The article explores the attitude of the participants of the primary health care (PHC) delivery process to the redistribution of functions between medical and non-medical personnel in order to release the working time of general practitioner, that is not directly related to the provision of medical care to patients, as well as the qualitative changes in the functionality of the general practitioner’s nurse by transferring functions that do not require special skills to non-medical personnel.
OBJECTIVE
To explore the attitude of doctors and nurses of the district service, and patients to organizational solutions on improvement of the PHC delivery process with redistribution of functions between doctors, nursing and non-medical personnel.
MATERIAL AND METHODS
A survey of doctors, nurses of the district service and patients of polyclinics was carried out using specially designed questionnaires in 2022. The sample included 550 doctors, 679 nurses and 430 patients.
RESULTS
The study analyzed the structure of time costs in the PHC provision from the perspective of the participants, namely doctors and nurses of the district service. The functions of medical and nursing personnel of organizational and administrative character have been defined. The functions that are most available for transfer from the district general practitioner to the nursing and non-medical staff in order to free up the doctor’s time at the appointment were highlighted. According to the survey data, the majority (53.1%) of doctors support the expansion of nursing functionality. This proposal is opposed by 51.1% of nurses. In addition, 76.0% of doctors and 71.7% of nurses consider the redistribution of functions to be an effective tool to reduce the current pressure on medical personnel. The majority (73.7%) of the surveyed patients expressed their willingness to complete their visit to the polyclinic and not to see the doctor if the nurse could resolve their issue.
CONCLUSION
The redistribution of functions between the medical and non-medical personnel of the district service, according to all participants in primary health care, is an effective solution to free up the time of highly qualified specialists (physicians and nurses) to directly provide health care and increase its accessibility. At the same time, there is a need of a broad discussion within the health community about the proposed changes in order to achieve maximum results and implement all the goals.
