S J Asfendiyarov atyndagy Kazakh Ulttyk Medicine Universitety

S. J. Asfendiyarov atyndagy Kazakh Ulttyk Medicine Universitety Kazakh National Medical University Satisfaction of patient quality of medicare Completed: 613 -2 group

. Actuality: Satisfaction of patients with medical care is one of indicators of its quality. The president of the Republic of Kazakhstan N. A. Nazarbayev in the message to the people of Kazakhstan "– new economic recovery – new opportunities of Kazakhstan" celebrated new decade that: "Health of the people is the integral component of success of Kazakhstan in achievement of the strategic objectives" (Astana, on January 29, 2010). For achievement of a goal, in Kazakhstan the State program of reforming and development of health care of RK of "Salamatta Kazakhstan" for 2011 -2015 is introduced [1]. In the State program development of system of accreditation, standardization, etc. was provided in health sector – for the purpose of realization of the regulating function of the state in a control system of quality and safety of medical care. Ministry of Health set the tasks of the solution of questions of timely and high-quality delivery of health care, protection of the rights of patients and of introduction of modern mechanisms of quality management of medical care, introduction of modern medical technologies, including application of clinical protocols of diagnostics and treatment, with emphasis on the resourcesaving, economically effective methods increasing availability to the population of medical care.

Improvement of quality management of medical services takes an important place in the context of strategic development of health care of Kazakhstan till 2020. According to the Order of the deputy. The Minister of Health of RK No. 468 of 22. 07. 2011 "About the approval of methodical recommendations about carrying out questioning of citizens for definition of degree of satisfaction with level and quality of the provided medical care" KKMFD – Committee of control of pharmaceutical and medical care RGP on PHV "Republican Center of Development of Health Care" of MZ RK carries quarterly out questioning among the medical organizations of Almaty.

I showed results of researches of the developed countries that in the majority of industrially developed countries the level of satisfaction with work of branch is quite high – about 90% of respondents in Sweden and Switzerland, about 70% in Great Britain, Germany, Spain and Slovenia. At the same time an overall picture not iridescent – about 70% of the interrogated patients in Italy and Poland are inclined to negatively estimate the impressions of contact with health system [2]. Influence satisfaction of patients with medical care: availability; equality and justice in rendering of services; independence in making decisions on the health; existence of sources of clear information on medical questions of the general character, volume of exhaustive data on structure and opportunities of national health system [2].

Main problem this long expectation ("waiting times") of consultations of experts, medical procedures. To patients not demanding the emergency help suggest to wait days, weeks and months before providing necessary services and discontent is caused by the expectation directly at an office of the doctor lasting sometimes till several o'clock. According to patients, during long expectation they test not only inconvenience, but also are exposed to risk of deterioration of a state of health.

Seeking to find a way out, they invent own solutions of a problem: tendency of the address of patients to accident wards of hospitals, call of an emergency medical service in occasions which are within the competence of general practitioners, they found mutual friends, gave to doctors gifts, and also offered money. In Spain decrease in average time of expectation for survey by general practitioners for 10% led to 20% reduction of number of addresses to accident wards of hospitals. Understanding importance of this problem, the governments make attempts by various methods to correct a situation with terms of expectation of medical care. In Sweden in 1992 the list of "guarantees on health protection", including 12 diagnostic and medical procedures was legislatively approved. Because of deficiency of medical shots in 1997 the three-months limit was cancelled, and instead of it terms of expectation of visit to the doctor began to vary on a territorial sign. In Great Britain, Germany, Spain schedules of work by turns of doctors, making an appointment by phone and by e-mail, placement on the Internet of "lists of expectation" of medical services in the different organizations of health care were entered. [2]

Purpose: to develop recommendations about improvement of quality of medical care on the basis of complex sociological research of opinion of patients at the level of PMSP.

Тask 1. Review of world experience in area of health care, …. 2. Studying of satisfaction of patients with PMSP of Almaty provided by medical care in the concrete medical organization; 3. Preparation of the recommendations promoting improvement of quality and efficiency of medical care

Research methods: - Sociological - Statistical Focal group consumers of services of health care at the out-patient level, including the patients consisting on the dispensary account. The population which addressed to the medical organization giving primary medical and sanitary and consulting and diagnostic help in the city of Almaty participated in polls. Object of research – the organizations of health care rendering medical services. (No. 3, 6, 8, 9, 10, 17 policlinics) Methodology: For the purpose of the analysis of satisfaction of patients with quality of the rendered medical services we carried out questioning of 210 patients from policlinic aged is more senior than 60 years.

Results: The greatest percent of respondents is made by aged people is more senior than 60 years (55%). 55% of total number of patients pensioners. In general quality of medical care satisfied 80%, aren't satisfied – 20% of respondents. The main claims of respondents consist: in a long time of expectation in turn (about an hour and more), impossibility to get on reception to narrow experts. Respondents are dissatisfied with the inconvenient schedule of work of clinical and biochemical laboratory, also note narrowness and an unsatisfactory sanitary and hygienic condition of some policlinics.

Your age: Your sex: 65% 55% 35% 20% 15% 5% 5% to 25 age 25 -35 age 35 -45 age 45 -60 age over 60 years male female

Your occupation: 55% 30% 10% 5% Student Working not working pensioner

1. Удовлетворяет ли Вас результат медицинского обслуживания (в поликлинике по месту жительства)? Абсолют % 105 50 Да 63 30 Нет 42 20 Не полный мере 210 Итого 2. Устраивает ли Вас режим работы поликлиники? 115 55 Да 95 45 Нет 210 Итого 3. Удовлетворены ли Вы отношением к Вам врача? 84 40 Да 126 60 Нет 210 4. Если нет, в чем причина: 63 30 Часто отвлекается Разговаривает по телефону 84 40 Р Нет достоверных вероятности 63 30 Не обращает внимания 210 Итого 5. Удовлетворены ли Вы отношением к Вам медицинского персонала (медицинская сестра, санитарка)? Да Нет Итого 147 63 210 70 30 Нет достоверных вероятности

6. Хотели бы Вы сменить своего участкового врача? 110 52 Нет достоверных вероятности Да 100 48 Нет 210 Итого 7. Рекомендовали бы Вы нашу поликлинику друзьям и родственникам? 140 67 Нет достоверных вероятности Да 70 33 Нет 210 Итого 8. Знаете ли Вы сайт поликлиники? 53 25 Нет достоверных вероятности Да 157 75 Нет 210 Итого 9. Удовлетворены ли Вы в целом результатами обращения/лечения в Поликлинике? 105 50 Нет достоверных вероятности Да, вполне удовлетворен (а) 63 30 В среднем удовлетворен (а) 42 20 Нет не удовлетворен (а) 210 Итого 10. Какие свойства и качества медицинской помощи, по Вашему мнению, необходимо совершенствовать? Доступность Безопасность Компетентность мед. персонала 126 31 60 15 Нет достоверных вероятности 21 10 Результативность Этика медицинского персонала 11 5 21 10 Итого 210

How often do you go for help in medical institutions?

Are you satisfied with the operating mode clinics? ? 45% 55% Yes No

Are you satisfied with the result of medical care (in the clinic in the community)? 50% not fully 20% No 30% Yes

Удовлетворены ли Вы отношением к Вам врача? Если нет, в чем причина: 40% 60% 30% 40% Да Нет Часто Разговаривае Не обращает отвлекается т по телефону внимания

Удовлетворены ли Вы отношением к Вам медицинского персонала (медицинская сестра, 70% санитарка)? 30% Да Нет

Хотели бы Вы сменить своего участкового врача? 0% 47% 53% Да Нет

Удовлетворены ли Вы в целом результатами обращения/лечения в Поликлинике? Нет, не удовлетворен (а) 20% В среднем удовлетворен (а) 30% Да, вполне удовлетворен (а) 50%

Какие свойства и качества медицинской помощи, по Вашему мнению, необходимо совершенствовать? 60% 15% 10% Доступность Безопасность Компетентность мед. персонала 5% Результативность 10% Этика медицинского персонала

Рекомендовали бы Вы нашу поликлинику друзьям и родственникам? Знаете ли Вы сайт поликлиники? 75% 67% 33% Да Нет 25% Да Нет

Conclusions: Thus, the research conducted by us allows to draw the following conclusions: Satisfaction of patients with the organization of medical care, first of all is connected with deontologichesky aspects, the attitude of the medical personnel towards patients. The analysis of results showed that in the wishes patients note need of warmer and sensitive attitude towards patients, stimulating recovery. Thus, results of sociological poll of patients allow the management of the medical organizations to improve organizational and administrative technologies in improvement of quality of the rendered medical services.

Recommendations 1) to Develop the standard of the attitude towards the patient (the ethical code) for all levels of the medical personnel of healthcare institutions 2) the accurate organization of workplaces and rational use of working hours, continuous professional development and improvement of professional skill, creation of optimum working conditions of nurses with use of computer technologies 3) Registries for elderly and veterans of the Second World War with the maximum comfortable conditions for expectation and rest of patients and the persons 4) accompanying them) Separate registry with the TV (with a DVD prefix on which broadcast videos with recommendations about a healthy lifestyle, a balanced diet. ), to create comfortable conditions for expectation 5) to Organize clubs (an office of a suitsidolog for anonymous consultations, for elderly Gold Years club), schools of health

THE LIST OF THE USED SOURCES 1. http: //strategy 2050. kz/ru/page/gosprog 1/ 2. http: //www. mednovosti. by/journal. aspx? ARTICLE=5136 3 http: //chemstat. com. ru/node/17 4. http: //medstatistic. ru/theory/t_cryteria. html