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Information × Registration Number 0215U006258, 0110U000522 , R & D reports Title Study on subpopulation health indicies as the basis to reform Ukrainian Health System. popup.stage_title Head Ocheredko Oleksandr Mikolayovich, Registration Date 09-02-2015 Organization Dovganeuk Inna popup.description2 During the research work of system approach for the first time in Ukraine developed integrative methodology for studying the processes disability ARS - design, which would provide an effect age cohorts (by birth) and years including medical and social characteristics of rural areas; statistically justified geographic model of disability due to CVD risk, on the basis of territorial studied patterns formation disability in Zhytomyr Oblast; likelihood function obtained Survival disabled due to acute myocardial infarction and stroke by assuming proportional hazards, discrete years of research, pravotsenzurovanyh panel data and competing risks; scientifically proven new model of medical support in patients with acute myocardial infarction and stroke in terms of health care reform; The proposed system of territorial efficiency study implementations of new models based on geographical model. In the second phase developed a methodology for assessing the risks of modifications EU residents in rural areas, depending on the medical and organizational factors and population-based analysis of the profile; a new approach to the study of factors modulate EC multinomial logit-based model; A method for estimation of the partial effects of risk factors on the plan case-control series with variable ratios cases, control of matchinhom based survival curves; scientifically based medical support system of the rural population in the EU in terms of traveling reform. The third stage was first developed an econometric model of behavior in terms of increasing medical burden patients investigated expected results; empirical validation of the proposed methodology changes in the scope of services to a change in load patients on doctor-patient MFYS algorithms; Experimental verification of the proposed methodology consequences of changes in physician behavior under increasing load patients on duration of hospital stay and the risk of subsequent hospitalization ICSU-based model of competitive risks. As a result, for the first econometric model povelinky doctor scientifically based system reduction measures next hospitalizatsiyi.Na Based on these research introduced some elements of the proposed algorithm of actions to improve the quality of hospital care in the health care reform in Vinnitsa and Zhitomir regions, aimed at rotation curve compensation income through compensatory payment mechanisms work as a doctor, an increase in the consumer price elasticity of demand inpatient services, reduce monopoly power producer inpatient care and improved monopsonic power consumers of health care services, including through participation of researchers in preparing the orders of the Ministry of Health of Ukraine 30.08.2010r №735 "On the determination of the main stages of health care reform" and of 03.10.2013r №851 "On Science -metodychnyy and organizational support specific tasks of the National Action Plan for 2013 "in the 24.9" model of resource development district hospital, "and the decision 3 sessions Vinnytsia Oblast Council of 28.01.2011 "On the main directions of health care reform in the task and local governments, local authorities to ensure effective public health services." Also introduced a new pathway with acute coronary syndrome and stroke in rural areas; assessed the risks of emergency cardiovascular conditions among residents of Vinnitsa and Zhitomir regions depending on the medical and organizational, population factors and geographical features; resulting in significantly reduced population risk of mortality due to acute myocardial infarction and stroke. In particular, the effect is estimated as 1757.6 introduction of additional months of life during the first 5 years of the onset of the disease across the Vinnitsa region every year. It was shown that only 15.8% of the total effect of implementation falls on improving the quality of patients and 84.2% of it improving accessibility EMD and specialized care. With the full implementation of the model is expected to increase survival 4.6738 extra months of life of the patient during the first 5 years of onset. The survey results used at the state level by including suggestions on the Draft Law of Ukraine "On Vinnitsa, Dnipropetrovsk and Donetsk regions experiment with health care reform," orders the Ministry of Health of Ukraine 30.08.2010r №735 "On the determination of the main stages of health care reform ". Also algorithm implemented actions to reform the EMD in rural areas; assessed the risks of emergency conditions in rural residents according to medical and organizational factors and population, estimated reserves impact on mortality due to emergency conditions (EC) reasonably integrated optimization model of medical support of the rural population in the EU according to levels of care. The main improvement of the system are: the creation of EMD OC and IC with a main institutions and funds manager EMD system, Outbound clinics, family medical clinics creation in villages with a population of over 1000 people., Providing additional brigades (41.25) points SMP (57), sanitary transport units (59) posts of doctors (52.8) and nursing staff SMP (633.4) for 20 minutes of arrival, authorization doctors in rural health network be contacted directly call medical consultants EMD, Creating a single mobile performance space to include AF village health centers, CA, creating a database EP Vinnytsia region, the introduction of funding signifies our strong vertical and centralized supply. The result of the proposed model parameters in the process of reform in Vinnytsia region has been declining since his arrival SHD 16.8% delays the provision of medical care by 22.0%, arrival time consultant for 24.3% of the population claims to activity on SMP 12.7% of complications due to the EU by 7.1%, 3.9% mortality, emergency hospitalization of 3.2%. It has been proved that improving timeliness associated 98% is the reform EMD. The survey results used at the national level in the development of "Regulations on primary health care" approved by the Ministry of Health of Ukraine in December 2010, at the regional level through the introduction of certain elements of the proposed system optimization measures EMD in functionality timeliness in the process of reforming primary health care in rural areas of Vinnitsa region (acts introduction), including decision 3 session of the Regional Council of 28.01.2011 "On the main directions of health care reform in the task and local governments, local authorities to ensure effective public health services", Head of the Department of Health orders and K Vinnytsia Regional State Administration "on create a single operational communications "from 20.12.2010," on approval of the public Service disaster Medicine Vinnitsa region "№ 249/108/394 from 29.04.11" On creation of a database of emergency pathology in Vinnitsa region. "on 01.02.2011.5481 Product Description popup.authors І. В. Паламар І. Ю. Андрієвський І.В. Яремина А.В. Дерезюк А.В. Пірникоза В. Л. Пилипчук В. П. Клименюк В. С. Василик Л. О. Діденко Л. П. Гуцол М. Б. Тарасюк Н. М. Кізлова Н. Т. Комарницька О. М. Крекотень О. М. Очередько О.В. Ігнащук О.Р. Безугла Р. В. Харковенко Т. О. Слєпова popup.nrat_date 2020-04-02 Close