2013 № 7 Emergency (acute) disinfection of air and living surfaces in a complex system of infection security of medical organizations (JSC «Publishing House «Manager of Health Care», Moscow, Russia Россия)
Annotation: In the article there are considered organizational-methodical aspects of processing events on emergency (acute) disinfection of air and living surfaces which is the core part of complex program on infection security in medical-prevention organizations.
2020 № 7 Legal regulation of involuntary hospitalization of persons with coronavirus infection what needs to be done
The article presents an analysis of legal acts regulating the procedure for hospitalization and / or isolation in cases of
coronavirus infection. It is shown that currently, in accordance with the law, medical intervention is allowed without the consent of a citizen in respect of persons suffering from diseases that pose a danger to others. At the same time, the authors prove that the concepts of “medical intervention” and “hospitalization” are not identical. In turn, the legislation does not provide for involuntary hospitalization and involuntary isolation of persons suffering from diseases that pose a danger to others. The lack of clear legal regulation of these issues makes it difficult to implement effective measures to prevent the spread of coronavirus infection. The article proposes to define and legislate the procedure for involuntary hospitalization and involuntary isolation in cases of diseases that pose a danger to others.
2022 № 2 Adaptation and initial reliability testing of the Russian-language version of the safety attitudes questionnaire for medical organizations
The article presents the results of adaptation and initial reliability testing of the Russian version of the safety attitudes questionnaire (SAQ) for medical organizations. The reliability of using the questionnaire has been proven: all scales have high internal consistency and correlate with original factors. Using exploratory and confirmatory factor analysis, the features of the seven-factor structure of the Russian version of the questionnaire are shown: 1. teamwork climate; 2. safety climate; 3. job satisfaction; 4. stress recognition; 5. perceptions of management (department level); 6. perceptions of management (hospital level); 7. working conditions.
2013 № 12 The directions to improve the admission office staffing in the medical institutions of the Moscow region (Moscow Regional Clinical and Research Institute (MONIKI) M.F. Vladimirsky, Moscow, Russia)
Improvement of the admission office staffing in the Moscow Regional medical institutions like in the whole Russian Federation should be based on the principle of 1 physician per 215 patient beds used for planned hospitalization and 260 beds for urgent cases but no less than 1 daily post per medical department. Medical aid should correspond to these principles which should be differentiated according to the patient stream to admission offices working in planned, urgent regimes or with outpatients without further hospitalization.
2021 № 5 New system of control measures in relation to medical organizations within the framework of compulsory health insurance
One of the most serious innovations in the system of compulsory health insurance is the change in the procedure for conducting control measures. In accordance with the new version of Federal Law No. 326-FZ (in accordance with the provisions of the Federal Law of December 8, 2020 № 430-FZ On Amendments to the Federal Law "On Compulsory Medical Insurance in the Russian Federation"), the procedure for monitoring the volume, timing, quality and conditions of providing medical care for compulsory medical insurance to insured persons, as well as its financial support, is now established not by the Federal Fund for Compulsory Medical Insurance, but by the Ministry of Health of the Russian Federation. At the same time, both the participants of the CMI system who have the authority to conduct control measures, and the procedure for conducting control, are changing.
2021 № 10 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.
2021 № 4 NEW SYSTEM OF CONTRACTS WITHIN THE FRAMEWORK OF COMPULSORY HEALTH INSURANCE
The system of compulsory health insurance is regulated by a large number of regulatory legal acts. Nevertheless, many issues related to the relationship between the participants of the MHI system, and above all – financial, are determined by the content of the contracts concluded between them. This article analyzes the new system of contracts that has developed in the system of compulsory medical insurance in connection with the adoption of Federal Law No. 430-FZ of December 8, 2020 “On Amendments to the Federal Law “On Compulsory Medical Insurance in the Russian Federation”, as well as other related regulatory legal acts. There have been changes not only in the content of the contracts, but also in the composition of their participants. In addition, there is a new, previously absent type of contract. The purpose of the work is to analyze changes in contracts in the MHI system and their possible consequences.
2020 № 8 Changes in the procedure for financial support of medical organizations in the system of compulsory medical insurance at the present stage of the spread of coronavirus infection
In the context of the spread of coronavirus infection, the main problem of medical organizations is not an obvious increase in the cost of providing medical care associated with ensuring the sanitary and epidemiological regime (personal protective equipment, disinfection, etc.), but a decrease in income due to a drop in the volume of planned medical care, suspension of preventive measures, downtime (during the period of re-profiling, etc.).
The state quickly responded to this situation by making changes to the relevant legislation and adopting a number of special regulatory legal acts. However, the implementation of these rather varied measures tied to a number of factors, such as the presence or absence of restrictive measures on the territory of the Russian Federation; participation or non-participation in the care of patients with coronavirus infection; periods within which the one or the other order advances, etc.
All this causes difficulties in understanding what financial security mechanism is applied to this particular situation, what should be the actions of medical organizations.
This article is devoted to the analysis of ways of financial support of medical organizations in the system of compulsory medical insurance at various stages of the fight against coronavirus infection.
2020 № 4 The effect of coronavirus Сovid-19 on the situation in Russian healthcare
The relatively slow initial rate of spread of COVID-19 coronavirus in Russia has its own objective reasons related to the size of the territory, population density, tourist activity of the population, etc. They have played a positive role in making it possible to better prepare for the fight against it, taking into account, among other things, the experience of countries where the rate and scale of the spread of the coronavirus was much higher.
Despite the serious damage to the economy, there are no global financial threats to health care yet. However, it is important that resources arrive in time to medical organizations in the context of large-scale conversion of beds, etc. Unavoidable periods of downtime during periods of re-profiling, being in standby mode, etc., lead to the fact that many medical organizations risk finding themselves in a difficult financial situation, even with sufficient resources in the industry. Therefore, at this stage, it is sometimes more important than serious financial infusions, and mechanisms aimed at com- pensating for the loss of income.
2020 № 5 Russian Health Care in the background coronavirus COVID-19: Opportunities and Threats
The effectiveness of any public system, including health care, is determined by the adequacy of its legal regulation. The situation with coronavirus exposed many problems in this area, a number of which were quickly resolved with varying degrees of success. However, there are still many unresolved issues and the need to further improve the legal regulation of health care. This applies, among other issues, to the remuneration of medical workers engaged in providing medical care to patients who have been diagnosed with COVID‑19 coronavirus infection. The article presents an analysis of the procedure for implementing incentive payments at the expense of Federal funds, and suggests measures to improve it. The article presents a SWOT analysis of the state of Russian healthcare against the background of the spread of COVID‑19 coronavirus.
2019 № 3 Рayment for medical care provided in excess of the volumes of granting of medical aid in system of obligatory medical insurance
Сurrently, health organizations are extremely important are the issues associated with excess of volumes of granting of medical aid in system of obligatory medical insurance. This is the so-called problem of "super-planned patients". The current legislation does not provide for payment of super-planned volumes of medical care.. But the incidence rate is difficult to predict with a high level of accuracy. Within the framework of the current regulatory framework, all financial risks in this situation are assigned to the medical organization, which does not correspond to the logic of insurance. However, there are some options to mitigate this problem. This is illustrated by the court practice in this area.
сompulsory medical insurance, volumes of medical care, insurance medical organizations, medical organizations, sanctions, the Commission on development of the territorial judicial practice.
2022 № 1 Financing of the compulsory health insurance system in 2022
The most important factor affecting the amount and methods of financial support of the compulsory medical insurance system, as in the last two years, continues to be the spread of coronavirus infection COVID‑19.
In the proposed paper discusses not only the indicators of the budget of the Federal compulsory medical insurance Fund, but the dynamics of indicators, including, in comparison with the rate of inflation, and other factors.
New directions of the use of compulsory medical insurance funds are identified, the reasons for their appearance are considered.
2020 № 6 Assessment of public policy in relation to certain issues of healthcare functioning during the spread of COVID-19 Coronavirus
Health care, as a predominantly public system, is objectively subject to serious regulation in special operating conditions, which include the spread of COVID-19 coronavirus infection. It is also important that the private healthcare system is also subject to direct or indirect regulation. At the same time, public authorities are sometimes forced to resort to "manual management", the consequences of which are not always clear for both public and private health care.
2020 № 3 The problems of paying for medical care provided to residents of other subjects of the Russian Federation within the framework of compulsory medical insurance
The legislation guarantees citizens the right to receive medical care under a compulsory health insurance policy (CHI) throughout the Russian Federation. But in some cases, in accordance with current legislation, a referral is required to receive medical care. This also applies to situations where a citizen receives medical care outside of the subject of the Russian Federation where the citizen is insured. The system of such referrals to medical organizations located in another region is more or less regulated only when they are sent to Federal medical organizations. The situation is further compounded by the fact that the Supreme court contrary to law, making decisions, actually leveling a direction. At the same time, payment for medical care provided outside the region in which the MHI policy is issued depends on the payment of this assistance from the Territorial Fund of this region. This leads to numerous delays in payment and, as a result, reduces the interest of medical organizations in providing medical care to "nonresidents". Patients suffer as a result. All this raises the question of the need to improve the current mechanism for conducting inter-territorial settlements in the MHI system.
2014 № 12 Independent assessment of services provided by medical organizations (Federal Research Institute for Health Care Organization and Information of the Ministry of Health and Social Development of Russian Federation, Moscow, Russia)
In the framework of the events, related to introduction of the efficient contract, there is planned an independent assessment of provided state (municipal) services. In relation to this, there were adopted a lot of normative legal acts. With big potential opportunities, such system, however, is associated with a number of risks, which is important to factor in order to avoid the decrease of subjectiveness, real dependency and efficiency of introducing the independent quality assessment.
2023 № 3 Scientific substantiation of proposals for improving medical care for villagers.
P u r p o s e o f t h e s t u d y : based on the analysis of the medical and demographic situation and the staffing of the rural population, develop proposals for improving medical care for the villagers.
M a t e r i a l s a n d m e t h o d s : statistical, analytical, direct observation. The article used the forms of state statistical observation of the Ministry of Health of the Russian Federation. The results of the actual research.
Materials and methods: statistical, analytical, direct observation, the forms of state statistical observation of the Ministry of Health of the Russian Federation were used.
R e s u l t s . The rural population in the Russian Federation (2021) is 36,9 million people (25,2% of the country’s population). The proportion of the rural population of working age was 53,8%, which is lower than in Russia as a whole – 56%. A 21-year analysis showed that the birth rate of the rural population increased until 2012, while mortality rates decreased, in 2013 the mortality and birth rates became equal and amounted to 14,5‰ each, in 2020 the death rate increased to 15,4‰ due to the COVID‑19 pandemic. The average (expected) life expectancy of the rural population (70,7 years) is lower than that of the urban population (71,8 years); the indicator for rural men is extremely low (66 years). The
overall incidence of the rural population is 1,4 times lower than that of the urban population, 117993,2 and 166901,5‰oo respectively. Primary morbidity is also 1,5 times lower (55082,4 and 83002,2‰oo, respectively). The difference in primary morbidity rates of the rural population in the federal districts (2020) was 1,3 times, in the constituent entities – 8,3 times. The incidence of COVID‑19 in the rural adult population (2020) was 1986,0‰oo, which is 2 times lower than in the Russian Federation as a whole (3913.9‰oo). There was a significant difference in these indicators (by 59 times) in the subjects of the Russian Federation, which can be associated with a lower density of the rural population,
low availability of medical care in the countryside, as well as the ambiguity of COVID‑19 coding. For 6 years (2016–2021), the provision of doctors in medical organizations in rural areas in the Russian Federation decreased from 14,8 to 13,6‰o, and of nurses – from 54,6 to 49,3‰o. The number of nursing staff individuals working for feldsher-obstetric station decreased by 12,5%, paramedics – by 9,4%. Given the special importance of paramedical assistance in the countryside, the reduction in the number of paramedics should be considered a negative.
C o n c l u s i o n . The unfavorable medical and demographic situation in the countryside requires the development of organizational and managerial decisions aimed at increasing the availability of medical care to the villagers.
C o n c l u s i o n s . Proposals have been developed to improve the provision of medical care to the population of rural areas.
2019 № 9 Restructuring of a regional system of rendering stationary medical care on the basis of means of tool benchmarking
In work approach to justification of management decisions on restructuring of a regional system of rendering stationary medical care with use of means of tool benchmarking is considered. Results of activity of hospitals were measured by calculation of an indicator of technical efficiency on the basis of a method of the analysis of the environment of functioning. Specialization of hospitals was measured by means of the index of the theory of information constructed on the basis of data on the clinic-statistical groups used in hospitals. The dependence between the index of specialization of hospitals and efficiency of activity of hospitals when rendering medical services on the basis of which a set of scenarios of restructuring of a regional system of rendering stationary medical care is formulated is revealed.
2018 № 4 Logistics of medicines as the point of optimization of costs of the medical organizations
This article examines 3 main types of schemes for the supply of drugs in healthcare organizations. The advantages and disadvantages of each scheme are described. Based on practical experience of using various types of schemes in the Clinical center of the Federal STATE First MSMU n. a. I. M. Sechenov of the Russian Ministry of health shows the economic and organizational advantages of the centralized inventory management scheme
2016 № 3 Primary Health care. Medical Network organization features and staff provision
Annotation. Changes of Medical organizations network, providing ambulatory treatment, were studied, for past 10 years. In addition, trends of manning tables formation in outpatient clinic were analyzed, as well as population provision by district doctors (uchastkoviy doctor) and general doctors. The analysis of main indicators of doctors’ activities in medical organizations, providing ambulatory treatment, is provided.
2015 № 7 The role of medical panel in providing medical aid: why is it not fulfilled in the total capacity and what the action plan should be
The article demonstrates and proves that in most of the medical organizations today medical panels do not play a leading role in the activities aimed to enhance the provision of medical aid. Authors draw attention to the issues of incomplete development of panel’s responsabilities and functional described in the Federal Law dated 21 November 2011 N 323-FL «On the principals of Health Protection of citizens of Russian Federation» and in the Order on creation and conducting medical panels in a medical organization, certified by the Order of Russian Ministry of Health Care and Social Development dated 05.05.2012. № 502. Authors suggested and justified additions and changes, which these documents must include.
2022 № 1 Features of the state of the network and the provision of a bed fund of medical organizations in Russia
The implementation of the healthcare development strategy, effective management of the healthcare system is impossible without monitoring and comprehensive comparative analysis at various levels of the state and development of the network, resources and activities of medical organizations, individual services and the healthcare system as a whole.
P u r p o s e of the study is scientific assessment of the state of the network of medical organizations providing medical care in outpatient and inpatient settings, as well as analysis of the provision of beds for the population of the Russian Federation in 2012–2019.
M a t e r i a l s a n d m e t h o d s . Within the framework of the conducted research, official statistics data were analyzed, modern trends and trends in the provision of beds and the state of the network of medical organizations in Russia at the regional level were determined. Statistical data processing was carried out using SPSS, Excel‑2007 packages. Such methods as analytical, statistical methods, study and generalization of experience, comparative analysis were used.
R e s u l t s . The analysis has shown that the unevenness and the level of high differentiation of indicators of provision of beds by subjects of the Russian Federation remains. Thus, over the period 2012–2019, the provision of specialized beds for all the main profiles of beds is decreasing, the largest reduction affected socially significant beds – dermatovenerological – by 1,5 times, as well as therapeutic – by 32,5%, gastroenterological – by 28,2%, pediatric – by 24,4%, and infectious – by 20,3%.
F i n d i n g s . The results of this study confirm the reduction in the number of beds of the main profiles, as well as the conversion of part of the bed stock, especially in the context of a pandemic of a new coronavirus infection, which showed the need for structural and functional transformations of health resources in general and the bed stock in particular.
2022 № 8 Professional standards: the role and importance in ensuring the quality and safety of medical activities, the main tasks
The article deals into detail with the application of professional standards in the activities of medical organizations and in the training of medical personnel. The authors substantiate that the application of professional standards in the regulation of labor relations of medical workers, as well as in the development and implementation of both professional educational programs and additional professional programs is an essential tool for ensuring the quality and safety of medical activities. The main tasks facing today in the field of the application of professional standards, the implementation of which will contribute to improving the quality and safety of medical activities, are identified: the creation of legal mechanisms for the effective application of professional standards by educational organizations; ensuring continuity in the application of professional standards between the training of medical personnel and the regulation of labor relations in the process of medical activity; the need to constantly maintain professional standards up to date
2020 № 6 What checks are cancelled and which are retained for medical organizations of the country in terms of the situation with coronavirus infection
The article contains a detailed analysis of the legal acts issued in April 2020 in connection with coronavirus infection and regulating the issues of state control (supervision) in relation to medical organizations until the end of 2020. In the publication, the authors present the main control and Supervisory measures that will be carried out in medical orga- nizations during 2020. A number of issues related to the legal regulation of control and Supervisory activities that require clarification are identified. In terms of the quality and safety of medical activities, the attention of medical organizations is drawn to the expediency of ensuring their own maximum readiness for various scenarios of carrying out certain control and Supervisory measures established before the end of 2020.