The health grounds of Dnipropetrovsk region’s population, and Ukraine as whole, can be estimated as unsatisfactory. Such integral health indicators as life expectancy at birth in 2011 year was 69,64 years, less than 1.38 years than in Ukraine (71.02 years) and inferior value of this index by 5.5/10.5 years in Europe generally and in the EU particularly (72.3/77.2 years corresponding).
In the structure of the prevalence of diseases, primary disability and total mortality of population first place is occupying the diseases of the circulatory system. 75.5% of the adult population has different kind of cardiovascular system disease, 42% of them is the working age population. Leading among them are hypertension and coronary heart disease.
Among the main problems which is associated with negative situation regarding circulatory diseases include insufficiency of ambulatories, especially in cities, lack of doctors and nurses of general family medicine practice, low level of their qualification, dispersion of secondary hospital care and low level of utilization of modern medical diagnostic technologies and medical treatment of cardiovascular disease.
The aim of subproject is to improve effectiveness and efficiency of medical services for patients with cardiovascular disorders in the primary and secondary levels.
Expected key results include:
-reduction of mortality and disability from cardiovascular diseases;
-efficient use of resources;
-increasing of public satisfaction with quality of care;
Subproject will be implemented in three main directions:
1. Ensuring proper and physical accessibility of primary health care.
2. Improving the quality of medical care at the primary level for patients with cardiovascular disease and cerebrovascular disease.
3. Improving the quality of medical care for patients with cardiovascular and cerebrovascular diseases at the second level by optimizing the size of hospitals and theirs restructuring.
According to operational results of the subproject is expected to achieve the following specific results:
- Escalation of potential of regional health care system for prevention, treatment and control cardiovascular and cerebrovascular diseases.
- Improving of the performance of health care region in terms of relevance, effectiveness and quality of their services. Estimation of results will be made by analyzing the volume and quality of health care facilities, medical services, their correspondence to medical and sanitary needs and patient’s expectations.
- Implementation of modern management approaches, methods and tools, and also using of modern medical equipment. Appraisal of results will be made by analyzing the utilization of modern approaches, methods and tools for health protection management, which depend on management decisions;
- Structural improvement and functional capacity of healthcare facilities. Evaluation of results will be made by observation the coordination mechanisms and management of the network of health care institutions, patients flow, continuity of treatment and accountability.
This subproject will be implemented for the target group, such as patients with high-risk groups and cardiovascular disease patients.
In Dnipropetrovs’k region mortality and disability rates of population generally remain high due to circulatory disease. There are extremely high lethality rates with a high level of hospital care utilization from acute myocardial infarction (11.1 %) and stroke (19.2%).
The project is planned to implement at the expense of the World Bank loan in the amount of 40.0 million USD and co-financing from the local budget in the amount of 25.2 million dollars.
For subproject realization will be involved such components as centers of primary medical and sanitary assistance, three powerful municipal hospitals of Dnepropetrovsk, Kryvyi Rig, and Pavlograd, Dnipropetrovs’k regional base of special medical supply, Department of the Capital Construction of Regional State Administration, Dnipropetrovs’k State Medical Academy, regional Information and Analytical Center of medical Statistics. Current control by implementation of subprojects will carry out the Department of Health Dnipropetrovs’k Regional State Administration.
Subproject provides physical accessibility of primary medical care and this is unconditional prerequisite for the success fight against the prevalence of cardiovascular disease in the population and reduces the frequency of negative consequence. To achieve this, it is planned to expand the network of ambulant clinics closer to the places of population residence. Additionally will be opened 29 ambulant clinics in Dnipropetrovsk and 35 ambulant clinics in Kryvyi Rig . All ambulant clinics will be furnished with the necessary facilities and with the necessary staff.
It is planned to provide adequate patients treatment with cardiovascular disease at the primary level of medical care by improving standard medical examination, continuous treatment, controlling the regularity of treatment, indemnification the cost of antihypertensive drugs, etc. At the secondary level of medical care is the size optimization and restructuring of hospitals, it is primarily about the formation intensive medical care hospital of second level.
To achieve these objectives subproject will be material and technical equipped, implemented with information technology and educational programs for medical and nursing staff.
Successful project implementation will improve the effectuality, quality and efficiency of providing health services for patients with cardiovascular and cerebrovascular pathology at primary and secondary levels.