2016 № 5 Modern approaches to the development of medical and technological assignment and effective design of healthcare institutions
Annotation. In the present paper a study of healthcare facilities design models is presented. It is shown how the functional and spatial diagramming, diagramming of flows and modelling/design of healthcare facilities (BIM) allow us to determine (as early as at the stage of medical and technological assignment) the possibility of application of modern medical technologies and equipment, arrangement of process flows, cost of the project and operating costs, construction period time, as well as to ensure the development of high-quality design and detailed documentation.
2016 № 4 The quality of medical care as a tool of resource-saving in obstetric institutions in conditions of compulsory health insurance
Annotation. In this article we represented data of quality of medical care in Maternity hospitals operating in the conditions of compulsory health insurance system. Identification of medical care defects during medical and economic expertise shall be sanctioned and fine by health insurance organizations. Analysis of that sanctions allow you reduce internal economical costs and keep economical resources of the obstetric hospital.
2019 № 1 Methodological approaches to the assessment of compliance of activity of medical organizations order of rendering of medical care
The article presents the results of the development, implementation and experimental testing of the conformity assessment system based on order of medical care, which can be used by any medical organization in order to improve the planning and management of its activities.
2021 № 1 Experience in using the staff management structure in a redesigned infectious diseases hospital to provide medical care to patients with a new coronavirus infection
The article presents the experience of using the staff management structure in the conditions of redesigning
a multi-specialty hospital into an infectious hospital for providing medical care to patients with a new coronavirus infection. For example, one of the largest hospitals providing specialized medical care during coronavirus infection, proven effectiveness staff management structure as the most optimal for the purposes of redesigning and further use against the growing epidemic Covid‑19.
2022 № 8 Self-assessment of health and conditions for receiving medical care by residents of the Russian Federation
In the context of higher interest of healthcare executives in patient-centeredness, development of value-based healthcare and increasing public satisfaction with medical care, it is very important to have access to detailed information about how people evaluate the care provided, as well as to specify problems associated with receiving care. Such detailed information can provide directions for further development of organizational technologies and serve basis for developing management decisions.
T h e p u r p o s e of the study is to analyze results of sociological surveys of the Russian population on self-assessment of health and conditions for receiving medical care.
M a t e r i a l a n d m e t h o d s . The study used data available from the Rosstat (Federal State Statistics Service) official website – “Comprehensive monitoring over living conditions of the Russian population” (conducted in 2014, 2016, 2018 and 2020) in terms of questions related to receiving medical care by the survey respondents, based on a sample survey of representatives of various groups and population strata covering 10 thousand households. Analysis of the presented data was carried out using descriptive statistics methods by the following sections: respondents’ self-assessment of health, smoking and alcohol consumption, receiving outpatient care, receiving dental care, seeking emergency medical care, receiving inpatient care, non-care seeking if medical care is needed.
R e s u l t s . The share of those who rated their health as “excellent” and “good” has increased. It should be noted here that males were more optimistic in assessing their health status than females. The share of the respondents reporting a chronic disease diagnosed by a doctor decreased from 30.2% in 2014 to 27.2% in 2020. There is no significant difference between urban and rural population.
The share of non-smokers and those who have never smoked decreased from 63.5% in 2014 to 62.1% in 2020. The share of male alcohol consumers remained stable adding up to 70%, while the female share tended to increase from 49.5% in 2014 to 52.1% in 2020.
Assessment of an average time spent on making an appointment with a doctor in outpatient settings has not changed in dynamics and equaled to about 18 minutes. The share of those receiving timely medical care out of those applied for care increased from 92.6% in 2016 to 95.1% in 2020.
The share of those calling an ambulance tended to decrease: from 10.8% in 2014 to 10.1% in 2020. According to the surveys’ results, every year some 7–8% of the population receive specialized medical care in inpatient settings.
The analysis of cases of non–care seeking if medical assistance is needed showed a decreased share of such respondents: 33.6% in 2014, 33.0% in 2016, 34.5% in 2018, and 29.2% in 2020. The share of those failing to get to or experiencing difficulty getting to a health care facility equaled to 3.3%, 2.5%, 2.8% and 1.9%, respectively. 7.2% of the respondents had “no time” for care seeking in 2014, 8.2% in 2016 and 2018, and 4.7% in 2020. A significant decrease in this indicator is rather logical and unsurprising in the context of the pandemic caused by a new coronavirus infection.
C o n c l u s i o n s . From 2014–2020, self-assessment of health has improved; in general, males rate their health higher compared to females.
Men smoke 5 times more often than women. Generally, they start smoking during the teen years. As a positive trend, we can point out an increasing share of people who quit smoking.
Men drink alcohol 9 times more often than women. The share of the female alcohol consumers tends to increase.
Negative trends in care delivery are as follows: increased waiting time for emergency medical care; increased average number of days waiting for hospital admission; decreased share of those admitted to the hospital on the day of the visit.
Positive trends in care delivery include the following: decreased denials of outpatient care due to lack of necessary equipment or medicines, shorter lines in waiting premises to see a doctor; decreased offers of payed services; decreased waiting time for a doctor’s appointment; increased share of those receiving timely dental care.
A tendency among the respondents towards self-medication and not seeking medical care due to lack of time has decreased.
2017 № 7 Comparative analysis and integrated assessment economic efficiency of the developed three-level system of provision of urological care to the population in the region compared to the traditional approach
Medico-economic efficiency of functioning of the regional urological service at the modern stage of healthcare development is not optimal. In article the analysis of work-level system and the restructuring of urological care in Voronezh region for the total amount of direct costs for diagnosis and treatment of all patients and the cost of diagnosis and treatment in terms of a particular patient, for example urolithiasis, benign prostatic hyperplasia and prostate cancer. The study included two stages: a traditional system of provision of urological care to the implementation of the system restructuring, and after implementing three-tier system of care for patients with urological disorders. The results demonstrate a strong statistically significant objective reduction of economic costs of diagnosis and treatment for the vast majority of patients in all three nosological forms presented in this study reflect the ultimate performance of the regional urological service (on the example of Voronezh region), in terms of its functioning in the format developed a three-tiered system of medical care in comparison with the traditional approach.
2020 № 8 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.
2014 № 5 Responsibilities of medical organizations (Penza State University, Penza, Russia)
Аbstract. In the article obligations of the medical organizations (article 79 of the Federal law of November 21, 2011 № 323-FZ «About bases of health protection of citizens in the Russian Federation») are analyzed. The subject of duties is defined. The maintenance of such duties as is opened: to inform law-enforcement bodies on arrival of patients concerning whom there are sufficient bases to believe that harm to their health is done as a result of illegal actions; to carry out insurance on a case of infliction of harm of life and (or) to health of the patient when rendering a medical care. In article the maintenance of obligations of the medical organizations fixed in other statutiry sources (for example, in the Federal law of November 29, 2010 № 326-FZ «About obligatory medical insurance in the Russian Federation») is considered.
2017 № 6 Review of international experience in process-oriented management of medical organization on the example of the Mayo clinic (USA)
The article presents the Genesis of the process approach to management, presented the benefits of this approach, an overview of the implementation of a process-oriented approach at the Mayo clinic, brief description of key aspects of the management of the specified medical organizations
2019 № 9 To the question of training of medical workers within internal control of quality and safety of medical activity
Changes in the legislation concerning the organization of internal control of quality and safety of medical activity put forward new requirements to training of medical workers. These requirements concern the mandatory training on early detection of cancer, ensuring the provision of medical assistance to citizens in emergency form, the use and operation of medical devices. The article deals with the practical implementation of these requirements at the level of the medical organization.
2018 № 4 The role and importance of criteria for evaluating the quality of medical care, approved by order of ministry of health of Russia from 10.05.2017 n203n for healthcare organizations working in the mandatory health insurance system
The article analyzes the regulatory framework governing the quality control of medical care in the system of mandatory health insurance (MHI) and the application of criteria for assessing the quality of medical care in a medical organization. It is noted that the criteria for assessing the quality of medical care are an integral tool for ensuring and controlling the quality of medical care for all medical organizations without exception, including those operating in the MHI system. The authors explain and emphasize that the legislation on compulsory medical insur¬ance in no way limits the use of these criteria medical organizations working in MHI. At the same time application of the specified criteria allows to prevent or reduce number of defects of medical care / violations at rendering medical care, and also number of defects of registration of primary medical documentation
2014 № 1 Differentiated payment for labor of doctors of Federal Center of Traumatology, Orthopedics & Endoprothesis (Cheboksary) within the framework of quality management system (The Federal State Institution Federal Center for Traumatology, Orthopedics & Endoprothesis Replacement, Cheboksary, Russia)
the methods of calculating of differentiated system of payment for labor of doctors, which, in our opinion, is one of the components of motivational mechanisms to improve medical care quality, are presented in this article. The system of payment for labor is based on qualitative and quantitative indicators of labor of Center doctors.