MS Power Point

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Organizational Model of the Primary Medical Care Center

Partnership between

Odessa (Ukraine) – Boulder (U.S.A.)

Presented by V.V. Bespoyasnaya V.V.

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Partnership Objective:

The objective of the Odessa-Boulder partnership for 2001 is to develop the major components of the integrated

Primary Medical Care System (PMCS) based on the principals of family

medicine, including introduction of prevention programs and new

technologies in psychosomatic medicine

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Population Number of families Number of people in the population

Total Children

Student families (Family and Youth

Board)

50 150 50

Disadvantaged families

10 20 -

Families residing in the vicinity of the Center

100 350 85

Families of personnel of the Family Health Scientific Research

Center

50 175 61

Families of port workers

30 105 22

Total 240 800 218

Principal Characteristics of the Populations Served by the Primary Medical Care Center

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Date the Center opened and began to operate:May 31, 2000Organizational Structure

Type of facility Designation Number of rooms

Offices of physicians and nurses

Examination room,

Nurse’s room

6

1

Clinical-diagnostic unit X-ray room

Laboratory

2

1

Auxiliary rooms Registration

Break room

Laundry

Rest rooms

1

1

1

2

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Principal members of the Primary Medical Care Center Staff

Manning table (planned –12.5 positions, currently occupied – 6.0)

Position Title Planned number Actual number on 01/01/2001

Family physician 2 1

Assistant to the department of family medicine

2 1

Radiologists 0,5 -

Nurse manager 1 1

Family nurse 5 2

X-ray and lab technician 1 -

Nurse’s aid 1 1

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primary disease prevention services to the public (screening)

clinical work

preventive measures

funding

integration with other subdivisions of primary medical care

Work Priorities

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Work Priorities (Continue)Primary prevention (screening)

Risk assessment Patient history

Objective assessment

Reservometry (examination protocol)

Rating and possibility of follow up monitoring of preventive and therapeutic measures

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Work Priorities (Continue)Clinical Work

Development of standards for evaluation the quality of medical care

Enhancement of the role of nursesAdoption of new medical technologies

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Work Priorities (Continue) Preventative Measures

Clinic’s first priority – issues of reproductive health

Prevention of early pregnancy and STD and HIV-infections

Decrease of smoking rateDevelopment of a tuberculosis prevention

model

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Prevention programs to be implemented for high-priority issues and supported by the Information Processing and Analysis Center for Work with the PublicMain principle of funding for prophylactic programs: whatever resources remain after treatment programs shall be used to improve public healthIn the future, we plan to establish an Information and Health Maintenance Center to implement this principle

Work Priorities (Continue)Preventative Measures

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ФИНАНСИРОВАНИЕFinancing methods used by our Research Institute in the Past:

Most promising methods under the new PMCS model

Cash

Agreements with employers

Medical insurance and loans

Charitable funds

Funded scientific-research projects

Instructional activity

Investments

Government funding

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Funding of Family Medical Center

Companies Payment at time of service

Medical insurance Charitable medical services

Subscription fees

At time of service

(not involving cash)

Cash Voluntary medical insurance

Credit union

Disadvantaged

Students

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INTEGRATION OF PRIMARY MEDICAL CARE CENTER

Consulting polyclinic

Research Institute of the Public Health

Center

Laboratory-diagnostic division

Family medicine clinic

Multi specialty daytime

inpatient clinic

Family dentistry

clinic

Poison control center

Hospice Information processing and analysis center

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FAMILY DENTISTRY CLINIC Serves all members of the familyInteracts closely with the family medicine

clinicEmphasis on preventive careTreats patients at home

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POISON CONTROL CENTER

Information and consulting aid To the public To companies To medical institutions

Coordination of the activities of medical facilities providing emergency aidStudy of the causes of poisoning in the regionInformation support to the analytic center for developing preventive programs

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HOSPICE Coordination of the activities of social, medical, and

municipal services, public service organizations and volunteers

Care of incurably ill at home Provision of necessary equipment and supplies Inpatient care

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INFORMATION PROCESSING AND ANALYTIC CENTER

Analysis of indicators of health status and morbidity in the region

Identification of the highest priority medical problems

Development of therapeutic and preventive programs

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ISSUES IN SETTING UP A PRIMARY

MEDICAL CARE CENTER: ADMINISTRATIVE TECHNOLOGICAL ECONOMIC -need to change the traditional territorial principle of health care to which the directors of medical care facilities and the public are used to-limited possibilities in expert assessment of fitness to work-inadequate level of personnel training-lack of standardized accounting and reporting documentation-lack of an algorithm for interacting with other health care and maintenance facilities

-lack of indicators and parameters for evaluating the health of family members-primary prevention technologies-inadequate level of knowledge on primary prevention technologies-inadequate knowledge of related specialties-no criteria for assessing quality of performance

-no government funding-lack of mechanism for attracting other sources of funding-no mechanisms for including insured medical care

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PERIODIC ASSESSMENT OF CENTER’S PRIORITIES

Evaluation of the needs of the population served (Based on results of a sociological survey conducted in January, 2000)

30% of the population of Odessa experience difficulties obtaining adequate medical care20% of the population evaluates the existing health care system positively48% of the members population evaluate their own health as satisfactory17% as poor5% as very poor

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PERIODIC ASSESSMENT OF CENTER WORK PRIORITIES (continued)

Current priorities (revision of the model) and prediction of the way the Center’s activities will develop

Intensified work to prevent poisoning and accidents Help of public service organizations to recruit the public into the

healthy lifestyle movement Development of an infrastructure for working with the public Improvement of methods for observation of patients according to

the principles of risk assessment and reservometry Improvement of interactions with Health Care and Maintenance

Organizations Improvement of mechanisms for funding and economic support of

the Center

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USE OF EVALUATION METHODOLOGIES

Social marketing to study public opinion in the area of health care

Conducting patients’ surveys on the quality of the medical services they received

Incorporation of quality standards for provision of medical care

Medical cost effectiveness of the work of various primary medical care subdivisions

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Continued development of the concepts for primary medical care based on specific strengths of our partnership programPlan for implementing this model in other regionsImprove the multi-specialty approach to primary careStrengthen the role of nurses

PLANS TO DEVELOP THE PRIMARY

MEDICAL CARE MODEL

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PLANS TO DEVELOP THE PRIMARY

MEDICAL CARE MODEL (continued)

Continuation of work on clinical standards for primary medical care

Development of programs to train medical personnel in primary care

Development of strategies to ensure stable functioning of the program

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PRINCIPAL COMPONENTS OF THE PROGRAM STABILITY STRATEGY

Financial stabilitySocial stabilityAdministrative stabilityTechnical stability