ANALYSIS OF THE OPINIONS OF PRACTICING PHYSICIANS AND HEALTH CARE ORGANIZERS ON CLINICAL AND ORGANIZATIONAL APPROACHES OF PREVENTION OF THE EPIDERMAL DYSPLASIA OF THE SKIN

Oshyvalova O. O., Ziukov O. L.

SOCIAL MEDICINE AND ORGANIZATION OF HEALTHCARE PROTECTION

Scentific article

Studying the opinion of all participants in the treatment and diagnostic process on various aspects of health care is a feedback mechanism that allows us to assess both the level of overall satisfaction with the quality of care and the degree of readiness of medical staff to provide quality medical services. The purpose of the work was to study the opinions of practicing physicians and health care organizers regarding health care at the stages of clinical algorithm of medical care (CAMC) for patients with epidermal dysplasia of the skin (EDS). Methods. An anonymous questionnaire was developed and 19 health care organizers (OS) and 48 practicing physicians were provided to provide medical care to patients with EDS at the State Scientific Institution “Scientific and Practical Centre of Preventive and Clinical Medicine” of the State Administration in accordance with the Local Protocols. Statistical estimate using χ2, Student’s t test. Results. The analysis of satisfaction with medical care at the stages of implementation of the proposed CAMC indicates a high level of assessment of the compliance of staff with the standards of medical care. Practicing physicians and health care organizers expressed unanimous satisfaction with the diagnostic process (67.9%, 65% and 63.2%) and EDS treatment (67.9%, 65% and 63.2%). Among the components of the professional competence of health care providers providing medical care to patients with EDS, the most important practicing physicians and health care organizers noted practical experience (92.9% and 90%). Practicing physicians gave the highest satisfaction rating to the organizational component, “Ability to perform most medical manipulations and procedures” (4.75 ± 0.04 and 4.75 ± 0.09, respectively), “Histological examination” (4.68 ± 0.04 and 4.75 ± 0.09 respectively) and “Required Professional Competency” (4.79 ± 0.04 and 4.7 ± 0.05 respectively). Conclusions. According to practicing physicians and health care organizers, adherence to standards of care, staffing process of diagnosis and treatment of EDS, the organization of medical care in the institution is at a sufficiently high level.

epidermal dysplasia of the skin, clinical algorithm of medical care, importance and satisfaction, practicing physician, health care organizers

1. Oshyvalova O, Ziukov O. Kliniko-orhanizatsiinyi pidkhid do vdoskonalennia profilaktyky epidermalnykh dysplazii shkiry. Klinichna ta profilaktychna medytsynа. 2019;2(8). Dostupno: https://cp-medical.com/index.php/journal/ article/view/58 [in Ukrainian].
2. Marshall M, Shekelle P, Davies H, Smith PC. Public reporting on quality in the United States and the United Kingdom. Health Aff. 2003;22(3):134- 48. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12757278
3. Loeb J. The current state of performance measurement in healthcare. Int J Qual Health Care. 2004;16(1):5-9. Available from: https://www. ncbi.nlm.nih.gov/pubmed /15059982
4. National Healthcare Disparities Report. Rockville, MD: Agency for Healthcare Research and Quality; 2006. [Accessed March 16, 2008]. Available from: http://www.ahrq.gov/qual/nhdr06/nhdr06.htm
5. National Healthcare Quality Report. Rockville, MD: Agency for Healthcare Research and Quality. 2006. [Accessed March 16, 2008]. Available from: http://www.ahrq.gov/qual/nhqr06/nhqr06.htm
6. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press. 2001. р. 164-80.
7. Institute of Medicine. To err is human: building a safer health system. Washington, DC: National Academy Press. 1999.
8. McNally MK, Page MA, Sunderland VB. Failure mode and effects analysis in improving a drug distribution system. Am J Health Syst Pharm. 1997;54:17. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9117805
9. Wallin L, Bostrom AM, Wikblad K, Ewald U. Sustainability in changing clinical practice promotes evidence-based nursing care. J Adv Nurs. 2003;41(5):509-18. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12603576
10. Berwick DM. Developing and testing changes in delivery of care. Ann Intern Med. 1998;128:651-6. Available from: https://www.ncbi.nlm.nih. gov/pubmed/9537939
11. Chassin MR. Quality of Care–part 3: Improving the quality of care. N Engl J Med. 1996:1060-3. Available from: https://www.ncbi.nlm.nih.gov/ pubmed/8793935
12. Rosenthal MM, Sutcliffe KN, editors. Horn SD, Hickey JV, Carrol TL, Dean JM. Can evidence-based medicine and outcomes research contribute to error reduction? Medical error: what do we know? What do we do? San Francisco, CA: Jossey-Bass; 2002. p. 157-73.
13. Joss R. What makes for successful TQM in the NHS? Int J Health Care Qual Assur. 1994;7(7):4-9. Available from: https://www.ncbi.nlm.nih. gov/pubmed/10140850
14. Nwabueze U, Kanji GK. The implementation of total quality management in the NHS: how to avoid failure. Total Quality Management. 1997;8(5):265-80.
15. Jackson S. Successfully implementing total quality management tools within healthcare: what are the key actions? Int J Health Care Qual Assur. 2001;14(4):157-63.
16. Lekhan VM, Ziukov OL. Porivnialnyi analiz dumok orhanizatoriv okhorony zdorovia i praktykuiuchykh likariv na problemu yakosti medychnoho obsluhovuvannia onkolohichnykh khvorykh. Visnyk sotsialnoi hihiieny ta orhanizatsii okhorony zdorovia Ukrainy. 2008;2:22-7. [in Ukrainian].
17. Oshyvalova O. Efektyvnist vprovadzhennia lokalnoho protokolu medychnoi dopomohy khvorym na epidermalni dysplazii shkiry u bahatoprofilnomu medychnomu zakladi. Visnyk problem biolohii i medytsyny. 2019;1(148):307-13. [in Ukrainian].
18.  Lapach SN, Chubenko AV, Babych PN. Statystycheskye metodу v medyko-byolohycheskykh yssledovanyiakh s yspolzovanyem Excel. K.: Moryon; 2000. 320 s. [in Russiаn].
19. Saltman RB. Reformу systemу zdravookhranenyia v Evrope. Analyz sovremennуkh stratehyi: per. s anhl. M.: Heotar Medytsyna; 2000. 423 s. [in Russian].

«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 335-343 pages, index UDK 614.253.1/.6:616-089:615.851/.853:616-066.6-082

10.29254/2077-4214-2019-3-152-335-343