Assessment of the effectiveness of measures to improve the patient routing system in the provision of planned medical care (experience of Tomsk region)

Introduction. This article reviews the results of the development and implementation of organizational solutions aimed at reducing the time of providing routine medical care to patients in outpatient settings and increasing its availability. Among the reasons negatively affecting the waiting times for medical care are complex routing schemes and the high level of administrative overhead that accompanies each stage of the treatment and diagnostic process.

Aim: To develop and evaluate the effectiveness of measures to improve the system of organization of planned medical care on the example of medical organizations of Tomsk region.

Material and Methods. The study included medical organizations providing primary health care in outpatient settings (31 institutions). The study was conducted in stages: 2018–2019 the main set of measures (creation of offices of the organization of planned care) was developed and implemented, 2020–2021 – summarized interim results, 2022 – performance assessment was carried out. For comparative analysis all medical organizations were divided into 2 groups (group A and group B) depending on implementation of planned activities. Statistical processing was performed using the Statistica 10.0.228.8 software package.

Results. It was found that the waiting time for a doctor’s consultation Group A reduced by 5.5% (p = 0.025) in 2019 compared with 2018, in contrast to Group B. The waiting time for a routine diagnostic examination in Group A also reduced by 16.6% in 2019 compared to 2018 (p = 0.041), while no differences were found between waiting times for routine diagnosis in Group B for the same period (p = 0.101).

Summary. The study has shown that the problems of accessibility of planned medical care can be effectively solved through the creation of a patient flow management system at all stages of the treatment and diagnostic process.

1. Chukreyev M.P., Kalinkin D.E. Satisfaction with the quality of outpatient care of medical students as an element of the assessment of the current system of medical care. The Siberian Journal of Clinical and Experimental Medicine. 2023;38(1):181–185. (In Russ.) DOI: 10.29001/2073-8552-2023-38-1-181-185.

2. Vyalyh N.A. Social perceptions of the health care model in Russian society. Bulletin of Tomsk State University а. Philosophy. Sociology. Political Science. 2020;(56):157–172. (In Russ.) DOI: 10.17223/1998863X/56/16.

3. Timakov I.V. Reform of Russian health care – threat to the safety of social groups or evolution of health care? Sociodynamics. 2020;(11). (In Russ.) DOI: 10.25136/2409-7144.2020.11.33884.

4. Bakalskaya E.V., Brylyaeva E.V. Trends in Improving the Effi ciency of Medical Organization. Russia: trends and prospects for development. 2022;17(3):325–330. (In Russ.) URL: https://cyberleninka.ru/article/n/napravleniya-povysheniya-effektivnosti-meditsinskoy-organizatsii/viewer (02.08.2023).

5. SHejman I.M., SHevskij V.I., Sazhina S.V. Priority of primary health care – a declaration or reality? Social Aspects of Public Health [online publication]. 2019;65(1). (In Russ.) DOI: 10.21045/2071-5021-2019-65-1-3.

6. Deev I.A., Kobyakova O.S., Shibalkov I.P., Protasova L.M., Boykov V.A., Baranovskaya S.V., Suvorova T.A., Babeshina M.A. Optimization of patient flow routing as a basis for improving organizational effi ciency of outpatient care (experience of the Tomsk region). The Siberian Journal of Clinical and Experimental Medicine. 2020;35(4):95–102. (In Russ.) DOI: 10.29001/2073-8552-2020-35-4-95-102.

7. Noncommunicable diseases. Fact sheets; World Health Organization. [Electronic resource]. (In Russ.) URL: https://www.who.int/ru/news-room/fact-sheets/detail/noncommunicable-diseases (07.06.2022).

8. Rugol L.V., Son I.M., Kirillov V.I., Guseva S.L. Organizational technologies that increase the availability of medical care for the population. Profilakticheskaya Meditsina. 2020;23(2):26–34. (In Russ.) DOI: 10.17116/profmed20202302126.

9. Bojko A.YU., Petrosyan K.M., SHCHerbin A.V. Assessment of quality and accessibility of clinical outpatient medical carein moscow and some other regions. Medical Bulletin of the Ministry of Internal Affairs. 2020;(3):7–14. (In Russ.) URL: https://www.elibrary.ru/item.asp?id=43019628 (07.06.2022).

10. Budarin S.S., Elbek Yu.V. Impact of resource management quality on access to health care. Bulletin of the Kazan State Agrarian University. 2020;15(3(59)):88–93. (In Russ.) URL: https://www.elibrary.ru/item.asp?id=44286306 (07.06.2022).

11. Zherebtsova T.A., Liutsko V.V., Leontiev S.L., Mikhailova D.O., Anufrieva E.V. Improving the organization of primary health care in the Sverdlovsk region. Current Problems of Health Care and Medical S tatistics. 2022;(3):427–446. (In Russ.) DOI: 10.24412/2312-2935-2022-3-227-446.