ЗНАЧИМОСТЬ СТЕПЕНИ КОМПЛАЕНСА КАК СОЦИАЛЬНОЙ ХАРАКТЕРИСТИКИ ПАЦИЕНТА В ФОРМИРОВАНИИ ЕГО ОТНОШЕНИЯ К ОРГАНИЗАЦИИ МЕДИЦИНСКОЙ ПОМОЩИ, ОКАЗЫВАЕМОЙ В АМБУЛАТОРНЫХ УСЛОВИЯХ

Abstract

Until now, the degree of compliance or adherence to treatment has been considered only in the context of determining and correcting a clinical approach to the patient or, in a few studies, as a determinant of public health. Another, unrelated at first glance, to this is the problem of assessing performance quality of medical organizations. The prevailing practice in such assessment is the correlation of certain elements of performance of a medical organization and the performance standard, as a rule, outlined in regulatory documents. In this case, there is an approach to consider the patient as a passive object, rather than an active object of relations between them and medical organizations. However, if we are to consider the patient as an active object, then a more positive attitude of the patient, in accordance with the presented logic, should be expressed in higher performance evaluation of the medical organization and healthcare system in general. A more positive attitude of the patient can manifest itself in the degree of their compliance or adherence to treatment. The available literature shows that significance of compliance as a social characteristic of the patient for developing an attitude to the organization of medical care delivery is hardly covered. The purpose of the study was: to analyze significance of the degree of compliance as a social characteristic of the patients in the formation of their attitudes towards the organization of medical care provided in outpatient settings. Material and methods. The primary data were obtained through interviewing 502 patients of medical organizations in Moscow that provide medical care in outpatient settings. The first (main) group included patients with a high level of compliance – 197 patients. The second group (the first control group) included patients with a low level of compliance – 131 patients. The third group (unspecified compliance level) included 171 patients. Results. With a high degree of compliance, the patients are more loyal to the activities of the medical organization and the city (district) administration related to the organization of medical care compared to patients with a low degree of compliance. They differentiate the performance of a medical organization and more critically evaluate the work of the administration rather than the medical organization. Patients with a low degree of compliance do not carry out such a differentiation and give equally low ratings to the performance of both the medical organization and state and municipal authorities (administration). A decrease in the degree of patient compliance is combined with more frequent complaints about the organization of work of narrow specialists, the registry and management of the medical organization. More compliant patients had fewer complaints about work organization of all departments in the polyclinic. Most often such claims were related to work organization of narrow specialists and management of the polyclinic. Conclusion. With a high degree of compliance, patients are more loyal to the work of the medical organization and city (district) administration in terms of medical care organization rather than patients with a low degree of compliance. They differentiate performance of medical organizations and evaluate the work of the administration more critically rather than a medical organization. Patients with a low degree of compliance do not carry out such differentiation and give equally low ratings to the work of both the medical organization and state or municipal authorities (administration).