No abstract

Significant opportunities to increase economic efficiency in health care are associated with increased planned approach to the management of the volume and structure of care and patient flow. In 2010, the Research Institute of Urology in conjunction with the Government of the Voronezh region developed a regional program "Urology". The main objectives of which were: the reduction of morbidity, complications and disability in pa-tients with urological profile, improving the quality and accessibility of urological care to the population area. The essence of the program is to organize medical urological care according to the principles of prevention, standardization, quality control of the organization of care, optimizing the financial costs of the state of health care. In our work we have tried to move away from the principle of "negotiability" and to focus on the active identification of complaints by the survey population. The concept of preventive health care, implemented in the sub-program "Urology" in full compliance challenges of the day – simple, effective, does not cost much. On the example of BPH, it was shown that the introduction of such a system in any branch of medicine will allow maximum transfer care to a new level , away from the provision of assistance in uptake, the majority of accident and emergency assistance on a "detection", routine medical care, and accordingly to plan state assignment for each specific type of care, and as a result, plan on spending on health care , which will lead to the rational use of finance to health care, improve the quality and availability of specialized and high-tech care.

Prostate cancer (PCa) is one of the most common cancers in men and the actual problem of modern oncology. Based on the results of worldwide research, the expected number of patients with prostate cancer in the city of Voronezh and the Voronezh region was calculated. This calculation shows, how the volume of patients requiring medical intervention, will have to face health care, not only in the Voronezh region, but in other regions of the Russian Federation. Existing health care system, where the systematic and standardized approaches to medical care didn’t available, calls into question the successful implementation undoubtedly important and necessary screening. The way out of this situation is to create a system based on the existing urological care to the population of the Voronezh region , « three-tier system of health care ,» which implies an increase in the number and volume of services at the outpatient phase , as well as the division of hospital care on the technological principle according to the principles of prevention and standardization, transfer of care from the principle of « negotiability « to the principle of « detection «, the organization of control of quality of care, established urology service of the Voronezh region is ready to run, and the decision of screening programs.