Bezugla O. Medical and social justification of the improved health care model amongst the railway employees.

The thesis is devoted to the scientific substantiation, development and implementation of an improved health care model of the railway employees in the following areas: health financing, health care management, assessment of professional competence, and the implementation of medical care. The study found that such important economic events as the professional competence loss and hospitalization are the reliable effects of the prolonged morbidity. It is proved that the total duration of the incidence of temporary disability was 40 or more days per year prior to the recognition of the loss of life which has caused a significant increase in the risk of the professional competence loss in 71% of p = 0.008. Also, it was found that the presence of long-term (40 days or more) incidence of temporary disability railroad has significantly (p <0.0001) increased the frequency of hospitalizations at 94.2%; almost doubled it. Justification of the improved health care model of the railroad was conducted precisely in terms of the reduction of the disease duration of a temporary disability and hospitalization. The risk of hospitalization as a consequence of an improved health care model of the railway employees on average was decreased by 38%, providing an average of 3.7 months in addition to the next hospitalization. This result confirms more effective health services since the first year of the experiment. Comprehensive studies have established the inadequacy of the existing health care system of the railway employees, where one may observe high levels of the professional competence loss (almost 40% of the retirement age), a distorted structure of morbidity with the temporary disability when most of the cases are retained in hospitals, lack of financing with a significant distortion of the supply and demand concealing health disorders, and low confidence in the Ukrainian railway medical services. Certainly findings make an important scientific study, causing the development and implementation of the improved health care model of the railway employees, and bringing the medical, social and economic efficiency.