Substantiation of the integrated system of primary health care model
DOI:
https://doi.org/10.32782/2077-6594/2023.3/12Keywords:
primary health care, integration, potentially preventable hospitalizations.Abstract
Purpose is substantiation, development and evaluation of the potential effectiveness of the model of the integrated system of primary health care (PHC). Materials and methods. An analysis of the uninterruptedness of PHC was carried out, the influence of relations between the owner of PHC facilities, the customer of medical services and providers of PHC was studied, the model of the integrated system of PHC system was developed. Analytical, sociological, conceptual modeling, sociological, and expert assessment methods were used. Results. Summarizing the materials of the cascade analysis shows the pronounced fragmentation of the existing PHC system. The relationship between PHC providers, service customers and facility owners does not ensure the effectiveness of PHC. A well-founded model of an integrated PHC system, the leading place in which is given to a continuum of measures ensuring the connection of stages of medical care at the level of PHC and dyadic communication with the secondary level of care. The components of the model are also included measures to improve patient adherence, strengthening the structure of PHC, optimization interaction with the owners of PHC facilities and the customer of medical services, improving digital health, as well as a set of auxiliary services, which serve to support the integrated of primary care. The implementation of the model can potentially reduce the level of preventive hospitalizations of the adult population with ambulatory care sensitive conditions by 28.2-32.9%. Conclusions. The research established that PHC in Ukraine is characterized by a high level of fragmentation, defects in connections with various institutions on which the functioning of PHC depends. A substantiated model of an integrated primary health care system, the introduction of which can significantly reduce the level of hospitalizations of the population and, in the long term, positively affect the dynamics of the health of the population of Ukraine.
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