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Aim. To optimize principles of gastroenterological care management in outpatient clinics and monitoring of medical service quality for patients with acid-dependent gastroenterological disease (ADGED) in the group of poor health patients for making decisions to optimize diagnosis, treatment and prophylaxis in outpatient setting. Material and methods. Regulated standards were used in examination of 448 ADGED patients. Optimisation of outpatient medical care for poor health patients was conducted basing on the 3-level model of the consulting-diagnostic process. Results. Among patients who suffer from ADGED most seriously 57.3% had H. pylori infection. Such patients benefited more from antihelicobacter treatment. Conclusion. Increasing number of patients with severe ADGED is explained by poor compliance with measures of prevention, healthy life style, treatment including antihelicobacter, low adaptation of gastric mucosa. Prophylaxis in ADGED patients should become a leading direction in medical care for such patients.