Articles from rubric: «Marketing in health care»
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2023 № 2 Influence of exclavity and income level of the population on consumer preferences of patients in the market of medical services.
The article presents the results of a qualitative analysis of the influence of exclavity and the level of income of the population on the consumer preferences of patients in the medical services market using the Kaliningrad region as an example. Economic disparity in access to healthcare services contributes to the psychographic stratification of healthcare consumer preferences. Territorial isolation from the country and the proximity of foreign countries leave an imprint on the social and economic life of the population of an exclave subject and commitment to medical tourism.
M a t e r i a l s a n d m e t h o d s . In the period from September to November 2022, a one-time comparative study of consumer preferences for choosing a country and a medical organization in the medical services market of 773 working-age residents of the Russian Federation was planned and conducted. All respondents were stratified into two groups according to their place of residence: residents of the Central Federal District and the Kaliningrad Region. The groups were comparable in terms of gender and age. Methods used: open online survey, qualitative analysis, statistical. The significance of differences in the percentages of the trait was estimated by the Fisher angular transformation coefficient (φ) with a given confidence level of 95%.
R e s u l t s . The influence of exclavity and income level on consumer preferences for choosing a medical organization has been established. The features of the priority motivators for the choice of public, private or foreign medical services of the respondents of the Kaliningrad region are revealed. The comfort of receiving medical services (“lack of queues”) was 1,4 times more likely to motivate the choice of private medicine among respondents in the Kaliningrad region compared to respondents in other regions. The demand for the services of private and foreign clinics in the exclave territory is proportional to the level of income. Medical tourism services were used by 28,7% of respondents from the exclave territory who prefer private medicine.
C o n c l u s i o n . A distinctive feature of consumers of medical services in the exclave Kaliningrad region is the increase in demand for private medicine and treatment abroad in proportion to the increase in income levels. Respondents from the exclave territory are 1,4 times more likely to choose private clinics and 23,9 times more likely to use medical tourism services compared to residents of the Central Federal District. Every fourth respondent in the Kaliningrad region does not trust the quality of training of doctors in the Russian Federation. Transport accessibility of the EU countries, dissatisfaction with the level of training of medical personnel, the lack of a number of medical services in the Russian Federation, the ability to realize the desire to combine treatment with a trip abroad with a sufficient level of income of the population in the exclave region, along with a shortage of medical personnel in the subject, contribute to increasing the attractiveness of private medical organizations, import of medical services and outflow of patients abroad. Recommendations are given to increase the attractiveness of state medicine in the exclave territory. -
2022 № 4 Patient support program as a part of value-based healthcare implementation
Patient support programs as a new institutional phenomenon take over part of the functions of the Institute of Healthcare in drug provision, diagnostics, clinicians and patients education, infrastructure support.
Purpose: to evaluate the role of patient support programs (PPMS) by describing the mechanisms of their implementation.
Materials and methods. On the basis of open sources of information and scientific literature data, the initiatives to launch PPP in Russia of medicines and medical devices were analyzed.
Results. The most common programs are that combine financial and information mechanisms. The key principle of the development of the PPP is orientation to the patient’s pathway. Typical tools for the implementation of PPP include the following: hotline, SMS-informing, patronage service, online monitoring, patient training, insurance. The effectiveness of the PPP is assessed by four groups of indicators: patient adherence, quality of life and patient experience, clinical outcome indicators, cost savings.
Conclusions. Health authorities and medical professionals should be aware of the possibilities of programs to achieve the goals of improving the quality and accessibility of medical care, and can also help to systematically assess the effectiveness of such programs from the perspective of public health. -
2022 № 4 Choosing optimal treatment organisation strategy for unresectable liver cancer: case of Moscow region
Introduction: despite quite low morbidity with up to 6 thousand cases per year in Russia, therapy for unresectable liver tumors is based on costly therapy with tyrosine kinase inhibitors or anti-PD‑1L agents thus leading to extremely high costs per life year saved. In the meantime, transaterial radioembolization (TARE)technique is reported to show better outcomes in this patient group compared to conservative treatment and transarterial chemotherapy (TACT). This article researches strategic options for regionwide treatment programs focused on involving TARE in unresectable liver tumors treatment.
Methodology. Epidemiological data provided by national cancer report. Systematic review of literature (not meeting PRISMA criteria) was done for TARE vs. TACT and TARE vs. conservative treatment overall survival. Treatment costs were based on current governmental treatment tariffs for Moscow region. Only direct oncology costs were included without possible complications analysis. The final analysis was done for optimistic, pessimistic and moderate expected numbers of patients eligble for TARE.
Results. Optimal treatment strategy implies maximum allowable rate of TARE with patients concentration in selected hospitals. For Moscow region (population of 7,6 million people) estimated yearly benefit of this strategy is 309,3 RUB (USD3,4 million USD) and 284 life years saved based on moderate prognosis. -
2022 № 2 Features of the organization of medical care in the interests of clinical testing of methods of prevention, diagnosis, treatment, rehabilitation and registration of necessary documentation
Medical care in the interests of clinical approbation of methods of prevention, diagnosis, treatment and rehabilitation is carried out to confirm evidence of efficiency and is essential function of medical organizations. Based on the clinical approbation, the Expert Council of the Ministry of Health Care of the Russian Federation can recommend a method for inclusion in clinical guidelines (treatment protocols) to providing medical care.
The article contains an example of the assessment of 28 reports on the implementation of the clinical approbation protocols completed in Russian Scientific Center of Roentgenoradiology of the Ministry of Health of Russia at 2016–2020. In the provision of medical care during clinical approbation, improvement is arrived in 59,6%, recovery – 32,9%, no change – 7,5%, there were no bad ones. As well as the procedure for the provision of medical organization to carry out clinical approbation, which is presented to medical organization by the Expert Council of the Ministry of Health Care of the Russian Federation. -
2022 № 2 Patient-Oriented Approach in Nursing
Nursing care is aimed at achieving the best treatment results and improving the patient’s quality of life. Professional practice based on the use of a patient-centered approach in nursing care contributes to health promotion, healing, disease prevention, provides not only physical, but also psychosocial comfort for the patient, including the ability to adapt to his condition, cope with illness or disability.
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2022 № 2 Rationale for optimizing the organization of providing coloproctological assistance to the population by assessing the quality of different approaches of its providing
In this article, in order to justify the optimization of the organization of providing coloproctological care to the population, the results of assessing the quality of various approaches to its provision are presented.
Materials and methods. A comparative analysis of the coefficients of medical efficiency for the traditional coloproctological profile service system and the proposed system is carried out. The quality of coloproctological care was assessed using efficiency coefficients and an integrated quality indicator.
Results. As a result, a higher level of medical, social and economic efficiency is shown in the conditions of the developed
system. The data are reliable, differences are noted both for individual coloproctological pathologies and in general. An integral quantitative assessment of the quality of coloproctological care also showed a higher efficiency of the developed system (p<0.05), which reflects its medical, social and economic effectiveness.
Conclusions. The creation of regional coloproctology centers combining inpatient treatment and outpatient care; provided with highly qualified personnel with sufficient experience in this specialty; equipped with modern equipment, including video endoscopic equipment for performing diagnostic procedures; introducing new high-tech operations, will further improve the timely diagnosis of coloproctological diseases and provide highly qualified specialized care to patients. -
2022 № 2 A research of the impact of the call routing strategy on the call-centre work efficiency as a medical organisation providing primary hospital health care
The article provides an estimation of the efficiency of a call-centre work when using two different strategies of targeting incoming calls. The authors clearly demonstrate a reduction in the waiting time for communication with the operator and the frequency of call cancellations, an increase in the number of processed requests and an increase in the level of service when using the strategy of interactive navigation of incoming calls, which generally creates favorable conditions for increasing the availability of medical care to the population.
The purpose of the study is to study the effect of routing incoming calls on the efficiency of a medical call center in order to improve its operation.
Materials and methods. The comparison of the effectiveness of the polyclinic call center was carried out according to the indicators according to GOST R 55540-2013 under the conditions of using the scheme of random and interactive navigation of incoming calls.
The target values of quality indicators are established empirically, taking into account the accepted industrial standards. The analysis of statistical information was carried out using special software “Asternic call center stats”. A total of 72 statistical indicators were studied in both cases within the same seasonal period.
Results. It was found that the organization of the scheme of interactive guidance of incoming calls helps to increase the productivity of a medical call center by optimizing the processing of calls without increasing the number of operators. The average waiting time for a patient to communicate with an operator has decreased by 2 times, the frequency of call cancellations has decreased by 3 times, the processing time for patient calls has decreased by 15.6%, the level of service has increased by 1.6 times. The practical significance of the proposed scheme for navigating incoming calls is due not only to the effective increase in the functionality of the medical call center, but also to the ease of scaling due to the unified IP telephony architecture in medical call centers.
Conclusions. Thus, as a result of the study, a call routing strategy has been identified, which makes it possible to improve the performance indicators of the medical CC, to service more calls faster without attracting additional personnel, and to create conditions for increasing the availability of medical care to the population. -
2022 № 2 Estimation of the impact of trans-regional routing of patients with ST-segment elevation acute coronary syndrome on acute myocardial infarction mortality reduction based on the digital twin of Kurgan region
Reduction of the time required for medical evacuation to the regional vascular center in order to carry out percutaneous coronary intervention in case of ST-segment elevation acute coronary syndrome is an essential factor directly affecting the mortality rate of this condition. The concept of territorial attribution in rendering emergency medical services militates against the effective use of such emergency medical services aimed to promptly deliver patients to the hospital.
Research objective. The research objective is to study the efficiency of trans-regional communication in reducing the time required to deliver patients with ST-segment elevation acute coronary syndrome to hospitals in order to carry out percutaneous coronary intervention and its impact on acute myocardial infarction mortality rate basing on the digital twin of Kurgan region.
Materials and methods. the digital twin of the Kurgan region represents the time required to evacuate patients with ST-segment elevation acute coronary syndrome to regional vascular centers by ambulance crews in pursuance with an applicable order, compared with patient routing in case of trans-regional cooperation with vascular centers of neighboring regions.
Results: due to the implementation of trans-regional cooperation, mean patient evacuation time within the region had been reduced by 21,3 ± 9,84 minutes, and mean time on routes from the localities wherefrom it was faster to deliver patients to vascular centers in neighboring regions had been reduced by 55±25,73 minutes. The estimated myocardial infarction mortality rate on average for the Kurgan region caused by medical evacuation time reduction in case of implementing trans-regional cooperation had been reduced by 5,32%.
Conclusions: the use of resources of neighboring regions when working out regional orders on routing the patients with acute coronary syndrome in a number of instances contributes to the provision of two-hour availability of percutaneous coronary intervention and serves as a significant reserve for acute myocardial infarction mortality reduction. -
2021 № 9 Current issues of evidence-based management of state and municipal health care.
The topic of evidence-based management is relevant due to a significant increase of managerial innovations in medicine, healthcare commercialization, changes in approaches to the use of evidence sources in healthcare and high commercial, investment, social and reputational risks of poorly evidence-based decisions. The article deals with awareness and practical use of the evidence-based management approach among the executives of budgetary medical cites. The results of the first Russian study of evidence-based management among health care managers are presented, in particular, their awareness of the evidence-based approach, attitude to evidence-based management practice, and the sources of information used by them are studied.
The purpose of the study is to investigate the existing practice of applying evidence-based approaches in the management, awareness of the approach, it’s application in practice, drawing conclusions about the factors influencing managerial decisionmaking, and making recommendations for their improvement.
Materials and methods. The study of the management practice of heads of medical organizations was conducted using an online survey. The general part of the questionnaire included questions about the demography of respondents, their management experience, education, and the size of the organization. The special part assessed: respondents ‘ awareness of the approach; their attitude to the evidence-based management practice; sources of information when making decisions. Their opinion on the role of corporate culture in the formation of evidence-based management practice was clarified.
Results. Only 17% of managers use an evidence-based approach in practice, and only 5% use at least six sources of information for this purpose. The popularity rating of information sources is presented as follows: own experience 81%, consultations with external experts 60,3%, internal data of the organization 56,9%, scientific data 38%, the opinion of colleagues 36,2%. Most managers consider the use of data in practice to be the most difficult in making managerial decisions. Only 31% of healthcare managers regularly summarize their managerial experience. The majority of respondents, 75.8%, recognize the important role of corporate culture in forming the habit of making decisions on an evidence-based basis, but also assess the organization’s resources for making informed management decisions as insufficient. Only 20,7% of respondents rated the degree of the organization’s learning ability and its readiness for changes as high.
Conclusions. Further improvement of the practice of making managerial decisions on an evidence-based basis is possible due to the informatization of healthcare and the development of the corporate culture of municipal medical organizations. Evidence-based management practices should be integrated into the trajectory of continuing medical education of healthcare managers in order to improve the efficiency of the industry. -
2021 № 9 Independent assessment of the quality of medical care in a multidisciplinary hospital
The assessment of the quality of the conditions for the provision of medical services from the patient’s point of view is an integral part of the management process of medical organizations within the framework of the implementation of the concept of patientoriented healthcare.
The purpose of the study is to analyze the results of a patient survey as part of an independent assessment of the quality of medical care conditions in a round-the-clock hospital of a large multidisciplinary medical organization.
M a t e r i a l s a n d m e t h o d s . As part of the independent assessment, the inpatient patients were surveyed using questionnaires approved by the Ministry of Health of the Russian Federation. A mathematical analysis of the results of the survey was carried out according to five criteria for assessing the quality of medical care conditions.
R e s u l t s . The results of an independent quality assessment in the hospital allow us to assess the effectiveness of measures to ensure comfortable conditions for the patient’s stay and can be used in practical healthcare for organizing measures to eliminate defects and making strategically important decisions on the management of a medical organization.
F i n d i n g s . The survey of patients allows not only to fulfill the requirements of the Ministry of Health of the Russian Federation on participation in an independent quality assessment, but also to identify “pain points” in the organization of medical care processes. The opinion of patients helps to focus attention on problematic areas in the activities of the Ministry of Health, which are often not noticed by the medical staff, gives an understanding of the effectiveness of innovations and reforms. -
2021 № 9 Health care organizers about the possibility of using outsourcing in medical organizations.
I n t r o d u c t i o n . The ratio of the number of administrative and administrative and auxiliary personnel to the main staff, as well as the share of their remuneration in the total cost structure, is one of the criteria for the effective use of resources of medical organizations.
The use of the outsourcing mechanism allows us to solve a number of problems that arise when such a ratio is observed, without reducing the quality and availability of medical care.
T h e p u r p o s e o f t h e s t u d y is to study the opinion of health care organizers about the possibility of transferring certain areas of activity of a medical organization to outsourcing.
M a t e r i a l s a n d m e t h o d s . The following methods were used in the study: statistical, sociological and analytical.
R e s u l t s a n d d i s c u s s i o n . More than half of health care organizers believe that the introduction of outsourcing in a medical organization is necessary (66,1%). The study participants believe that it is possible to outsource such positions as cleaning of territories (94,4%), security of a medical organization (93,5%), laundry services (91,1%), maintenance of vehicles of a medical organization and maintenance of non-medical equipment and communications (87,1% each), etc. In their opinion, it is impossible to outsource such functions as planning and economic activities (69,4%), personnel records management (68,5%), procurement / contracts (58,1%), accounting (57,3%), legal support of the activities of a medical organization (37,9%), etc. Most often, the following functions have already been outsourced in medical organizations: laundry services (64,3%); maintenance of medical equipment (57,3%), motor transport of the Ministry of Defense (46,4%), non-medical equipment and communications (46,4%); cleaning of territories (35,7%).
C o n c l u s i o n . Outsourcing allows you to focus on the profile activities of a medical organization and improve the quality of services provided to the population. Before transferring certain functions of a medical organization to outsourcing, the head needs to analyze the practical experience of regions and other medical organizations, which will help to avoid the negative aspects of outsourcing, expand its scope and the range of functions transferred to outsourcing companies. -
2018 № 4 Corporate brand as a method of increasing the competitiveness of a non-governmental healthcare system
The article identifies the concepts of brand, corporate brand and branding, problems and methods of using the brand in medical organizations. The results of the conducted research and analysis of efficiency, evaluation of intangible components and values of the corporate brand are presented. The directions of marketing work for increasing competition in the institutions of the non-state healthcare system are suggested. The need to create a single corporate brand for the entire national healthcare system is highlighted
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2018 № 4 Assessment of financial flows and expenditures in HIV/AIDS infection in Tajikistan
In Tajikistan, despite the measures taken, there are still problems in reducing the spread of the epi-demic and covering the HIV/AIDS prevention and treatment measures related to HIV/ IDS financing. Development of measures to ensure long-term financing of national programs and strategies related to HIV/AIDS response. The need to finance HIV/AIDS programs in the long term until 2020 was developed on the basis of a mathematical model for assessing the epidemic’s development and forecasting. Based on the mathematical model, assessing the development of the HIV/AIDS epidemic shows that in the case of sufficient financing of all basic services within a budget of $129 million for the period until the end of 2020, about 8,360 new cases of infection and the preservation of 101,700 DALYs. Sufficient funding for all basic services related to the prevention and treatment of HIV/AIDS will effectively achieve the goal of preventing the further spread of the HIV / AIDS epidemic by 2030
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2013 № 12 Analysis of the target audience of medical organization (Baykal State University of Economics and Law; JSC «Doctor Bermental»; Irkutsk State Medical Academy of Continuing Education, Irkutsk, Russia)
The article is dedicated to the marketing research's results of medical organization's target audience. This organization provides health care for overweight. As a result a «portrait» of a consumer was compiled, particularly, socio-demographic, behavioral and psychological characteristics of this consumer were explored. Also some alternative target groups were identified.