The experience of reforming primary health care in conditions of increasing of population average age

Abstract

The article presents the experience of reforming primary health care in Belgorod Oblast in 2016-2019. In the process of reforming, the original organizational model of new interaction pattern "family doctor - patient - family members", was developed and implemented. The measures were taken to strengthen material-technical base and manpower potential of primary medical care. The general practitioners offices were positioned within "step accessibility" for patients. The continuous training of family doctors was organized at the workplace. The unified regional medical information system was developed and implemented enabling corporate conference communications, remote consultations, public feedback and remote arrangement of visits of patients to physician. The differentiated approach to remuneration of medical personnel was implemented using key performance indices that permitted to increase salaries and work quality. As a result of the reforms, the percentage of patients under supervision of family doctors increased up to 13%, the number of medical emergency calls decreased up to 3.3% and the number of calls because of illness decreased up to 17%. The mortality of population older than able-bodied age began to decrease and life expectancy reached relevant 74 years in 2019.