All articles by Sheiman I. M.
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