Review of the development of various primary health care aspects in the context of national health systems of the member states of the Commonwealth of Independent States. Part 1: Organizational aspect
Abstract
The article based on an analytical review of information sources on the status and development of various aspects of primary health care (PHC) in the world and in selected countries, as well as international evidencebased recommendations, to assess the prospects of using international experience and recommendations for the development of PHC in the Commonwealth of Independent States (CIS) member states with regard to the organizational aspect, which is considered in this article. A database of scientific publications, regulatory legal documents, and Internet resources was used with an emphasis on evidence-based reviews and methodological documents that were included on the basis of selected keywords and concepts related to organization aspect of health systems and PHC and characteristics, as well as by the criteria of potential impact on the results of PHC provision. Priority in the search was given to materials from the last decade and to the countries with similar models of health systems. The characteristics of the main aspects of national PHC subsystems — organizational, management, resources, financing, digitalization and results — were identified, systematized and ordered in the structure of the PHC characteristics matrices in the selected countries. This two-part article presents results of an analysis of the development of the organizational aspect of PHC and its characteristics, including the implementation of recommendations selected in the review process with proven effectiveness in the CIS member states. Analysis of the development since 2002 of the WHO idea of the transition of the PHC subsystem organization from the "radar" principle associated with the concept of "completed case of medical care" to the continuous and permanent management of patients with chronic diseases by a team of specialists, as well as the experience of the CIS member states in the medical examination of the attached population and dispensary supervision (implementation of management programs) for patients with chronic diseases gave reason to propose an updated name for the principle of constant medical care in managing people health throughout their lives — the principle of "permanence". And also suggest using it not only in the management of chronic conditions,