Chereshnyuk G. S., Pylypchuk V. L., Krekoten O. M., Tarasyuk M. B., Grabovych L. O.

CONTENTS

Scentific article

This paper presents an in-depth analysis of the activities of primary health care (PHC) centers from the reform starting in one of the pilot regions – the city of Vinnytsia. The objective of the article is to cover positive and negative aspects and to show the problems arising on reforming of the medical branch, its primary level in particular. The article is based on a large number of works of the Public Health Department of Vinnytsia City Council, scientists of the Department of Social Medicine and Health Care Organization of Vinnytsia National Pirogov Memorial Medical University, including the personal experience of one of the authors in family medicine management, abroad as well. At present at the beginning of the 21 century the state of the population health in the countries of the Former Soviet Union is much worse than in the European countries. The Soviet public health protection should have been adapted to the market conditions as far back as 23 years ago when our country chose the other way of development different from the socialist one. Nowadays the resources of Ukraine are extremely exhausted that’s why the deliberation of decisions directed at implementation of the first stage of the reforms (Law of Ukraine No. 3612-VI of 07. 07. 11), setting up of PHC centers, personnel training for family medicine management is especially urgent. Implementing the reforms the authors point out achievements and especially unsettled problems. Public health institutions subject to reforming in Vinnytsia constituted the subject of the research. The main achievements included: training of the key personnel of PHC centers for management of general practice – family medicine (GP-FM), extra training of GP-FM doctors of the city at the specially organized off-site training, establishment of the insurance company “Misto” principally meant for continuous health insurance. The common project of the city of Vinnytsia, the state of Israel and Poroshenko’s Fund for building of a modern self-sustained city diagnostic center has been successfully implemented. At the same time consultative-diagnostic divisions at multifield hospitals have been opened. Specialized cars, computers, furniture and equipment for PHC centers have been received. The authors think that the main problem is non-compliance of PHC centers and possibilities of their financing, quick opening of outpatient clinics in the city, imperfect order of the Ministry of Public Health of Ukraine concerning temporary staff standards of PHC centers where there are no laboratory assistants, including X-ray laboratory assistants, day hospital doctors, assistant nurses and others. There are problems of dividing streams of adults and children, pregnant and other women in PHC centers created on the basis of the existing polyclinics. Transfer of institutions of the second level to the regional budget according to the regulatory documents will lead to the process uncontrollability and deterioration of the quality of medical services provided to the population. The article presents proposals for improvement of the situation.

reforming of the medical branch, PHC centers, outpatient clinics of general practice-family medi- cine, high quality medical care

• Закон України №3611-VI «Про внесення змін до основ законодавства України про охорону здоров’я щодо удоскона- лення надання медичної допомоги», м. Київ, 7, 2011.
• Закон  України  №3612-VI  «Про  порядок  проведення  реформування  системи  охорони  здоров’я  у  Вінницькій, Дніпропетровській, Донецькій областях та місті Києві», м. Київ, 2011 р.
• Наказ МОЗ України №384 від 29. 06. 2011 р. «Про затвердження Примірного статуту Центру первинної медико- санітарної допомоги».
• Наказ МОЗ України №645 від 05. 10. 2011 р. «Примірні штатні нормативи центру первинної медико-санітарної допо- моги у Вінницькій, Дніпропетровській, Донецькій областях та місті Києві».

«Bulletin of problems biology and medicine» Issue 3 part 1 (110), 2014 year, 375-380 pages, index UDK 614. 2:338