Mankind has been able to significantly improve the conditions of their living and existence thanks to medicine. We live longer, happier, less sick. If health problems occur, we rush to the doctor. However, not everyone is comfortable looking for individual specialists for each disease. That is why the idea of concentration was implemented so that many specialists could combine their efforts to achieve a common goal. This provides for the creation of a number of institutions: medical, specialized, research. For us, the first are of most interest.
Introductory information
Begin with a definition. Outpatient facilities are organizations of a medical-prophylactic type that provide the population with first-level medical care both in the place of permanent basing and at home. Such institutions were also created to implement a set of measures aimed at preventing the possibility of the development of diseases.
How is their work built
The organization of outpatient facilities is designed in such a way that they provide community-based medical care. It is provided to people who come to see a doctor, as well as at patients home. Outpatient care is the most widespread and generally accessible medical activity. It is of paramount importance to help the population. Institutions of this type serve to combat mild forms of disease, as well as to identify symptoms of larger problems and make appropriate decisions (for example, sending them for additional diagnostics).
Classification
Outpatient facilities include the following organizational structures:
- Outpatient clinics and clinics, which are part of the medical units and hospitals.
- Dispensaries.
- Separate city clinics, including children's.
- Paramedic-obstetric points.
- Rural medical dispensaries.
- Health centers.
- Women's consultations.
If we talk about their topology, then only four main types should be distinguished:
- To serve the adult population. These include medical units, territorial clinics, diagnostic and diagnostic centers, women's clinics and dental institutions.
- To serve the children's population. These include medical units, territorial clinics, diagnostic and consultative centers and dental institutions. Designed to receive fewer patients than adults.
- Outpatient medical institution of a mixed type. These are organizations that can serve both adults and children.
- Dispensaries. Specialized institutions.
How do medical care principles evolve?
It should be noted that the territorial and workshop medical areas are constantly growing and enlarged. Their improvement is facilitated by specialization and the formation of a multi-level system. What does it consist of?
At the first level are territorial clinics and medical units. They provide assistance mainly in the most common medical profiles. These are therapeutic, surgical, neurological, otorhinolaryngological, ophthalmic, dermatovenerological and gynecological.
At the second level, city polyclinics are located. They provide consultative and diagnostic assistance, have specialized rooms and departments. They have urological, endocrinological, pulmonological, gastroenterological and other rooms. The activities of outpatient facilities at this level are aimed at treating common problems that do not require special conditions.
What to do, is it a serious illness? In this case, the third level comes to the rescue. These are city centers for specialized medical care. They include an outpatient advisory room, in-patient department with the appropriate profile, and sometimes a round-the-clock support service.
About relationships
Outpatient clinics should not be considered as something separate, not interacting with other elements of the healthcare system. Such institutions are closely interlinked with inpatient and emergency care. The effectiveness of not only individual institutions, but also the entire preventive and treatment-diagnostic processes depends on the degree of their interaction and continuity in work. Their development directly affects the use of the existing fund of hospitals and sanatoriums. The interconnection between the various institutions is ensured through document management, joint scientific and practical conferences, alternation practices, when doctors alternately work in the hospital or in the clinic.
System improvement
In general terms, it was considered what constitutes the structure of an outpatient institution. But one cannot say yet that it is perfect. Topical issues of advanced training of medical staff of outpatient care. For this, a number of institutes organize special courses, departments and faculties. In some cities, seminars are held on an ongoing basis. There are also issues with strengthening the material and technical base of institutions and providing them with personnel. Indeed, now there is a rather strong shortage of specialists in remote regions, villages and villages. This is true for small healthcare institutions, for example, feldsher-obstetric centers.
With clinics, the situation is slightly better. Diagnostic centers are also being improved. They are equipped with highly efficient equipment and medical equipment, equipped with highly qualified personnel. At the same time, attention is paid to the possibilities of using the potential of higher educational institutions. Outpatient health care institutions establish beneficial relationships with them. There are also close and mutually beneficial ties with research structures and multidisciplinary hospitals.
What are the performance indicators of outpatient facilities taken into account to determine their need?
After the reforms in the country that affected health care, many medical facilities were merged. Why did the business take such a turn? At the moment, the influx of population into large cities is recorded. In addition, the general population is declining. The number of people is declining because fertility is not keeping pace with mortality. Therefore, many large objects become not very profitable to maintain. Therefore, in place of the previously functioning multidisciplinary clinics and large maternity hospitals , smaller medical structures were organized, since the influx of patients decreased sharply.
Here comes to the fore a very important factor - the population. It depends on how many visitors will come to the medical facility. So, the largest clinics, according to the current regulatory documentation, are designed to serve 1200 people per day. Usually they have significant additional features (diagnostic rooms, hospital). The fewer people living in a village, the fewer people need medical attention. This is especially true for doctors of narrow specialties. In addition, the evaluation criterion of medical institutions is the number of complaints sent by citizens, the presence of settlements in the district, the effectiveness of the prescribed treatment, and mortality.
Organizational structure
Outpatient facilities can either exist in the status of a separate organization, or be part of a specific inpatient medical and preventive territorial entity. In the first case, they should be located in separate buildings. Their placement in residential and public buildings is allowed, but only under the condition that structures in which there are sources of ionizing radiation (for example, an X-ray room) do not have adjacent living spaces.
In addition, it is necessary to ensure compliance with hygiene standards, as well as provide protection against noise. If the institution is of a mixed type (serving both adults and children), then the part that works with people under the age of 18 should be isolated and have a separate entrance.
Design Requirements
What should buildings designated as outpatient facilities look like? Their composition and structure are determined at the design stage. At the same time, normative and calculated indicators and population are taken into account.
The buildings themselves consist of three main functional parts:
- Lobby.
- Treatment and prophylactic structures.
- Household and household departments.
In addition, it is recommended that a centralized disinfection unit be provided. All exits and entrances must also be equipped with external ramps for the disabled. The area of common premises is calculated by the number of visitors who will be in the institution. But for offices the rules are the same. So, their height should not be less than three meters. If sufficient airspace is provided in a cubic volume (this is 37.7 m 3 per employee), then a height level reduction of up to 2.6 meters is allowed.
Conclusion
The article examined the characteristics of outpatient facilities, their types, purpose, development paths, organizational structure, as well as the requirements for the buildings in which they are located.