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Manager Zdravoochranenia 2018 #10
Published: 2018-10-22
1018
CONTENT OF THE ISSUE
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About terms and order of provision of information constituting a medical secret to the institution of inquiry and investigation, the court, on request of the prosecution and of the criminal-executive system
The article shows and justifies which bodies in accordance with the legislation of the Russian Federation belong to the bodies of inquiry and investigation. The authors pay attention to a number of important features that need to be taken into account by medical organizations when working with requests for information constituting medical secrecy, the bodies of inquiry and investigation, the court, at the request of the Prosecutor’s office and the body of the penal system, as this activity is regulated not only by the legislation in the field of health, but also by regulatory legal acts regulating the activities of these bodies.
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About the transparency of compulsory health insurance
The problem of insufficient information openness in the system of compulsory medical insurance in Russia is considered. The non-transparency of the procedures of planning and execution of its budget of the Federal Fund of obligatory medical insurance. Distribution of subventions is carried out by mathematical formulas, the principles of calculations are not defined, and the coefficients used - closed. Financing the high-tech health sector is becoming unregulated. The list of new expensive medical services includes operations performed in the middle of the last century. In the system of obligatory medical insurance it is necessary to provide a clear and open mechanism for the development, adoption of and implement solutions related to common health problems
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Methodologikal aspects of evaluation of effectiveness in health care
Modern health care is characterized by a number of problems and contradictions in the field of performance evaluation. Analysis of the research and legal documents indicates the absence of a common approach to the issue. In this regard, the development and implementation of evaluation systems in the public sector is still relevant and very difficult task.The article provides information on the main stages of the development of the assessment methodology in accordance with the various stages of reforming domestic health care. Conceptual approaches to the terminology of the problem are being conceptualized and the variety of techniques to study this phenomenon is visually demonstrated.The authors draw attention to the need to systematize the accumulated knowledge in this field and to find a clear conceptual basis for constructing an evaluation system.It is concluded that existing theoretical, methodological and practical developments, including those fixed at the legislative level, do not allow an objective and unambiguous assessment of the phenomenon under study.
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To the issue of strengthening and preserving health of employees in the enterprises of the russian Federation
Тhe problem of strengthening and preserving the health of workers at the enterprises of the Russian Federation is сonsidered. It is shown that improving the effectiveness of preventive measures to strengthen and preserve the health of workers is possible with the active participation of employers. This requires control by the trade Union organization, the medical service of the enterprise and preventive organizations of the region (center for medical prevention, health centers).
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Analysis of morbidity, mortality from malignant neoplasmsand organization specialized medical care for the population with oncological pathology in Moscow region
The article presents morbidity and mortality in the Moscow (MO) from cancer for improvement organization of specialized medical care with oncology pathology. An analysis is made of the reasons for the excess of the specialized Medical Assistance (MSP) (including high-tech medical care - ВМП) for residents of the Ministry of Defense for malignant neoplasms more than 2 times mean values for the Russian Federation, in a 24-hour hospital due to a larger residents of the Moscow region of the NSR and the VMP at the expense of federal medical centers in Moscow.
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The experience of interregional Clinic and Diagnostic Centerin health care delivery within the mandatory medical insurance and charged services
An article discusses differences in the legal and regulatory framework in regulating the mandatory medical insurance and charged services. It is found out that conditions that lie at the root of the mandatory medical insurance system could be fully implemented using the causal approach to diagnostics and disease treatment. The causal approach within the mandatory medical insurance allows responding to the cause of the disease quickly and affordably. It is concluded that implementing mandatory medical insurance systems and charged services in a medical facility requires their different positioning, and in this case they will not repeat each other or compete with each other, but complement each other perfectly. The article describes the experience of Interregional Clinic and Diagnostic Center in organizing charged services using a system approach that allows forming an aggregate picture of a disease taking into account a plenty of factors and opinions from various experts. The conceptual differences in organizing the health care delivery in the mandatory medical insurance systems (causal approach) and charged services (system approach) within the activities of Interregional Clinic and Diagnostic Center allowed to define both systems as mutually supportive systems that fully meet the needs of people in medical services.
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Problems of normative support of health care institutions in the context of structural reforms
The results of the analysis of the effectiveness of structural reforms in health care, their validity, compliance with the Program of state guarantees of free medical care to citizens of the Russian Federation, adequate provision of medical organizations with resources. It is proved that the formation of a network of medical organizations should be justified by the objective needs of the population in medical care, confirmed by the data of monitoring the health status of the population and the study of consumer demand. It is also necessary to take into account the forecast of changes in the needs of the population in the volumes and types of care, as well as to scientifically justify the profiling, typing and staffing of medical organizations.
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Questions answered by PhD of Economic F.N. Kadyrov
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Directory of articles, published in the magazine in 2018 year
