2019 № 2 Influence of socio-economic living standards of the population of the region on the market of paid medical services
The purpose of the study was a comprehensive analysis of the market of paid medical services in the Trans-Baikal Territory, taking into account the influence of regional factors. Using the correlation analysis, the influence of regional socio-economic factors on the change in the volume of paid medical services has been studied. To assess the market of paid medical services, a comprehensive analysis of indicators characterizing consumers and service providers on a reimbursable basis was carried out. Analysis of the activities of medical organizations that provide paid services in the framework of primary health care reflects an increase in the number of visits per shift, specialized medical care – an increase in the number of beds. These data indicate an increase in demand for paid medical services among the population of the region and an increase in their volumes. A demographic estimate of the population of the Trans-Baikal Territory as consumers of paid medical services has revealed a decline in the economically active population, the over-mortality of able-bodied citizens, and the depopulation of the entire population in the region. Socio-economic analysis identified a slight increase in gross regional product, an increase in average per capita incomes, as well as an increase in unemployment, a decrease in the number of employees, etc. Among the factors affecting changes in the volume of paid medical services, indicators characterizing the socioeconomic standard of living of the population were identified. The study made it possible to characterize the market for paid medical services from the perspective of producers and consumers of services, as well as to identify the influence of regional socio-economic factors on the volume of paid medical services.
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.