CONTENT OF THE ISSUE
MODERN APPROACHES TO SOLVING THE TASKS OF MANAGEMENT OF MEDICAL ORGANIZATIONS
A large amount of data is currently appearing in the information systems of medical organizations, which requires a revision of those industrial relations that exist in the practice of health care institutions.
T h e p u r p o s e o f t h e s t u d y is to study the possibilities of mathematical methods using the concept of “an object with estimates in a certain state” to solve management problems that are in the practice of medical organizations.
R e s u l t s . The authors use the term “production process”, which is not typical for the classical description of the activities of a medical organization. This is due to the fact that the approaches to solving management problems available in a medical organization are valid not only for medical and diagnostic work, but also for other household work. New approaches to solving the existing management problems of a medical organization consist in the fact that the description of the solution to the control problem is made in the form of some algorithm, which can then be implemented in some programming language. The digitization of production processes leads to the need for their formalized description in the language of mathematics, as well as the widespread use of mathematical methods, on the basis of which algorithms for solving control problems are built. Markov chains make it possible to find general patterns in the behavior of control objects within the framework of the problem being solved, which can be used to construct a tree giving a detailed description of the behavior of each control object. Further, the method of oriented
trees with estimates is applied, which provides information for writing job descriptions for employees of the Ministry of Defense, on the basis of which the management problem will be more optimally solved. It is necessary to highlight four features of the method of oriented trees with estimates: it allows to give a detailed analysis of the sequence of transitions of each object for the selected states; in the presence of a large number of analyzed objects, the resulting tree is difficult to analyze; you can rebuild the branches of the tree; in the course of building a tree, it is possible to change a set of states without changing the obtained chronological sequences of states of each control object in the initial data. Oriented trees with estimates can be used to simulate the production process, which is based on the possibility of simultaneously changing both quantitative and qualitative characteristics of the tree.
The article presents two options for modeling using changes in the qualitative characteristics of the tree.
F i n d i n g s . The introduction of digitalization in healthcare requires a different approach to solving management problems, which should be carried out with extensive use of mathematical methods at the stages of analysis and modeling. The work on the use of mathematical methods in solving management problems should be organized by regional medical information and analytical centers.
It is necessary to carry out work on the formalization of production processes, the creation and storage of algorithms for solving control problems. Promising methods that allow solving most of the management problems available in the practice of medical organizations are the methods of Markov chains with estimates, branching processes with estimates and oriented trees with estimates.
EXISTING APPROACHES TO ASSESSMENT THE EFFECTIVENESS OF THE IMPLEMENTATION OF STATE PROGRAMS IN HEALTHCARE AND THE POSSIBILITIES OF THEIR IMPROVEMENT
In recent years, health care has been in the focus of reform. Additional allocations of funds from the federal budget and extrabudgetary funds are allocated for national development goals until 2030. The results of research work in the state task of the RANEPA 2021 are presented by the authors in this article. Scientific and practical approaches and mechanisms of budgeting and administration of the financial sector are studied and the positions of an important addition to management tools and methods of social design are revealed.
AVAILABILITY OF HIGH-TECH MEDICAL CARE TO THE POPULATION OF THE ASTRAKHAN REGION
I n t r o d u c t i o n . In article problems of availability of high-tech medical care for residents of separately taken region are considered.
Communication of an increase of the rendered medical care depending on sources of financing and a regulation of a level cofinancing is analyses.
T h e p u r p o s e o f t h e s t u d y : a background of principles of realization of the program of the state guarantees of free rendering of medical aid at availability of insufficient financing the region, based on the analysis of existing problems in the organization of maintenance of availability of high-tech medical care.
M a t e r i a l s a n d m e t h o d s . In research were used a database of a subsystem of monitoring of realization of the state task on rendering high-tech medical care of information-analytical system of Ministry of Health of Russia and regulatory legal documents.
The statistical, analytical method and a content-analysis were applied.
R e s u l t s a n d d i s c u s s i o n . It is revealed, that at a quadruple increase of medical institutions rendering the given type of the help in territory of region, the percent of its rendering decreases, not leaving for its limits. Since 2012, decrease in grants from the federal budget almost twice is ascertained. Thus during last four years financing from means of the budget of the Astrakhan area remains at a constant level.
C o n c l u s i o n . For the big percent of the patients leaving for limits of region, the given type of the help in fact is not at all «free» as there is an indispensability of payment of additional inspection and travel. And absence of a precise regulation of a level cofinancing provides the way to allocate money resources from the federal budget by «a residual principle».
IMPROVING THE SYSTEM OF PREVENTIVE DRUG TREATMENT FOR TEENAGERS IN THE CONDITIONS OF THE DRUG TREATMENT DISPENSARY OF THE UDMURT REPUBLIC
The article presents data on the organizational activities of the republican drug treatment dispensary in the subject of the Russian Federation to improve the system of preventive drug treatment for.teenagers. A SWOT analysis was carried out, as a result of which strong and weak characteristics were identified in the preventive work of the prevention department and the office of preventive care for teenagers in preventing the development of dependence on the use of narcotic drugs and surfactants.
The risks and opportunities of improving the system of preventive drug treatment for adolescents in a drug dispensary are identified by increasing the level of interaction with various interdepartmental structures, introducing distance learning aimed at the target audience (adolescents at risk, their parents, healthy teenagers who have not tried at least once surfactants and narcotic drugs with their parents for consultations on motivation for healthy lifestyle, primary health care workers, specialists of related departments, law enforcement agencies, ministries, volunteers; creation of a separate organizational and methodological center for the implementation of remote network modern technologies in the municipalities of the republic for drug prevention work, namely, working in groups according to the cognitive metastil and the style of information encoding.
QUALITY AND COMPETITIVENESS OF THE HEALTH AND SPA COMPLEX: MODELS, CRITERIA AND METHODS
The urgency of the problem. One of the directions of state policy in the field of modernization of health care and sanatoriumresort business in particular, should be the development of methods and technologies for improving management systems. Regulators should take on the sponsor function, primarily with their policies and budgets, and professional associations should implement this policy by initiating and organizing assessment and competitive procedures to support sanatorium-resort organizations that are actively introducing and applying systematic quality management technologies in their activities. their services for sustainable longterm development.
Purpose of the study – development of a Sectoral model for assessing the management system of a sanatorium-resort
organization on the basis of internationally recognized criteria in order to improve the results and improve the activities of a sanatorium-resort organization and the industry as a whole.
Materials and methods. The analysis of models for assessing various aspects of the activities of organizations (ISO 9001, EFQM, JCI), incl. applied in health care using the methods of comparative and logical-structural analysis of their characteristics, which made it possible to identify the strongest solutions in the models under consideration and became the basis for building a model for assessing the management system of a sanatorium-resort organization.
Results. The criteria of the Sectoral Assessment Model and their content are harmonized with globally recognized management models, the principles of which emphasize the priority of consumers, the creation of sustainable values and the satisfaction of their needs, as well as the needs of stakeholders in the face of partners and the ecosystem and contain a re- the list of aspects of activities in which the organization must be successful.
Conclusions. An independent assessment of the level of maturity of the management system of a sanatorium-resort organization and the publication of its results form trust on the part of patients, vacationers, members of their families, large customers of sanatorium-resort services, as well as regulatory bodies and investors, help to attract investments in a sanatorium-resort complex and its sustainable development. The assessment model can also be used for self-diagnosis and improvement of the management system of any health resort organization.
PREVENTIVE EXAMINATIONS OF MINORS AS PART OF NEW GOVERNMENT INITIATIVES IN THE CONTEXT OF THE COVID‑19 PANDEMIC
The article discusses the medical and organizational aspects of conducting preventive examinations of minors as part of new state initiatives of a post-COVID‑19 orientation. The main positions of the Draft Order of the Ministry of Health of May 19, 2021, which will enter into force on September 1, 2021, have been studied, where a structural algorithm has been developed for conducting preventive examinations of minors in the context of an epidemic situation. The regulated positions presented in the document have been studied in the aspect of general medical tasks declared by the state during the modern period of development of the healthcare industry. Such directions, formed in the Project, as diagnostics of post-COVID‑19 complications from various systems of the body of minors, issues of monitoring of reproductive health and physical development are considered. The continuity is shown in the implementation of measures to level violations of the health status of minors within the framework of legislative, managerial
and organizational initiatives.
Purpose: analysis of modern legislative materials initiated by the State in the field of preventive examinations of minors, including during the period of the new coronavirus infection COVID‑19; characteristics of the concept of new directions of the program of preventive examinations of minors.
Materials and methods. The analytical sources of the study were the legal framework, scientific literature data on the issues of preventive examinations of minors. Methods were used in the work: bibliographic, analytical, statistical, comparative analysis.
Results. A comprehensive analysis showed that the algorithm for conducting preventive examinations of minors is determined by the legislative branch level and checked by the time factor, but is not a constant. Changing living conditions dictate new challenges, determine the inclusion of additional items in the survey of the contingent – laboratory and diagnostic directions, as well as change in time parameters in the examination and organizational support for preventive examinations of minors. The changes introduced undoubtedly require monitoring analysis of indicators on the problem, including comparative scientific analysis and prompt response to new tasks that are determined by time, issues of the medical and social environment.
Findings. The main organizational directions in the structure of preventive examinations of minors are: diagnostics of post-COVID‑19 complications, monitoring of physical development and the formation of reproductive health, determination of scientifically grounded approaches to admitting the contingent to physical education, the formation of a “data bank” of the results of basic and additional research methods. A comparative analysis of the prevalence of the distribution of minors by health groups based on the results of preventive medical examinations showed the lack of dynamics of indicators in the time period 2014–2020. Undergoing preventive medical examinations, as well as targeted regional policy in this direction, purposefully forming a “healthy childhood environment”, taking into account the development of the local industrial infrastructure.
THE MORBIDITY DYNAMICS MODELING AS AN INFORMATIONAL BASE TO MEDICAL CARE MANAGEMENT FOR THE OVER WORKING AGE POPULATION
P u r p o s e o f t h e s t u d y : The substantiation of the need to use modeling of the dynamics of primary and general morbidity of the elderly and old population to improve the management of medical and preventive care for this age group.
R e s e a r c h m e t h o d s : analytical, modeling and mathematical-statistical methods.
R e s e a r c h b a s e . This study was conducted on the basis of the Moscow region with a population of 7,7 million people as of 01.01.2021.
R e s u l t s . Shown, that use of mathematical modeling of the morbidity rate as an information database is one of the most optimal ways for calculating and assessing the needs in the volume of medical care for specific age groups of the population. The use of a nosological approach is proposed, because it allows to assess the required volume of medical care based on the existing pathology not on existing organizational models that may change. Morbidity modeling and forecasting is designed to promote optimization of medical and preventive examinations for elderly and old people in terms of determining the necessary forces and means based on knowledge of the magnitude of the existing need.
C o n c l u s i o n . Taking into account the forecasting data, the use of the proposed models makes it possible to form an idea of the magnitude of the need and to monitor the implementation of state guarantees for the medical provision of elderly and old people.
REVIEW. INTERNATIONAL ACCREDITATION IN COMMONWEALTH OF INDEPENDENT STATES CLINICS AND WORLDWIDE PRACTICE
Accreditation is a process of external evaluation of clinics, and is accepted worldwide as a tool for healthcare quality improvement.
There is a number of international accreditation commissions, who carry out accreditation for medical organizations. The most widely recognized is Joint Commission International. There is also a head accreditation commission, called ISQua. They accredit commissions, standards and educational courses. Among CIS countries, Kazakhstan owns the leadership in the number of JCIaccredited clinics. Analysis of international experience showed that accreditation could have its positive effect on organization of everyday work of clinic, treatment outcomes, patient satisfaction and economic efficiency. Accreditation is a helpful tool to make optimal the general level of the medical service performed by organization.
ACCOUNTS PAYABLE OF MEDICAL ORGANIZATIONS OPERATING IN THE COMPULSORY HEALTH INSURANCE SYSTEM
Among the indicators used to assess the financial condition of medical organizations, one of the most important is accounts payable, which characterizes the risks to their normal activities.
In this article, this problem is considered in relation to the system of compulsory medical insurance from the point of view of factors that do not depend on the medical organizations themselves.
ISSUES OF INAPPROPRIATE AND INEFFICIENT USE OF FUNDS IN STATE AND MUNICIPAL HEALTHCARE INSTITUTIONS
Numerous bodies that control the financial and economic activities of state and municipal healthcare institutions often make unfounded claims. In order to competently counter such claims, it is necessary to clearly understand the regulatory framework, demanding correctness in these matters from the regulatory authorities themselves.
Management in health care
Manager of heath care consults
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