Patient-oriented model of organization of medical care provision to patients suffering from drug addiction diseases

Abstract


The problem of low patient referral rates for drug-related diseases to healthcare facilities, leading to high latency of drug-related pathology among the population, requires the development of new organizational solutions that help reduce stigmatization and discrimination against patients. The objective of the study was to develop a patient-oriented model for organizing the provision of medical care by psychiatrists-narcologists to individuals with previously unreported drug-related diseases. Materials and methods. The model was studied based on the drug treatment service of one of the largest constituent entities of the Russian Federation — the Samara Region. Organizational and methodological management of the drug treatment service is provided by the Samara Regional Clinical Narcological Dispensary (SRCD). Specialized medical care in the profile of “psychiatry-narcology” is provided in five drug treatment units of the SRCD located in the cities of the region: Samara, Tolyatti, Syzran, Novokuibyshevsk and Chapayevsk, and in 30 drug treatment offices in other cities and municipal rural districts of the region. The staffing level of psychiatrists-narcologists as of the end of 2023 exceeded 90%, with the number of individual psychiatrists-narcologists being 107 people. Based on the analysis of the activities of the narcological service of the Samara region, the literature and the regulatory framework for the provision of medical care to patients suffering from drug-related diseases were studied to develop a model for organizing the provision of medical care. The following research methods were used: content analysis, analytical, organizational modeling. Results. A low-threshold patient-oriented model for organizing the provision of medical care for individuals with an unreported drug-related disease, in the absence of signs of substance abuse syndrome, has been developed. The model is based on the reorganization of the routing of drug-related patients; organization of outpatient appointments in the offices for the prevention of drug-related disorders of the drug-related dispensary using special speech modules, involving psychologists and psychotherapists for diagnostic and psychocorrectional work to identify and eliminate the causes of drug use; use of the “Doctor—Patient” software product for better communication during dispensary observation. Conclusion. Since 2023, a patient-oriented model for organizing the provision of medical care by psychiatrists-narcologists to people with previously unregistered drug addiction has been developed and implemented in the Samara Region, demonstrating its effectiveness and not requiring significant financial costs. Currently, the results of the medical, social and economic efficiency of the implementation of this model are being assessed.

About the authors

Sergey A. Tsarev

Samara State Medical University, Samara, Russia

Email: tsasergey@yandex.ru

Sergey A. Suslin

Email: sasuslin@mail.ru

Galina P. Bogatyreva

Email: gp1308@yandex.ru

Alexander K. Kashirin

Email: mail@sokgvv.ru

Nikolay S. Izmalkov

Email: clinica@samsmu.ru

Saniya Kh. Sadreeva

Samara State Medical University, Samara, Russia

Email: sadreeva063@mail.ru

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