The calling a doctor in: what an optimal model can be? (publications review).

The primary health care represent the most common segment of medical care in many countries and provides prevention and treatment of diseases, dynamic monitoring of patients with chronic diseases and medical rehabilitation. There is substantial shortage of health personnel to meet health needs all over the world, especially in primary health care. The COVID-19 pandemic exacerbated this problem. It changed workload in primary health care and demonstrated need for new organizational solutions to increase access to primary health care. One of the new transformations in general practice can be redistribution of medical work in primary health care. In this research, five options for organizational models of primary home care were identified. We used "performer (doctor / nurse)", "payment method for the home visit", "frequency of patient visits per week" as indices. There is lack of unified approach in the way how home visits are organized so optimal organizational model of primary home medical care is needed. This will increase access of most demanded type of medical care and ensure rational use of human resources at the primary health care level, especially during COVID-19 pandemic.

[The social hygienic evaluation of condition of system of maternity and childhood care at the regional level].

The maternal and child welfare system development is the priority target for state social policy. The strategic objectives of health care are targeted to preserving health of mother and child and are implemented through complex activities of various state institutions of maternity and childhood protection system with predominant focus on medical social and economic efficiency. The purpose of study is sociological hygienic evaluation of actual state of maternity and childhood health protection system at the Trans-Baikal Territory. The study used sanitary-statistical, sociological, structural, organizational, expert methods. The estimation of reliability of difference of dependent samples with qualitative indicators was carried out on the basis of the calculation of the non-parametric Cochran test. According to the results of expert assessment, the most significant problem areas in the system of maternity and childhood health protection at the regional level were identified: material and technical equipment of medical organizations, scarce staffing of medical organizations, lack of legal regulation, inadequate organization of medical care of children within the framework of implementation of procedures of provision of medical care, limited availability of medical care, declarative nature of the order of interdepartmental interaction of medical organizations with state social institutions in the system of maternal and child health protection. The established problem areas have negative impact on medical and demographic indicators, coefficients of health of the population in the region and result in decreasing in medical, social and economic efficiency of health care system. The current situation requires adoption of organizational and managerial decisions by executive authorities.