2017 № 10 Financial reserves of the state (municipal) institutions health
. The difficult economic situation makes to search for possible variants of optimization of resources and reserves in the state (municipal) institutions. Many heads of agencies believe that the reserves for salary increases in accordance with the «Мay» decrees of the President have been exhausted. However, they did not start the process of normalization, the introduction of professional standards and effective contracts. On the other hand, the legal environment in which agencies are often not allowed to implement the legislation provided for the possibility of attracting additional resources. These issues are discussed in this publication
2019 № 4 The experience and results of lean manufacturing introduction in health care
The World Health Organization gives notice an increasing demand for medical service on the one hand and a tendency toward deterioration of financial conditions in the healthcare system on the other that is the cause of the main concern in modern medical management. The article is considerate feasibility of using principles and methods of lean production for the purposes of organizing practical healthcare. Analyzed the results of lean production implementation of over the past few decades, the main early successes achieved using the tools and methods of lean production, as well as the basic limitations of the application are evaluated. Special attention is given to potential roles of the leader of healthcare institutions in lean production adaptation as well as evaluating the success of a strategy. A deep analysis of modern economic indicators of lean production successful implemen- tation in medical clinics abroad is presented, the key points of the effective introduction of lean production are being updated. In additional to economic indicators, the impact of lean production implementation in medical organizations on reducing mortality rates, transmission of nosocomial infections, mortality from hospital infections, reducing waiting times for medical services (especially in the admission department) is estimated. The current task facing the health care system in the Russian Federation is updated. The main conclusion is made about a huge amount of positive results after introducing lean production, including the positive economic effect and the increase in the quality of medical care after the introduction of the principles and methods of lean production, and also the entity of lean production as a separate method of organizing processes.
2019 № 7 Performance optimization of the operating unit in conditions of high patient turnover using economical technologies
Proposed methods for optimizing the work of the receiving department. The efficiency and validity of the implementation
of these methods in the work of the receiving department has been shown. Analyzed the effectiveness of
innovations. An assessment of the result is given.
2019 № 3 Performance optimization of the operating unit in conditions of high patient turnover using economical technologies
Presents optimization methods of functioning of the operating unit. The efficiency and validity of the implementation of these methods in the work of the operating unit, and in the units involved in the preoperative preparation, is shown. Analyzed the effectiveness of innovations on the example of two departments of the surgical profile. An assessment of the result is given.
2013 № 6 Models of the optimal distribution of the planned volume of financial means in the sphere of compulsory health insurance of Saint-Petersburg (The territorial compulsory health insurance fund of Saint-Petersburg, Saint-Petersburg, Russia)
The article deals with the mathematic modeling of distribution of the planned volume of financial means in the compulsory health insurance and the results of modeling.
2021 № 8 Ways of optimizing the organization of providing ambulatory coloproctological assistance to the population
The article substantiates the priority directions of optimization of the organization of outpatient coloproctological care to the population of the Perm Region.
The purpose of the study is to substantiate the priority directions for optimizing the organization of outpatient coloproctological care to the population.
Materials and methods. The data on the reasons for 4822 calls to outpatient polyclinic offices for specialized medical care in the profile of «Coloproctology» in the Perm Region in 2018, as well as about 2222 calls to the Center of Coloproctology with a day-long hospital stay were analyzed.
Results. It is shown that the frequency of detection of DND in the center of coloproctology was 22.50%, with the frequency at polyclinic appointments‑11,83%, p<0,001. At polyclinic appointments, the frequency of detection of ZNO was 5,96%, in the center of coloproctology – 12,15%. The results obtained can be explained by the number and quality of diagnostic measures performed at the Coloproctology Center, which allows for almost complete coverage of all patients of the center with rigid rectoscopy – 98,38%, with 33,80% (at outpatient appointments (p<0,001). Sigmoscopy, which is not available in the coloproctologist’s offices at the Coloproctology Center, was performed in 7,02% of patients, FCS was performed in 34,29% of cases, compared to 9.49% in the polyclinic (p<0,001).
The presence of an emergency appointment in the Center of Coloproctology explains the higher frequency of detection of acute hemorrhoids – 7,06%, versus 3,2% in polyclinics; acute paraproctitis – 2,29% and 0,62%, respectively; ECC – 1,53% and 0,5%, respectively; anal itching – 1,44% and 0,64%, respectively; proctitis – 0,99% and 0,16%, respectively; rectocele – 0,99% and 0,18%, respectively; injuries of the colon and rectum – 0,72% and 0,16%, respectively; anal insufficiency – 0,72% and 0,37%, respectively; p<0,005.
Conclusions. The traditional model of providing outpatient coloproctological care (offices in polyclinics) is not effective even in diagnostics, since it does not have its own endoscopic and anesthesiological service, which significantly affects the volume and quality of the necessary studies. It is proposed to reorganize the service in order to organize a primary link on the basis of an outpatient coloproctology center with a day-long hospital, separate or at the coloproctology department of the State Clinical Hospital.