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Improving the Generalist-Specialist Interface for Getting Higher Quality Medical Care

Student: Gevorgyan Mariya

Supervisor: Vasily Vlassov

Faculty: Faculty of Public Administration

Educational Programme: Master

Year of Graduation: 2014

Abstract The work addresses the impact of attending physician and consulting physician interaction on quality of care. The major objective of the work is evaluating the level of effectiveness in this professional interaction and exploring the ways to improve it. Current interface between attending physician and consulting physician caused by law qualification and artificial limits of primary-care physicians authorities and undefined regulation of consultation as well. In this survey sociological data compiled, the Delphi method of expert evaluation including depth interviews and statistical analysis used. The most important results of the study are: 1) a conceptual model of professional relationship sin health care is developed, the need to concentrate the entire patient information from the treating physician to ensure continuity of care concluded, the need for individual responsibility of the attending physician is emphasized; 2) Collected data provides evidence on the low level of effectiveness of professional generalist-specialist interaction. 3)an empirical analysis of the causes of inefficient generalist-specialist interaction is conducted;4) the recommendations on improving the generalist-specialist interaction based on empirical results are compiled: elimination of disparities between general practitioners and medical specialists, medical counseling regulation technology, the creation of conditions to extend the functionality of the attending physician, the improvement of information in health care, the adjustment of control and supervisory functions of the administration of health care institutions. Excessive specialization narrows physician functionality, reduces coordination and continuity of care. Keywords: generalist-specialist interface, curative physician, consultant, health care specialization

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