CONTENT OF THE ISSUE
Model of interaction between medical organizations based on the principles of Fund management – a way to improve the efficiency of primary health care
The article analyzes the experience of per capita financing of primary health care based on the principles of
stock provision in the system of compulsory health insurance (MHI). The article shows the features of practical implementation of Fund-forming models of per capita financing, their impact on the final results of the activities of medical organizations of Fund-holders. A unified scheme of interaction between the MHI participants (medical organizations, insurance medical organizations, territorial MHI Fund) (medical and economic model of business processes) is proposed for the implementation per capita financing of primary health care, with provision of decoding with partial filling of the Fund for the implementation of a patient-oriented model of medical care.
Medical and social aspects of the development of health resources in the Federal districts of Russia
An important area of health care is the implementation of equal rights of citizens to preserve health throughout
Russia. In order to analyze the dynamics of the development of the main forces and means of the medical industry in
the territory of the macroregions of our country, we used the following methods: analytical, logical, statistical and direct
ranking. The results of the study were established, the dynamics of primary morbidity of the population, the security of
citizens medical staff capacity outpatient organizations and hospital beds Fund, and the differences of these indicators in the federal districts.
Improving rural health care through business process management
Meeting the needs of the rural population in all types of primary health care (pre-medical and general medical
care), as well as specialized medical care, improving the quality of medical care for the rural population is an important
public health problem that is difficult to solve and is of particular concern to government structures at all levels of government. The article presents an analysis of the literature on the use of business processes in modern healthcare, the main tasks of which are the creation and development of effective models for the provision of medical care that increase not only its accessibility and quality, but also the satisfaction of the population. As part of the activities of the modernization program for the implementation of information technology in healthcare, it is planned to create information resources and services that would allow, using this system tool, to move to a qualitatively new level of organization of industry management. It is noted that at present, at the level of management of the medical organization as a whole, and in the management of individual areas of its activity, the application of the process approach is becoming relevant, in which the medical organization can be considered as a separate business system, which is a related set of business processes, the ultimate goal which, undoubtedly, is the provision of quality medical services. It is shown that the development and modeling of business processes will increase the relevance of management information, will make it possible to focus on rationalizing cross-functional processes to significantly reduce time and / or costs, increase revenue, improve service quality and reduce risks, the information system allows you to simulate processes and carry them out further optimization.
The analyzed works examine the experience of process-oriented management in medical organizations and its role in ensuring the improvement of the quality of medical services provided. In addition, the introduction of a process approach will allow the application of certain managerial decisions necessary in each specific situation, including in the field of medical services for the rural population.
Organization of tertiary hospital functioning during novel coronavirus pandemic.
We analyzed organizational changes in the structure and functioning of Moscow Clinical Scientific Center named after A. S. Loginov during novel coronavirus pandemic. The paper presents challenges in the implementation of N. A. Semashko “mobilizational” system of healthcare provision and reasoned conclusions on its advantages.
Satisfaction of patients as an indicator of the effectiveness of organizational models of providing medical care in the outpatient sector
The object of the study is patient satisfaction with the medical care provided as a potential tool for evaluating the effectiveness of organizational changes in the outpatient unit. The patient-oriented approach is becoming more and more widespread in the world and domestic health care, so it is also necessary to take into account the opinion of the recipients of medical care in order to evaluate the ongoing changes. The purpose of the study was to test the developed online patient satisfaction assessment service TesMed in the implementation of systemic organizational changes in the outpatient section of the Tomsk region (united in one document – the Standard for organizing outpatient care in the Tomsk region). Patients were able to use the smartphone functionality to identify the medical organization and put a rating on a five-point scale. If the patient scored less than five points, the app asked them to select a reason for dissatisfaction from the list. The data of 2898 forms were analyzed. By the time of the beginning of noticeable
changes for visitors of polyclinics (changing the format of the reception area, staff jobs, registry, formation of corporate culture), the share of visitors who rated the work of a medical organization by five points was 57.78%. After a month of project implementation, this parameter increased to 85.79% and did not fall below 72% until the end of 2019. The analysis of factors affecting negative ratings showed that the structure of reasons for their decline has not changed significantly. The study showed that the use of assessment methods used in the provision of medical care organizational models based on the opinion of patients, along with standard performance indicators, contributes to improving the effectiveness of interaction between medical organizations and patients.
The core vital values and requirements defining quality of life of country people are more senior than working-age of the Kaliningrad region
Article is devoted to studying specific needs of persons also their interests affecting quality of their life are more senior than working-age. The purpose of work is to reveal the core vital values and requirements defining quality of life of country people is more senior than working-age of the Kaliningrad region. Within the project of Partnership “Northern measurement” in the field of health care and social wellbeing in 2019 the social research among 211 villagers aged from 60 up to 88 years is conducted. Methods of carrying out work: sociological, analytical, mathematical statistics. Distribution of age and gender structure of the interviewed population reflects universal trends. Social and demographic and medico-social characteristics of country people are studied. Results of a research showed that the quality of life of persons is more senior than working-age most is defined by priority vital values and requirements: state of health and level of material welfare; loneliness; difficulties in use of digital technologies; the disrespect shown from youth i.e. quite objective reasons which solution generally depends on the state measures for support of the senior generation. Significant first 10 vital values at elderly people during the different periods of time are tracked.
Studying the opinion of graduates of a medical university about the factors that determine the choice of place of work.
The strategy for the development of healthcare in the Russian Federation improves the staffing of the healthcare system, identified as a priority. The state programs set target indicators for the provision of the population with medical personnel, measures to equip medical organizations with medical workers, and measures of social support for medical workers. The aim of the work was to study the factors relevant for graduates that determine the choice of place of work and the development, based on the data obtained, of measures aimed at improving the availability of qualified medical personnel for medical organizations.
The results of a sociological study of graduates of a medical university on the problems of employment in medical organizations are studied.
Analyzed: indicators of the population of the region with doctors; the need for medical organizations of the region in medical personnel; events implemented in the region in order to provide medical organizations with qualified personnel.
The measures, the implementation of which is aimed at increasing the availability of medical organizations with qualified personnel and achieving the effectiveness of employment of graduates of the university, are determined.
Problems of relevant medical services markets: research of domestic and foreign experience
The article reflects the results of an analysis of studies by different authors on the problems of domestic and foreign relevant markets for medical services. The essence of concepts is revealed: a medical service, its competitiveness, the market of medical services. The situation is described, associated with problems in the formation of a competitive environment, the main factors hindering the competitiveness of medical services, the nature of their functioning, which determines the need for government intervention in the health sector. The main participants of the medical services market are presented and the reasons for the conflict of their interests are substantiated.
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.
Issues of implementing incentive payments for cancer detection
Management in health care
Social aspects of health
Manager of heath care consults
Questions and answers