Browsing by Author "Lordkipanidze, Ana"
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Item The Gatekeeper Model: patient’s view on the role of the family physician(Family Medicine & Primary Care Review, 2020) Verulava, Tengiz; Dangadze, Beka; Jorbenadze, Revaz; Lordkipanidze, Ana; Karimi, Leila; Eliava, Ekaterine; Maglakelidze, TamarBackground. An adequate primary healthcare system substantially determines quality of population health and effective spending of healthcare resources. The family physician serving as a ‘gatekeeper’ can make judicious decisions about the appropriate use of medical services. Objectives. The goal of this study was to find out patients’ characteristics, preferences and behavior in regards to the role of the family physician as the gatekeeper in The Republic of Georgia. Materials and Methods. As part of a cross-sectional quantitative study, respondents were interviewed using a structured questionnaire. Results. Majority of the respondents (53.7%, n=245) had a permanent family physician, but were not satisfied with a level of family physician’s professionalism (56.6%, n=258) and preferred self-referral to specialists (55%, n=253). Only 19.5% (n=89) referred to specialists upon family physician’s advice who would coordinate all services and 23% (n=103) have used both family physicians and self-referral. Private health insurance companies were more interested in implementing cost reducing mechanisms rather than the Social Service Agency (which is responsible for Universal Health Care Program). Conclusions. It is appropriate to share private health insurance experiences for developing a model of gatekeeper in the UHCP. In order to improve a family physician institute and increase confidence in it, it is recommended to raise the level of family physicians’ skills of relations with patients as it has a significant effect on the patient preferences. It is advisable to develop a flexible and voluntary gatekeeper model which will better suit the needs of both patients and physicians.Item Introduction of Mandatory Vehicle Inspection and its impact on Health: Case of Georgia(Taylor & Francis Group, 2019) Lordkipanidze, Ana; Bigvava, Nana; Verulava, TengizTo fight atmospheric air pollution, the Georgian government has implemented a law about vehicle inspection. The aim of this survey is to determine under which conditions are owners of technically faulty vehicles ready to give up using technically faulty cars. Within the qualitative study the in-depth interviews were conducted. Taxi drivers think that this law is harmful to them though they appreciate the efficacy of vehicle inspections. Controls should be placed on the quality of fuel as part of the development of public transport while increasing awareness about the harmful effects of atmospheric air pollution.Item Obstacles in the Development of Nonprofit Hospitals in Georgia(Taylor & Francis Group, 2019) Verulava, Tengiz; Lordkipanidze, Ana; Besiashvili, Nino; Todria, Mirian; Lobjanidze, Zviad; Jorbenadze, Revaz; Eliava, EkaterineThe most common form of ownership of medical establishments worldwide is a nonprofit organization. In contrast, the number of nonprofit medical institutions in Georgia is very scarce, while private profit organizations hold about 90% of the medical market. The goal of the research is to study the factors that affect the development of nonprofit hospitals in Georgia. Since there are very few nonprofit medial institutions in Georgia, we hypothesize that there is not enough motivation for functioning of such institutions. For the purposes of this research, six in-depth interviews were conducted with managers and experts of nonprofit organizations. As the research demonstrated, there is no sufficient motivation for functioning of the nonprofit form of medical organizations. Although the Tax Code provides tax benefits, they exist only in a token way and do not support the development of nonprofit medical organizations. It is necessary to improve the tax benefits provided for nonprofit hospitals in the Tax Code and share the world experience in order to increase number of nonprofit organizations in Georgia. It is recommended for Government to give more support to nonprofit organizations, in order to increase their functioning efficiency and bring incentive for development of new nonprofit medical institutions.Item Readmission after hospitalization for heart failure in elderly patients in Chapidze Emergency Cardiology Center, Georgia(Emerald Publishing, 2021) Verulava, Tengiz; Jorbenadze, Revaz; Lordkipanidze, Ana; Ghonghadze, Ana; Tsverava, Michael; Donjashvili, MananaPurpose: Heart Failure (HF) is one of the leading mortality causes in elderly people. The goal of our study is the assessment of readmission in elderly patients with HF. Methodology: We explored medical records of elderly patients with HF (75 years and more) at Chapidze Emergency Cardiology Center (Georgia) within 2015-2019 years. We analyzed the structure of the cardiovascular diseases and readmission rates of hospitalized patients with HF (I50, I50.0 I50.1). A multivariate logistic regression model was used to identify factors, associated with readmission for any reason during 6-9 months after the initial hospitalization for HF. Findigs: The major complication of cardiovascular diseases in elderly patients is Heart Failure (68.6%). Hospitalization rates due to the HF in elderly patients were increased during the past years, which is associated with the population aging process. This trend will be most likely continued during the next years. Despite significant improvements in the HF treatment, readmission rates are still high. HF is the most commonly revealed cause of readmission (48% of all readmissions). 6-9 months after the primary hospitalization due to HF, readmission for any reason was 60%. Patients had concomitant diseases including hypertension (43%), myocardial infarction (14%), diabetes (36%), and stroke (8%), affecting the readmission rate. Originality/value: HF remains an important problem in Public Health. During HF associated hospitalization both cardiac and non-cardiac conditions should be addressed, which has the potential for health problems and disease progression. Some readmissions may be prevented by the proper selection of medicines and monitoring.