Approaches to territorial planning of medical care on the example of the surgical service of the Moscow Region

• Konstantin E. Sobolev

Abstract

Within the framework of the program of state guarantees in the field of health care and the basic program of compulsory health insurance, when forming a territorial program, the average Russian standard for the volume of medical care per 1 resident or per 1 insured person (under the CHI program) is taken as a basis. For the provision of modern medical care in various regions of Russia, in a number of different factors that take into account the regional features of the provision of medical care, the density of residence, the climatic and geographical features of the region and transport accessibility are essential. All these factors are listed in the program of state guarantees, but currently, at the federal level, there are no methodological approaches to take into account these regional factors, and each region is forced to make its own decisions when forming territorial standards that take into account these features.

Thus, the development, justification and practical use of criteria that allow an objective assessment of the effectiveness of functioning is an urgent task, first of all, of territorial planning of medical care for the population of the regions of Russia.

The article discusses the criteria developed in the Moscow Region for assessing the effectiveness of the surgical service, allowing to take into account the potential of inpatient departments of multidisciplinary hospitals, to provide high-quality medical care, both at the place of residence and within the framework of regional routing of patients, in accordance with the stages (levels) of its implementation. These criteria make it possible to optimize the planning process within the framework of the territorial program of compulsory medical insurance and determine the rational placement of the planned volumes of inpatient care in medical organizations, with its subsequent financing at the expense of compulsory health insurance.

The application of uniform criteria for all surgical hospitals increases the objectivity of planning and financing and ultimately leads not only to an increase in the economic efficiency of the service, but also affects the clinical and social aspects of medical care.

Keywords:methodical approaches; surgical care; performance criteria

References

• Federal Law «On compulsory medical insurance in the Russian Federation» dated 29.11.2010 No. 326-FZ. (in Russian)
• Letter of the Ministry of Health of the Russian Federation dated 13.01.2022. No. 11-7/I/2-275 «On the formation and economic justification of territorial programs of state guarantees of free medical care for citizens for 2022–2024». (in Russian)
• Letter of the Ministry of Health of the Russian Federation dated 02.02.2022. No. 11-7/I/2-1619 and FFOMS dated 02.02.2022. No. 00-10-26-2-06/750 «Methodical recommendations on methods of payment for medical care at the expense of compulsory medical insurance». (in Russian)
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