2017 № 6 Communication system as an increasing efficiency factor of a large medical center
The approach of creation the common communication system as an increasing efficiency factor of a large medical center is presented. The definition of the communication system, its structure and main characteristics are provided on the example of the Tatarstan cancer center. The principles of Tatarstan cancer centers information space are described. Communication channels of healthcare organization are cited. Unique classification of the information that is used in information space of Tatarstan cancer center. Rules of information interaction and principles of a communication feedback are also described. The Product of a transparent system of communication is a clear and distinct information that is available to all stakeholders, the aim of transparent communication system construction is an efficient healthcare organization goal achievement; communication system in medical center has a number of distinctive features and depends on the organizational structure, regulations of information interaction of various healthcare organizations and characteristics of the formed communication channels, and characteristics of organizational culture
2021 № 9 Current issues of evidence-based management of state and municipal health care.
The topic of evidence-based management is relevant due to a significant increase of managerial innovations in medicine, healthcare commercialization, changes in approaches to the use of evidence sources in healthcare and high commercial, investment, social and reputational risks of poorly evidence-based decisions. The article deals with awareness and practical use of the evidence-based management approach among the executives of budgetary medical cites. The results of the first Russian study of evidence-based management among health care managers are presented, in particular, their awareness of the evidence-based approach, attitude to evidence-based management practice, and the sources of information used by them are studied.
The purpose of the study is to investigate the existing practice of applying evidence-based approaches in the management, awareness of the approach, it’s application in practice, drawing conclusions about the factors influencing managerial decisionmaking, and making recommendations for their improvement.
Materials and methods. The study of the management practice of heads of medical organizations was conducted using an online survey. The general part of the questionnaire included questions about the demography of respondents, their management experience, education, and the size of the organization. The special part assessed: respondents ‘ awareness of the approach; their attitude to the evidence-based management practice; sources of information when making decisions. Their opinion on the role of corporate culture in the formation of evidence-based management practice was clarified.
Results. Only 17% of managers use an evidence-based approach in practice, and only 5% use at least six sources of information for this purpose. The popularity rating of information sources is presented as follows: own experience 81%, consultations with external experts 60,3%, internal data of the organization 56,9%, scientific data 38%, the opinion of colleagues 36,2%. Most managers consider the use of data in practice to be the most difficult in making managerial decisions. Only 31% of healthcare managers regularly summarize their managerial experience. The majority of respondents, 75.8%, recognize the important role of corporate culture in forming the habit of making decisions on an evidence-based basis, but also assess the organization’s resources for making informed management decisions as insufficient. Only 20,7% of respondents rated the degree of the organization’s learning ability and its readiness for changes as high.
Conclusions. Further improvement of the practice of making managerial decisions on an evidence-based basis is possible due to the informatization of healthcare and the development of the corporate culture of municipal medical organizations. Evidence-based management practices should be integrated into the trajectory of continuing medical education of healthcare managers in order to improve the efficiency of the industry.
2017 № 7 The issues of creation and functioning of centralized laboratories in the system of compulsory medical insurance
Centralization of laboratory diagnostics is a time commitment associated with the benefits it provides. However, the appeal to this topic is also connected with the new factors that are considered in the article. The difference in the regional features of the organization of health care, the availability of various sources of financial support for medical organizations, etc., suggest a distinction between specific models of centralization, the system of financial relationships, etc. In addition, the centralization of the laboratory service, having undoubted merits, also carries certain risks and threats that must be taken into account. This article addresses these and other issues related to the practical aspects of the centralization of the laboratory service.
2021 № 8 Theoretical approaches to the effective interaction of the state and private medical institutions in the format of public-private partnerships
Expanding the sphere of interaction between the state and the medical business is one of the priorities for the development of the medical services market in the Russian Federation. The healthcare reform, based on the principles of evidence-based medicine, digital healthcare, and high medical technologies, is primarily aimed at improving the quality of medical services and the availability of highly qualified medical care for all segments of the population. Accessibility, quality and timeliness of medical care are the main postulates of the daily activities of a private medical institution. during the period of increasing crisis phenomena in the economy and social sphere, private medicine can provide significant assistance to the state health service, become the “lifesaver” for the domestic health protection system, which today is mostly represented by the public sector. One of the most effective mechanisms of interaction between the state and private business, adopted all over the world, is the system of public-private partnership.
The purpose of the study is to analyze possible forms and mechanisms of interaction between the medical business and the state within the framework of public-private partnership.
M a t e r i a l s a n d m e t h o d s . The assessment of the current regulatory framework was carried out, a significant volume of domestic and foreign literary publications was analyzed, the main theoretical hypothesis was formulated on the basis of the systematic scientific method and a research plan was built.
R e s u l t s . In the course of the conducted research, objective main cause-and-effect factors affecting the development of an adequate system of public-private partnership in the field of medicine and healthcare have been identified and analyzed, in terms of the distribution of benefits, costs and risks carried out on the principles of long-term, voluntary, manageability, legal validity between a private medical organization and federal and/or municipal executive authorities. The main causal factors include insufficient funding, an unfavorable demographic situation, low efficiency of using the resource base, a reduction in the bed fund under the guise of “optimization”, a decrease in the social level of the population and the redistribution of the medical and diagnostic structure due to the COVID‑19 infection pandemic.
It should be recognized that the state system of medical care is not always able to fully meet the needs of societies for high-quality qualified medical care. The analysis of foreign literature has shown that medical services abroad successfully use the principle of public-private partnership, redistributing efforts to form the necessary institutional environment in healthcare between private business and the state. Such a form of interaction as concession, leasing, franchise, outsourcing, aufstaffing allows us to optimally balance the interests of the medical business and public health, significantly optimize the budget costs for health protection, especially in a difficult epidemiological period.
The result of the research was the development of a conceptual and theoretical model of various forms of interaction between private medical business and government agencies within the framework of public-private partnership programs.
C o n c l u s i o n s . Thus, public-private partnership is an effective economic tool that ensures the coincidence of the interests of private medical business and the state, allowing to make a profit for both subjects of medical activity, with a reduction in state budget expenditures for healthcare purposes, but with the preservation of high quality medical services and resource provision.