Elements of mutual GP (CB) ...

Elements of mutual GP (CB) for hospital care to the population not initially assumed that ultimately determined the amount of fundholding in relation to the magnitude of the annual premium on the OMC, approved in the territory of Volgograd. Financial calculations were performed by the standard in the Volgograd region scheme of financing medical institutions for providing volumes of medical care - for the quantity and the quality of the GP (CB) of medical services. Such a financing model for professional activities of physicians in this category is rational, because it stimulates the development of general practice, the use of least-cost technology of care, intensifying the use of preventive methods. Analysis of the results of the experiment, providing funding for a GP (family doctor) with partial fundholding has shown that already at the first stage, 30% of completed medical diagnostic, preventive medical activities and medical manipulations went beyond the purely therapeutic administration. General Practitioner (family doctor) to function as a therapist in 76% of cases, as a pediatrician - to 20,8%, as a cardiologist - in 7,8% of cases, make arrangements and manipulation of the first medical assistance provided by the surgeon - in 8.4 % of cases, assumed the role of otorhinolaryngologist - in 3,3% of cases, a neurologist - in 4,1%, an obstetrician-gynecologist - a 4,1% of cases. Independently performed in the volume of the first medical care outpatient surgery, spent instrumental study of eye, ENT organs, and also used functional methods of diagnosis - ECG, laboratory tests of blood - glucose levels and hemoglobin in the blood. Obtained in functional and laboratory parameters allowed him to identify deviations in health status of patients in the early stages of development, the most common diseases. Analysis of GP visits (HR) professionals for help enabling the Committee in conjunction with the Family Medicine Department, Volgograd State Medical Academy to make adjustments in the training program specialist. Thus, only 51% of GPs directions (NE) were addressed to the therapist, to some extent due to the specific purpose of physiotherapy treatment. Other doctors involved to correct diagnostic and treatment tactics. With the organization of the GP (family doctor) with partial fundholding identified the following qualitative indicators provided to them primary care residents embodied Territorial area: a wide range of activities of primary health care, the increased frequency of visits to the doctor and nurses, patients at home to routine inspection, the low level of hospitalization of patients: the percentage of hospitalizations in the area amounted to 0.97% with an average of 3% of clinics, the low mortality rate, amounting to 13.8 per 1000 population, with an average of 19.8 in the city, the optimal ratio number of visits and completed cases, treatment (two visits per completed case, with an average urban indicators 2.9 per completed case), as well as the number of paraclinical investigations and cases, outpatient treatment, the relatively low incidence population area with temporary disability to be 11, 4% of patients after outpatient treatment.