DOI: 10.21045/2071-5021-2017-56-4-4

Ivaninskiy O.I.
Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk

Contacts: Oleg I. Ivaninskiy, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Abstract

Background. Healthcare Development Strategy within the context of integrated medical and social care to population requires improved performance of its primary level of care delivery focused among other things on continuity of emergent, first and urgent care.

Purpose of the study. To substantiate priorities for optimizing organizational and methodological approaches to development of the territorial logistic model system for urgent care delivery to the rural population on the basis of territorial and transport zoning.

Methods: statistical, cartographic, sociological, expert methods, situational analysis and organizational modeling.

Results. Optimization model system for providing urgent care to the rural population includes: priorities for optimizing urgent care delivery to rural population; structural re-organization; implementation of regional target programs and healthcare modernization program; monitoring performance of the system of urgent care delivery. On the basis of the territorial matrix a medical zoning was undertaken to identify the best locations for urgent care centers. Analysis of transport accessibility between regional centers of the Novosibirsk region helped to develop territorial logistic model of urgent care delivery.

Discussion. Despite a sufficient deal of attention to organization of urgent care delivery, there is a lack of comprehensive studies on the performance analysis of urgent care delivery as a comprehensive care to the rural population.

Conclusions. 1. Optimization model system for providing urgent care to the rural population at the regional level includes priorities for optimization; structural reorganization; implementation of regional target programs and healthcare optimization programs; and performance monitoring.

2. Implementation of priorities for optimizing urgent care delivery to rural population includes the following: advanced training of care providers; timely care delivery and patient transportation; development of standards and protocols for urgent care delivery; development of telecommunication system of urgent medicine; development of the system of self and mutual assistance to patients in urgent conditions; cooperation with other regional services.

3. Structural reorganization of the system of urgent care delivery to the rural population at the regional level involves creation of: emergency care facilities in rural areas; interregional and regional specialized centers to provide urgent care at the regional hospitals and federal centers, development and implementation of regional target programs.

4. Organizational and methodological approaches to develop the territorial logistic model of the system of urgent care delivery to rural population on the basis of territorial and transport zoning include the following: identification of the remote rural settlements for a special procedure for emergent and first care; development of the inter-regional center of urgent care.

5. Implementation of the optimization model showed its efficiency.

Keywords. Urgent medical care; optimization model; territorial and logistic model; rural population.

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