2014 № 9 Problems associated with provision of paid medical services while using equipment purchased at the expense of state funds or funds from mandatory medical insurance system (FSHI «Health Organization and Informatics» Ministry of Health Care of Russia, Moscow, Russia)
One of the issues, that doesn't have a precise normative regulation, is usage of equipment, purchased at the expense of state budgets of different levels and funds from mandatory medical insurance system when delivering paid medical services. The policy of state and municipal institutions with regard to possibility and regulation on using equipment, purchased at the expense of state budget and funds of MMI (Mandatory Medical Insurance) in the course of a running a profitable activity, is quite controversial. It is not decided, where amortization of the equipment should be directed in such cases. The article is dedicated to possible solutions to this problem.
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.
2017 № 5 Possible options of citizens' participation in the financial provision of rendering medical assistance using resources not provided by the program of state guarantees
Active search of new forms of co-financing of medical care is the answer to financial difficulties in the health sector. However, equally important is the streamlining of those forms of relations between medical organizations and patients about co-payments in the provision of medical care within program of state guarantees that exist. The analysis shows that the legalization of shadow payments, proper design of the acquisition at the expense of and at the request of the patient more quality of medicines, health care products, as expressly provided under the program of state guarantees, etc., can serve the interests of both patients and society as a whole. The article discusses specific payment options at the expense of patients, resources that are not provided under the program of state guarantees allowed under the current legislation
2018 № 2 «Other conditions» as a basis for payment of medical care. Part 1
The legislation determined that one of the grounds for the provision of medical care for a fee is its provi- sion on other conditions than provided by the state guarantees program. However, the interpretation of «other con- ditions» is rather ambiguous and requires detailed consideration. For this purpose it is necessary to study not only the state guarantees program itself, but also a number of other regulatory legal acts. Thus it is necessary to distinguish accurately other conditions of rendering medical care from household and service. The article deals with various aspects of medical care for a fee on the basis of its provision on terms different from the state guarantees program
2018 № 4 The sources of financial provision of rendering emergency medical care
Free provision of emergency medical care is provided by the legislation. This requires a clear definition of the source of cost recovery for medical organizations that provide this assistance, In a particular situation, how¬ever, there are often situations where law enforcement officials refuse to pay for emergency assistance provided to their employees, referring to the above-mentioned legislative requirement. Many problems in the provision of emergency arises in the system of compulsory health insurance. Payment for emergency medical care rendered in excess of the approved amounts remains an unresolved problem. The problem of compensation for emergency assistance to uninsured citizens is not settled either. These problems are especially urgent for private medical organizations
2018 № 3 «Other conditions» as the basis for payment of the rendered medical care. Part 2
The legislation determined that one of the grounds for the provision of medical care for a fee is its provision on other conditions than provided by the state guarantees program. However, the interpretation of «other conditions» is rather ambiguous and requires detailed consideration. For this purpose it is necessary to study not only the state guarantees program itself, but also a number of other regulatory legal acts. Thus it is necessary to distinguish accurately other conditions of rendering medical care from household and service. The article deals with various aspects of medical care for a fee on the basis of its provision on terms different from the state guarantees program
2016 № 2 The challenges, related to provision of paid medical services on anonymous basis
Current legislation has quite clearly settled the questions regarding the provision of the medical aid on a paid basis. Medical organisations, participating in the realization of the programmes of state guarantees for delivering free medical aid and territorial programmes of state guarantees for providing free medical aid to the population have a right to provide patients with paid medical services anonymously exempt for the cases set forth by Russian legislation. However, the provision of medical aid on a paid basis requires conclusion of contracts. There is no special legislation or other normative regulation for contract conclusion on anonymous basis. Nevertheless, an analysis of the normative basis, related to the anonymous provision of medical aid allows finding solutions to the most frequently occurred problems.
2019 № 2 How to arrange the provision of paid medical services anonymously
he article proposes specific mechanisms for the implementation of the right of patients to receive paid medical services anonymously. The authors propose and justify the use in the provision of paid medical services anonymously as the patient’s name alias (fictitious name), which should be reflected in the documentation – in the contract, the patient’s medical record, informed voluntary consent to medical intervention, etc. The Implementation of the proposals expressed by the authors of the article will allow to provide medical care anonymously in compliance with all the requirements of the law.
2017 № 4 Paradoxes of law: the guarantee of free medical aid often limit the rights of patients to improve quality
The legislation of the Russian Federation, recognizing the rights of citizens on free medical aid and paid medical services, however, makes clear the roll the side free of charge. At the same time guarantee free of charge formulated in such a way that often limit the rights of citizens to receive medical care with the use of drugs, medical devices, etc., not provided for in the programme of state guarantees of free rendering to citizens of medical aid. Moreover, if the rights of citizens to receive paid medical services directly spelled out in the law, the right of citizens to self-purchase of medicines, medical devices, etc. did not say anything. There is no outright bans, which in practice leads to numerous conflict situations. The article provides specific suggestions for improving the legislation in this field.
2017 № 3 The paid services in the field of family planning
The paid services in the field of family planning (including in the form of a voluntary medical insurance) are perceived as a violation, although legally they are not prohibited. But the legislation provides specific protection in this area, which is quite legitimate. Sometimes the guarantee is worded in such a way that in practice, healthcare organizations can easily get around them. The analysis of these problems addressed in this article.
2019 № 6 Legal issues of non-conformity of payment medical services to expectations of the patient
The article is devoted to the problems arising in the course of inconsistency with the patient’s expectations in the context of providing paid medical services. The legal regulation of this service sector needs to be improved, so the paper analyzes the documentation of the legal relationship between the medical organization and the patient, considers the basic conditions that are mandatory for implementation and determines the specific nature of the medical service within the framework of delineating patient information when provided for payment and free medical care.
2020 № 1 Is the medical organization obliged to ask the patient for an identity document when applying for paid medical services?
The article shows and proves that when a patient applies for paid medical services, a medical organization is obliged to ask him for an identity document. First of all, this is enshrined in the requirements for the maintenance of accounting and reporting documentation established by the legislation of the Russian Federation. At the same time, the authors emphasize that even if the patient does not have an identity document, the refusal to conclude a contract for the provision of paid medical services is unacceptable. The issue of presentation of an identity document by a patient when applying for the provision of paid medical services became particularly relevant after the introduction of such a control tool as the control purchase of paid medical services.
2018 № 5 The program of state guarantees as a tool for ensuring social obligations of the state in the field of health protection of citizens
The program of state guarantees of free medical care is a tactical tool to ensure the social obligations of the state in the field of public health. It is shown that the current system of state guarantees at the macrolevel provides funding for all types, forms and conditions of medical care in the full range of diseases, but free medical care is not fully provided. In the overall structure of health care spending in Russia, the share of personal funds of citizens is almost half, which is more than three times higher than in the European Union. The data presented in the article suggest that the population pays not for the possibility of obtaining medical care, but for its quality. The authors believe that it is necessary to change the relationship between the doctor and the patient, to create conditions for the traditional spiritual and intellectual development of the Russian professional medical community
2019 № 6 Control purchase when providing paid medical services: what medical organizations must know
The article deals with changes in legislation relating to the test purchase in order to verify compliance with the medical organization of the order and conditions of paid medical services. It is emphasized that control purchases in the provision of paid medical services is now one of the areas of state control of quality and safety of medical activity. The authors present the characteristics of the control purchase in conjunction with other forms and methods of control, including unscheduled inspections and control without interaction with legal entities, individual entrepreneurs. It is noted that the control purchase in the provision of paid medical services can be used by the relevant Supervisory authorities not only in the implementation of state quality control and safety of medical activities, but also in the implementation of supervision in the field of consumer protection, as well as in the implementation of the Federal state sanitary and epidemiological surveillance.
Keywords: control purchase, paid medical services, medical organization, control without interaction with legal entities, unscheduled on-site inspections, quality control and safety of medical activities, separate types of state control (surveillance)
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Abstract. The article deals with changes in legislation relating to the test purchase in order to verify compliance with the medical organization of the order and conditions of paid medical services. It is emphasized that control purchases in the provision of paid medical services is now one of the areas of state control of quality and safety of medical activity. The authors present the characteristics of the control purchase in conjunction with other forms and methods of control, including unscheduled inspections and control without interaction with legal entities, individual entrepreneurs. It is noted that the control purchase in the provision of paid medical services can be used by the relevant Supervisory authorities not only in the implementation of state quality control and safety of medical activities, but also in the implementation of supervision in the field of consumer protection, as well as in the implementation of the Federal state sanitary and epidemiological surveillance.
2019 № 5 Providing income activities as a conscious necessary for functioning of the state (municipal) medical providers
Realization of the rights of citizens to health care and medical care free of charge, enshrined in the Constitution of the Russian Federation, carried out by state and municipal health care institutions «… at the expense of the relevant budget, insurance premiums and other income». Analysis of the dynamics of the volume of financial sources for 2014–2017 showed a significant increase in revenues of medical organizations, which are state budgetary institutions, funds from income-gener- ating activities.
The article describes the main financial sources that a medical organization – a state (municipal) institution may have for providing medical care, as well as for implementing the Program of state guarantees of free medical care to citizens. The rationale for the insufficiency of public funds to ensure the necessary level of wages for medical workers is given on the example of comparing tariffs of the compulsory health insurance system and prices (tariffs) of private medical organizations in the city of Moscow.
The regulatory and legislative conditions for obtaining funds from various financial sources by a public institution are con- sidered, the relevance of developing measures to attract additional financial sources, which include revenues from providing paid medical services to the population, including through voluntary medical insurance, is justified.