Horokh V. Medico-social substantiation of optimization of the model of medical care for the adult population of the agricultural region with diseases of blood and blood-forming organs.

The dissertation focuses on the solution of an important scientific and practical problem - scientific substantiation and development of optimization of the model of medical care for the adult population of the agricultural region with blood and blood-forming organs diseases within the framework of reforming the medical care system. A comprehensive socio-hygienic study proved the inconsistency of the current situation with providing medical care to the population with diseases of blood and blood-forming organs in the agricultural region to the real needs. The optimized functional and organizational model of medical care for the population of the agricultural region with diseases of blood and blood-forming organs, which is patient-oriented, is substantiated and developed. The strategic direction of the substantiated and developed optimized model is to improve the quality, efficiency and accessibility of medical care for diseases of blood and blood-forming organs through the implementation of management and organizational measures, and the tactical direction was the structuring of hematological medical care by stages and levels: primary, specialized and highly specialized in developing mechanisms for professional relations between them. Structurally innovative is the creation of hematological diagnostic and consulting room (one per hospital district) and in-patient specialized hematology department (0.27 beds per 10 thousand of population) on the basis of the intensive care hospital; and the formation of regional highly specialized hematology center with certain consultative, diagnostic, medical, organizational and methodic functions with the inclusion of family doctors into the system of primary care on the basis of the regional clinical hospital. The proposed model was positively evaluated by experts (9.26 ± 0.42 points) and recommended for implementation in the health care system of Ukraine in the process of reforming the sphere.