2020 № 9 From patient-centered medicine to 4p-medicine: the semantic aspect of the trend
The step-by-step guidelines for the formation, development and implementation of the direction defined as “patient-oriented medicine” in the scientific and practical segments of healthcare are presented. It reflects not only the historical aspect of
this semantic plot, but also gives a characteristic of the diverse models of interaction between subjects – a doctor and a patient.
The analysis of definitions of “patient-oriented medicine” in the framework of foreign and domestic scientific schools, as well as
the analysis of the relationship of the pattern with the new concept of health care development – 4P-medicine is given. The structure of the 4R-medicine concept is characterized, the ideological implications of the prospects for its development are given. The legislative and organizational initiatives for the development of patient-oriented medicine are outlined.
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 № 3 Influence of doctors’ patient-orientation on patient involvement in treatment
In the article it is shown that nowadays in the public health care of different countries researches of patient-orientation are actively conducted. At the same time patient-orientation as a characteristic of the patient’s communication with the doctor is considered the basis of the patient-doctor relationship. All this corresponds with the feasibility of forming in the domestic health care model of 4P medicine, already repeatedly voiced in recent years on various medical forums. The authors carried out an assessment of the patient-oriented corporate culture of the medical organization. For this purpose, two types of questionnaires were developed and analyzed: “Involvement of health workers” and “Patients’ involvement in treatment”. It has been established that the level of the doctor’s involve- ment in achieving the strategic goals of the medical organization directly affects the level of intention of patients to fulfill doctors’ recommendations. The range of this influence is 43.3% on average