Management in health care
  • 2020 № 8 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.

    Authors: Mingazova E. N. [18] Bakirova E. A. [3]

    Tags: business process reengineering1 business processes1 management14 process approach7 quality of medical care19 rural health care1

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  • 2022 № 10 Problems of medical support for persons over working age (by the example of the Republic of Tatarstan)

    Currently, most countries are showing a demographic trend characterized by an increase in the number of older people. In Russia, there is also a significant aging of the population, in connection with which, the number of people older than working age seeking medical care is growing every year. At the same time, the need is growing not only for treatment and rehabilitation, but also for the prevention of diseases, the implementation of active longevity programs. All this emphasizes the relevance and necessity of high-quality and sufficient medical support for this category of people.
    Purpose: to study the features of medical support for people older than working age on the example of the Republic of Tatarstan.
    Materials and methods: the data of official statistics, including those of the Ministry of Health of the Republic of Tatarstan, were used in the work. Analytical, statistical, mathematical research methods were used.
    Findings: To create optimal resource provision in the provision of medical care to people older than working age, it is necessary to: introduce new indicators of the state of health, increase the number of geriatricians, increase the number of geriatric beds, not reduce therapeutic beds, constantly increase the coverage of preventive medical examinations, medical examinations of people older than working age age, based on their share in the population structure (at least 25%).

    Authors: Bakirova E. A. [3]

    Tags: health status2 medical support1 morbidity11 people older than working age1

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  • 2022 № 7 Analysis of morbidity and staffing of the population of rural areas in the Russian Federation

    Rural health care is the most important socio-economic resource in the system of the agrarian economy.
    Purpose of the study. Based on medical and demographic indicators and analysis of morbidity and staffing of the rural population, develop proposals for improving the organization of medical care for rural residents.
    M a t e r i a l s a n d m e t h o d s : analytical, statistical, direct observation. The article used the forms of federal statistical observation of the Ministry of Health of the Russian Federation.
    R e s u l t s . The mortality rate of the rural population over the 20 years of analysis for all the years has been and remains higher than that of the urban population. In 2020, there was a sharp increase in the mortality of the population: urban – from 11,9 to 14,3‰, rural – from 13,3 to 15,4‰, which is associated with the COVID‑19 pandemic. The indicators of the general and newly diagnosed morbidity of the rural population are lower than those of the urban population, which is associated with the low availability of medical care to the rural population.
    The ranking of indicators of the general incidence of the rural population in the federal districts of the Russian Federation (2020) showed that the difference in indicators was 1,5 times. The highest indicator was noted in the Volga Federal District – 142220,6‰00, the lowest in the Far Eastern Federal District – 96922,8‰00. In the subjects of the Russian Federation, the difference in indicators is 8 times. Lower rates of primary morbidity in the rural population than in the urban population were noted for all classes of diseases. The incidence of COVID‑19 among rural residents was 2151,9‰00, lower than in urban areas – 4539,5‰00, in the Russian Federation the figure was 3384,5‰00. In 2020, the primary morbidity rate of the rural population decreased for all classes of diseases, except for respiratory diseases. In dynamics (2014–2020), the provision of medical organizations located in rural areas increased with doctors from 12,1 to 14,0‰0, with nurses from 44,4 to 50,3‰0, the number of physical EMS persons decreased by 14,8%, paramedics – by 11,6%, the number of FAPs and AFs decreased by 8,9%. The analysis shows that the Decree of the Government of the Russian Federation dated 02.02.2015 No. 151-r “Target indicators of the strategy for sustainable development of rural areas of the Russian Federation for the period up to 2030” is not being implemented.
    C o n c l u s i o n . Proposals for providing medical care to the population of rural areas are presented

    Authors: Kalininskaya A. A. [13] Lazarev A. V. [4] Shlyafer S. I. [4] Kizeev M. V. [4] Bakirova E. A. [3]

    Tags: covid-1924 doctors7 medical and demographic situation3 morbidity (general1 mortality20 paramedic2 primary health care (phc)2 primary premedical health care (pfmsp)1 primary)1 rural population4 staffing10

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