ALGORITHM FOR IMPLEMENTATION OF ORGANIZATIONAL AND ECONOMICAL PREREQUISITES FOR EVIDENCE-BASED SCREENING AND THERAPEUTIC MANAGEMENT WITHIN THE HEALTH CARE FACILITIES OF THREE LEVELS
DOI:
https://doi.org/10.11603/1681-2786.2019.1.10281Keywords:
evidence-based screening, diagnostic-conjugated groups, degrees of complexity of diseases and surgical interventions, cost of labor costs of a doctor, treatment costs, computer programAbstract
Purpose: to present an organizational algorithm for evidence-based screening and treatment management using the otorhinolaryngological medical service as an example.
Materials and Methods. Using the methods of structural-logical analysis and target prognosis, the proposals on the technology of implementing evidence-based screening in the process of secondary prevention and treatment management are presented on the basis of a retrospective analysis of a significant number of case histories and outpatient otorhinolaryngological patients' cards of Kirovohrad Regional Hospital for 10 years.
Results. In order to improve the quality of improvement of health of residents of the family doctor area, the article proposes an algorithm for the organizational option for the implementation of evidence-based screening in the implementation of secondary prevention, such as the "gold standard" of the American working group of preventive measures, as well as the mechanism for determining the real cost of treating diseases of various degrees of complexity in the process of medical management on the route of the patient from the ambulatory of family medicine to secondary and tertiary health care level institutions of medical district.
Conclusions. The execution of the questionnaire-anamnestic section of evidence-based screening by the patronage nurse will ensure the formation of a "risk group" of diseases with obvious economic effect. The technology of calculating the cost of labor costs for doctors and the cost of treatment for diseases will facilitate the possibility of reasonable planning of real financial needs for the improvement of residents of the family doctor’s area. In order to release physicians from numerous calculations of the cost of treatment for each disease, it is necessary to create appropriate computer programs for health facilities of three levels of the medical district.
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