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Manager Zdravoochranenia 2019 #6
Published: 2019-06-09
994
CONTENT OF THE ISSUE
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Reduction of time of providing medical service due to approach realization of “10 seconds”
The 10 seconds model which cornerstone creation of a multilevel cascade system of interaction with the patient in the medical organization is is offered. The main organizational documents on the basis of which realization of the specified approach is possible are listed. Introduction advantages are allocated and proved. Process realization on the example of activity of reception and diagnostic office in MSCh KFU is opened.
Keywords: -
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)
… Р. 6-10
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. -
Perfection of organizational forms of work in dermatovenerology in conditions of “lean production”
An important part of the activity in dermatovenerological care in the conditions of “lean production” is the improvement of organizational forms of work of medical organizations (MO), providing medical care to patients with dermatovenerological pathology at all stages of its provision.The survey was conducted at the Samara oblast, the dermatovenerologic dispensary (SACVD). Based on the diagnosis of “zones of inefficiency” in the provision of medical care to patients with dermatovenerological pathology, the reorganization of dermatovenerological care was carried out, including: restructuring of the MO network, the creation of mo areas of responsibility for the provision of dermatovenerological care; the organization of an interdistrict center; the reorganization of three city CVD departments; the opening of CVC; the development of regulations for intradepartmental interaction of dermatovenerologists with doctors of other specialties; the organization on the basis of THE; information support of participants of interaction; increase of professional level of medical personnel. The economic effect due to the elimination of duplication of laboratory and diagnostic studies in the medical examination of patients with dermatovenerological pathology was in 2015 1190266,7 rubles. Sociological surveys of patients who applied to the CSQ, showed that the majority of respondents were satisfied with the medical care, positively assessed its availability (90,3%) and quality (96,1%).
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Experience of practical use of SWOT analysis when organizing a medical department based on a fitness center
Abstract. SWOT analysis - relevant today strategic management can be actively used in the health care organization. Nevertheless, a full formal analysis is hampered by a number of factors, among which are high financial and time-consuming. Another difficulty in carrying out quantitative assessments will be the risk of creating an” impression” of a unique solution, without taking into account the subjective factor during the determination of weight coefficients. At the same time, this type of analysis remains a good working tool when using it to make a decision and identify key aspects of the organization’s strategy. This article provides an example of the practical use of the method of SWOT analysis with the subsequent implementation of the developed recommendations. A full Swot-analysis was conducted to determine the strengths and weaknesses of the creation of a medical unit on the basis of a modern fitness center. Specific recommendations were created after ranking the factors by importance. The analysis confirmed the feasibility of establishing a medical department, which can increase the number of consumers of services with high margins. Taking into account the obtained data, the implementation of the recommendations was carried out and the relevance of the use of this management tool in the health care organization was confirmed. The final result of the practical application of swot analysis was the expansion of the market at the expense of patients in need of rehabilitation and preventive measures.
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Main trends in mortality from injuries among elderly persons
Р. 34-38
Abstract. Despite the fact that the main economic and demographic negative contribution to the death rate from injuries is caused by cases among the able-bodied population, a huge social role is played by mortality among the elderly and senile age. For all the major causes of death from injuries, with the exception of death in road accidents and due to injuries with sharp objects, where the maximum rates are recorded for men of working age, the leading age groups are65 years or more, and peak values occur at the age of 80 years or more.The problem of high mortality among seniors is interdepartmental in nature; to solve this problem, it is necessary to involve not only health authorities, but, above all, social services. For persons of old age, an organization of an accessible environment is necessary, not only at public and private facilities, but also at the place of residence. -
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.
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Medical staff resources of the Moscow psychiatric service during its reform
Medical staff resources of the Moscow psychiatric service during its reform. Since 2010, a modernization of the psychiatric service has been carried out in Moscow. Reforms affect both outpatient and inpatient units. An analysis of the staff resources of the service reflects the effectiveness of the reforms. The aim of the study was to improve the quality of psychiatric care based on the analysis of staff resources of the Moscow psychiatric service. The article presents data on the staff resources of the psychiatric service in 2008-2017. During the modernization of the psychiatric service, the number of psychiatrists was at a high level, the provision of psychiatrists to the Moscow population of was higher than the average provision to the Russian Federation. Growth in the number and staffing of ambulatory rates in psychiatric institutions in Moscow in 2015-2017 partially compensated for the decrease in the number and staffing rates in psychiatric hospitals, however, there is currently a staff shortage in the psychiatric service of Moscow, as indicated by the excess of job-sharing coefficients in individual institutions. During the study period, there was a positive change in the number of visits per 1 psychiatrist.
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Assessment of attainability of fifth place in the global ranking of the publishing activity on priority areas in biomedicine
During 2012-2018 in the Russian Federation, pursuant to Presidential Decree No. 599 of 05/07/2012, a set of state support measures was implemented aimed at increasing the specific gravity of Russian publications indexed in international databases. The national project “Science” (NPS) designed to realize the goals set by Presidential Decree No.204 of 05/07/2018 “On the National Goals and Strategic Tasks for Development of the Russian Federation until 2024” continues and develops the theme of increasing the publication activity of the Russian Federation in the internationalized space. One of the six NPS targets is “The place of the Russian Federation in terms of specific gravity in the total number of articles in areas defined by the priorities of scientific and technological development in publications indexed in international databases”. The purpose of this study was to evaluate the basic value of this indicator for biomedical disciplines related to the priority direction (paragraph 20c) of the Strategy for Scientific and Technological Development of the Russian Federation. We compared volumes of publication flows of the Russian Federation in 20 biomedical disciplines with a similar indicator of countries ranked fifth in the number of publications on the subject area under consideration, indexed in the Web of Science Core Collection (WoS CC). A 5-10 fold lag of the Russian Federation was recorded for the most part of the priority areas in the field of biomedicine identified by the NTS passport. The impact of public policy measures aimed at increasing the national biomedical publication stream for the period of 2012-2018 was estimated as insufficient to meet the considered NTS target.
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Management in modern management in foreign health care systems(scientific literature review)
This science literature review was conducted for five-year period. It has been established that the process of improvement by lean management has more than 50 years history in industry, and the experience is best carried out, in primary health care; the main of lean management introduction in healthcare is to ensure optimal participation of medical staff in the changes; the concept of medical care in the first place has the aim of improving the quality and availability of healthcare processes; mapping is a basic tool allows to visualize the process of changes and evaluate progress; project management is a method of comprehensive changes in healthcare in which the elements of lean management are also used to ensure general increase in the efficiency of transformations. Lean management is becoming increasingly scientific and practical tool in health management nowadays.
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Control of dispensary supervision in system of obligatory medical insurance: the solution of a problem of formation of protection of the rights of the patient within the Federal direction «Fight against cardiovascular diseases» of the National Project «Health Care»
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New rules of obligatory medical insurance: major changes
The rules of obligatory health insurance regulate legal relations of subjects and participants of compulsory health insurance. New rules of obligatory health insurance developed by the Ministry of health of Russia in accordance with the recommendations of the Ministry of justice. The essence of these recommendations was not to make regular changes to the existing rules of obligatory health insurance, but to approve new rules of obligatory health insurance. To a large extent, these changes are associated with the Informatization of health care, with the advent of legislative regulation of the use of telemedicine technologies. Most of the changes affect the order of calculation of the value of sanctions applied to the medical organisations in the mandatory medical insurance system. In turn, these changes reflect the desire to reduce the financial burden on state (municipal) institutions and make it easier for them to achieve the level of wages provided for by the "may" presidential Decrees of 2012.
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Additional payments for medical care within the framework of the state guarantees program: questions and answers
