2016 № 5 Ranking definition method of health insurance companies based on hierarchical classification.
The official site of Federal compulsory medical insurance fund presents 21 activity indicators for the 59 health insurance organizations (HIOs) for 2015. Each indicator represents an activity efficiency criteria of HIO in the certain area as following: its larger or smaller value defines whether the company activity is successful or not. The HIO rating is defined per each of these criteria. Undoubtedly, HIO ranking definition problem on set of all the considered criteria is becoming particularly urgent. The purpose of this work is to apply the metrical approach for HIO activity efficiency assessment, based on the hierarchical classification method that assumes the distance calculation among HIOs as among the points of multidimensional space in the coordinate system corresponding to the criteria of their efficiency. The concept of reference organization that accumulates the best value of all of the HIO criteria is introduced in this paper. The ratings of insurance companies are established in accordance with the distance to the reference organization by the principle – the smaller the distance, the more efficient the company is and the higher its rating is (the place in the HIO list). The method is implemented in the environment of the STATISTICA statistical package. HIO ratings, defined by the proposed method can be used to identify promising and unpromising HIOs in order to plan their upcoming development or structural changes, they can also act as the specific navigator when choosing the health insurance company
2017 № 3 Online method medical-economic control of prescriptions for preferential drug provision
There is a high probability of making mistakes (intentional and unintentional) while filling the electronic form of the recipe for preferential drug provision, that may lead to violations in the prescription of drugs. Expert detection of prescription form filling errors after the drugs had been released to the patient in pharmacy can’t prevent the negative impact on patient’s health. The purpose of the study is to improve the effectiveness of organizing and performing the medical control of drugs prescribing, to simplify procedures for providing citizens with preferential medicines, applying the developed methods and algorithms for real-time verification of the selected recipes. The paper represents the method and the development of decision making support algorithm to be used while performing the medical expertise, also called medical -economic control. The opportunities of unified information system for prescribing and releasing of preferential recipes in the Krasnodar Region are observed in the paper in the frame of implementation of the “electronic prescription” technology and medical expertise of preferential drugs prescribing in real time. The prospects of medical expertise performing for detecting cases of polypharmacy in advance are established in cases of multiple drugs prescription (more than five). The importance of performing medical expertise was defined for all kinds of prescription, not only for preferential drugs, consequently the suggested method and developed algorithm should be applied to medical expertise of all kinds of electronic prescription in real-time