Economics of health care
  • 2017 № 8 The Results of a study of financing of TB control activities

    Tuberculosis control in the Russian Federation has a high national priority, confirmed a high level of funding for TB activities. The value of the costs per patient of tuberculosis is the highest in the world. The main economic burden of TB falls on the budgets of the constituent entities of the Russian Federation. The article presents the results of the analysis of volumes of financing on the main financial sources and areas of spending of budget funds for TB care in 2015. Presents cross-country comparative analysis of the financing of TB control in countries with high burdens of tuberculosis and tuberculosis, caused by the pathogen with multidrug resistance. The dynamics of the state of basic funds of TB of the medical organizations and the calculations of the financial requirements for their updating

    Authors: Obukhova O. V. [18] Sterlikov S. A. [6] Nechaeva O. B. [2] Belilovsky E. M. [1]

    Tags: anti-tuberculosis measures1 the basic foundations of healthcare organizations1 tuberculosis3

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  • Financial management
  • 2019 № 1 Methodology for estimating the costs of identifying, diagnosing and treating tuberculosis with multiple and extensive drug resistance

    Estimating the cost of treating patients with extensive drug-resistant Mycobacterium tuberculosis is useful both in planning financial resources for anti-tuberculosis activities and in determining the economic burden of this phenomenon. The article proposed the author’s methodology for estimating the costs of identifying, diagnosing and treating tuberculosis with multiple and extensive drug resistance, calculated estimates of the cost of combating the general drug resistance of mycobacteria tuberculosis.

    Authors: Obukhova O. V. [18] Sterlikov S. A. [6] Rusakova L. I. [1]

    Tags: anti-tuberculosis activity1 direct costs5 dr-tb1 mdr-tb1 multi-drug resistance of mycobacterium tuberculosis1

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  • 2016 № 9 Payment arrangements for interrupted case of medical care, including ultrashort course, in the system of compulsory medical insurance

    Annotation. According to the draft program of state guarantees of free medical care to citizens in the years 2017–2019, when paying for medical care provided in a hospital, as well as in the provision of medical rehabilitation services in specialized medical institutions (structural units) in the compulsory medical insurance system, used payment method for interrupted, including ultrashort, the case of medical care. Issues correct compensation for the medical organization with ultrashort or interrupt the event is dedicated to the treatment of the material costs.

    Authors: Obukhova O. V. [18] Brutovа A. S. [5] Bazarova I. N. [6]

    Tags: case of treatment1 interrupted case of treatment1 methods of payment medical care1 system of compulsory medical insurance1 ultrashort case of treatment1

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  • 2015 № 9 Influence on age and gender considerations costs while providing high-aid in profile «traumatology and orthopedics»

    Annotation. Relevance. One of the economic problems in health care in the shortage of funds is to find mechanisms of payment, the most adequate and reliable-specific medical care. This is especially true of the cost of such a species as a high-tech medical care. One of the most appropriate ways to pay for medical care provided in inpatient and day hospital is to pay as part of the clinical and statistical groups of diseases. When forming groups, in addition to such major criteria as the ICD-10 code or having surgery, apply additional criteria, taking into account the peculiarities of medical care to patients of different age and gender categories. Material presented in the article findings justify the need for such a differentiated approach to the formation of groups of high-tech expensive medical care

    Subject of research: the group of high-tech medical care, approved by RF Government Decree of 28.11.2014 №1273 in the framework of the provision of state guarantees of free medical care to citizens for 2015 and the planning period of 2016 and 2017.

    Objective: research to justify the use of a differentiated approach to the establishment of standards for the financial costs of groups of high-tech medical care, taking into account age and gender considerations. Methods of work: statistical, analytical.

    Results: for the first time carried out an in-depth analysis of the cost structure of the federal health care organizations in the provision of high-tech medical care, identified factors affecting the size of the cost of medical organizations in the profile «Traumatology and orthopedics», to justify proposals to optimize the standards of financial costs on the profile «traumatology and orthopedics.»

    Conclusions: the patient population, which is a high-tech medical care in the profile «Traumatology and Orthopaedics », consists mainly of older persons of working age, mainly women. The average standard of financial expenses higher in the older working age.

    Authors: Obukhova O. V. [18] Perkhov V. I. [18] Brutova A. C. [2]

    Tags: high-tech medical care in the profile «traumatology and orthopedics»1

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  • 2015 № 4 High-tech medical care in the system of compulsory health insurance

    Health care reform had an impact on the such expensive type of medical services as a high-tech medical care. Since in 2015, as planned new federal legislation, went into the system of compulsory health insurance. Answer to the question, what is the purpose of the transfer of high-tech health care insurance rails, whether all the volume of this type of medical care today is subordinate stringent requirements of the compulsory health insurance, and what kind of the medical organization involved in providing this type of care, to what extent and for the what funds are reimbursed which health organizations can get the volume of the entire high-tech medical care, dedicated to this material.

    Authors: Obukhova O. V. [18]

    Tags: compulsory health insurance13 high-tech medical care7 program of state guarantees2 tariffs in the public health insurance system1

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  • Management in health care
  • 2016 № 1 Organisation and outcomes of monitoring medical-economical factors of high-technology medical aid

    This article explores individual organisational-methodological approaches to constructing monitoring informational systems of high technology medical aid. Authors conclude that there is a necessity to create unique monitoring systems and databases, formed by personified audit of the most significant signs of surveillance subject. Article’s materials can be used while modelling information systems for practical implementation of high medical technology in circumstances of one stream financing.

    Authors: Obukhova O. V. [18] Perkhov V. I. [18] Bazarova I. N. [6] Gorin S. G. [3]

    Tags: high technology medical aid1 informatization of healthcare2 one channel financing1

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  • 2015 № 9 The condition and renovation of capital assets of TB-institutions in the Russian Federation (2012–2014)

    The state of capital assets of TB organizations in the Russian Federation: buildings and structures, machinery and equipment, motor vehicles evaluated. Discovered increased depreciation of capital assets, imbalance of wear, imbalances of renovation. The ways of harmonization of state assets offer.

    Authors: Son I. M. [38] Obukhova O. V. [18] Sterlikov S. A. [6]

    Tags: anti-tb institutions1 capital assets1 health economics1 tb care1

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  • Manager of health care consults
  • 2020 № 6 Assessment of public policy in relation to certain issues of healthcare functioning during the spread of COVID-19 Coronavirus 

    Health care, as a predominantly public system, is objectively subject to serious regulation in special operating conditions, which include the spread of COVID-19 coronavirus infection. It is also important that the private healthcare system is also subject to direct or indirect regulation. At the same time, public authorities are sometimes forced to resort to "manual management", the consequences of which are not always clear for both public and private health care.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Bazarova I. N. [6] Starodubov V. I. [30] Endovitskaya  Yu.  V. [3]

    Tags: coronavirus3 covid-197 crisis3 financing10 health care20 mandatory health insurance5 medical organizations15

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  • 2020 № 2 The Main approaches to the evaluation of the effectiveness of the implementation of the “effective contract” in health care

    The upcoming reform of the wage system involves a more detailed analysis of not only the advantages and disadvantages of the existing system (as well as previous ones), but also the practice of its application. The most obvious criterion for evaluating the effectiveness of the current wage system is to assess how well it has enabled the implementation of an effective contract and the tasks assigned to it. At the same time, it is necessary to analyze what were the problems of introducing an effective contract that are not directly related to a specific wage system.
    One of the main methodological problems with the introduction of an effective contract is that the recommendations for its introduction, developed at the preliminary stage, were not revised following the evaluation of the implementation of an effective contract and its results. Best practices and mistakes were not taken into account, which made it impossible to adjust and specify approaches to the introduction of an effective contract.
    In many ways, this is why many institutions have approached the introduction of an effective contract quite formally.
    The proposed article is devoted to the criteria for evaluating the success of implementing an effective contract in state (municipal) health care institutions.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Chililov A. M. [7]

    Tags: effective contracts1 incentive payments3 indicators and criteria for evaluating the performance of employees1 remuneration1 remuneration systems1 state (municipal) institutions6

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  • 2019 № 1 Financing health care in 2019: new priorities and channels for the movement of funds

    Analysis of the future financing of health care shows that in 2019–2021, despite the difficult financial situation, the volume of financial support for the industry will continue to grow. Thus, the size of health care spending from the Federal budget is growing not only in absolute terms, but also occupies all a large share in the structure of Federal budget expenditures. The increase in expenses in the system of compulsory health insurance (CHI) in absolute terms is still quite large. Among the priorities of 2019 are the increase in funding for cancer care, as well as high-tech medical care, which directly follows from the provisions of the Decree of the President of the Russian Federation May 7, 2018 № 204 "The national goals and strategic objectives of the Russian Federation for the period up to 2024" (presidential Decree № 204). The distribution of funds to the compulsory medical insurance system is based on these priorities, and based on the results of implementation of decrees of the President 2012 for leveling a series of problems, such as unreasonable reductions in personnel. All this should have a positive impact on the further development of health care.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Brutova A. C. [2]

    Tags: compulsory medical insurance9 deficit5 expenses5 federal budget6 federal fund of chi1 financing10 health care20 income5 insurance contributions1 inter-budgetary transfers1

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  • 2018 № 1 Prospects of health financing in 2018

    New 2018 in terms of funding health care will differ from the previous - it is expected a sharp increase in funding from all types of sources. However, this is due not only to increased revenues and the restructuring expenses. It becomes more rational - "saving" (for example, reducing expenditures on more costly inpatient care in the Federal budget). In the system of obligatory medical insurance is the refusal of a number of "non-core" expenditure. All of this should have a positive impact on the development of health care

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Brutovа A. S. [5]

    Tags: compulsory health insurance13 deficit5 expenses5 federal budget6 federal the mandatory medical insurance fund1 financing10 healthcare6 income5 surplus2

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  • 2017 № 1 Нealth care Funding in 2017 – another paradox: the means was less than planned for 2016, but the financial support for the industry has improved

    In recent years, the Federal budget is closely linked to the budget of the Federal mandatory medical insurance Fund – they cannot be analysed separately from each other. The Federal funding is reduced, but the budget of the Federal mandatory medical insurance Fund in 2017 favorably with previous: 2016 was suddenly executed with a surplus. Large carryovers for 2017 are not evaluated as a negative factor, as it was before, but as positive, as they relate to the refusal of the state from the withdrawal of the Federal budget planned amounts. Therefore, a sharp drop of healthcare financing from the Federal budget does not mean the deterioration in the financing industry – changing channels the movement of funds. This is due to the fact that the government became aware that the transformation of the budget of the Federal mandatory medical insurance Fund to source for other budgets will not ensure the implementation of presidential Decrees on raising wages. In addition, there have been major changes to the financing of high-tech medical care, which is not included in base program OMS –2017 it is almost completely financed by funds. In the article the analysis of dynamics and trends of health financing from different sources.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Brutovа A. S. [5]

    Tags: budget5 deficit5 expenses5 federal fund of compulsory medical insurance1 finance1 health3 income5 inflation2 obligatory medical insurance3 surplus2

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  • 2015 № 9 Provision of medical aid within a medical approbation

    Currently there are developed legal and methodological principals for medical aid provision within a clinical approbation of prevention methods, diagnostics, treatment and rehabillitation. Despite the imperfections of the developed system, it allows to eccelerate the process of implimenting new medical technologies into the health care system, having simultaneously provided financial support to federal clinics, experiencing serious economical burdens due to budget cuts for the most common types of medical care in circumstances of economical instability. The article analyses the issues and provides recommendations for improving organizational mechanisms of clinical approbation.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Perkhov V. I. [18] Starodubov V. I. [30]

    Tags: clinical approbation1 clinical experiments1 clinical research1 clinical-economical analysis1 effectiveness5 financial support of medical activity1 medical aid2

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  • Manager of healthcare consults
  • 2020 № 5 Russian Health Care in the background coronavirus COVID-19: Opportunities and Threats

    The effectiveness of any public system, including health care, is determined by the adequacy of its legal regulation. The situation with coronavirus exposed many problems in this area, a number of which were quickly resolved with varying degrees of success. However, there are still many unresolved issues and the need to further improve the legal regulation of health care. This applies, among other issues, to the remuneration of medical workers engaged in providing medical care to patients who have been diagnosed with COVID‑19 coronavirus infection. The article presents an analysis of the procedure for implementing incentive payments at the expense of Federal funds, and suggests measures to improve it. The article presents a SWOT analysis of the state of Russian healthcare against the background of the spread of COVID‑19 coronavirus.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Bazarova I. N. [6] Starodubov V. I. [30] Yu. V. Endovitskaya [6] N. Ya.  Nesvetailo [2]

    Tags: coronavirus3 covid-197 crisis3 financing10 health care20 mandatory health insurance5 medical organizations15

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  • Manager of heath care consults
  • 2021 № 1 Financing of healthcare in 2021 from the federal budget: priorities within the national project “Healthcare” in the context of the fight against coronavirus infection Covid‑19

    An analysis of the upcoming financing of healthcare from the Federal budget shows that in 2021–2022,
    despite the difficult financial situation, the volume of financial support for the industry will continue to grow. These are all
    the more important parameters because the upcoming budget in the period under review assumed a slight reduction in
    funding compared to the approved figures of the Federal budget for 2020. This should help to ensure the stable functioning
    of health care.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Bazarova I. N. [6] Endovitskaya  Yu.  V. [3]

    Tags: expenditures1 federal budget6 financing10 healthcare6 national project «healthcare»1

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  • 2020 № 8 Changes in the procedure for financial support of medical organizations in the system of compulsory medical insurance at the present stage of the spread of coronavirus infection

    In the context of the spread of coronavirus infection, the main problem of medical organizations is not an obvious increase in the cost of providing medical care associated with ensuring the sanitary and epidemiological regime (personal protective equipment, disinfection, etc.), but a decrease in income due to a drop in the volume of planned medical care, suspension of preventive measures, downtime (during the period of re-profiling, etc.).
    The state quickly responded to this situation by making changes to the relevant legislation and adopting a number of special regulatory legal acts. However, the implementation of these rather varied measures tied to a number of factors, such as the presence or absence of restrictive measures on the territory of the Russian Federation; participation or non-participation in the care of patients with coronavirus infection; periods within which the one or the other order advances, etc.
    All this causes difficulties in understanding what financial security mechanism is applied to this particular situation, what should be the actions of medical organizations.
    This article is devoted to the analysis of ways of financial support of medical organizations in the system of compulsory medical insurance at various stages of the fight against coronavirus infection.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Chililov A. M. [7]

    Tags: advance payment1 financial support1 mandatory medical insurance10 medical insurance organizations4 medical organizations15 payment for medical care4 volumes of medical care2

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  • 2020 № 1 Health care Financing in 2020: priorities within the national project «Health Care»

    Analysis of future health financing shows that in 2020–2022, despite the difficult financial situation, the growth of financial support for the health system will continue. Among the priorities for 2020, we should highlight the increase in funding for cancer care. This is the implementation of the provisions of the Decree of the President of the Russian Federation on may 7, 2018 No. 204 "on national goals and strategic objectives of the development of the Russian Federation for the period up to 2024". The allocation of funds in the compulsory health insurance system is also based on these priorities. In particular, at the expense of mandatory medical insurance funds, financial incentives are provided for employees to identify oncological disease. Among the positive aspects are inter-budget transfers to the budget of the compulsory health insur¬ance Fund from the Federal budget to pay for high-tech medical care that is not included in the basic program mandatory medical insurance and birth certificates. All this should have a positive impact on the further development of health care.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Bazarova I. N. [6]

    Tags: deficit5 expenses5 federal budget6 federal fund1 financing10 healthcare6 insurance premiums1 inter-budget transfers1 mandatory medical insurance10 rev¬enues1

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  • Questions and answers
  • 2020 № 10 Questions related to the procedure for allocating volumes of medical care to regional medical organizations

    Authors: Obukhova O. V. [18]

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