Potseluev V. Substantiation study of system of monitoring the quality and accessibility of health care in the institutions of family medicine (by way of example the rural population of the Sumy region).

The dissertation is devoted to theoretical generalization and a new practical solution of the problem of the scientific assessment of changes accessibility, the resources, the scope and quality of primary health care (PHC) by monitoring approaches. It has been proved that the quality enhancement was due to: staffing diagnostic equipment (p<0,05), increasing the number and capacity of day hospital institutions (p < 0,05), improving the geographical and territorial availability (p<0,05) the normalization of the total population in the family doctors areas. It is shown that the amount of care in family medicine clinics (FMC) at the stages of the quality monitoring was characterized by a significant decreasing of calls for home care to patients with chronic diseases (p<0,05) and to children (p<0,05), a reducing the number of admissions to level 2 hospitals (from 8,2±0,4 to 6,9±0,4 per 100 inhabitants), and an increasing the number of medical consulting (p<0,001; mainly due to complaints of childhood inhabitants). The monitoring the quality of primary health care methodology has the further development and practical implementation of specific organizational and technological content. The components of this methodology are: the qualimetric assessment of the availability and resource support institutions, the dynamic analysis of the volume of preventive, diagnostic and therapeutic activities, and qualimetrical efficacy analysis.