Efficiency evaluation of the implementation of a New medical organization model providing primary healthcare services in medical organizations of the Sverdlovsk region operating in the compulsory medical insurance system

Abstract

Nowadays, creation of a new medical organization model providing primary healthcare services (New Model) is broadly associated with the introduction of lean manufacturing technologies. In the setting of modern healthcare development, the challenge of evaluating the efficiency of the medical organization activities remains primary and unresolved, especially in the context of introduction of new methodological approaches. The article describes the experience of creating and evaluating the efficiency of the New Model implementation in medical organizations of the Sverdlovsk region operating in the compulsory medical insurance system.The purpose of the study. To present the results of evaluating the effectiveness of the implementation of the New Model in medical organizations in the Sverdlovsk region.Research materials. The activities of 79 medical organizations involved in the New Model creation and expansion in the period between 2017 and 2019 were analyzed.Research results. The rate of staff involvement in the medical organizations was examined using an express “Questionnaire Q12” method; herewith 1,489 employees were interviewed in 2018, and 3,640 employees in 2019. The level of patient satisfaction with the medical care quality and availability, the number and amounts of fines/deductions/withdrawals for the outpatient care services collected by insurance medical organizations (IMOs), Territorial Fund of Compulsory Medical Insurance of the Sverdlovsk Region (TFCMI SR) were studied.Conclusion. The New Model implementation increases the level of patient satisfaction with the medical care quality and availability, the number of fines/deductions for the outpatient care services collected by IMOs, TFCMI SR has been decreased. A high staff involvement in the medical organization activities has been observed, however certain activities aimed at satisfying the HR needs and staff motivation need to be developed. It is necessary to continue further evaluation of the efficiency of the New Model implementation in terms of medical, social and economic indicators. Crucial in the New Model implementation is the interaction between TFCMI SR, IMOs, and medical organizations in the provision of primary healthcare services aimed at the assessment of the medical care availability and quality, including patient satisfaction.