General Practitioner Institutions: Problems of Development as seen in Moscow

Historically in our country there was a system of primary health care (PHC), is carried out on the principle of territorial and precinct. However, over the years of its existence due to various circumstances, the national system of primary health care has become ineffective both medical and economic terms. Finding ways to improve the health and cost-effectiveness of PHC and the health system as a whole has become especially important in the conditions of increase in the structure of morbidity multimorbid pathologies, deepened the economic crisis of recent years and the 2014 reorganization of the capital health. (Reduction of hospital care, increasing the load on the outpatient unit). One of the recognized effective PHC systems in different countries is a system of general practitioners, a key element of which - general practitioner (GP). On introduction of the institute of GPs in our country are talking to the 80-ies of the last century. Spend any pilot project, gained experience of the regions showing the decline in SMP calls, hospitalization, directions for consultations to specialists and unnecessary examinations, increased detection of cancer in its early stages, public satisfaction with the outpatient, etc. However, we still live in a territorial polyclinic inefficient system. The aim of this paper is to examine the institution of development problems in general practice in Russia on an example of Moscow and the development of recommendations on improvement of the organizational structure of primary care and the development of the institution of general practice. In a qualitative sociological study of this work (expert interviews with doctors (16), and heads of polyclinics (6) and in-depth interviews with patients (4)). Based on the study identified the main problems in the development of the institute in the capital of GP outpatient, identified the main reasons for the formation of these issues and recommendations to address them.