医疗行业改革条件下初级医疗服务的可及性水平:一种营销方法

Vasyl Matviyev
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引用次数: 0

摘要

卫生保健系统的初级医疗保健环节的改革成为乌克兰卫生保健系统变化的一个指标。考虑到医疗制度的主要环节是作为优先事项进行改革的,因此人民的反馈,即人民对获得高质量医疗服务的评估是很重要的,这将有助于确定改革的后果和前景。本文对2018-2020年医疗服务的质量、财政和地域或时间可获得性这三个基本医疗服务可获得性标准(水平)的动态进行了营销分析,从而可以根据对初级医疗保健受访者单位的调查,找出积极和消极的发展趋势。特别值得一提的是,在这一特定时期,医疗服务的质量有提高的普遍趋势,但与此同时,确保医疗服务的财政、领土或时间供应的水平却不足。对答复者关于质量标准、财政和地域或时间可用性等主要指标的意见进行市场分析,使人们能够更客观地评估初级医疗保健环节改革的后果。受访者认为,医疗服务质量的提高主要是由于医务人员、医生对病人态度的改善和提供医疗服务的物质条件的改善,实际上可以用建立"医患"互动的社会心理因素和医疗机构财务独立的积极影响来解释。在调查中,购买药品和接受有效治疗的能力指标表明,医疗服务的财政可获得性在不断提高,这一积极趋势是由于"负担得起的药品"方案的实际实施,(根据与国家卫生服务机构签订的合同)提供了大量免费医疗服务,以及对额外医疗服务实行了最优定价政策。最后,医疗服务的地区或时间可得性标准得到了广泛的评价(答复者的评价从积极到消极),这一方面证明了病人选择医生的时间可得性和机会增加带来的积极后果,另一方面表明了初级保健设施在地区方便安置的问题尚未解决。特别是在农村地区网络减少的情况下。我们考虑为初级和二级专业保健机构制定切实可行的建议,以改善医疗服务的质量、财政和地域或时间可得性等个别指标,作为研究这一问题的一个角度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
LEVELS OF ACCESSIBILITY OF PRIMARY MEDICAL SERVICES IN THE CONDITIONS OF THE REFORM OF THE MEDICAL INDUSTRY: A MARKETING APPROACH
The reform of the primary medical care link of the health care system became an indicator of changes in the health care system of Ukraine. Considering the fact that the primary link of the medical system was reformed as a priority, the feedback of the population, its assessment of the availability of quality medical care, is important, which will allow determining the consequences and prospects of the reform. The marketing analysis conducted in the article of such three criteria (levels) of the availability of primary medical care services as quality, financial and territorial or temporal availability of medical services in their dynamics for 2018-2020 made it possible to find out positive and negative development trends based on surveys of respondents units of primary medical care. In particular, it was established that during the specified period there is a general tendency to improve the quality of medical services, combined at the same time with an insufficient level of ensuring their financial and territorial or temporal availability. The marketing analysis of the respondents' opinions regarding the main indicators of quality criteria, financial and territorial or time availability made it possible to more objectively assess the consequences of the reform of the primary medical care link. The increase in the quality of medical services, which respondents attributed mainly to the improvement of the attitude of medical staff doctors to patients and the material conditions for the provision of medical services, is actually explained by the socio-psychological factors of the establishment of the "doctor-patient" interaction and the positive effect of the financial independence of medical institutions. The positive trend of increasing the financial availability of medical services, expressed in the survey by indicators of the ability to purchase drugs and receive effective treatment, is due to the practical implementation of the "Affordable Medicines" program, the availability of a significant range of free medical services (under the contract with the National Health Service) and the optimal pricing policy for additional medical services. In the end, the criterion of territorial or temporal availability of medical services, having received a wide range of evaluations (from positive to negative among respondents, testifies, on the one hand, to the positive consequences of the increase in temporal availability and opportunities for patients to choose a doctor, and on the other hand, it demonstrates the unresolved issue of territorial convenience placement of primary care facilities, especially in the conditions of reduction of their network in rural areas. We consider the development of practical recommendations for primary and secondary specialized health care institutions to improve individual indicators of quality, financial and territorial or temporal availability of medical services as a perspective for the study of the problem.
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