The justice as key principle of humanitarian model of quality management of health care system from position of sociology of medicine

Abstract

The problem of detection, measurement, evaluation and elimination of inequity and injustice related to health continues to be unresolved in all countries. The study was carried out to evaluate situation related to quality of medical care in primary health care at the regional level and to determine means of its amelioration on the basis of humanitarian model of system of quality management from positions of sociology of medicine. The materials of territorial foundation of mandatory medical insurance of the Chelyabinskaia oblast were taken as basis for analysis. The sampling consisted of 54 383 acts of expertise of quality of medical care, including 42 998 expertises of medical care provided by pediatricians and 61 860 by therapists. The design related to type of clinical audit of medical documentation of completed case in polyclinic practice. The significant differences were established concerning rate of defects of quality of medical care in oblast centers, large cities, towns ans rural regions. The phenomenon of sub-optimization of quality of medical care in towns, and rural districts during period of financing increase of health care is established. The results of study testify availability of injustice in issues of health care of population residing in unfavorable social economic conditions. To support justice related to health the concept of humanitarian model of system of management of quality from positions of sociology of medicine was developed.