State and prospects of introduction of family medicine in Ukraine

BACKGROUND: In Ukraine, implementation of family practice is declared to be a priority. Development of primary health care on the basis of family practice is defined by legislative acts. Nevertheless, family clinical practice is neglected. Funds are spent on expensive inpatient treatment, while cheap primary health care is forgotten. Hospitals and outpatient clinics, ambulance cars are used to provide everyday medical care. Approximately one third of hospital patients should get out-patient treatment. The aim of this study was to analyze the functioning of the national system of primary health care based on family medicine, to identify the main trends of its development and current problems.MATERIALS AND METHODS: This study is exploratory. Eight semi-structured interviews with family doctors from Kyiv city and Kyiv region were conducted with "snowball" sampling. The data was analyzed through qualitative content analysis of the content of the interviews.RESULTS: All respondents expressed a positive attitude to the implementation of family medicine. They emphasized that the development of family medicine is economically feasible and socially effective. Most respondents pointed out that not enough time is devoted to the training of family doctors. None of the respondents provides gynecological care and manages pregnancies. Family doctors are not interested in independent treatment of patients, taking responsibility for them, and thus expanding their skills and enriching their experience. All respondents stated that the current system of family practice financing and remuneration is not up-to-date and must be changed.CONCLUSION: The interviewed family practitioners believe that the implementation of family clinical practice in health care institutions is appropriate for improvements of the health care system. Meeting the task of family medicine development is possible, provided that the approach to financing of the sector, specialist training and incentives system is changed.