[The issues of medical care enhancement]

The structure of 8617 patients' home visits performed by general practitioners and district physicians is analyzed. The expert assessment technique was applied to investigate the quality of medical care rendered to 485 patients at home. The timekeeping of hours on duty of 18 district physicians and general practitioners was implemented during 965 hours. The studies were carried out during 2004-2005 and for the research base were chosen 8 polyclinics in 4 cities of the Republic of Dagestan. The general practitioners and district physicians, when visiting their patients at home, diagnose diseases of respiratory system in 29.2% and 35.2%, diseases of circulation system in 25% and 25.3% and diseases of digestive system in 16.1% and 14.4% correspondingly. It is noticed that the general practitioners encounter the patients of non-therapeutic profile almost twice more often than the district physicians. The home treatment of patients by the district physicians and general practitioners was not timely in 33.4% and 27.1% of cases; in 38.7% and 29% of cases it was not of full-fledged quality. The study revealed that general practitioners as compared with district physicians 1.5 time more contribute to prevention activities and almost twice to family medical social support. The research data was used to develop the guidelines and proposals regarding the optimization of medical care rendering at home.