大都市健康保障体系:创新发展的方向与途径

O. Korniychuk
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摘要

本文提出了大都市卫生保健系统任务的构建、创新方向和解决途径。它们的目标应该是克服在获得治疗方面的严重不平等,主要是针对社会中易受伤害的阶层。这应以确保提供有效和高质量的医疗服务和减少家庭保健服务费用为基础,主要是通过培养高素质的家庭医生。根据他们的身份,他们将有能力在病人身体出现危机状态之前发现疾病的早期迹象。一种创新机制是实施分权改革,将提供初级医疗服务的责任移交给社区,将提供二级医疗服务的责任移交给新建的地区,将提供三级医疗服务的责任移交给地区的大学诊所。在分权进程完成后,城市医疗保健系统的发展将得到有力的推动。这将要求城市当局和地方自治机构在三个城市重力区(第一个区域-最多15公里)实施协调一致的行动。第二段可达60公里。第三段(最长300公里)。乌克兰活跃的大都市包括基辅、哈尔科夫、敖德萨、第聂伯罗、利沃夫。开创性的步骤应该是使家庭医生与狭义专科医生之间、医生与护士之间的关系人性化,给予后者自主提供医疗服务的地位,医务人员与病人之间的关系建立在知情对话的基础上,实行预防保健和传统医学的优先地位,确保制药业进行系统性改革,生产非专利药品,并采用生物医学。改革大都市地区和整个乌克兰的卫生保健系统应以现代专家发展、国内外管理人员、经济学家以及科学和实践医学界为基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
THE HEALTH PROTECTION SYSTEM OF THE METROPOLIS: DIRECTIONS AND WAYS OF INNOVATIVE DEVELOPMENT
In the article, the structuring of the system tasks of the metropolis's health care, innovative directions and ways to solve them is carried out. Their goal should be to overcome the critical inequality in access to treatment, primarily for the socially vulnerable sections of society. This should be based on ensuring the provision of effective and high-quality medical services and reducing the costs of health care services on the part of households, primarily through the institute of highly qualified family doctors. According to their status, they will have the ability to detect early signs of diseases before the onset of a crisis state of the patient's body. An innovative mechanism is the implementation of the decentralization reform with the transfer of responsibility for the provision of primary medical care to the community, secondary medical care to newly created districts, and tertiary medical care to university clinics in the region The development of the metropolitan healthcare system will receive a powerful boost after the decentralization process is completed. This will require the regulatory implementation of coordinated actions by the metropolitan authorities and local self-government bodies in three metropolitan gravity zones (the first zone – up to 15 km., the second – up to 60 km., and the third – up to 300 km.). The active metropolises in Ukraine include mm. Kyiv, Kharkiv, Odesa, Dnipro, Lviv. Pioneering steps should be the humanization of relations between family doctors and narrow specialists, between doctors and nurses, with the granting of the latter the status of autonomous providers of medical services, between medical personnel and patients based on an informed dialogue, the introduction of the priority of preventive care, traditional medicine, ensuring systemic changes in pharmaceutical industry for the production of generics and the introduction of biomedicine. Reforming the health care system in metropolitan areas and in Ukraine as a whole should be based on modern expert developments, domestic and foreign managers, economists, and the scientific and practicing medical community.
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