2020 ◽  
pp. 170-177
Author(s):  
Владимир Петрович Косолапов ◽  
Галина Владимировна Сыч ◽  
Наталья Николаевна Чайкина ◽  
Алексей Владимирович Сыч
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Service Sector ◽  
Care Delivery ◽  
Healthcare Management ◽  
Medical Organization ◽  
New Model ◽  
Primary Health ◽  
The Creation

Повышение эффективности использования государственных ресурсов и качества предоставляемой медицинской помощи в настоящее время остается одной из приоритетных задач науки управления здравоохранением. Зарубежными странами накоплен опыт решения подобных задач. В промышленности и сфере услуг разные методы находят успешное применение. Одним из таких подходов стало внедрение в практику принципов бережливого производства. В октябре 2016 года по инициативе Управления по внутренней политике Администрации Президента Российской Федерации стартовал пилотный проект по совершенствованию системы оказания первичной медико-санитарной помощи «Бережливая поликлиника»: создание медицинской организации, ориентированной на потребности пациента, бережное отношение к временному ресурсу как основной ценности за счет оптимальной логистики реализуемых процессов, организованной с учетом принципов эргономики и соблюдения объема рабочего пространства, создающей позитивный имидж медицинского работника, организация оказания медицинской помощи, которая основана на внедрении принципов бережливого производства. Создание «Бережливой поликлиники» стало возможно с помощью реализации комплекса мероприятий, направленных на соблюдение приоритета интересов пациента, организацию оказания медицинской помощи пациенту с учетом рационального использования его времени, повышение качества и доступности медицинской помощи, обеспечение комфортности условий предоставления медицинских услуг, повышение удовлетворенности уровнем оказанных услуг, сокращение нагрузки на медицинский персонал за счет повышения эффективности деятельности медицинской организации переходом на электронный документооборот, сокращением объема бумажной документации. В работе представлен анализ организационных направлений по созданию новой модели оказания первичной медико-санитарной помощи Increasing the efficiency of the use of state resources and the quality of medical care provided currently remains one of the priority tasks of the science of healthcare management. Foreign countries have accumulated experience in solving such problems. In industry and the service sector, different methods are successfully applied. One of these approaches was the introduction of lean manufacturing principles into practice. In October 2016, at the initiative of the Department for Internal Policy of the Presidential Administration of the Russian Federation, a pilot project to improve the system of providing primary health care "Lean Polyclinic" was launched: the creation of a medical organization focused on the needs of the patient, respect for the time resource as the main value due to optimal logistics of the implemented processes, organized taking into account the principles of ergonomics and compliance with the volume of the working space, creating a positive image of the medical worker, the organization of medical care in which is based on the implementation of the principles of lean production. The creation of the "Lean Polyclinic" became possible through the implementation of a set of measures aimed at observing the priority of the patient's interests, organizing the provision of medical care to the patient, taking into account the rational use of his time, improving the quality and availability of medical care, ensuring the comfort of the conditions for the provision of medical services, increasing satisfaction with the level of services provided. Services, reducing the burden on medical personnel by increasing the efficiency of the medical organization, switching to electronic document management, reducing the volume of paper documentation. The paper presents an analysis of the organizational directions for the creation of a new model of primary health care delivery

scholarly journals REFORM OF PRIMARY HEALTH CARE IN RUSSIA

2017 ◽  
Vol 19 (1) ◽  
pp. 32-36
Author(s):  
Mikhail G Karaylanov ◽  
Iliya T Rusev ◽  
Dmitriy N Borisov ◽  
Oleg Yu Bakanev ◽  
Igor G Prokin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Access To Health Care ◽  
Gradual Transition ◽  
National Healthcare ◽  
Primary Health ◽  
Access To Health ◽  
High Level

Explore the historical domestic experience of primary health care to the population of major cities, the establishment of this type of medical care as the main and the largest national healthcare system partition stages of the reform of primary health care to date, with a gradual transition to a system of health insurance in order to further increase the availability of and quality of care. Due to the recent modernization of the health system outpatient offices were equipped with modern innovative medical devices for the delivery of primary health care at a high level. In addition, historically proved the effectiveness of medical care at the district territorial principle, which defines and improves access to health care, with subsequent referral to narrow specialists (bibliography: 20 refs).

scholarly journals Epidemiological safety as a component of the operational management unit of the infocenter in introduction of lean manufacturing in a medical organization that provides primary health care

2020 ◽  
Vol 28 (2) ◽  
pp. 223-233
Author(s):  
Albert A. Kurmangulov ◽  
Yuliya S. Reshetnikova ◽  
Natalya S. Brynza
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Lean Manufacturing ◽  
Medical Personnel ◽  
Management Unit ◽  
Primary Health Care System ◽  
Medical Organization ◽  
Emergency Situations ◽  
Primary Health ◽  
Operational Management

Currently, the primary health care system is undergoing active reformation. Lean manufacturing technologies are being introduced into the activities of medical organizations that help reduce the loss of medical and auxiliary processes. One of the main methods of lean production is visualization, which is implemented in the operational management of a medical organization in the form of creating information centers (InfoCenters) that reflect the main parameters of the activity of a medical organization in the SQDCM system: safety, quality, order execution, costs and a comfortable environment. Criteria of safety of medical activity most relevant for the national healthcare system are parameters of epidemiological safety. A parameter most difficult for indication, but necessary for reflection of epidemiological diagnostics in the InfoCenter is the accident rate at work. Aim. Generalization of literature data on the possibility of including epidemiological safety parameters into the operational assessment of the InfoCenter. Epidemiological studies conducted in our country in medical organizations of various profiles show an increasing rate of emergency situations among the medical personnel. With this, the system of indication and identification of all emergency cases still remains imperfect, and medical personnel often hide cases of emergency situations. Conclusion. Introduction of criteria of epidemiological safety into the practical activity of a medical organization as a component of the operational management unit of the InfoCenter will contribute to the formation of functioning and constantly improving system of analysis of the activity of medical organizations, to the control of provision of medical care, and to standardization of invasive procedures to ensure epidemiological safety. The key tasks of the InfoCenter are: focusing the attention of medical organization employees on problems, prompt response to emerging problems and risks, and also ensuring effective communication of all participants of operational meetings in a single information space.

scholarly journals Analysis of architectural and planning solutions for visualization systems of medical organizations

2021 ◽  
Vol 20 (4) ◽  
pp. 60-66
Author(s):  
A. A. Kurmangulov ◽  
N. S. Brynza ◽  
Yu. S. Reshetnikova
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Personnel ◽  
Medical Organization ◽  
Visualization System ◽  
Security Breaches ◽  
Visual Elements ◽  
Primary Health ◽  
Visualization Systems ◽  
Architectural Planning

Introduction. Currently, visualization is recognized as one of the main criteria for the quality of space of the new model of a medical organization providing primary health care. Purpose of the study to establish the features of architectural and planning solutions for visualization systems of medical organizations providing primary health care. Materials and methods. The object of the study was the visualization systems of 94 medical organizations from seven constituent entities of the Russian Federation, in which all available internal and external visual elements were studied in person. As a basis for assessing visualization systems, the author's checklist was taken according to the ALIDS method of 50 indicators, united by common characteristics in five blocks: architectural planning and design solutions, transmitted information, levels and methods of visualization. The block «Architectural and planning solutions» was represented by 10 parameters. A nominal dichotomous score was assigned for each criterion. Results. The general architectural and planning solutions of visualization systems of medical organizations providing primary health care are at a satisfactory level (6,3±1,8 points). The greatest correspondence among the architectural and planning solutions of visualization systems of medical organizations was found in the characteristics of safety (93%), cleanliness (88%) and ergonomics of the location (79%) of elements, the least — in the presence of general infographic schemes (9%) and routing (3%). The level of architectural and planning solutions for visualization systems of medical organizations correlates with the complexity of the architectural plan of buildings (r=–0,423; p<0,05) and the patients' assessment of the comfort of the conditions for providing services (r=0,345; p<0,01). Discussion. Improving visualization systems by improving the architectural and planning solutions of elements can lead to a significant reduction in the main and additional types of losses in lean production both on the part of patients and on the part of medical personnel. Conclusion. One of the main problems of organizing visualization systems in medical organizations is the lack of common maps with buildings, signs of entrances and other objects of the adjacent territory. The absence of a positioning sign on most schemes leads to a longer orientation in space, and in the case of placing the elements of the visualization system at the decision-making points, the intersection of patient flows and an increase in the risk of security breaches.

scholarly journals Analysis of the primary health care state for the rural population at the regional level

2021 ◽  
Vol 20 (1) ◽  
pp. 50-57
Author(s):  
M. G. Moskvicheva ◽  
M. M. Polinov
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Rural Areas ◽  
Rural Population ◽  
Care Delivery ◽  
Medical Science ◽  
Medical Personnel ◽  
Full Time ◽  
Primary Health

Introduction. The main goal of the state policy in the field of healthcare is to form a system that ensures the availability of medical care and increases the efficiency of medical services. The volume, type and quality of medical care must correspond to the level of morbidity, the needs of the population and the advanced achievements of medical science. Primary health care is the backbone of the health care delivery system. The problem of it improvement, including in rural areas, is a priority and has national significance. The development of measures to increase the availability of primary health care according to the territorial principle is an urgent scientific and practical problem.The purpose of the study — based on the analysis, methodologically substantiate and develop measures to increase the availability and improve the system of organizing the provision of primary health re to the rural population on a territorial basis.Materials and methods. Mathematical-statistical and analytical (quantitative, structural, comparative) research methods were used.Results and Discussion. In the Chelyabinsk Region, there are disproportions in the provision of the population with medical personnel: the provision of the urban population with doctors and l personnel is significantly higher than that of the rural population. The indicator of staffing with paramedical personnel in full-time positions of feldsher-obstetric stations is 20.1% lower than in the Russian Federation. The index of "combination rate" among doctors working in outpatient departments is 1.2 times higher than the target indicator of the National Health Project, and in rural areas it is 1.1 times. In order to unify the organizational and methodological approaches, the authors proposed a classification of medical stations and their organizational and functional structure.Conclusions. The organization of the provision of primary health care to the rural population according to the territorial-district principle with the formation of an organizational model of the rural medical district will increase the availability of primary medical health care to the rural population.

Primary Health Care and the ICD-11

2013 ◽  
Vol 10 (01) ◽  
pp. 33-37 ◽  
Author(s):  
M. Klinkman ◽  
D. Goldberg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Medical Care ◽  
Special Needs ◽  
Field Trials ◽  
Primary Medical Care ◽  
Dsm 5 ◽  
Primary Health ◽  
Icd 10

SummaryThis paper describes the necessity of adapting the major classifications of mental disorders exemplified by the ICD-11 and the DSM-5 for the special needs of primary medical care. An earlier version of the classification – the ICD-10-PHC – is described, and the process of adapting it is described in detail. The new 28 item version of the classification is described, and the procedures to be adopted in the Field Trials to be held during 2013 are set out, together with the specific problems these field trials will address.

Some results of the implementation of the priority project «creating a new model of a medical organization that provides primary health care»: problems and prospects

2020 ◽  
pp. 35-43
Author(s):  
Alexey Smyshlyaev ◽  
Maria Sadovskaya
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Quality Management System ◽  
Primary Health Care System ◽  
Medical Organization ◽  
New Model ◽  
System A ◽  
Primary Health ◽  
The Creation ◽  
Care Problems

Optimization of the activities of medical organizations providing primary health care requires the development of new organizational and functional models. The introduction of new approaches to organizing the activities of medical organizations is primarily a step towards patients. The new model is a patient-oriented medical organization, the management of which is based on the use of a process-oriented approach and «lean» technologies. Since 2019, within the framework of the federal project «Development of a primary health care system,» a project has been launched to introduce the «New Model of a Medical Organization Providing Primary Health Care». The implementation of the project is scheduled for 2019-2024 inclusive. The creation and replication of the «new model» is planned for the participation of all subjects of the Russian Federation. The introduction of lean technology methods in the work of medical organizations has reduced the waiting time for doctors, optimized the burden on doctors, reduced the time for obtaining research results, streamlining the process of moving a patient within a medical organization. The creation of an effective quality management system in medical organizations is achieved through the phased implementation of lean-technology.

A Human Resource Development Strategy for Primary Health Care: an Exploratory Study of Mixed Methods

2021 ◽  
Author(s):  
Huanhuan Jia ◽  
Hairui Jiang ◽  
Jianxing Yu ◽  
Jingru Zhang ◽  
Zhou Zheng ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Human Resource Development ◽  
Structural Equation ◽  
External Environment ◽  
Medical Personnel ◽  
Public Hospitals ◽  
Individual Development ◽  
Primary Health ◽  
The Government

Abstract Background: The serious shortage of primary health care (PHC) providers is a common issue in the health reforms worldwide, including in China. The government of China have proposed that encouraging and guiding qualified medical personnel to work in primary medical and health care institutions (PMHCIs) is an effective way to improve the overall quality and efficiency of PHC, but it has not produced good results. The problem of insufficient human resources of PHC has not been substantially ameliorated.Methods: Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PMHCIs from the perspective of guided objects. Through a three-phase investigation of 1,160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors.Results: A total of 5 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PMHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG, whereas CCPL had no significant direct effect. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of the institution and the willing of medical personnel to seek employment at PMHCIs. The values of fit index indicated an acceptable-fitting model.Conclusion: Family, remuneration, individual development, and job responsibility are closely related with the willingness of medical personnel to seek employment at PMHCIs, and the internal and external environment of PMHCIs is also an important factor. Based on this, targeted measures can be proposed to promote the development of PHC providers.

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