scholarly journals The agenda of management accounting in healthcare

2021 ◽  
Vol 22 (6) ◽  
pp. 697-710
Author(s):  
Andrei V. CHURIKOV
Keyword(s):  
Management Accounting ◽  
Medical Insurance ◽  
Voronezh Oblast ◽  
Comparison Analysis ◽  
Current Management ◽  
Accounting Practice ◽  
Accounting Management ◽  
Medical Institutions ◽  
Insurance Funds ◽  
The Russian Federation

Subject. This article discusses changes in the economic and legislative environment of State-financed healthcare institutions, regulatory framework of the Russian Federation, which influences management accounting indicators. Objectives. I outline a system of relations in the design of management accounting indicators of State-financed healthcare institutions. Methods. The study is based on the methods of grouping, comparison, analysis, and generalization. I analyzed the current management accounting practice in State-financed medical institutions of the Voronezh Oblast. Results. Analyzing regulatory documents and industrial distinctions and difficulties in healthcare, I outlined a system of relations in the design of management accounting indicators in State-financed healthcare institutions. I traced factors that influence the creation of management accounting in State-financed healthcare institutions. I suggest implementing the practice of accounting for costs incurred per patient into the accounting and information system of management accounting. Aspects of statistical accounting should be integrated into the accounting process for this purpose. Conclusions and Relevance. The specifics of financing sources now influence a set of indicators and internal reporting in management accounting. Management accounting of income becomes a priority in management accounting as part of compulsory medical insurance funding. Management accounting of income and process designing approaches are getting more and more specific as the methods for paying the medical assistance with compulsory medical insurance funds get changed.

Reforming Payment Methods for Basic Medical Insurance to Accommodate Traditional Chinese Medicine (TCM) in China : A Case Study of Shaanxi Province

2020 ◽  
Author(s):  
FANG ZHOU ◽  
XIAOHAO ZHANG ◽  
ZHIGUO MA
Keyword(s):  
Medical Insurance ◽  
Diagnosis And Treatment ◽  
Shaanxi Province ◽  
Insurance Fund ◽  
Payment Methods ◽  
Treatment Services ◽  
Basic Medical Insurance ◽  
Medical Institutions ◽  
Insurance Funds ◽  
Basic Medical

Abstract Background: Traditional Chinese medicine (TCM) attaches importance to the philosophy of holism and disease prevention. Meanwhile, costs arising from TCM diagnosis and treatment services are relatively low. Such features cater to the needs of less developed countries and regions to increase the equity and accessibility of medical services and to save basic medical insurance funds. However, China’s current payment system for basic medical insurance fails to fully regard these features, thus unable to incent the demand for and supply of TCM services. Methods: Based on the analysis of the features or rather the advantages of TCM, the article, taking Shaanxi Province located in central China as an example, studies the status quo of economic development, coverage of TCM diagnosis and treatment services by basic medical insurance, implementation of payment methods for basic medical insurance in TCM medical institutions, and aims to explore the reformation of payment methods for basic medical insurance. Results: Statistics have shown that the economic power of Shaanxi Province is below average in China, as a result of which, Shaanxi Province is confronted with a general lack of basic medical insurance fund. On the other hand, the present payment methods for basic medical insurance fail to accommodate the features of TCM. Besides, only a very limited number of TCM medical institutions, service items and medicines are covered by basic medical insurance. Consequently, the advantages of TCM are not exploited to the full in a country that has always treasured TCM. Therefore, reformation in payment methods is pressing. Conclusion: In view of the economic and social development of Shaanxi Province, this article proposes to reform the payment methods for basic medical insurance by introducing a new medicinal-effect-based payment method to accommodate TCM. This payment method has the following four features. Firstly, it advocates strengthening process supervision of diagnosis and treatment activities in medical institutions, establishing a rating system for therapeutic or prophylactic effects, and implementing a reward and punishment mechanism accordingly. Secondly, special audit standards for TCM services shall be determined by the health care department of the people’s government together with the relevant TCM administrative department, more TCM institutions, service items and medicines shall be covered by basic medical insurance, and the negotiation mechanism with medical insurance institutions shall be adjusted. Thirdly, in pricing the fees and standards for TCM services, the price control administrations of the people’s government shall consult TCM experts, and dynamic price adjustments based on costs and professional technical values shall be made. Last but not least, outpatient diagnosis and treatment services shall be covered by basic medical insurance fund, a practice which will not only give full play to the advantages TCM services, but also help reduce the financial burden on patients and save medical insurance funds.

ANALYSIS OF THE QUALITY OF MEDICAL CARE PROVIDED BASED ON INSURANCE SUPERVISORY

2020 ◽  
pp. 160-170
Author(s):  
Ольга Игоревна Муратова ◽  
Наталия Андреевна Матвеева
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Medical Insurance ◽  
Insurance Companies ◽  
Medical Services ◽  
Medical Organization ◽  
Medical Institutions ◽  
Quality Of Medical Care ◽  
The Russian Federation

Статья посвящена анализу качества медицинской помощи, оказываемой населению в рамках системы обязательного медицинского страхования (ОМС), на основе мероприятий страхового надзора над медицинскими организациями. Полис ОМС гарантирует пациентам доступность, качество и своевременность предоставления медицинских услуг. Проверка качества медицинской помощи производится путем осуществления экспертиз и контроля уполномоченными органами РФ по направлениям: законности работы медицинской организации, системности оказания медицинской помощи, результативности и своевременности проводимых мероприятий в рамках оказания медицинской помощи. Таким образом, страховой надзор за медицинскими организациями осуществляется путем соблюдения объема, сроков и условий оказания медицинской помощи, контроля качества медицинской помощи фондами обязательного медицинского страхования и страховыми медицинскими организациями в соответствии с законодательством Российской Федерации. Страховой надзор над медучреждениями осуществляется в рамках ОМС и включает следующие виды страхового надзора: медико-экономический контроль, медико-экономическая экспертиза и экспертиза качества медицинской помощи. Отличительной особенностью современного состояния системы страхового надзора за качеством оказываемой медицинской помощи в системе ОМС является его совершенствование на основе анализа удовлетворенности потребителей медицинских услуг, что позволяет выявить нарушения, которые допущены при оказании медицинской помощи. Причем эти мероприятия способствуют как повышению качества обслуживания застрахованных лиц, так и улучшению репутации медицинских организаций, что серьезно влияет на решения участников программы обязательного медицинского страхования. Повышение ответственности страховых компаний становится важным элементом модернизации системы ОМС. В этой связи актуальным является обеспечение эффективной работы страховых медицинских компаний и медицинских учреждений на принципах конкурентоспособности и повышения качества медицинской помощи, реализуемое с помощью механизмов ориентации на требования потребителей медицинских услуг The article is devoted to the analysis of the quality of medical care provided to the population within the framework of the system Compulsory health insurance (CHI), based on the measures of insurance supervisory over medical organizations. The CHI guarantees patients the availability, quality and timeliness of medical services. Quality control of medical care is performed by carrying out examinations and control by the authorized bodies of the Russian Federation in the following areas: the legality of the work of a medical organization, the consistency of medical care, the effectiveness and timeliness of measures taken within the framework of medical care. Thus, insurance supervisory of medical organizations is carried out by observing the scope, terms and conditions of medical care, and monitoring the quality of medical care by mandatory medical insurance funds and insurance medical organizations in accordance with the legislation of the Russian Federation. Insurance supervisory of medical institutions is carried out within the framework of the CHI and includes the following types of insurance supervisory: medical and economic control, medical and economic expertise and examination of the quality of medical care. A distinctive feature of the current state of the system of insurance supervisory over the quality of medical care in the CHI system is its improvement based on the analysis of satisfaction of consumers of medical services, which allows you to identify violations that have been committed in the provision of medical care. Moreover, these measures contribute both to improving the quality of care for insured persons and to improving the reputation of medical organizations, which seriously affects the decisions of participants in the compulsory medical insurance program. Increasing the liability of insurance companies is becoming an important element of the modernization of the CHI system. In this regard, it is important to ensure the effective operation of medical insurance companies and medical institutions based on the principles of competitiveness and improving the quality of medical care, implemented through mechanisms of orientation to the requirements of consumers of medical services

Appointment of Antimicrobial Medications in a Hospital Depending on the Results of Microbiological Monitoring of HAI

2020 ◽  
Vol 65 (9-10) ◽  
pp. 21-27
Author(s):  
S. D. Mitrokhin ◽  
O. E. Orlova ◽  
I. V. Gosteva ◽  
A. S. Shkoda
Keyword(s):  
Therapy Monitoring ◽  
Hospital Environment ◽  
Antimicrobial Drugs ◽  
Microbiological Monitoring ◽  
Medical Institutions ◽  
Extreme Drug Resistance ◽  
Microbiological Laboratory ◽  
The Russian Federation ◽  
Medical Programs ◽  
Epidemiological Situation

One of the tasks of the hospital-s clinical pharmacologists service is to continuously monitor the consumption of antimicrobial drugs (DDD analysis) depending on the microbiological and epidemiological situation in the hospital. This is necessary for the implementation of various medical programs and technologies aimed at reducing the selection pressure of antimicrobial drugs and reducing the risk of the emergence, accumulation, and spread of bacteria strains with multiple and/or extreme drug resistance to these drugs in the hospital environment. To date, some medical institutions, especially in the various regions of the Russian Federation, do not have a proper team of clinical pharmacologists and a modern, well-equipped and computerized microbiological laboratory. This does not allow full implementation of the above-mentioned programs in such hospitals, e. g. Antimicrobial therapy monitoring system — SСAT and technologies, e. g. «carbapenem-preserving technologies» and «microbiological monitoring».

PROBLEMATIC ISSUES OF SAFE CONDITIONS ORGANIZATION DURING THE PROTECTION OF SICK CONVICTED AS WELL AS DETAINED PERSONS IN MEDICAL INSTITUTIONS OF STATE AND MUNICIPAL HEALTH SYSTEMS

2020 ◽  
pp. 87-92
Author(s):  
Вячеслав Александрович Шиханов ◽  
Валерий Александрович Казначеев
Keyword(s):  
Health Systems ◽  
Russian Federation ◽  
Penal System ◽  
Medical Support ◽  
Relevant Today ◽  
Medical Institutions ◽  
The Russian Federation ◽  
Municipal Health

В статье подробно изучены и проанализированы нормативно-правовые акты Российской Федерации, охраняющие жизнь и здоровье каждого человека, так как данные нормативно-правовые акты в такой же мере распространяются и на лиц, находящихся в местах лишения свободы. Актуальность данной проблемы, на наш взгляд, обусловлена тем, что в своей практической деятельности администрация учреждения часто сталкивается с вопросом такого характера. Это в свою очередь порождает ряд проблем современной УИС: медицинское обеспечение УИС, сокращение численности штата, плохо организованное сотрудничество с государственными медицинскими учреждениями, что также было рассмотрено в данной работе. Авторы, проанализировав вышеупомянутые пробелы в УИС, предложили свои пути решения, которые, по их мнению, позволят решить как основную проблему - организацию безопасных условий во время охраны осужденных и заключенных под стражу лиц в медицинских учреждениях, так и сопутствующие проблемы. In this work, the author examined in detail the problematic issues of organizing safe conditions during the protection of convicted and detained persons in state and municipal medical institutions. For this, the author thoroughly studied and analyzed the regulatory legal acts of the Russian Federation protecting the life and health of each person, since the data of the legal acts apply to persons in prison to the same extent. In my opinion, the problem of this article in prisons is relevant today, since in its practical activities the administration of the institution often faces a question of this nature. I believe that the relevance of this article gives rise to many gaps that are inherent in penal correction systems, such as: medical support of Penal System, downsizing, poorly organized cooperation with state medical institutions, which was also considered in this paper. Having analyzed the above-mentioned gaps inherent in the Penal System, the author proposed his own solutions, which, in his opinion, will solve both the main problem, the organization of safe conditions during the protection of convicted and detained persons in medical institutions, and related gaps in general.

scholarly journals Healthcare-Seeking Behavior among Chinese Older Adults: Patterns and Predictive Factors

2021 ◽  
Vol 18 (6) ◽  
pp. 2969
Author(s):  
Yanbing Zeng ◽  
Yuanyuan Wan ◽  
Zhipeng Yuan ◽  
Ya Fang
Keyword(s):  
Older Adults ◽  
Predictive Factors ◽  
Medical Insurance ◽  
Utilization Rate ◽  
Heckman Selection Model ◽  
Healthcare Seeking ◽  
Inpatient Services ◽  
Medical Institutions ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

This study aimed to investigate the patterns and predictive factors of healthcare-seeking behavior among older Chinese adults. A sample of 10,914 participants aged ≥60 years from the 2011, 2013 and 2015 China Health and Retirement Longitudinal Study (CHARLS) was included. The bivariate analyses and Heckman selection model was used to identify predictors of healthcare-seeking behavior. Results shows that the utilization rate of outpatient services increased from 21.61% in 2011 to 32.41% in 2015, and that of inpatient services increased from 12.44% to 17.68%. In 2015, 71.93% and 92.18% chose public medical institutions for outpatient and inpatient services, 57.63% and 17.00% chose primary medical institutions. The individuals who were female, were younger, lived in urban, central or western regions, had medical insurance, had poor self-rated health and exhibited activity of daily living (ADL) impairment were more inclined to outpatient and inpatient services. Transportation, medical expenses, the out-of-pocket ratio and the urgency of the disease were associated with provider selection. The universal medical insurance schemes improved health service utilization for the elderly population but had little impact on the choice of medical institutions. The older adults preferred public institutions to private institutions, preferred primary institutions for outpatient care, and higher-level hospitals for hospitalization.

Organization of immunobiological therapy for severe bronchial asthma in the Sverdlovsk region

2021 ◽  
Author(s):  
Evgeny K. Beltyukov ◽  
Valery A. Shelyakin ◽  
Veronika V. Naumova ◽  
Alexander V. Vinogradov ◽  
Olga G. Smolenskaya
Keyword(s):  
Differential Diagnosis ◽  
Targeted Therapy ◽  
Medical Care ◽  
Clinical Guidelines ◽  
Medical Insurance ◽  
Continuation Therapy ◽  
Insurance Program ◽  
Routine Medical Care ◽  
Insurance Funds ◽  
Stay Hospital

Background: Biologicals use in severe asthma (SA) is associated with problem of targeted therapy (TT) availability. Ensuring availability of biologicals can be resolved within the territorial compulsory medical insurance program (TCMIP) in day-stay or round-the-clock hospital. Aims: development and implementation of program for introduction of immunobiological therapy (IBT) for SA in Sverdlovsk Region (SR). Materials and methods: Program for introduction of IBT for SA was developed in SR in 2018 to provide patients with expensive biologicals within the TCMIP. Program includes: SA prevalence study in SR; practitioners training in differential diagnosis of SA; organization of affordable therapy for patients with SA; register of SA patients сreation and maintenance; patients selection and management of patients with SA in accordance with federal clinical guidelines. Results: Atopic phenotype in SA was detected in 5%, eosinophilic - in 2.3% of all analyzed cases of asthma (n=216). Practitioners of SR were trained in differential diagnosis of SA. The orders of the Ministry of Health of SR were issued, regulating the procedure for referring patients with SA to IBT, a list of municipal medical organizations providing IBT in a day-stay or round-the-clock hospital; approved regional register form of SA patients requiring biologicals use; ungrouping of clinical and statistical groups of day-stay hospital was carried out depending on INN and dose of biologicals; patients with SA are selected for TT and included in the regional register. Initiating of TT in round-the-clock hospital and continuation therapy in day-stay hospital provides a significant savings in compulsory medical insurance funds. Conclusions: introduction of IBT for SA in SR is carried out within framework of developed program. Principle of decentralization brings highly specialized types of medical care closer to patients and makes it possible to provide routine medical care in allergology-immunology profile in context of restrictions caused by COVID-19 pandemic.

RELATIONSHIP OF ACCOUNTING AND STATISTICAL ACCOUNTING OF LOGISTIC COSTS IN THE INTEGRATED BUSINESS STRUCTURE

2021 ◽  
Vol 16 (3) ◽  
pp. 106-111
Author(s):  
Olga Gizatullina
Keyword(s):  
Supply Chains ◽  
Business Processes ◽  
Management Accounting ◽  
Added Value ◽  
Economic Activities ◽  
Legal Form ◽  
Economic Entity ◽  
Accounting Management ◽  
Supply Costs

For economic entities, business partnerships are not based on individual competition or improving individual business processes, but on improving supply chains. When making management decisions, the question arises about the performance indicators of business processes both at the level of an economic entity and at the macro level. When assessing the effectiveness of supply chains, it is necessary to assess the costs arising in the course of financial and economic activities. The logistics component has a large share in the supply costs. A full accounting of logistics costs allows you to obtain reliable information for the analysis and development of measures to reduce them, which increases the efficiency of the entire economic activity of an economic entity. The article proposes a classification of logistics costs according to the degree of added value creation and dependence on the volume of production, including the allocation of transaction costs, which make up a significant share in the overall structure of logistics costs. The classification of logistics costs should be transformed depending on the organizational and legal form of the organization and the field of activity. The system of accounting for the logistics costs of economic entities should highlight them when implementing all logistics functions; study information about the most significant logistics costs and the nature of their occurrence; study the interdependencies of logistics costs throughout the entire supply chain. The developed system allows keeping separate accounting of logistics costs on a separate account, which makes it possible to control them. In modern conditions, organizations are faced with the need to integrate various types of accounting, including accounting, management and statistical. The algorithm for the implementation of this task includes four stages: development of a methodology for the integration of accounting, management and statistical accounting; formation of management accounting policies; development of data transformation regulations; selection of software for the automation of statistical, accounting and management accounting

Pharmaceutical Concern TEVA

2011 ◽  
pp. 93-98
Author(s):  
B. Dubson
Keyword(s):  
Elderly People ◽  
Global Market ◽  
Living Standards ◽  
New Drugs ◽  
Global Trends ◽  
Pharmaceutical Firms ◽  
Pharmaceutical Group ◽  
Medical Institutions ◽  
Insurance Funds

The author explores the case of the Israeli pharmaceutical group Teva. It is noted that in modern conditions there are favorable factors for an entry into the global market of the small-and medium-sized pharmaceutical firms producing equivalents of patented drugs. The current global trends such as the growth of living standards increase the number of elderly people, who are the main consumers of medications, and the emergence of new drugs to fight the previously incurable diseases significantly increase the demand for medicines. The total costs of purchasing the drugs are becoming increasingly onerous for patients, for all kinds of involved medical institutions (hospitals, medical offices, insurance funds, etc.) and for the governments. Therefore, there is a growing interest in replacing expensive original drugs by the same quality, but cheaper generics.

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