The optimization of the prevention of chronic non-communicable diseases in united labor collectives by implementing a multi-stage screening program with online survey and patient-oriented approach
Keywords:online survey, preventive medical examination, screening program, chronic non-communicable diseases, general practitioner, labor collectives
Background. During the health care reformation in Ukraine, it is presumed the strengthening of prevention in the general practice, particularly in the fight against chronic non-communicable diseases (NCD), this will lead to increasing of interaction between institutions of general medical practice / family doctors and establishments. Thus, it is important to develop tools that will enable general practitioners to provide the effective preventive measures working with labor collectives. The purpose of the study is to optimize the programs of screening preventive examinations of the employees in general practice for the improvement of the prevention of NCD in the labor collectives. Materials and methods. A multi-stage screening program, which consisted of 3 stages, was developed. The first stage included a survey using a specially designed online questionnaire to assess risk factors and progression of NCD and health of workers, the second stage was an examination by family doctor, the third - consultation and examination by a specialist, depending on the results of previous stages. The 83 employees of the pharmaceutical company, 18 to 64 years old (male 24%, female 76%) attended in the study. Satisfaction and quality of medical examination was assessed by questionnaires. Data analysis and program effectiveness were conducted using statistical methods in Excel 2010. Results. The analysis of data received from online questionnaires and data received from comprehensive medical examination by general practitioner made it possible to optimize the time and method of screening, to offer patient-centrated proposal with multidisciplinary approach aimed at solving the most pressing problems of each employee. It influenced on the timing, medical, social and economic efficiency and adherence to participating in the program. The workers marked the sufficient quality of the multi-stage screening program and satisfaction with the preventive examination. The medical and social effectiveness of the program was 1.6. In assessing the economic efficiency of stages 1 and 2, it was found that implementation of online survey reduced the duration of the preventive examination of each employee in 50%. The ratio of benefit / expense (P) for the 2nd and 3rd stages of the screening program was P3>P2, respectively. Conclusions. The multi-stage program of screening of workers using online surveys has made it possible to reduce the time and cost of a preventive medical examination and, accordingly, increase the economic, medical and social efficiency. The patient-centered approach provided the opportunity to determine the required volume of examinations and procedures. Although patients were more adherent to be consulting by specialist, the collaboration between general practitioner and specialists within the multidisciplinary team was the most effective.
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