ACTUAL PROBLEMS OF LAW REGULATED PRIMARY HEALTH CARE

Abstract

Primary health care (PHC) is the basis of the system of medical care. The organization of the provision of PHC to citizens in order to get closer to their place of residence, place of work or study is carried out according to the territorial-precinct principle, which provides for the formation of groups of the serviced population at the place of residence, place of work or study. The efficiency and quality of the entire healthcare system, as well as the solution of many medical and social problems facing healthcare, depend on the state of primary health care. The purpose of the study was to study the compliance of the regulatory framework with the goals and objectives of the primary health care system for children. Statistical data on morbidity, preventive examinations of children, provision of outpatient polyclinic health care for the children’s population of St. Petersburg for 2016–2020 were analyzed. The labor costs for performing the functions of a district pediatrician for outpatient admission, apartment calls, dispensary supervision, preventive vaccinations, as well as the labor costs of specialist doctors for performing basic functions were calculated. As a result time spent by a district pediatrician on outpatient visits was found to amount to: 279.7 hours (acute pathology) + 345 hours (dynamic dispensary observation) + 422.4 hours (examinations before vaccination) = 1047 hours / year. Even when performing only these three positions in the structure of outpatient admission, the standard time (651 hours/year) exceeded by 1.6 times (or by 61.18 %). The time spent by a neurologist to participate in preventive medical examinations of children amounted to 87.0 % of the actual annual norm in hours, by an ophthalmologist — 59.0 %, respectively. When conducting an ultrasound examination, children must perform 26,835 conventional units of labor (UET) as part of a preventive medical examination, which requires an additional 1.5 ultrasound doctor’s rate. The existing problems in the provision of primary health care in the volume regulated by state documents hinder the effective operation of children’s polyclinics in the provision of primary health care, which negatively affects the availability and quality of medical care and patient satisfaction.