IMPROVEMENT OF THE MEDICAL CARE QUALITY MANAGEMENT MODEL BASED ON THE INTERNAL AUDIT MECHANISM IN THE HEALTHCARE FACILITY

Abstract

Introduction. Internal audit aims to improve the processes and outcomes of medical services by systematically reviewing the components of medical care in terms of certain criteria and implementing changes where the service does not reach the expected level. Severization of requirements for HCF service quality and increasing competition in HCFs require the elaboration and implementation of dynamic continuous internal mechanisms, which will contribute to healthcare quality improvement, professional development of medical personnel, and the increased satisfaction of medical service consumers. Objective: Elaboration of a medical and social internal audit mechanism in order to improve medical care quality at the level of a healthcare facility. Materials and Methods. We used system analysis, meta-analysis, descriptive modeling, medical and sociological survey, statistical analysis, and logical generalization in the study. Data collection methods were: a survey and copying of data from the primary accounting and reporting documents. Results. The study involved 226 patients with chronic noncommunicable diseases who were followed up at Sumy HCFs. The correspondence between the actual data in the outpatient medical records with the protocol’s quality indicators was assessed. Internal audit of the subjects’ satisfaction with medical services showed that they were sufficiently aware of the disease course, complication prevention, and the risks of non-compliance – 97% of patients confirmed that they received detailed information from their physician; however, they did not comply with the doctor's recommendations or complied poorly. Conclusions. We registered subjects’ poor compliance and unsatisfactory attitude towards the follow-up procedure. The development and implementation of the medical and social mechanism of internal audit contributed to the practical adoption of a management decision to ensure the continuous improvement of medical care quality for patients with chronic noncommunicable diseases, namely additional behavioral approaches to increase the level of patients’ compliance with the doctor's recommendations and their active involvement in follow-up control.