Lekhan V. M., Ginsburg V. G., Kryachkova L. V., Borvinko E. V.

CONTENTS

Scentific article

Objective. The scientific bases of the complex measures to modernize secondary (specialized) medi- cal care for improve its efficiency and quality. Materials and methods. The object of study is Dnipropetrovsk health care system secondary level. Materials: re- search publications, European Health for All database; Ukraine statistical information and data expert assessments. Original method was used to assess the structural efficiency of territorial health system. Methods: a systematic method and analysis, statistical method, expert assessments and comparative analysis. Results and discussion. This article describes ways to modernize secondary care in Ukraine. Study and sys- tematization of the existing approaches have shown that the most effective to ensure of equitable needs of the population in specialized medical care are directed at optimizing the interrelated structural, institutional, medical, technological and financial – economic components. It includes: the formation of the network of secondary health care levels to meet the needs of the population’s; optimization of the number of hospitals and hospitals beds; con- centration of intensive care in hospital intensive care; modernization of technical and technological support health care; transition from rationing burden on the grounds capacity to standards based on the scope and complexity; use of modern methods of financing; increase the autonomy of medical institutions; professional development of medical personnel; development and use of systemic measures to motivate medical personnel to intensive and high-quality work. Has been shown that a special place among the components of modernization of secondary care take up con- centration intensive care in hospitals intensive treatment. Research has found a clear pattern: low-power facilities mainly have the specialists, physician’s surgical specialties; anesthesiologists load for such professionals is several times less than the specialists in high schools. When conducting system of measures to modernize secondary health care, we can expect an increase in ef- ficiency. Modernization of maternity care that was in its regionalization by creating strong inter- staffed maternity centers, reflected in improved the maternal mortality rate decreased by 2,3 times over the period 2000-2013 bien- nium, decrease infant mortality and neonatal mortality. Index of structural efficiency, measured in the range from 0 (lowest) to 1 (highest level) and reflects the struc- tural imbalances in the industry in 2012 was the best in the pilot regions (Vinnitsa region – 0,658; Dnepropetrovsk – 0. 644; Donetsk – 0,523) where measures were taken to reduce costs for inpatient care, reducing the number of hospitals beds, reduction volumes of inpatient care, conversion of low-power hospitals. Conclusions. Improving indicators effectiveness maternity care and structural efficiency territorial health sys- tems in the pilot regions proved the efficiency of the package of measures to modernize secondary care has been proposed.

modernization, secondary (specialized) medical care, maternity care, structural efficiency

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