Promising models of the organization of general medical practices in a city

Abstract

Aim. To propose promising organizational and functional models of general medical practices in a city with the expansion of the functions of paramedical personnel. Methods. Analysis of the forms data of federal statistical observation in Russia and its subjects was carried out. The following research methods were used: content analysis, statistical method, direct observation, sociological method (questionnaire), functional organizational modelling. Results. The indicators of availability of general practitioners (family doctors) and nurses of a general practitioner in Russia and its subjects are presented. The main reasons for inhibiting the introduction of the institute of general medical practice in a city are revealed. The actual model of general medical practice in a medical organization is presented, that provides outpatient medical care, as well as prospective models of general medical practices, focused on the rational use of resources, including specialists with secondary-level medical education in accordance with their level of professional competence. Different variants of perspective models are discussed for general medical practice in the conditions of city policlinics serving the adult population and distinguished by the forms of work; (1) an independent appointment for patients with the general practitioner’s nurse is organized; (2) preliminary appointment for patients with general practitioner’s nurse together with a general practitioner; (3) independent, before-doctor appointment for patients with a medical assistant and a nurse of a general practitioner; (4) a complex team of general practice can include a medical register. Conclusion. The proposals on improving the organizational bases for the activities of general medical practices in a city were developed.