2. An important condition for properly organized
polyclinics work is to sum up and objectively
evaluate the effectiveness of its work. The collection
and accumulation of information is carried out daily,
and processing and analysis – periodically.
The information is collected through the
registration of the relevant primary accounting
documents. The completeness and quality of filling
these documents has a significant impact on the
calculated health indicators of the population,
providing the reliability of the materials in the reports
of treatment and prevention institutions.
3. Summary data is presented in accounting
documents, the list and contents of which, as
well as instructions for their completion, are
regularly reviewed and approved by the
decisions of the Ministry of Health of Ukraine.
Obligatory for filling out of all ambulatory-
polyclinic establishments is «the Report
about the diseases registered at patients
living in the area of service of the medical
institution» (f. № 12) and «Report of the
medical and preventive institution» (f. № 20).
4. In each of the sections the registered
diseases for the first time and the total
number of the main classes of diseases are
isolated individual nosological forms, as
well as the sex division, the morbidity
among the able-bodied and disabled
according to the age of the population, and
the number of those who are under the
dispensary supervision. The data from this
report is used to calculate most indicators
of morbidity (levels and structure).
5. The main sections of the «Report of the medical-preventive institution» (f. № 20):
List of main structural subdivisions of the medical-preventive institution.
Section I. State of the institution at the end of the reporting year.
Section II. Activities of the outpatient clinic (out-patient department), dispensary,
consultations.
Section III. Activities of the hospital.
Section IV. Work of diagnostic departments:
- X-ray department, ultrasound diagnostics, endoscopic department (cabinet),
laboratory, functional diagnostic office.
Section V. Work of medical and auxiliary departments (cabinets):
- offices and departments: radiation therapy, physiotherapy, physical education,
reflexology, pathology department.
6. State medical and prophylactic institution
(Information is taken from the report f. № 20)
Provision
of state
population
The number of full-time doctors
х 10000
Average annual population
Complexity
of the institution
by doctors
The number of doctors' positions occupied
х 100
The number of regular posts of doctors
7. Coefficient
of overtime
The number of occupied medical posts
The number of physicians in occupied posts
The ratio of the number
of occupied posts to the
occupational positions of
the medical staff by the
average medical staff
Number of positions occupied by middle medical
the staff
The number of occupied medical posts
8. B. Activities of the outpatient clinic (outpatient clinic), the work of doctors in the clinic
(information is taken from the report f. №. 20 and f. №. 039 / o)
Provision of
outpatient and
polyclinic care
The total number of visits to a doctor per year
Average annual population
The average workload of
the doctor per year
The number of doctors visiting this profile in polyclinics
for a year
The number of doctors occupying posts in this profile
The average workload of a
doctor for one day of work
The average number of doctor visits this is
profile for a year
Number of working days in this year
Average workload of the
doctor during the work
The average number of visits to this profile doctor
in one day
The average number of hours of operation of the doctor in the clinic for
one shift
9. Share of visits by doctors
in the polyclinic in
separate specialties
The number of visits by doctors to the polyclinic by specialty
х 100
The total number of visits to the outpatient clinic
The percentage of visits
to the clinic for preventive
examinations
The number of visits to the outpatient clinic for preventive
examinations х 100
The number of visits to the outpatient clinic
Share of visits at home Number of visits at home х 100
Number of all visits
10. Function of the medical post (number of patients and healthy, which should
be taken by a doctor of this specialty on a plan for the year):
Example:
Function of the doctor's position of the therapist = ((3,5х5) + (3х2)) х 251,
where:
3,5 – number of hours of work of the therapist in the clinic (according to the
schedule);
5 – the number of patients to be taken by the GP-therapist for 1 hour in the
clinic;
3 – the number of hours of operation of the therapist for the care of patients
at home (according to the schedule);
2 – number of patients, which the therapist should serve at home for 1 hour;
251 – number of working days per year.
11. Preventive examinations conducted by polyclinic
(information is taken from the reporting f. № 20)
Coverage of preventive
examinations of
adolescents
Number of examined teens
х 100
The number of all adolescents subject to preventive examination
Coverage of preventive
inspections of workers
and other contingents of
the population subject to
preventive examinations
The number of surveyed workers
х 100
Number of all workers subject to prophylactic examination
12. Population morbidity and dispensary of patients in the area of the medical institution
(information is taken from the report f. № 12 )
Morbidity Number of diseases detected for the first time this year
х 1000
Average annual population
Sickness
(prevalence)
The number of all diseases registered in the current year
х 1000
Average annual population
Completeness of
coverage by clinical
supervision of patients
subject to medical
examination
The number of all patients subject to dispensary monitoring (all
patients who are on the dispensary account
at the end of the year) х 100
The number of all registered in the
current year
13. G. The work of a hospital
Average annual
occupancy of the bed
The number of patients spent bed days
The average annual number of beds
Indicator of the average
length of stay of the
patient in the hospital
Number of bed days spent by patients
Average number of beds
Turnover / bed function The number of patients treated in the hospital
Average number of beds
Indicator
of mortality
The number of patients who died in a hospital
х 100
Number of discharged + the number of
patients who died in a hospital
The statistical map
of the retired from
the hospital (f. №.
066/o) also allows
for a sufficiently
detailed analysis of
the indicators of
mortality for hospital
departments by
classes and
individual diseases
for certain age or
sex groups of
patients.
14. Indicator of the frequency
of complications of
diseases
Number of complications in individual diseases
х 100
The number of patients with the corresponding illnesses
Indicator of the total
number of surgical
interventions for 100
surgical beds
Total number of surgical interventions х 100
The number of all surgical beds
The indicator of the
number of surgical
interventions by
individual species for
100 surgical beds
The number of surgical interventions for individual species
х 100
The number of all surgical beds
15. Indicator of the structure of
surgical interventions
The number of surgical interventions for individual species
х 100
Total number of surgical interventions
Indicator of the use of
equipment during operations
(laser, cryogenic,
endoscopic)
Number of surgical interventions using equipment
х 100
Total number of surgical interventions
Indicator of postoperative
mortality
Number of dead operated patients
х 100
Number of operated patients
16. Indicator of
postoperative
complications
The number of operated patients who had postoperative complications
х 100
The number of all operated patients
Indicator of urgent
surgical care
assessment
The number of patients delivered to the hospital later than 24 hours
after the established diagnosis х 100
Number of patients delivered for emergency assistance
The average number
of operations per one
occupied post of
surgeon
The number of operations carried out х 100
The number of surgeons posts
Indicator of
seasonality of the
disease
The number of patients admitted to the hospital at a specific time of
the year (summer, autumn, winter, spring) х 100
The number of all patients admitted to the hospital
17. D. Work of auxiliary maintenance offices patients in the clinic and in the hospital
Polyclinic The number of procedures, analyzes and more
х 100
The number of visits to the outpatient clinic
and at home
Hospital The number of procedures, analyzes and more
х 100
The number of all patients treated in the hospital
Pathologic
department
The number of deaths during which an autopsy was conducted
х 100
Number of all deaths in the hospital
Number of working hours
of doctors allocated for
sanitary education
The number of hours allocated to sanitary education
х 100
The total amount of hours belonging to all occupied positions by
doctors
Average number of
lectures read by one
doctor
Number of lectures read by all doctors
The number of all positions occupied by doctors
19. Family medicine - a set of scientific and practical activities for the organization
of family medical practice.
Family medical practice should be considered as one that provides long-term
care for the health of the citizen and all members of his family, regardless of the
nature of the disease, the state of organs and systems of the body in all periods of
human life.
Family medical practice is based on the principles of evidence-based medicine.
The general practice / family medicine model reduces the costs of:
► remuneration of narrow specialists
► inpatient care (due to reduction of unnecessary hospitalizations)
►training and housing
► for emergency care (in the case of a family doctor living in the service area
there is no need to call ambulance crews)
20. A general practitioner is a family doctor
1. The attending physician for the provision of primary medical
care on the basis of family medicine is a general practitioner - a
family physician of a health care institution of a health care
institution and its structural (separate) units, regardless of
ownership and organizational and legal form, providing organization
and provision of primary health care to the population, as well as a
general practitioner - a family doctor who conducts business
activities in medical practice as a natural person - entrepreneur
and may be in this institution in civil law relations.
2. General practitioner - a family doctor is elected by the
patient in the manner prescribed by the central executive body,
which ensures the formation and implementation of state policy in
the field of health care.
21. Basic principles of family medicine (1-1)
1. Family approach is the interaction of family medicine specialists
with the patient and his family members in order to create conditions
for maintaining, strengthening or restoring the patient's health;
providing primary care to several generations;
2. Patient-centeredness is the involvement of the patient in the
decision-making process regarding the use of medical interventions
(methods of diagnosis, prevention or treatment);
3. Preventive focus - is to predict the risk of developing the most
common diseases and the timeliness of appropriate preventive
measures;
4. Accessibility - is the provision of unimpeded access to the
subject of primary care;
5. Equality and non-discrimination is the provision of primary health
care regardless of race, color, sex, language, religion, political or
other beliefs, national or social origin, property or other status;;
22. 6. Multidisciplinary - is the prevention, diagnosis and treatment of
the most common diseases, injuries, poisonings, pathological,
physiological (during pregnancy) conditions using methods and
techniques of medical intervention in the process of providing primary
care;
7. Continuity - is the constant monitoring of the patient's health in
the process of providing primary care;
8. Longevity - is the provision of medical supervision and care in all
periods of human life, regardless of the nature of the disease, the state
of organs and systems of his body, on the basis of the relationship
between family medicine and the patient;
9. Coordination is a professional activity of a general practitioner - a
family doctor, which is aimed at interaction with specialists and health
care institutions that provide other types of medical care.
Basic principles of family medicine (1-2)
23. Obligations of the primary care physician (1-1)
1. Direct provision of primary health care to patients.
2. Formation and control of the plan of examinations and treatment, analysis of research
results, prescription of drugs and other therapeutic measures.
3. Providing medical care to patients in an emergency.
4. Referral in accordance with the medical indications of the patient who does not need
emergency medical care, to provide him with secondary (specialized) or tertiary (highly
specialized) medical care.
5. Coordination of work with other links of medical care.
6. Management of patients suffering from socially dangerous infectious diseases in accordance
with the legislation.
7. Implementation of immunoprophylaxis in accordance with current legislation.
8. Advice on a healthy lifestyle.
9. Carrying out of measures of mass and individual prevention of infectious diseases.
10. Assessment of individual risks of diseases and counseling on prevention. Development of
individual health examination and surveillance programs.
24. 11. Informing the patient about national screening programs and performing other functions in
accordance with the legislation or the program.
12. Dynamic monitoring of uncomplicated pregnancy.
13. Implementation of medical care for a healthy child.
14. Management of patients with mental disorders, in particular, taking into account the
recommendations of a specialist.
15. Provision of palliative care, including assessment of pain, prescribing drugs, psychotropic
substances and precursors, treatment of pain, prescribing drugs, psychotropic substances and
precursors in accordance with applicable law.
16. Coordination and organization of laboratory tests, collection of biological material.
17. Carrying out laboratory researches, including with use of fast tests.
18. Appointment of medicines with registration of documents according to the legislation.
19. Preparation of medical documentation for referral of persons with signs of permanent
disability for medical and social examination and medical and social rehabilitation.
20. Registration of certificates, forms, certificates of incapacity for work.
Obligations of the primary care physician (1-2)
25. The main documents of the policlinic
► Medical card of an outpatient (f. № 025/r);
► Extract from the medical card of an outpatient (inpatient) patient (file № 027/r);
► Journal of outpatient registration (file № 074/r);
► Individual card of the pregnant woman and the woman in labor (f. № 111/r);
► Exchange card of the maternity hospital, maternity ward of the hospital (f. № 113/ r);
► History of the child's development (file № 112/r);
► Emergency notification of an infectious disease (f. № 058/r);
► Journal of accounting for work on hygienic education of the population (f. № 038/r);
► Report of a patient with a first-time diagnosis of active tuberculosis or its recurrence
(f. № 089/r);
► Report of a patient with a first-time diagnosis of cancer or other malignancy (f. № 090/r).
26. Hospital registration documents
• Medical card of an inpatient (f. № 003/r);
• Temperature sheet (f. № 004/r);
• Leaflet for medical appointments (file № 003-4/r);
• Statistical map of the patient who was discharged from the hospital (f. № 066/r);
• Logs of admission of patients to the hospital (f. № 001/r);
• Journal of refusals in hospitalization (file № 001-1/ r);
• Logbook of surgical interventions in the hospital (file № 008/r);
• Protocol (map) of pathological examination (file № 013/r);
• History of childbirth (f. № 096/r);
• Newborn development map (f. № 102/r).
• Work incapacity certificate;
• Certificate of temporary disability.
