Topic number
№ 1 . 2019
Content
Actually today

Effectiveness of the regional healthcare systems in Russia (rating–2017)

Аннотация

The Higher School of Healthcare Organization and Management (VSHOUZ) has updated healthcare effectiveness ranking in the regions (states) of Russia for 2017 year. This ranking shows how effective is their healthcare policy. The effectiveness is calculated by comparing the level of life expectancy between the regions of the Russian Federation and public healthcare spending on it. Meanwhile it also takes into account the difference in GRP per capita and strong alcoholic beverages consumption per capita in region. It is shown how the position of the region has changed in 2017 compared to 2016.

Approaches to the formation of the project for the National drug policy. Part II. National drug policy as a strategical paper. Part III. Assessment of the financing needs for the necessary amounts of the outpatient pharmaceutical consumption and range of drugs for the next 2-5 years and for the development of new drugs in the Russian Federation for the future 10 years

Аннотация

Higher School for Healthcare Organization and Management (VSHOUZ) continues the cycle of articles devoted to the issues of scientific foundation of National drug (pharmaceutical) policy. Part 2 describes the concepts and definitions of the National drug policy, its goals and objectives, content and interdepartmental approach for development. In part 3 were assessed the needs for the necessary amounts of financing and outpatient pharmaceutical provision of the population of the Russian Federation for the next 2-5 years, also was presented the classification of diseases for which it's necessary to compensate the population's costs for drugs in the first place, were considered the methods for calculating the required volumes of pharmaceuticals. The required financing is additionally 330 billions of rubles annually in the prices of the year 2017. Basing on comparison with developed countries, were made calculations of the necessary investments for the development of 30 innovative drugs in the Russian Federation for the future 10 years, were suggested approaches to the management of this process. Based on the analysis, it is shown that additional scientific researches are required for the resolution of National drug policy.

Effective management

The political economy of healthcare system: how to get out of the crisis

Аннотация

As a result of reforms, Russia received chimerical healthcare financial model: institutional and corporate medicine was borrowed from the Semashko model; government market of commercial services was inherited from the setup time; from the USA experience corporate voluntary medical insurance was taken, which in Russia is backed by national government (business profits tax relief and personal income tax of employees); and the idea of delegating medical health care financing to the subject of the Russian Federation was borrowed from Canada. In the article key reason that led to this are listed, the inevitability of new reforms carrying out is confirmed and mistakes of the old ones are described. Also, the health care systems of USA (funding is disintegrated into many independent channels, there is no social medical insurance), Israel (social insurance) and Canada (the British model is used) were analyzed and compared. In addition, models of social insurance in the world and in Russia are compared. In the article variants for surmounting the crisis are represented, the main of which is to turn the compulsory health insurance system into fully realised social insurance (roadblocks on the way to achieving it are described), based on which the short-term goal is necessity to turn compulsory health insurance into a nationwide financial system of generally accessible medical aid with an annual budget of at least 6% of GDP (gross domestic product), by consolidating all budget and non-budgetary sources in it. Initial steps on the road to achieving the goal and alternatives to the described strategy are also listed.

Excess consumption of table salt: epidemiological significance and management strategies

Аннотация

Despite the widescale program of the Priority National Project «Health» (2009-2012), aimed at preserving and strengthening of the Russian population health through improving disease prevention, some tasks were not fully implemented. Irrational nutrition and, in particular, table salt excessive consumption (NaCl), as before, remains insufficiently studied and poorly controlled risk factor of chronic non-communicable diseases. A systematic analytical literature review, based on scientific sources from the Medline and e-library databases, mainly for the last 10 years, reflects in detail the problem of NaCl excessive consumption at the individual and population levels. It is persuasively demonstrated that NaCl use in an amount of more than 5 g/day is a significant risk factor for cardiovascular diseases occurrence and progression. The epidemiological data on NaCl consumption in various countries and regions of the world are presented and the problems of NaCl abuse revealing are indicated. The most successful prevention models and strategies aimed at consumption of table salt limiting are considered.

Interactive medical and social online communication based service: design and development experience

Аннотация

Aim. Prove the parameters of specialized medical and social service operating at the base of online communication.

Material and methods. Medical and sociological study including 444 patients entered in hip and knee joint replacement program with use of specially designed and implemented in practice of Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University named after V.I. Razumovsky interactive online service for supporting patients before the surgery and in rehabilitation period.

Conclusion. Interactive medical and social service at the base of online communication for orthopedic patients was designed and tested in practice. The special criteria were proved and it was provided the estimation of its demand among the patients and efficacy parameters for the interested parties were represented. It's shown that further implementation of given service in practice let make contribution to health processes management by means of improving patients' flow administration quality and informational interaction between key healthcare participants in the frames of distant rehabilitation.

Practical experience

Process-based management in the Vsevolozhsk Clinical Interdistrict Hospital

Аннотация

Implementation of the process approach to medical institution management helps to respond to dynamically changing conditions faster and to insert the necessary adjustments. The process approach itself is expressed in chain of actions building with logical transitions from one link to another, without temporary losses for extra actions, the result of which will be high-quality healthcare service delivery. Process-based management realization is expressed in: clear understanding of how the process of healthcare service delivery is currently taking place, process optimization with the aid of lean manufacturing methodologies, process standardization for all employees and institution's departments, and finally, systematic inspection of process execution correctness on the ground of approved institution standard.

In the article implementation path of the first stage of the process approach in management of the Vsevolozhsk Clinical Interdistrict Hospital is described. The problems in its implementation are considered. The ways to solve them and to optimize implementation scheme of the approach in future are suggested. In addition, the authors set a challenge of process matrix implementation for transition to the next stage of process approach in medical institution management.

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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