Khunov Y. Scientific grounding of the reforms' directions with optimization of Public Health System (PHS) available resources and their implementation in the present-day economies conditions at the regional level

The dissertation on receiving of a scientific degree of the Doctor of Medicine (D.M.) on the speciality 14.02.03 - Social Medicine. The National Medical University named after Acad. O.O.Bogomolets of Ukrainian Ministry of Health, Kyiv, 2003. It concerns substantiation of rationale of the PHS development programmes at the regional level. It presents some special features and tendencies of medical-and-demographic situation in the chosen region and health status of different social groups, its dependence on effects of the whole complex of factors (ecological, professional, medical and behavioral). It also gives prognosis to the number of medical and demographic indices trends to perspectives in the region. The volume and nature of treatment and prophylactic care provision for population of the region, their quality and accessibility to different social sections have been also examined as well as factors of their formation. The effectiveness of such progressive forms of medical aid and care as primary health care (PHC) on practice provided on the basis of family medicine, the stationary-replacement forms of hospitalization the mobil (going-out) treatment-diagnostics' teams has been proved. The prognostic requirements to medical personnel and its composition for the regional PHS has been calculated as well as measures for its professional advancement. Some reserves to increase the effectiveness of the regional PHS management have been revealed as well as improvement of its resources supply by introduction of the multi-channel financing scheme. The conceptual approaches towards formation of regionally based policy in the PHS have been substantiated. The principles of introduction of strategically-oriented and target-program planning in the PHS have been proved to be very effective in medical, economical and social terms. The comprehensive program of the regional PHS development has been drawn up based on wide-ranged partnership and multi-sectoral cooperation in its implementation.