Orlova N. Medical-social grounds of restructuring the network of outpatient clinics in accordance with medical-demographical features of Ukrainian regions

Dissertation is devoted to the scientific ground of conceptual directions and methodology of restructuring the network of outpatient clinics in accordance with medical-demographical features of Ukrainian regions and modern economic methods of management. The existing imperfect regional ambulatory care systems, local features of health state and social structure of population were determined by this complex medical-social investigation. The conceptual directions and methodology of restructuring the network of outpatient clinics for regional population on the basis of varied modeling of out-patients clinics were scientifically grounded in accordance with medical-demographical features of regions. Special attention was paid to structural differentiation of ambulatory service with picking out functionally intercommunicated, legally and economically independent structures and forming of regional programmers guaranteed ambulatory care to the population. Two level model of ambulatory care was worked out, the main features of which is the adaptation to specific regional conditions and providing the new methods of approach to management of medical services and financial resources. The first level of model is the basic out-patients center of district population service which provides the available, qualified primary health care to families on team-based approach to functioning doctors of five basic specialties on which falls up to 70% of ambulatory calls. The second level - provides consultative ambulatory care for population by specialists. The expert estimation of the suggested model testified its prognosis efficiency and expediency of usage in the regions of Ukraine. Key words: restructuring, ambulatory care, medical-demographical peculiarities, regions of Ukraine.