Priorities of Development the Urological Medical Assistance in the Republic of Moldova

Abstract

In the Republic of Moldova, the surgical practice of urologists among the national hospitals is narrowing with less case diversity and a greater focus on subspecialties. These trends are even more evident among urban urologists compared to rural practice. A quantitative study was carried out, 96 urologists were interviewed out of the total number of 116 people involved in urological healthcare in the Republic of Moldova. The purpose of the study was to evaluate the organization and functioning of urological medical care in the Republic of Moldova for the elaboration and argumentation of recommendations in accordance with contemporary standards in the field. The human resources involved in urological medical assistance in the country were analyzed, the analysis of the functionality of the urological services provided at different levels, both ambulatory and hospital, and various aspects of the field of providing urological medical assistance was carried out. The correlation of doctors' gender with their age, the distribution of work experience by geographical areas and depending on the place of providing urological medical assistance were evaluated. Also, in order to establish the quality of service to patients, the doctors participating in the study were interviewed regarding access to high-performance investigations, the professional load in terms of the number of territorial units served, the number and type of urological interventions performed annually, as well as rate of recorded complications. The majority of urologists - 70.9% provide services in the Center area and the municipality of Chisinau, which reveals a hyper centralization of urologists, it was also established that 59.4% of the surveyed urologists practice minimally invasive interventions, and in outpatient only 17.6% practice this type of intervention, and about 1/3 of those interviewed practice surgical interventions insufficiently. In conclusion, it was established that the current improvement of urological medical care in the Republic of Moldova must be based on the principle of quality, responsibility, modernization and focusing on the patient's needs.