Стратегии новых моделей медицинских организаций в системе первичной медико-санитарной помощи.

Abstract

At present, primary health care is improved by the new models of organisation’s work. All elements of the transformational change process are based on a patient-centered system of medical care that is sustainable in the long term. The urgent problem for outpatient clinics to become improve effectively using a patient-centered approach. The aim of this study was to describe the strategies on patient-centred outcomes used in primary care in Russian regions. Materials and methods. A systematic literature review was conducted in Google Scholar and Elibrary databases using keywords. According to the inclusion criteria, the studies described the experience of implementing new strategies in the Russian primary health care system between 2017 and 2023, resulted in a total of 2874 articles being found. After reviewing the abstracts of the retrieved articles, 211 were retained for further analysis. Another 175 articles were excluded after reading the full text. Results. In this article, we describe a set of priorities strategies related with a new models in primary health care: expanded role of nurses in primary health care, improvement of Ambulatory complementary technologies, use of new organizational structures of medical care, using remote technologies. Findings. The strategies of new organizational models in primary health care are based on the successful experience of reforms. Factors affecting the expansion of strategies to other health care organizations include: teamwork of medical and non-medical professionals, low level of interprofessional collaboration to ensure effective implementation and delivery of patient-centered care, lack of incentives to improve the Ambulatory complementary technologies, patient routing problem for primary health care services, systematization of experience of telemedicine technologies in outpatient practice.