TERRITORIAL FEATURES OF THE INTRODUCTION OF A NEW POLYCLINIC MODEL AT THE REGIONAL LEVEL

DOI: 10.22138/2500-0918-2025-22-1-113-126

V.A. Sovina ¹, A.A. Kurmangulov ², T.A. Mezentseva ³, 
D.O. Mikhailova ³, S.L. Leontiev ³

¹Regional State Budgetary Healthcare Institution «Krasnoyarsk Interdistrict Polyclinic No. 5», Krasnoyarsk, Russian Federation;
²Federal State Budgetary Educational Institution of Higher Education «Tyumen State Medical
University» of the Ministry of Healthcare of the Russian Federation, Tyumen, Russian Federation;
³State Autonomous Institution of Additional Professional Education «A.B. Blokhin Urals Institute of Health Care Management», Yekaterinburg, Russian Federation

Abstract. The introduction of a new model of a polyclinic based on lean manufacturing principles helps improve the quality and availability of primary care. The purpose of the work: to assess the level of implementation of the new model in the divisions of medical organizations providing primary health care in the Krasnoyarsk Territory, depending on the territorial distance from the regional center. Material and methods. The source of information was the consolidated data of statistical forms of the Krasnoyarsk Territory for the period from 2019 to 2024. The study involved 111 divisions of medical organizations providing medical care to the adult and child population of the Krasnoyarsk Territory, which implemented the new model during the study period. It has been established that the level of implementation of the new model is affected by the level of urbanization of the location of the medical organization's division (p<0.001) and the age category of the attached population (p<0.001). Divisions of medical organizations located at a distance of more than 250 km from the administrative center of Krasnoyarsk Krai, statistically significantly participate to a lesser extent in project activities (p<0.05), achieving the criteria of the second, third levels of the new model (p<0.05) and a block of additional criteria of the entry zone (p<0.001). The conducted correlation analysis of the data between the territorial remoteness of the medical organization's division from the regional center and the level of implementation of the new model in it indicates an inverse statistically significant linear relationship of medium strength (r=–0.430, p<0.001). Results. It has been established that the level of implementation of the new model is affected by the level of urbanization of the location of the medical organization's division (p<0.001) and the age category of the assigned population (p<0.001). Divisions of medical organizations located at a distance of more than 250 km from Krasnoyarsk, statistically significantly participate in project activities (p<0.05), achieving the criteria of the second, third levels of the new model (p<0.05) and a block of additional criteria of the entry zone (p<0.001) to a lesser extent. The conducted correlation analysis of the data between the territorial remoteness of the medical organization's division from the regional center and the level of implementation of the new model in it indicates an inverse statistically significant linear relationship of medium strength (r=–0.430, p<0.001). Conclusion. The high level of implementation of the new model in the divisions of medical organizations at a distance of 0-25 km from the regional center is due to the location in a large city, which provides more opportunities for advanced training, exchange of knowledge and relevant information, as well as a decrease in time and transportation costs. The low level of implementation of the new model in rural areas may be a consequence of a shortage of personnel, insufficiently developed infrastructure. Insufficient level of implementation of the new model, limited implementation of project activities, failure to achieve levels 2, 3 and a block of additional criteria of the entry zone in the divisions of medical organizations located at a distance of more than 250 km from the regional center is caused by territorial remoteness from the regional center and, as a consequence, the impossibility of carrying out face-to-face control activities, low involvement of employees of these divisions due to poor resource, personnel, information and communication support.

Keywords: lean technologies, primary link, new model, regional center of primary health care organization, federal project, Krasnoyarsk Krai

There is no conflict of interest.
Contact information for the corresponding author:
Valentina A. Covina
omrkrasmp5@mail.ru
Received: 11.02.2025
For citation: Sovina V.A., Kurmangulov A.A., Mezentseva T.A., Mikhailova D.O., Leontiev S.L. Territorial features of the introduction of a new polyclinic model at the regional level. [Online] Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2025, Vol. 22, no. 1, pp. 113–126. DOI: 10.22138/2500-0918-2025-22-1-113-126 (In Russ)

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Authors
Valentina A. Covina
Krasnoyarsk Interdistrict Polyclinic No. 5
Deputy Chief Physician for Organizational and Methodological Work
Krasnoyarsk, Russian Federation
omrkrasmp5@mail.ru
ORCID – 0009-0001-6072-4073
SPIN: 4572-2907

Albert A. Kurmangulov
Tyumen State Medical University of the Ministry of Health of the Russian Federation
Doctor of Medical Sciences, Associate Professor, Associate Professor of the Department of Public Health and Public Health, Head of the Training Center for Lean Technologies in Healthcare
Tyumen, Russian Federation
kurmangulovaa@tyumsmu.ru
ORCID: 0000-0003-0850-3422
SPIN: 1443-3497

Tatyana A. Mezentseva
Ural Institute of Public Health Management named after A.B. Blokhin
Candidate of Medical Sciences, scientific worker
Yekaterinburg, Russian Federation
umsep-ta@yandex.ru
ORCID: 0000-0001-6318-8037
SPIN: 2627-2450

Diana O. Mikhailova
Ural Institute of Public Health Management named after A.B. Blokhin
Doctor of Medical Sciences, Deputy Director for Development
Yekaterinburg, Russian Federation
umsep-do@yandex.ru
ORCID: 0000-0001-8068-5940
SPIN:9236-1821

Sergey L. Leontiev
Ural Institute of Public Health Management named after A.B. Blokhin
Professor, Doctor of Medical Sciences, Director
Yekaterinburg, Russian Federation
ls.04@yandex.ru
ORCID: 0000-0003-4092-4577
SPIN: 8386-2137