The dissertation is devoted to the solution of the current problem of domestic social medicine - the preservation and restoration of oral health of the population. For this purpose, the functional-organizational model of the dental care quality management system was developed. The author investigated the regional features of the incidence and prevalence of oral cavity diseases, the needs of the population for dental care and management approaches to their satisfaction. Regulatory, organizational, structural, technological, informational, and motivational inconsistencies were found in the existing quality management system.
It has been proven that the limitations of the legal regulation of oral health preservation, the non-completion of the reform of health care, the imbalance in the distribution of human resources between primary, secondary and tertiary medical care, the inconsistency of licensing requirements and accreditation standards and the requirements of the standard for quality management systems, the universal nature and insufficient the methodical security of this standard, the imperfection of the management of the processes of providing dental care, the lack of evidence-based technologies create gaps in the provision of patient-oriented, accessible, continuous, timely, comprehensive dental care and the prevention of dental diseases.
The conceptual functional-organizational model of the dental care quality management system in Ukraine was justified and developed. The main differences of the model are: the strengthening of legislation on the regulation of the influence of common risk factors for general and oral health, the use of national, regional and local programs to strengthen and restore the health of the population. Oral health is a component of these programs. The programs provide with financial coverage of the annual examination of each resident by a dental hygienist or dentist, the provision of high-quality dental care according to the criteria of clinical effectiveness, safety, patient-orientation, based on evidence-based medicine technologies and priority funding of accredited institutions and certified quality management systems.
The model provides for the harmonization of all mechanisms of external quality regulation and improvement of their methodological support: concentration of regulatory requirements in licensing conditions; the presence of requirements for the implementation of medical and diagnostic technologies and patient safety - in the accreditation standards, the introduction of quality management requirements - in the healthcare-specific version of the national standard for quality management systems.
The author's model of the dental care quality management system is implemented by individual elements at the regulatory level and in health care institutions. The model was highly rated by highly qualified independent experts on a five-point scale: for the social component – 5.0±0.0 points, for the medical component – 4.75±0.44 points, for the economic component – 4.30±0.57 points.
The experts' evaluations confirmed the potential efficiency of the model and allow recommending the further implementation of the model in the sphere of health care of Ukraine.
Keywords: oral health; quality of dental care; standards for the quality management systems; license conditions; accreditation; quality criteria and indicators; patient safety.
