[The problems of medical care quality in primary section of private sector of health care].

The efficiency of quality control of medical care in medical organizations providing medical care in out-patient conditions is inadequate. The purpose of the study is to identify main problems of ensuring quality of medical care in private medical organizations providing medical care in out-patient conditions and to develop suggestions for their elimination. The assessment of medical care quality in private medical organizations network was carried out using expertise technique (n = 1070), intra-organizational attestation (n = 47), questionnaire survey of administrative (n = 28) and medical personnel (n = 241). The total number of medical care defects made up to 4,822, and 97.3% of them were related to diagnosis and treatment. A full justification of diagnosis was recorded in 65.8% of cases. The cases of insufficient and excessive examination have been identified. The non-compliance with duration of treatment and frequency of visits have been established. The inadequate medical efficiency (67.6%) reliably effected on low compliance of patients, recorded in 18.9% of cases (p < 0.05). The main problems of ensuring medical care quality are related to organization of internal control system, involvement and motivation of medical personnel and development and maintenance of necessary organizational culture. In the private health care sector, quality issues can be solved solely by means of material resources. It is necessary to improve of medical personnel management, internal quality control of medical care and management of organizational culture.