[The means of optimization of dispensary monitoring of patients in psycho-neurological dispensary].

ABSTRACT

The actual direction of improving provision of mental care of population is increasing of efficiency of specialized primary medical sanitary care of patients with mental disorders in conditions of implementation of biopsychosocial model of its realization. The study of mental disorders morbidity demonstrated that qualitative changes occurred in structure of contingents of mental institutions towards decreasing of number of dispensary patients and corresponding increasing of number of patients receiving medical and consultative assistance. The analysis of indicators of movement of contingents with mental disorders testifies decrease in effectiveness of dispensary observation that is confirmed by decrease of rate of de-registration due to recovery, by increase of de-registration due to death, increase in number of suicidal attempts and in disability among patients with mental illness of able-bodied age. It was established that problems in ensuring quality of medical care are conditioned manly by lack of actual organizational and methodological support of dispensary observation of patients, predominance of passive dynamic observation by local psychiatrist. Based on the results of study of organization of functioning of district psychiatrist, medical and organizational measures were developed to improve organization of dispensary observation of patients with mental disorders.