ACTUAL PROBLEMS OF DERMATOVENEROLOGICAL SERVICE DEVELOPMENT: OPINION OF SERVICE PROVIDERS.

Gruzieva, Tetiana S; Korolenko, Volodymyr V; Inshakova, Hanna V

OBJECTIVE The aim: To determine the features and trends of dermatovenerological health of population; to identify conditions and problems of providing dermatovenerological care. PATIENTS AND METHODS Materials and methods: Bibliographic, epidemiological, medico-statistical, sociological methods were used. Scientific literature, data from the Center of Medical Statistics of the Ministry of Health of Ukraine concerning population health and dermatovenerological establishments activity on 2000-2019, data of authors` own sociological researches on opinion of dermatovenerological profile experts about available problems and ways of their decision were analyzed. RESULTS Results: A long-term tendency towards a decrease in the incidence of skin and subcutaneous tissue diseases by 8,6% during 2000-2017 and the incidence of venereal diseases during 2000-2019 was revealed (for syphilis - by 15,5 times, gonorrhea - by 6,8 times). At the same time, during 2014-2019 there was an increase in the incidence of atopic dermatitis by 3,6%, of contact dermatitis - by 5,2%, of trichophytia and microsporia by 22,6%, as well as increase in the prevalence of psoriasis - by 6,0%. The incidence of sexually transmitted diseases remains significant. Trends in recent years indicate a deterioration in dermatological health and an increasing need for medical services. During healthcare reforming over the course of nineteen years there was a reduction in the amount of dermatovenerologists and their number per population by 31,5%, the amount of dermatological institutions - by 2,6 times and beds - by 3,9 times. According to 18,6±3,1 per 100 surveyed respondents, the availability of dermatovenerological care to the population is low, and its deterioration in the COVID-19 pandemic was confirmed by 80,1±4,0. Some factors that negatively affect the quality of medical services have been identified: insufficient amount and quality of medical equipment (57,1±4,0 per 100 respondents), insufficient opportunity for continuous professional development (34,0±3,8); lack of computers (30,8±3,7); lack of motivation to improve the quality of work (28,8±3,6). The priority measures that need to be taken to improve dermatovenerological medical services have been identified. CONCLUSION Conclusions: The study of dermatovenerological profile experts` opinion regarding the current state of the dermatovenerological service, human resources, the availability and quality of the services made it possible to identify a number of organizational and administrative problems as well as to prioritize activities on providing dermatovenerological care to the population in the context of healthcare reform and COVID-19 pandemic.