This document outlines the levels and types of medical care in Ukraine's healthcare system. It discusses primary, secondary, and tertiary levels of care. It also describes different types of care like outpatient, inpatient, urgent, emergency, and sanatorium-resort care. The document also discusses the role of polyclinics in providing primary and secondary care, conducting preventive services, and referring patients to hospitals when needed. Infrastructure is developing for family medicine, including family doctor clinics and reorganizing polyclinics and rural healthcare.

1. Sumy State University
Medical institute
Department of social medicine
Kinds of
Medical care
Assistant Smiianova O.I.

2. Guiding principles of health care as an important
component of health care:
- Availability;
- High quality of care;
- The sequence outpatient and inpatient care (if
necessary);
- The responsibility of medical workers in
professional activities;
- The rights of patients;
- Independence medical staff (except for
restrictions which are defined ethical and
deontological regulations).

3. Levels of care on the complexity:
Primary - is a major part of health care
for the population and provides
consultation of general practitioner
(family), diagnostics and treatment of
major common diseases, patient referrals
to provide specialist care, preventive
measures. The primary medico-sanitary
care is the first level of providing medical
care.
At this level the first contact of patients
with the public health services system
occurs.

4. Secondary (Specialized) -
provided by doctors of the
professions in the direction of
a general practitioner,
provides qualified advice,
diagnosis, treatment,
rehabilitation and prevention
of disease.

5. Tertiary (highly
specialized) - is the direction
of the physician to provide
primary or secondary care
physicians (or groups) who
have appropriate training in
difficult to diagnose and treat
diseases that are rare.

6. Types therapeutic and preventive care
Outpatient ( ambulatory-polyclinic) care is
provided to individuals who require periodic
medical observation, treatment in the prehospital
phase and preventive measures. The out-patient -
polyclinic care is the preventive, medical -
diagnostic and rehabilitation help performed by the
out-patient - polyclinic organizations of public
health services (including general / family practice)
in the established volumes.
It is obtained when applying directly to outpatient
clinics or at home.
The case of polyclinic service is:
-each visiting by the patient of an out-patient
department with a definite purpose to its
realization.

7. Urgent and emergency
medical care is provided
patients with sudden illness
with severe and those affected
by accidents, provides health
care to the greatest extent
possible in the place of the
call, during transportation
and hospitalization.

8. Stationary (inpatient) care
is provided to patients who
require constant medical
supervision, use of complex
survey methods and
intensive treatment and
surgeries that can not be
performed on an outpatient
basis.

9. Sanatorium-resort care - kind of
treatment and preventive care is
provided in health centers -
specialized medical institutions,
which are mainly used for the
treatment of natural (climate,
mineral water, mud), physical
therapy equipment, treatment
and dietary regime.

10. In ambulatories and health centers medical
care is provided by doctors of one or different
specialties. Most of these institutions are only
general practitioners / family physicians.
In polyclinics (outpatient departments of
hospitals), which in modern terms could serve
as a consultative and diagnostic centers, help
perform medical professionals of many
disciplines. However, to date, provided all
structures of primary care centers also provided
primary care appropriate to the population.

11. Hospital - a place for a permanent stay of patients with
trauma, one way or another disease or suspected it,
which provides short-term or long-term medical care,
diagnosis, treatment and rehabilitation.

12. Types of Medical facilities:
1. Treatment and prevention facilities: (polyclinics,
hospitals, clinics, health centers)
2. Hygiene and care facilities (sanitary-
epidemiological and disinfection stations)
3. Pharmaceutical institutions (pharmacies and
pharmaceutical warehouses)
4. Institutions of social health protection (centers
for medical and social expertise)
5. Other institutions (pathologoanatomic and
forensic medicine bureau)

13. The main tasks of polyclinic:
- Provision of primary and secondary (specialist)
care outpatient and home;
- Conducting of follow-up on various contingents;
- Conducting of medical examination disability;
- Organization and implementation of preventive
measures, including anti-epidemic;
- Hygienic education of the population;
- The study of health indicators.

14. During the reform of health care system
a work of polyclinics should aim at
improving the quality of population
treatment, complete a comprehensive
examination of its social importance
groups, a complete rehabilitation. These
measures are aimed at reducing the
current very high level of hospitalization
and ensuring reasonable to send patients
to hospital treatment. Further planned
specialized care is provided by primary
care physicians referral.

15. At present time for estimation of
polyclinic activity, the following
reporting forms:
- Report of the Medical Institutions (
form № 20);
- Report on the number of diseases
registered in the patients who reside
in the service of the medical
institution (form № 12).

16. According to the data the Form № 20 and recording
forms can calculate and estimate:
- The average number of visits to physicians per 1 citizen;
- The proportion of preventive visits (%);
- Full coverage of preventive examinations of different
groups of people (separately for each group) (%);
- Be comprehensive clinical examination of the persons
(%);
- Timely capture of patients to dispansery
observation(%);
- The division of clinical patients by health groups;
- The frequency of disease exacerbations in patients with
dispensary groups ( per 100 people).

17. Based on the form №
12 are calculated
incidence and
prevalence rates of
diseases and their
structure.

18. Infrastructure of family medicine in Ukraine is
developing the following areas:
- Reorganization of the existing network of city
polyclinics to provide medical care for adults and
children of the transformation units of
practitioners and pediatricians in the department
of Family Physicians
- A network of family doctors clinics in urban and
rural areas;
-Reorganization of the existing network of rural
districts health care in family doctor ambulatories.

19. Family doctor - a qualified
medical professional, who
personally provides primary
care and continuum of care
to individual patients,
families and public of
district, independently of
age, sex and type of disease.

20. Most of all appeals of citizens
concerning the state of his
health is realized by providing
them with appropriate
medical care at the primary
level, and specialized care is
needed no more than 20% of
patients.