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The organization of a population survey on preventive medicine and satisfaction with the quality of medical care

Priority areas of development: management
Department: Laboratory of Economic Problems in Health Care
The project has been carried out as part of the HSE Program of Fundamental Studies.

Object of research: Urban and rural population aged 16 years and over.

Goal of research: To identify the population's attitude to disease prevention, and how satisfied they are with different components of the quality of medical care.

Empirical base of research:

Population survey commissioned by the HSE and implemented by the Levada Center in September 2013 in 279 towns and villages of Russia, located in 62 subjects of the Federation. The sample represents the adult (16 years and over) population of the Russian Federation. The sample size is 3302 respondents.

Results of Research:

The main sources of information for citizens about preventive medicine and a healthy lifestyle are the mass media - 88% of those interested in this information, got it through television, radio, press and the internet. A quarter of this group (26%) get information on the subject through friends, neighbors, acquaintances, and only 18% receive information about prevention and healthy lifestyles from health professionals.

Public attitude towards the introduction of health warnings on the dangers of smoking on cigarette packaging is rather indifferent - 40% do not pay any attention to them. Most of the measures to combat smoking and alcohol abuse are finding support among the general population (regardless of the presence of these harmful habits among Russians), with the exception of any steps to raise the price of cigarettes, strong or weak alcohol. However more than half of respondents support such measures.

The vast majority of Russians (81%) agree with the need for regular medical examinations. Thus for the last two years almost half the adult population (46%) have undergone medical examinations, 27% ​​of population have had them less than a year ago and 17% - a year ago. A fifth of the population had their last medical examination about three or more years ago, and the same number have never been examined.

22% of patients who have undergone medical examinations, were recommended outpatient treatment, and 6% - inpatient treatment.

Among those who had the chance to have medical examinations, about 7% said that they had refused to undergo medical examinations in the past three years.

During the last year 40 % of Russians were offered vaccinations (including influenza), and only every second had them​​. Younger age groups (16-24 years), among which students make up a large proportion, were offered vaccinations more often.

The population remains poorly informed and passive about using opportunities the new health centers offer: 11 % know and have visited the centers, 33% had heard of such centers, but did not go to them for help. More than half of the population (56%) is unaware of the existence of the health centers.

Most Russians associate quality of medical care primarily with positive outcomes, an improvement in their health, the timeliness of the care provided, not having to wait long to be seen, and the availability of modern medical equipment.

The main directions of improving the quality of care are consistent with how the majority of citizens understand their needs. Half of the respondents want to see a more conscientious attitude in doctors to their work. Expectations for equipping hospitals and ambulances and improving their drug provision were second in importance.

Most interviewed patients have expressed high levels of satisfaction with the last case of outpatient and emergency care (at least four out of five), dental care (at least nine out of ten respondents), and hospital care (84% of respondents).

However, a comparison in levels of satisfaction with quality of care with the estimates obtained in a large-scale population survey conducted in 2009 by the Roszdravnadzor shows that over the past 4 years the satisfaction of the population with inpatient care did not increase for each dimension of quality, except for the provision of drugs in hospitals. With regard to outpatient care, neither did the satisfaction with the results of treatment increase, and the level of satisfaction with the attitude of all categories of health personnel towards patients went down.

The staffing of outpatient clinics by medical specialists has deteriorated. According to the 2009 survey data, 40% of respondents noted a lack of sufficiently qualified specialists in the health care facility where they usually receive medical care, while in the 2013 survey data, the share of respondents who reported a lack of sufficiently qualified medical specialists in accessible polyclinics was 53%.

Despite the introduction in recent years of electronic records to the doctor, patients are forced to sit in line for more than half an hour in almost half of the cases (in 40% of cases in 2009).

According to the results of previously conducted studies, every tenth respondent had difficulties when calling an ambulance. Nowadays the situation has worsened: every fourth case was problematic, and in cities with a population of 100 to 500,000  the share of such cases is 30%.

Level of implementation, recommendations on implementation or outcomes of the implementation of Results:

The results of the population survey can be used to pinpoint the priorities of public health policy and programs aimed towards improving the quality of medical care.

Field of application:

Scope of activities to promote healthy lifestyles and disease prevention, health care system.