2020 № 8 Satisfaction of patients as an indicator of the effectiveness of organizational models of providing medical care in the outpatient sector
The object of the study is patient satisfaction with the medical care provided as a potential tool for evaluating the effectiveness of organizational changes in the outpatient unit. The patient-oriented approach is becoming more and more widespread in the world and domestic health care, so it is also necessary to take into account the opinion of the recipients of medical care in order to evaluate the ongoing changes. The purpose of the study was to test the developed online patient satisfaction assessment service TesMed in the implementation of systemic organizational changes in the outpatient section of the Tomsk region (united in one document – the Standard for organizing outpatient care in the Tomsk region). Patients were able to use the smartphone functionality to identify the medical organization and put a rating on a five-point scale. If the patient scored less than five points, the app asked them to select a reason for dissatisfaction from the list. The data of 2898 forms were analyzed. By the time of the beginning of noticeable
changes for visitors of polyclinics (changing the format of the reception area, staff jobs, registry, formation of corporate culture), the share of visitors who rated the work of a medical organization by five points was 57.78%. After a month of project implementation, this parameter increased to 85.79% and did not fall below 72% until the end of 2019. The analysis of factors affecting negative ratings showed that the structure of reasons for their decline has not changed significantly. The study showed that the use of assessment methods used in the provision of medical care organizational models based on the opinion of patients, along with standard performance indicators, contributes to improving the effectiveness of interaction between medical organizations and patients.
2020 № 10 Self-assessment of health and satisfaction with medical care by country people of age 60+ of the Kaliningrad region
With age the state of health worsens, it is necessary to see doctors more often. Availability and quality of the
provided medical care, a set of medical services can differ depending on the place of its rendering. The work purpose – to study a self-assessment of a zdorovyapatsiyentama of age 60+ of rural out-patient clinic of the Zelenograd district of the Kaliningrad region and their relation to the organization of the primary health care (PHC) and satisfaction with it. Survey among 211 patients of rural medical out-patient clinic aged from 60 up to 88 years, within the project of Partnership “Northern measurement” in the field of health care and social wellbeing is conducted (further in the text – the Project). The factors offered in the questionnaire having the greatest impact on health, according to patients, and satisfaction with the PHC organization are studied. The patients living in rural areas often visit the medical organizations with the medical and diagnostic and advisory purposes, pay attention to medical examination passing that can testify to an active position of the general practitioner working in the Project as in answers about the factors having the greatest impact on health, questions of prevention at poll got the last place. The satisfaction with the PHC organization made in general 3.6 points on a five-point system.
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.