Managerial and methodological approaches to assessing the effectiveness of primary health care within the implementation of variable models of general practitioner performance

Introduction. To enhance primary health care, new models of medical service delivery are increasingly being introduced. Variative operational models of district general practitioners implemented across Russia’s federal subjects demonstrate promising outcomes. Nevertheless, large-scale adoption is impeded by the absence of a unified system for evaluating their efficacy, necessitating harmonization and standardization.

Purpose. To develop and scientifically validate criteria for measuring the effectiveness of primary health care provision while implementing variative models of general practitioner’s operations.

Materials and methods. The study employed searches for variative models, managerial modeling, analytical techniques, and content analysis.

Results. The analysis has demonstrated variable models to contribute to the increased capacity of therapeutic units, improved access to medical services, and expanded coverage with preventive measures. Team-based work managing of general practitioners allows for more efficient distributing of job functions, reducing doctor’s workload, and increasing the number of patients served. Optimization of regulatory provisions ensures an increase in the number of attached residents, simultaneously improving the quality of provided medical care. The proposed performance evaluation criteria based on classical indicators make it possible to compare variable models. The application of these criteria will provide scientific justification for selecting the most effective model of primary health care (PHC) institution.

Research limitations. The study is restricted in that it evaluates the effectiveness of variative models solely within the scope of PHC delivery.

Conclusion. The validity of the utilized evaluation methodology is demonstrated by extant models, highlighting positive trends toward enhanced patient service quality under current Russian conditions.

Compliance with ethical standards. This type of research does not require review by a local ethics committee.

Contribution of the authors:
Khodakova O.V. — research concept and design, editing;
Miroshnichenko A.I. — collection and processing of material, writing the text, compilation of the list of literature;
Bachegova E.M., Shakhova A.M. — collection and processing of material.
All authors made an equal contribution to the search and analytical work and preparation of the article, read and approved the final version before publication.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: October 13, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026