Stepchuk M.A.
Medical Information and Analytical Center, Belgorod.

Contacts: Mikhail Stepchuk, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Abstract. The purpose of this review is to study transition of outpatient care and prospective lines of its development.

Main objectives: to evaluate organization of the outpatient care in Russia and abroad; to identify its strengths and reason of its inefficiency. To achieve this goal the author analyzed scientific literature from available sources.

Historical insight into developmental milestones of the outpatient care in Russia showed that outpatient care evolved along with the healthcare. In pre-revolution Russia, the fee-for-service medicine was replaced by county (zemsky) and city (urban) medicine, while in the European countries it was replaced by the solidarity model with free care delivery to the poor and low-income citizens. Medical insurance failed to tighten growth of expenses in the developed countries and as well as solve backlog problems in Russia that were caused by residual principle of healthcare funding and the use of administrative management methods.

Implementation of targeted projects and programs over the last decade had a beneficial effect on some health indicators and development of outpatient care. Current modernization of the Russian healthcare was stated as priority for the next few years. Regional modernization programs have been developed and implemented. At the same time healthcare management and medical society are yet to elaborate a unified position related to modernization, its aims, objectives and approaches towards developing and shaping the modern system of health care and health promotion.

We suppose that modernization is not just strengthening and renovating infrastructure and sound financial management but also system changes in healthcare that are expected to improve its performance even under the conditions of financial and economic crisis.

Performance effectiveness should be achieved through introducing modern organizational, managerial and clinical technologies and methods, latest scientific and technical achievements, and improving primary care – the principal element of healthcare system and the most available type of care assuring its quality and efficiency. Primary care is an integral part of the whole process of social and economic development of the society.

Therefore, this review is relevant and suggests the need for detailed elaboration of the stated goal of outpatient care improvement and healthcare system modernization in general.

Keywords: outpatient care; primary care; patronage.

References

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