scholarly journals Assessment of the prospects for introducing drug insurance into military healthcare as part of project activities

2020 ◽  
Vol 22 (2) ◽  
pp. 125-133
Author(s):  
A. Y. Fisun ◽  
Y. V. Miroshnichenko ◽  
M. P. Shcherba ◽  
R. A. Golubenko

It is shown that one of the priority areas of the social policy of the Russian Federation is the consideration of improving the drug supply, the rationale for the national drug policy, as well as the introduction of the drug reimbursement (insurance) system, as one of the key mechanisms to increase the affordability of drugs by partially or fully reimbursing their cost citizens when providing medical care on an outpatient basis. It was revealed that in the context of reforming the healthcare system, the specifics of the work of power ministries and departments are not sufficiently taken into account. In this regard, the features have been studied and an assessment has been given of the prospects for introducing drug insurance into military health care as part of project activities, as one of the mechanisms for implementing interagency cooperation in modern socio- economic conditions when reforming drug supply. It is reflected that the introduction of drug insurance mechanisms can increase the availability of drugs, have a positive effect on the health of the assigned contingents, and reduce the frequency and duration of hospitalizations. At the same time, the following were identified as the main prospects and systemic prerequisites for implementation: the need to create a reliable legal basis for the formation and subsequent development of a unified state system of drug supply, taking into account the specifics of military health; transition to a rational system of financing drug supply for the provision of medical care on an outpatient and inpatient basis as part of a project to develop a new model for the provision of primary health care and specialized medical care based on a unified medical and technological hospital base; prospective reduction of expenses for the supply of medical care in stationary conditions; optimal distribution of rights and responsibilities, ensuring coherence between health authorities; prevention of duplication, ensuring equal and guaranteed drug supply for citizens as part of the project to ensure the quality and accessibility of medical care to privileged contingents of the Ministry of Defense of the Russian Federation. A possible model of drug supply for contingents attached to military medical organizations is substantiated when providing medical care on an outpatient basis when introducing a drug insurance system at the state level. The following key elements of a grounded model are described: adjustment of drug supply management; clarification of the categories of assigned contingents; optimization of the order of dispensing of drugs; the formation of restrictive lists of drugs; optimization of financing.

2019 ◽  
Vol 21 (3) ◽  
pp. 15-22
Author(s):  
N V Allamyarova ◽  
E G Sanakoeva

The legislation in the field of e-health, adopted in 2017, opens fundamentally new opportunities in the development of medical care using telemedicine technologies. The article provides an analysis of regulatory legal documents that establish the legal framework for the provision of medical care using telemedicine technologies. An assessment is made of the current state of telemedicine legal regulation in Russia. The law on telemedicine requires adjustment and refinement of existing regulations, procedures, standards of medical care with a detailed regulation of tools and situations of their application.


Author(s):  
L. E. Smirnova ◽  
V. G. Butova

In the health-care system in the Russian Federation, the units providing medical care in outpatient and inpatient conditions employ more than 55,000 individuals of dental doctors of various specialties, dental doctors and dental hygienists every year from 2014 to 2018. The availability of dentistry by doctors tends to decline from 4.20 (2014) to 3.75 (2018). By 2018, 99.45% of dentistry doctors and 99.3% of dental doctors have a specialist certificate and accreditation certificate. 38.16% of dentistry doctors and 54.88% of dental doctors confirmed their qualification category. In dynamics there is a tendency to decrease the passing of certification for obtaining qualification category by these specialists. These facts show a decrease in the availability and quality of dental care, as it is ensured by the availability of the necessary number of health workers and their level of qualification.


2019 ◽  
Vol 100 (5) ◽  
pp. 796-801
Author(s):  
E V Arsentyev

Aim. To analyze the dynamics of the development of voluntary medical insurance in the Russian Federation. To identify the factors hindering the development of this insurance sector in modern conditions. Methods. In the course of the study, analysis was conducted of the legislative framework for organizing medical care for the population of the Russian Federation in the system of voluntary medical insurance. The problem-chronological, systematic, and analytical research methods were used. Results. It has been established that, despite the development of voluntary medical insurance system over the past 25 years, the availability of this type of insurance for citizens of the Russian Federation still remains very low. The policy of voluntary medical insurance is mainly available only to working citizens, and only in those large enterprises where the employer is interested in preserving and protecting the health of its employees. For most citizens of the Russian Federation, the voluntary health insurance policy remains inaccessible due to the high cost of the policy, as well as due to relatively low incomes. At the same time, a voluntary health insurance policy is required by law for labor migrants to obtain a patent for employment in the Russian Federation. However due to the absence of legislative framework for voluntary health insurance, organization of medical care for labor migrants is not always standardized. Conclusion. For the further development of voluntary medical insurance, it is necessary to develop the measures for decreasing the cost and increasing the availability of a voluntary medical insurance policy for citizens of the Russian Federation; to optimize organization of health care for labor migrants it is necessary to primarily develop regulatory framework of emergency health care.


Author(s):  
Ольга Фадеева ◽  
Olga Fadeeva

The paper reflects the state of the modern healthcare system and various enforcements of the right to medical care guaranteed by the Constitution of the Russian Federation. The right to health, as well as the provision of qualified, free, and timely health care, are among the most important and fundamental human rights. The paper also features some key enforcement problems concerning the right to health protection and medical care, guaranteed by Article 41 of the Constitution of the Russian Federation, e.g. a lack of medical personnel, untimely provision of the first aid, and insufficient financing in the health care system. The article also considers the causes and consequences of "staff shortages" in Russian hospitals, employment of medical graduates, and financial support of young medical specialists. The author analyzes the equipment status of medical organizations in 2018 and 2016, voices the problem of optimization in healthcare institutions by reducing the inpatient level and expanding outpatient clinics, and offers statistics of complaints to the Department of Public Health on quality and timeliness of medical care. The author believes that the enforcement of the right of citizens guaranteed by Article 41 of the Constitution of the Russian Federation can be characterized as very low, which indicates the pretentiousness of the law.


Author(s):  
V.V. Chuksina ◽  
◽  
K.A. Mirvoda ◽  

The subject of this article is Law of the Russian Federation on Amendments to the Constitution of the Russian Federation (14.03.2020 No. 1-Federal Constitutional Law) «On improving the regulation of certain issues of the public power organization and functioning», namely, aspects of «coordination of health care» and «protection of the family, motherhood and childhood». The authors analyzed the issues of the medical care provision centralization, the impact of these amendments on the legal capacity of citizens. For a more in-depth analysis, the experience of foreign countries (Canada and Germany) was used. Despite the fact that the health care systems of the countries cited as an example differ in their essence and organization, nevertheless, they influence the formation of the availability of medicine for the population. As a result of the study of this experience, it was concluded that the delegation of freedom in the provision of medical care to lower levels of government allows to provide to the population affordable and high-quality medical care. It is noted that at present it is necessary to review the degree of participation of local governments in ensuring the availability of medical care in accordance with the federal law.


2020 ◽  
pp. 26-36
Author(s):  
I. V. Laricheva ◽  
◽  
I. M. Son ◽  
E. S. Yastrebova ◽  
V. V. Neroev ◽  
...  

Retinal diseases are significant causes of blindness and vision loss and they take the second place in the structure of disabilities due to blindness in Russia. Objective: analysis of the official statistical data on the disease and availability of health care to patients with age-related macular degeneration (AMD) and diabetic retinopathy (DR) that are prescribed intravitreal injection of drugs (IVD) as the first-line therapy for wet age-related macular degeneration and diabetic macular edema, respectively. Materials and methods: Epidemiological parameters were assessed by the data obtained from the form of statistical records № 12 for 2018–2019 years. The availability of IVD was analyzed by the information registered in the form of statistical records № 14 for 2016–2019 with a recalculation per 1000 population. Results: In 2019 in the Russian Federation 330 thousand patients with AMD were registered (0.45% among the population older than 40 years old). The incidence rate was significantly lower than in other countries (8.69%). The data on the number of patients with DR was unavailable for statistical recording because of the absence of the code Н36.0 IDC‑10 in form № 12. However, according to the federal register of diabetes mellitus, the total rate of DR can reach 760 thousand people all over Russia. The availability of IVD for all-day inpatient health care was 0.39 injections per 1000 population. In 26 subjects of the Russian Federation, the availability was higher than the average in Russia, while in the rest 59 subjects, the availability was lower than the average. Presently, there are no data on the number of IVD performed in day-time inpatient facilities. Conclusions: The current rate of application of IVD in Russia can be estimated as low considering the revealed problems with the registration and accounting of patients with AMD and DR. It is impossible to perform a complete evaluation of the availability of IVD for the Russian population within obligatory medical health insurance because of the lack of data on the provision of IVD in day-time inpatient facilities. For the rational planning of the volumes of medical care provision to patients with AMD and DR, the form of statistical records should include the data on the indication of IVD in the day-time inpatient facilities in the subjects of the Russian Federation.


Author(s):  
Elena Nikolaevna Dombrovskaya

The article is devoted to the features of the organization and accounting of payment for medical care provided by medical institutions. The article highlights the trends in reforming the system of payment for medical care, which include the use of per capita payment based on the principles of Fund maintenance. The review of the current regulatory framework in the field of financial support of medical care was conducted. Based on the analysis of models of per capita financing of primary health care in the subjects of the Russian Federation, their insufficient focus on achieving final results is noted. The article deals with the organizational mechanism and accounting mechanism of payment for medical care in health care institutions.


2018 ◽  
Vol 12 (3) ◽  
pp. 112-119 ◽  
Author(s):  
A. M. Lila ◽  
R. О. Dreval ◽  
V. V. Shipitsyn

This article reviews data on the assessment of the incidence of rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA, arthropathic psoriasis), as well as related disability and the economic burden of these nosological entities, including their therapy with biological agents. It considers the issues of organization and quality of medical care, drug supply, normative and legal regulation. The paper also shows the important epidemiological and socioeconomic importance of RA, AS, and PsA in Russia, points out the regional peculiarities of medical care and drug provision, and proposes solutions for their optimization at the federal and local levels. In preparing this investigation, the authors have taken into account the opinions of many specialists and experts in this field from different subjects of the Russian Federation.


Author(s):  
Lindenbraten A.L. ◽  
Kolomiychenko M.E.

Sociological research is an important tool for assessing the social effectiveness of medical care, it allows you to analyze the quality of the organization of medical care and social satisfaction of consumers. This study is an analysis of the results of "Selective observation of the quality and availability of services in education, health and social services, employment promotion." This statistical observation has several advantages: complex procedure for forming a sample, coverage of the population in all constituent entities of the Russian Federation, including urban and rural population, ensure that the data is representative, and allow for complex analysis in the dynamics. As a result of sociological surveys of the population of the Russian Federation in 2015, 2017, 2019, it was determined that the share of respondents satisfied with the work of health center and diagnostic services remains low (less than half of the respondents). When interviewing respondents, the reasons for dissatisfaction with the work of the health center were highlighted, the “leader” among which is “the length of waiting in queues”. Moreover, the share of respondents who choose “the work of medical specialist” and “the lack of necessary equipment and drugs” as negative aspects in the provision of medical care on an outpatient basis is increasing. About half of the respondents are satisfied with the comfort of their stay, the availability of drugs and modern equipment in the hospital. Analysis of the main negative phenomena observed in the provision of medical care to the population made it possible to determine the leading trends, which remain the high cost of drugs and an increase in the volume of paid medical care. More than half of respondents noted a decline in the quality of medical services, insufficient equipment of health center and hospitals.


2021 ◽  
Vol 65 (1) ◽  
pp. 69-73
Author(s):  
Boris T. Velichkovsky ◽  
Roman S. Serebryany

This article is devoted to V.V. Trofimov, Minister of Health of the RSFSR, an outstanding health care manager, who tried to introduce the modern methods of self-financing, automated information systems, etc., into the management of medical science during the period 1962-1983. At the initiative of V.V. Trofimov, for the first time in the country, the Main Department of research institutes and coordination of scientific research was established, the purpose of which was to ensure a scientific breakthrough in medicine through the development and implementation of innovative methods. The experience of joint work of health authorities, medical universities, and research institutions began to accumulate. It allowed solving problems of improving the quality of medical care according to united comprehensive plans. The material and technical base for public health protection was developed. During the tenth five-year plan alone, 20 large multi-specialty hospitals were built for 600-1200 beds, 88 polyclinics for 750-1200 visits per shift, 80 maternity hospitals and departments for 8849 beds were put into operation, 24 women’s consultations for 1000 visits per shift, and 13 multi-specialty children’s hospitals. The availability of medical personnel increased from 34.8 in 1975 to 40.0 in 1980 (per 10,000 population). The reform of the financing of medical institutions included the transfer of hospitals and polyclinics to economic accounting. The reform was introduced to enhance medical workers’ financial incentives to improve medical care, as savings increased doctors’ and nurses’ salaries. In essence, it was an anti-pod to the extensive, expensive way of conducting the national economy adopted in the country. As the first Editor-in-Chief of the journal “Health Care of the Russian Federation” and he prioritized innovative research in editorial policy for many years to come.


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