COMPREHENSIVE ANALYSIS OF EFFECTIVENESS AND EFFICIENCY OF MEDICAL ORGANIZATIONS OF THE STAVROPOL TERRITORY PROVIDING PRIMARY CARE IN THE CONTEXT OF PRINCIPLES OF LEAN MANUFACTURING IN HEALTHCARE

Abstract

Significance. A large number of efforts of health professional, as well as many modern targeted programs and projects are aimed at developing primary health care, including the Federal project "Lean polyclinic". The principles of lean manufacturing gained momentum in the priority project "Creation of a new model of medical organization providing primary health care (2017-2022)". Increasing patient satisfaction, access to services, elimination of the existing time, financial and other losses, as well as organization of safe and comfortable workplaces for employees improve performance effectiveness and efficiency of medical organizations. The purpose of the study. Scientific substantiation of the adoption of evidence-based management decisions for developing primary healthcare sector based on results of the independent comprehensive assessment of primary care quality and accessibility in the Stavropol Territory. Material and Methods. The present study assessed the quality and accessibility of primary health care in the Stavropol Territory over the period 2014-2020 according to the improved methodology of integral indicators and well-being index with adaptation to the structural transformations in health care. All medical organizations providing outpatient medical care (multidisciplinary hospitals and central city hospitals with attached population; individual polyclinics; district hospitals and central district hospital; local hospitals and outpatient clinics) were included in the study. The methodology has been adapted and improved to reflect changes in information sources in accordance with the adjustment of federal and sectoral statistical observation forms in 2019-2020. Conclusion. A comprehensive assessment of quality and accessibility of primary health care in the Stavropol Territory in 2014-2020 showed a multidirectional well-being index as an integral assessment criterion. In the period 2014-2019, all medical organizations that provide primary health care had a pronounced positive well-being index. In the conditions of the COVID-19 pandemic, the primary health care sector has been actively involved in providing diagnostics and treatment to patients with COVID-19, reflected by the decrease in the average well-being index in dynamics in comparing 2020 to 2014. However, the study results show that the decrease in the well-being index was not pronounced due to sustaining lean manufacturing principles in the primary care sector during the COVID-19 pandemic. Scope of application. Chief physicians of medical organizations, managers, executors of the project "Lean Polyclinic" can use the study results in order to improve efficiency and effectiveness of medical organizations of the Stavropol Territory, providing primary health care.