Articles from rubric: «Foreign practice»

    2015
  • 2015 № 6 Reform of financing system of hospitals in the Republic of Moldova

    Until the implementation of the MHI health system in the Republic of Moldova, the health system was financed under a guaranteed minimum by the state, the rest of services being provided for paying services. This led to a serious degradation of the health system infrastructure and to a significant reduction of the access to health services. The situation was particularly unsatisfactory in the hospital sector. To redress the situation, with the MHI implementation, for financing the hospital care was proposed switching to the mechanism of payment «treated case by profile». Following the implementation of this mechanism has been increased significantly the productivity of hospital institutions manifested by increased levels of hospitalization for insured persons from 138 to 249%, the increase of share of using bed from 75,4 to 87,7 % etc. In 71,2 % of the leaders opinion of hospitals, the increase of hospital productivity was the result of the influence of used payment method. However, the mentioned method of payment has a number of drawbacks, the most important being that it had admitted a large disparity between costs within profile cases. To solve this problem, the method of funding per treated case was improved by switching to DRG. The rationale of switching to this method was made by comparing the logic assignment of cases to the group, but also by comparing the number of groups and cost differentials profiles encountered in contracted hospitals at the district level. To estimate the impact of the use of DRG on hospital activity were investigated: the number and provided complexity index cases, the number of operations and procedures carried out and a number of other indicators. Implementation of the DRG in Moldova has resulted in an increase in the number of cases rendered by 5%, the index of complexity of the case with 11,9%. Also, the average length of stay decreased by 7,4%.

    Authors: Damashkin G. P. [1]

    Tags: drg1 health services1 payment treated case by profile1 republic of moldova1

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  • 2015 № 4 Standards of medical care in Russia and USA

    Annotation. The analysis of the use of the term «standard of care» in the Russian Federation and the United States. The list of normative documents regulating the process of standardization of medical care, defined role and scope of clinical guidelines and standards of their legal component in the resolution of conflict and controversial clinical situations in health care. It is noted that the work on standardization of medical care due to objective socio-economic necessity of generalization, unification, of the desire to improve access to health care, including new medical technologies associated with the development of quality management of medical care.

    Authors: Samorodskaya I. V. [7] Stepchenkov V. I. [2] Batrova Y. V. [2] Saversky А. V. [1]

    Tags: clinical recommendations3 quality health care1 regulations4 standardization2

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  • 2015 № 3 International practice of incentive funding in health care

    There are analyzed approaches to enhancing incentive funding systems in the healthcare. There were identified problems with implementing incentive systems for suppliers of medical services. There was provided a case study of international practice in creating and developing incentive funding systems in ambulatory and in-patient sector.

    Authors: Sklyar Т. М. [1]

    Tags: incentive funding1 incentive system2 suppliers of medical services1

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