2018 № 1 Development of a new model of health care: a conceptual approach and pilot implementation
This paper presents an extended understanding of preventive healthcare model as a set of measures ad¬dressing risk factors (primary prevention), early detection of diseases (secondary prevention) and prevention of their complications (tertiary prevention). Four principles of service delivery are formulated to ensure the transition from a primarily curative to a predominantly preventive model, including strengthening the responsibility of citizens for the prevention of diseases, enhancing the role of primary care, overcoming physicians' interest in the volumes of care, as well as quality control based on the indicators of complications and neglected cases. The paper presents these principles pilot implementation in the reorganization of urological care in Voronezh oblast (Russia). Activities for early detection of diseases, strengthening the role of primary care providers, building interregional urological centers have significantly reduced the proportion of complicated cases, changed the structure of medical care towards the low-cost activities and eventually provided substantial clinical and economic benefits
2018 № 9 Comparative analysis and assessment of polyclinic work at the second level of urological care to the population in the region within the framework of the developed three-level system
The system of urological care in the region is an integral component of effective health care. The regional system of urological care, implemented in the form of the so-called “traditional approach” is not optimal. The article provides an analysis of the three-level system of restructuring of urological care in the Voronezh region in terms of the polyclinic activity of medical organizations of the second level of urological care on the example of urolithiasis, benign prostatic hyperplasia and prostate cancer. The study included two time stages: the traditional system of urological care before the introduction of the restructuring system and after the introduction of a three-level system of care for patients with urological pathology. The results demonstrate a strong statistically significant objective increase in outpatient activity and the level of medical examination for the vast majority of patients in all three diseases considered in this study reflect the ultimate performance of the regional urological service (on the example of Voronezh region), in terms of its functioning in the format developed a three-tiered system of medical care in comparison with the traditional approach.
2017 № 7 Comparative analysis and integrated assessment economic efficiency of the developed three-level system of provision of urological care to the population in the region compared to the traditional approach
Medico-economic efficiency of functioning of the regional urological service at the modern stage of healthcare development is not optimal. In article the analysis of work-level system and the restructuring of urological care in Voronezh region for the total amount of direct costs for diagnosis and treatment of all patients and the cost of diagnosis and treatment in terms of a particular patient, for example urolithiasis, benign prostatic hyperplasia and prostate cancer. The study included two stages: a traditional system of provision of urological care to the implementation of the system restructuring, and after implementing three-tier system of care for patients with urological disorders. The results demonstrate a strong statistically significant objective reduction of economic costs of diagnosis and treatment for the vast majority of patients in all three nosological forms presented in this study reflect the ultimate performance of the regional urological service (on the example of Voronezh region), in terms of its functioning in the format developed a three-tiered system of medical care in comparison with the traditional approach.