The activity of a new category of general practitioners and their role in the delivery of medical care for the population are analysed. The functional structure of the computer system for information supply of family doctor is considered. The flow chart of a unified primary information document of the given automated system is presented.
The experimental approbation of new conditions of economic activities revealed a discrepancy between the development of health service network and manpower potential and needs of population in medical care, the possibility of priority development of primary health care, promotion in the development of "semi-hospital" forms of medical care organization, the excessive level of hospital care, the interest among workers in increasing the volume of work and increase of effectiveness in the utilization of resources under normalization of economic relations in public health.
A methodology of estimating the professional level of physicians with the help of tariff scale is described. The tariff coefficients are determined by the correlation between the official salaries of physicians, having a qualification category, and a background monthly salary taken as a unity. The mean tariff coefficient of physicians can serve for public health bodies and insurance organizations as an assessment indicator of professional possibilities of an institution, complexity of the work performed, the cost and quality of medical services. For the leading staff of the institution the methodology is supplemented by the estimates of a number of intermediate indicators and their integral assessment which helps analyse the basic factors influencing the general level of physicians qualification.
The study data are provided on the volume of curative and preventive care for 1740 infants at the outpatient department and at home, an analysis is made of the working time spent by a district pediatrician in two polyclinics of Nizhniy Novgorod. It has been shown that most of his time is devoted to sick children. Practically no time is spent on follow-up group of children pertaining to the populations "at risk". To improve preventive work among children of the first three years of life it is proposed to establish departments for young children in the territorial children's polyclinics. The organization of these departments makes it possible to improve the main qualitative indicators of child health.
The health of industrial workers should be considered from the point of view of broad social positions and primarily from the working and living conditions and the state of health services. Environmental factors should also be taken into consideration. Periodic medical check-ups of industrial workers indicate that their health is improving. Despite the success achieved, this problem in Kazakhstan is not being adequately solved, there are only 61 health units. Hospital beds in these institutions do not have necessary specialization corresponding to the profile of industrial enterprises. Numerous industrial enterprises, oil-and-gas extracting works pollute the environment, which has been confirmed by respective examples. The authors provide evidence for the necessity of economic education for the population. Preliminary results of experimental introduction of a new economic mechanism and medical insurance in Kazakhstan are being considered as factors contributing to the improvement of public health financing resources.
Today home injuries, as evidenced by a current survey, constitute 21.53 +/- 0.58% in the pattern of all referrals to traumatological care units. New and objective data have been obtained by age and sex, place of accident, circumstances and mechanisms of occurrence of home injuries, which present a certain interest for working out preventive measures and medical care organization. The materials are submitted for consideration to the city health department.
This paper summarizes the experience gained in the training of surgery specialists at a medical institute and determines the main shortcomings of undergraduate and postgraduate specialization. A sociological survey carried out in the groups of subinterns indicated low effectiveness of preinstitute and intrainstitute professional orientation. Great emphasis is being placed on increasing the quality of training on fundamental sciences and preclinical disciplines. A positive appreciation is being given to the long application of the unified methodological system of specialists training, the use of the syndrome method of training at the graduate year, which is based on maximum activation of clinical thinking, motivated approach to the development of practical knowledge and skills. The important role of continuity in the training of surgeons in the subinternship and internship is stressed.
