Conceptual and methodological approaches to the development of an optimized functional-and- organizational system of medical care for patients with malignant neoplasms at the regional level

Abstract

Purpose – to develop conceptual and methodological approaches to the development of an optimized functional-and-organizational system for providing medical care to patients with malignant neoplasms at the regional level.Materials and methods. The bibliosemantic method and the method of structural-and-logical analysis were applied in the course of the study. Systematic approach was used as the methodological basis of the study. The legislative documents of Ukraine on reforming the health care system reform, data from scientific literature and the results of previous personal research served as the materials of the study.Results. Conceptual and methodological approaches to the development of an optimized functional-and-organizational system of medical care for patients with malignant neoplasms at the regional level are aimed at eliminating existing problems and providing the population of the region with affordable and high-quality comprehensive medical care for malignant neoplasms. Structurally, the problems are divided into the following groups. The first group of problems is associated with a decrease in the responsible attitude of the population to personal health. The second group of problems is associated with a low level of motivation and conditions for undergoing targeted preventive oncological examinations, which is the reason for a significant increase in the primary detection of malignant neoplasms in advanced stages of development. The third group of problems is related to the insufficient level of awareness of the population about the determinants and symptoms of the development of malignant neoplasms and the place and conditions for the population to receive the necessary medical care.The fourth group of problems is related to the state of primary health care and the level of readiness of primary care personnel to provide comprehensive medical care to the population in case of malignant neoplasms. The fifth group of problems is related to the negative impact of the war against Russian military aggression on the structure and resource provision of the system for providing oncological specialized medical care. The sixth group of problems is related to the reform of the system of specialized medical care, which, while improving its quality, reduces the level of territorial accessibility. The seventh group of problems is associated with the fact that free medical care guaranteed by the state does not fully provide it to patients with malignant neoplasms.The measures are comprehensive and involve a cross-sectoral approach with the distribution of tasks and functions for each participant in the process. The task for regional authorities – adoption of a regional target comprehensive program to provide the population with specialized oncological care and ensure the activities of the relevant coordination council; ensuring the operation of public transport for the population to receive specialized oncological care. The task for local authorities of territorial communities: adoption of a local target comprehensive program for the preservation of oncological health of the population or inclusion of the relevant section in the existing program for preserving public health; introduction of incentives for continuous improvement of competencies by primary care medical personnel and provision of family outpatient clinics with the necessary medical supplies. The task for National Health Service of Ukraine – to ensure maximum funding at the state expense of specialized oncological care for the population. The task for specialized medical care system – providing affordable and high-quality medical care. The task for the system of primary health care – detection of malignant neoplasms in the early stages of development, dynamic supervision of patients with malignant neoplasms, provision of palliative care in terminal stages of the disease.The task for public health system – formation of a motivated responsible attitude to personal health and adherence to targeted oncological preventive examinations among the population.Conclusions. The application of the proposed conceptual and methodological approaches will give possibility to develop an optimized functional-and-organizational system of medical care for patients with malignant neoplasms at the regional level to provide the population with affordable and high-quality oncological care.