PATIENT CULTURE AS A FACTOR IN ENSURING THE QUALITY OF MEDICAL CARE

Oleynik A.V., Mushnikov D.L., Germakhanov Z.Z., Drobysheva E.V.
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Abstract

The relevance of the study is due to the insufficient development of improving the structural component of the quality of medical care in terms of the cultural characteristics of the participants in their provision. The purpose of the study: to determine the contribution of the patient's culture factor to ensuring the quality of medical care of different profiles. The collection of material was carried out by the method of sociological survey of patients on the original questionnaires and the method of expert assessment of cases of medical care. The volume of the sample population formed by random selection amounted to 256 patients of dental profile, 320 therapeutic, 196 surgical (urological), 210 pediatric profile, respectively. An expert assessment of the quality of medical care was carried out according to the methodology that takes into account the implementation of its individual properties, for 984 cases of assistance. It is established that the quality of medical care is reliably influenced by the state of the cultural profile of patients. It was found that the assessment of the patient structural component of the quality of medical services without taking into account their profile was reduced to 40.6% relative to the maximum assessment, especially the characteristics of the sanological and information culture of the patient. The analysis of the role of patient cultural characteristics in the formation of the structural component of the quality of medical services showed the presence among them of characteristics that have a significant impact on the decline in the quality of services. The revealed differences in the value of the relative risk of the same patient cultural risk factor for reducing the quality of medical services in their different profiles substantiated the need to differentiate factors into high-risk and low-risk. The basis for managing the culture of patients should be measures to transform low gradations of cultural characteristics of patients into high ones, through medical information and education, socio-psychological counseling, patient education and the formation of behaviors focused on the preservation and promotion of health.
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患者文化是确保医疗质量的一个因素
这项研究的相关性是由于在提供医疗保健的参与者的文化特征方面,改善医疗保健质量的结构组成部分的发展不足。本研究的目的:确定患者文化因素对保证不同类型医疗服务质量的贡献。资料收集采用对原始问卷进行患者社会学调查的方法和对医疗护理案例进行专家评估的方法。随机抽取的样本量分别为牙科256例、治疗320例、外科(泌尿外科)196例、儿科210例。针对984个援助案例,根据考虑到具体情况的方法,对医疗服务质量进行了专家评估。这是确定的,医疗质量是可靠的影响状态的文化档案的病人。研究发现,在不考虑患者概况的情况下,对医疗服务质量的患者结构成分的评估,相对于最高评估,特别是患者的卫生和信息文化特征,减少到40.6%。对患者文化特征在医疗服务质量结构组成部分形成中的作用的分析表明,其中存在对服务质量下降有重大影响的特征。同一患者文化风险因素在不同情况下降低医疗服务质量的相对风险值存在差异,这表明有必要将这些因素区分为高风险和低风险。管理患者文化的基础应该是采取措施,通过医学信息和教育、社会心理咨询、患者教育和形成以维护和促进健康为重点的行为,将患者文化特征的低层次转化为高层次。
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