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Manager Zdravoochranenia 2015 #6
Published: 2015-06-05
1290
CONTENT OF THE ISSUE
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The need for more continuity and cooperation the relationship between quality of medical care in the mandatory medical insurance system and control of quality and safety of medical activities
The article shows the lack of continuity and the relationship between the quality of medical care in the mandatory medical insurance system (MMI) and control of the quality and safety of medical activity. Named a number of problems in this regard in public health practice, one of which is the absence in most of the medical organizations of the country internal control systems of quality and safety of medical activity. Asked to create one for the whole health of the Russian Federation the Order of evaluation of the quality and safety of medical care, regardless of whether this examination in a medical organization that is involved in the implementation of insurance programmes, or it is performed in a medical organization, in which the implementation of the programs of the MMI is not involved.
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Organizational and methological activities of chief specialists of the Ministry of Health of the Moscow Region in current conditions
Organizational and methological activities of chief specialists (CS) is any creative practical, organizational and educational activity aimed at development and implementation of modern medical and organizational technologies into regional system of public healthcare, including diagnostics and treatment of patients, analysis of populational morbidity and mortality, organization of scientific events and various tasks within specific profiles and types of medical activity. A Coordination Council has been established for planning, supervision and assessment of efficiency of CS activities in the Moscow Region, with a special informational monitoring system being run.
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Improving system specialized medical care in acute coronary syndromes: experience at the level of the Russian Federation, outstanding issues
A review is presented of the Kemerovo regional experience improving specialized medical care in acute coronary syndrome. Marked the problematic issues in the health care in acute coronary syndrome in modern conditions (late hospitalization, poor interaction of medical organizations). To improve the social and economic efficiency of medical care is necessary to strengthen the preventive orientation in the activities of the primary health care, to create organizational, economic conditions compliance with the order of care in hospitals, to carry out external control of health care health insurance organizations, to provide a system of care in acute coronary syndrome information and statistical tools.
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Possible methodological approaches to reviewing Russian clinical medicine journals in order to be published in Russian science citation index on the platform of Web of science
There was analysed a methodology for reviewing thousands of leading Russian journals in order to get published in the National Science Citation Index — Russian Science Citation Index in a form of a separate base created on the platform of Web of Science, which is used by coordinators of the project. There was suggested the methodology for reviewing domestic scientific journals in order to be included in the RSCI, which is formed on the basis of establishment of quotas of journals by subject areas in accordance with disciplinary structure of world science, as well as for identifying the most productive and dynamicly developed scientific disciplines in the frames of separately chosen subject area (using an example of clinical medicine).
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Reform of financing system of hospitals in the Republic of Moldova
Until the implementation of the MHI health system in the Republic of Moldova, the health system was financed under a guaranteed minimum by the state, the rest of services being provided for paying services. This led to a serious degradation of the health system infrastructure and to a significant reduction of the access to health services. The situation was particularly unsatisfactory in the hospital sector. To redress the situation, with the MHI implementation, for financing the hospital care was proposed switching to the mechanism of payment «treated case by profile». Following the implementation of this mechanism has been increased significantly the productivity of hospital institutions manifested by increased levels of hospitalization for insured persons from 138 to 249%, the increase of share of using bed from 75,4 to 87,7 % etc. In 71,2 % of the leaders opinion of hospitals, the increase of hospital productivity was the result of the influence of used payment method. However, the mentioned method of payment has a number of drawbacks, the most important being that it had admitted a large disparity between costs within profile cases. To solve this problem, the method of funding per treated case was improved by switching to DRG. The rationale of switching to this method was made by comparing the logic assignment of cases to the group, but also by comparing the number of groups and cost differentials profiles encountered in contracted hospitals at the district level. To estimate the impact of the use of DRG on hospital activity were investigated: the number and provided complexity index cases, the number of operations and procedures carried out and a number of other indicators. Implementation of the DRG in Moldova has resulted in an increase in the number of cases rendered by 5%, the index of complexity of the case with 11,9%. Also, the average length of stay decreased by 7,4%.
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Expert activity of insurance medical organizations as a solution to deliver insurance provision on mandatory medical insurance
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1 in 68 children is diagnosed with «Autism» (Autistic Spectrum Disorder)
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Myths around an effective contract…
Introduction of an effective contract exceeded the framework of a «concrete labor contract». It relates to a wide bredth of questions, such as how to increase salaries, at the cost of which resources, is it possible to cut renumeration within an effective contract and so on and so forth. Consequently, this gave birth to a lot of myths and wrong thinking around different aspects of an effective contract. This article is dedicated to the analysis of these wrong perceptions (myths).
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Questions answered by PhD. of Economic F.N. Kadyrov
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Review of actual normative documents
