Assessment of the effectiveness of measures to improve the patient routing system in the provision of planned medical care (experience of Tomsk region)

Abstract

Introduction. This article reviews the results of the development and implementation of organizational solutions aimed at reducing the time of providing routine medical care to patients in outpatient settings and increasing its availability. Among the reasons negatively affecting the waiting times for medical care are complex routing schemes and the high level of administrative overhead that accompanies each stage of the treatment and diagnostic process.Aim: To develop and evaluate the effectiveness of measures to improve the system of organization of planned medical care on the example of medical organizations of Tomsk region.Material and Methods. The study included medical organizations providing primary health care in outpatient settings (31 institutions). The study was conducted in stages: 2018–2019 the main set of measures (creation of offices of the organization of planned care) was developed and implemented, 2020–2021 – summarized interim results, 2022 – performance assessment was carried out. For comparative analysis all medical organizations were divided into 2 groups (group A and group B) depending on implementation of planned activities. Statistical processing was performed using the Statistica 10.0.228.8 software package.Results. It was found that the waiting time for a doctor’s consultation Group A reduced by 5.5% (p = 0.025) in 2019 compared with 2018, in contrast to Group B. The waiting time for a routine diagnostic examination in Group A also reduced by 16.6% in 2019 compared to 2018 (p = 0.041), while no differences were found between waiting times for routine diagnosis in Group B for the same period (p = 0.101).Summary. The study has shown that the problems of accessibility of planned medical care can be effectively solved through the creation of a patient flow management system at all stages of the treatment and diagnostic process.