Evaluation of the Effectiveness of Primary Health Care by Health Care Managers

Abstract

Introduction. There is a need for a dynamic assessment of the quality of medical care in the context of the opinions of stakeholders.
The purpose of the study is to assess the efficiency of the use of resources and the willingness to work of primary managers in the context of PHC organizations.
Methods. The study was conducted using the original questionnaire developed by us for PHC managers based on the AGREE methodology to study the effectiveness of primary care according to PHC managers. The study included 232 PHC medical organizations in 17 regions of Kazakhstan. The data analysis was carried out taking into account the group correlation.
Results. 1,754 respondents (managers) from medical organizations (city and district polyclinics) of 14 regions and three cities of republican significance of the Republic of Kazakhstan took part in the survey. Slightly more than half of the respondents (54.02%, n=948) work in city polyclinics. Women significantly predominate among the respondents (83.7%, n=1463). More than half of the respondents (57.13%,
n=1002) are aged 40 to 60, and respondents aged 18 to 39 account for 37.91% (n=665). When conducting a correlation analysis of the data of the questionnaire of the managers-respondents, we found a fairly significant correlation between the criteria “age” and “manager's experience” (r=0.537, p≤0.01), “total experience” (r=0.770, p≤0.01), “duration of work in PHC institutions” (r=0.587, p≤0.01), “duration of work
in the polyclinic” (r=0.456, p≤0.05)). In addition, the total experience of the specialist correlated strongly enough with the duration of work in PHC institutions (r=0.714, p≤0.05). Managers note the high efficiency of polyclinic management by the management (96%), the high level of knowledge of their professional duties by doctors (93%) and nurses (94%), the high level of interaction between doctors and nurses (94%), as well as the effective interaction of doctors and nurses with managers (96%). Managers also point out that it is easy for them to find solutions to
problems that arise in the polyclinic (95%), as well as good interaction with supervising organizations (Department of Public Health, Ministry of Health) (91%).
Conclusion. Managers of PHC organizations show a fairly high assessment of the effectiveness of the primary level of providing medical and preventive care in the Republic of Kazakhstan. At the same time, it should be borne in mind that as a polyclinic manager, it is necessary to have experience in PHC conditions and its duration. For the well-coordinated and effective work of the polyclinic, the coordinated work of doctors and secondary medical workers, as well as the rest of the institution's staff and sufficient equipment and medical products are necessary. In
addition, the competence of nurses and their well-coordinated interaction depends on the competence of doctors.