Improvement of out-patient therapeutic assistance to the rural population
The purpose of the study is the development of methodological recommendations for improving the organization and quality of therapeutic assistance to the rural population. Materials and methods. The study was conducted in 2018-2019. based on 4 rural medical outpatient clinics of the Republic of Dagestan. The volume and nature of outpatient therapeutic care was studied according to 9167 visits, the structure of 765 home visits made by local doctors was analyzed. The volume of medical and obstetric care was studied according to 3485 visits. The work used statistical, analytical and sociological methods. Results. The dates of patients' access to local doctors from the onset of the disease have been studied. It has been established that on average only half (48.7%) of patients go to the doctor in the first 3 days, and the rest 51.3% - in more than 3 days. In the structure of visits by the population of doctors by classes of diseases, the first place is occupied by diseases of the respiratory system (35.6%), the 2nd by the circulatory system (20.6%), the 3rd by the musculoskeletal system and connective tissue (9.8%), the 4th by digestive diseases (7.5%). The structure of the rural population's circulation to various outpatient organizations was analyzed, the first place was taken by polyclinics of central district hospitals (32.2%), the second by rural outpatient clinics (30.5%), and the third by feldsher-obstetric centers (29.3%). In the structure of the population's access to rural medical organizations, 30% of visits are to feldsher-midwife stations. The structure of visits and the load of medical personnel are influenced by the length of the site, the state of roads, the composition of the population, and the distance from medical institutions. The frequency of access of rural residents to paramedics remains high and is 647.3 %o. Based on the materials of the study, methodological recommendations were developed to improve the organization and quality of therapeutic assistance to the rural population