Topic number
№ 1 . 2015
Content
Editorial

Editorial

Аннотация
News

News

Аннотация
World, country, region

Russian healthcare: problems and solutions

Аннотация

The article describes common misconceptions about the health care system of the Russian Federation – on its non significant influence on mortality of the population; that it’s possible to extrapolate the data on medical personnel and hospital beds availability from developed countries to the Russian healthcare system directly; as well as the fact that primary care doctors can take any additional workload (for example on patient monitoring at their homes, prevention and other care). The authors prove the conclusion, that situation in Russia with mortality increase is becoming serious, so immediate interventions in healthcare system are necessary. To improve the situation «budget and managerial maneuver» is proposed. The essence of this maneuver – redirection of the expenditures from non-priority and inefficient health spending, and additional Federal budget resources, to solve the main problem – medical personnel evolution. Two scenarios (plans) of Russian healthcare strategic development are given: survival and basic.

It is shown, that for the conservation of total mortality at the level of 2013 (13.1 cases per 1000 population) the public healthcare financing should also remain at the 2013 level – it’s the scenario survival. The basic scenario provides step-by-step to the year 2020 public healthcare expenditures growth from 3.7 to 5.2% of GDP (or 1.4 times more than in 2013). This will allow to reduce the mortality rate to 11.8 cases per 1000 population, so to achieve the target value of life expectancy – 74 years. The article also describes the consequences of not taking any actions to increase public healthcare expenditures.
Actually today

The system of Diagnoses Related Groups in the European Union: challenges and results

Аннотация
The proposed translation of four articles from “The Health Policy Bulletin of the European Observatory on Health Systems and Policies” represent to Russian public health managers experience of several countries of the European Union in the implementation of Diagnoses Related Groups (DRG) system, which increases health care organizations transparency and promotes improvement of their effectiveness.
Management efficiency

The internal audit process of the medical organization and its efficiency

Аннотация

In reviewing the activities of the medical organization in terms of improving its effectiveness and efficiency are important control processes. Control is one of the fundamental elements of PDCA cycle and building a quality management system. The introduction of a transparent system of governance aimed at the achievement of performance indicators and efficiency involves building a system audit.

Audit – a systematic, independent and documented process for obtaining an objective assessment of the information and to establish the degree of compliance with agreed quality criteria (a set of policies, procedures or requirements) [4]. The ISO 9001-2001 defined the rules of conduct [3]. The importance of building internal audit processes due to the need to achieve the main goal – maintenance of Defense Quality Management System in continuous improvement. In this regard, the audit should be regular.

Defense System audit involves two basic elements, the internal audit and the documented procedures of the meeting. The purpose of the internal audit organization is the quality control of medical services, as well as the quality of the final product, in the form of patient satisfaction and (or) paid invoice register an insurance company.

Internal audit is a tool for monitoring the efficiency, effectiveness and safety of both individual employees, departments and the organization as a whole

Actually today

Analysis of the effectiveness of organizational technologies improving medical care for coronary heart disease at the regional level

Аннотация
Diseases of the circulatory system are the cause of the demographic depopulation. Analysis of health indicators and criteria of the effectiveness of health care organizations, held in the Chelyabinsk region, revealed the existence of problems in the organization of medical care to patients with coronary artery disease at the regional level. The findings justify the need for the development and implementation of new technologies to improve the efficiency of management and health care organization, so to improve the accessibility and quality of medical care to patients with ischemic heart disease.
Workforce and quality: basic priorities

History of standardization in the national healthcare system

Аннотация

This article is an abridged version of the chapter from the same volume “Standardization in healthcare. Negotiation of contradictions in legislation, practice and ideas”. In this book the authors give a detailed description of the Russian Federation standardization system formation; they have analyzed the problems of standards application in healthcare sector (for medical care quality evaluation, health professionals accreditation and welfare medical coverage); the information about international practice of standards application is provided; proposals to improve and develop system of standardisation in the national HealthCare are represented.

Standardization is aimed to establish the rules, in order for their voluntary or obligatory multiple usage in healthcare. According to the legislation standards in healthcare are divided: rules of healthcare organization and provision, standards of clinical care, clinical guidelines (protocols), national and regional standards, standards in information, equipment, etc. Currently it is a lot of contradictions in standards practical application especially in the field of their mandatory or voluntary usage, role in quality assessment. It is impossible to solve those questions without knowing how the process of their maturation took place. This process step by step is described in the book – from XIX century till nowadays.

There are 4 main steps: 1992–2001 – governmental standards of medical care establishment; 2012–2006 – national and organizational standards formation; 2017–2011 – introduction of standards of care and medico-economical standards, 2012 – till now – Federal standards of care and rules of healthcare organization. Legislative “blank spots” are also described.
Public private partnership: challenges and decisions

The risks of switching from 1 January 2016 to the accreditation of doctors and nurses for private health organizations

Аннотация

Currently admission to medical practice is the certificate of specialist. 2016 comes into force provision of the law on the accreditation of doctors and nurses. Simultaneously canceled the procedure of issuing certificates. These changes apply to medical professionals and medical organizations in terms of compliance with licensing requirements. The uncertainty of the accreditation procedure is a source of risk for organizations and employees.

Expert opinion on the article of D.A. Borisov

Аннотация

Public-private partnership – the mechanism of health care infrastructure Development

Аннотация

The international practice shows that use of mechanisms of public-private partnership is the effective instrument of health care infrastructure development in the conditions of limited budgetary resources. Interest in projects of creation of medical infrastructure is limited in Russia because of low investment appeal. At the same time, the potential of development of PPP in health care the considerable. Now the first federal investment project on creation of medical park in traumatology, orthopedics and neurosurgery in Novosibirsk realized on the terms of concession is prepared. Within the project the investor at the expense of own and borrowed funds will carry out reconstruction and equipment by the equipment of property of Novosibirsk Research Institute of Traumatology and Orthopedics of Ya.L. Tsivyan and organize on the basis of this property production of medical products for traumatology and orthopedics for 15 years. Return of the enclosed investments will be carried out by the investor independently at the expense of commercial revenue.

Competent preparation of the project allowed to make it investment and attractive, and implementation of the project will provide the solution of social tasks, including creation of import-substituting productions and new workplaces, within the shortest possible time.

Our patients

Skills for professional communication in medical practice

Аннотация
Became painful

Doctors' diaries: "Italian strike" in action

Аннотация
Old times

70th anniversary of Victory

Аннотация

About a scientific basis of Semashko health care model

Аннотация

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Guzel E. Ulumbekova
MD, MBA from Harvard University (Boston, USA), Head of the Graduate School of Healthcare Organization and Management (VSHOUZ)

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