scholarly journals Formation of public-private model in Russia health care organization

2021 ◽  
Vol 6 (3) ◽  
pp. 216-226
Author(s):  
V. I. Perkhov ◽  
S. I. Kolesnikov ◽  
E. V. Pesennikova
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Statistical Data ◽  
The State ◽  
Care Organization ◽  
Public And Private ◽  
Emergency Situations ◽  
The Social ◽  
Compulsory Health Insurance

The pandemic of COVID-19, the threat of technogenic and anthropogenic character, brought to the foreground non-market aspects of the general, corporate branch culture and strategy in medicine and health care. Therefore, in many countries, despite differences in state and private property ratios in health infrastructure, the state priority is ensuring cooperation within the national health care system which capable quickly and well-coordinated work in the extremely dangerous epidemics conditions and other emergency situations. The purpose of this article is discussing a problem of public and private models of medical care organization in Russian health care system.Materials and methods. Content analysis methods, economical and statistical analysis, information and analytical materials of the Russian and foreign news agencies, a summary across Russia of Rosstat form No. 62 of the state statistical observation «Data on resource providing and on delivery of health care to the population» (legal entities - the medical organizations which are carrying out activity in the sphere of compulsory health insurance), analytical materials and statistical data of World Health Organization (The European portal of information of health care of WHO: https://gateway.euro.who.int/en/hfa-explorer/), statistical data and metadata on the countries of the Organization for Economic Cooperation and Development (OECD, https://stats.oecd.org/), the materials of monographic researches and periodicals including placed on the Internet were used in this article.Results: the system of compulsory health insurance is an ancestor of the program of the state guarantees of free medical care of in Russian citizens. The length of the text of this Program so far was increased in 130 times in comparison with initial edition of 1998. At the same time, there is still no clear delineation for the bases, volumes and conditions differentiation of free and paid medical care rendering. As a result, the major human right to free medical care remains not completely realized. The numbers of the non-state medical organizations to provide free of charge medical care to the population according to the policy of obligatory medical insurance (i.e. financed from the state sources) in the period of 2011 to 2019 – from 648 to 2423 organizations respectively were increased in Russia four times. This demonstrates the creation of the new, «integrated» model of health care in Russia in the mode of public and private partnership for deciding of social tasks. Although, free medical care for citizens in the private medical organizations is not mentioned in the Constitution of Russian Federation (Main Law). In emergency situations such integration allows private medical structures to involve capacities and also be coordinated with one of the tasks of the Ministry of health target program «Development of the Fundamental, Transmitting and Personalized Medicine».Conclusions. There is a formation of the integrated, public and private (hybrid) model of health care in modern Russia that needs developing of a new partnership and principles of management in the sphere of medical care organization. State policy in the health care financing sphere should be directed not only to the state guarantees of medical care specification, but also to a gap in social and economic inequality reduction. The social protection systems should be focused, first of all, on people who are most in great need of medical care. For the protecting population from catastrophic payments for medical care, it is necessary to bring the concept of the social standards - a number of the general rules, norms and standards which must guarantee the state ensuring constitutional rights of citizens to free medical care in the health care legislation.

scholarly journals Problems of providing medical care in excess of the amount established territorial compulsory health insurance program

2020 ◽  
Author(s):  
A.M. Moshin
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Legal Framework ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Compulsory Health Insurance

The article deals with the legal framework and legislative problems of distribution of health care volumes for the territorial program of compulsory health insurance. The problem of conflicts of legislation in the field of compulsory health insurance in the area of distribution of the volumes of medical care.

Healthcare in Germany

2021 ◽  
pp. 66-73
Author(s):  
Elena Vladimirovna Frolova
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Federal Budget ◽  
Insurance Premium ◽  
German Population ◽  
Leading Position ◽  
Compulsory Health Insurance ◽  
Otto Von Bismarck ◽  
The Cost

Germany has long and firmly held a leading position in many areas: in the field of industry and entrepreneurship, culture and tourism, the introduction of advanced technologies and sports. Medical care is no exception. Annually, about 11.5% of GDP is allocated from the federal budget for health care; in 2019, 15.3 billion euro were spent on the expenditures of the German Ministry of Health, the lion's share of which (94.6%) went to providing public insurance. The first Law on Compulsory Health Insurance for the Whole Working Population entered into force in Germany back in 1883, before that it was valid only in Bavaria. This Act, proposed by German Chancellor Otto von Bismarck, was, in fact, the prototype for the introduction of a compulsory health care system around the world. Today, the compulsory health insurance system covers 90% of the German population. All residents of the country with a compulsory health insurance policy are entitled to almost the same range of medical services. At the same time, the amount of medical care received with compulsory health insurance does not depend on the amount of the insurance premium. The cost of health insurance for each citizen is determined based on the amount of his income.

scholarly journals Determinants of neonatal, postneonatal and maternal mortality on models of primary health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A B Guerra ◽  
L M Guerra ◽  
L F Probst ◽  
B V Castro Gondinho ◽  
G M Bovi Ambrosano ◽  
...  
Keyword(s):  
Health Care ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Public Policies ◽  
Family Health ◽  
Mortality Rates ◽  
Sao Paulo ◽  
The State ◽  
Care Organization ◽  
São Paulo

Abstract Background The state of São Paulo recorded a significant reduction in infant mortality, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality and maternal mortality in the state of São Paulo, Brazil. Methods In this ecological study, data from national official open sources were used. Analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality and maternal mortality rates were calculated for every 1000 live births, 2013. The association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. We used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted “p” at 5%. Results The increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates. Conclusions It was concluded that the Family Health Care Strategy model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model. Key messages Implementation of public policies with specific focus on attenuating these factors and making it possible to optimize resources, and not interrupting the FHS. Knowledge of the factors with impact on these indicators would be of help in formulating public policies.

THE ROLE OF SELF-HELP IN PATIENTS SOLIDAR RESPONSIBILITY TO OWN HEALTH

Vestnik ◽  
2021 ◽  
pp. 328-331
Author(s):  
С.К. Молдабаев ◽  
С.А. Мамырбекова ◽  
Д.Н. Маханбеткулова
Keyword(s):  
Health Insurance ◽  
The State ◽  
Shared Responsibility ◽  
Self Management ◽  
Health Insurance System ◽  
Insurance System ◽  
Self Help ◽  
Compulsory Health Insurance ◽  
The Republic

Согласно Концепции Государственной программы улучшения здоровья населения на 2020-2025 годы в рамках дальнейшего внедрения системы ОСМС в РК одним из основных задач госудаства является повышение солидарной ответственности граждан за свое здоровье. Существующая солидарная ответственность должна побуждать пациентов развивать навыки самопомощи/самоменеджмента с целью лучшего управления собственным здоровьем. Цель исследования. Анализ роли самоменеджмента пациентов в системе солидарной ответственности за свое здоровье. Материал и методы. Данный обзор основывается на материалах ВОЗ и статей зарубежных и отечественных исследователей. Выводы. На сегодняшний день, в системе здравоохранения Казахстана одним из основных моментов является солидарная ответственность государства, пациента и работодателя. Ведь каждый гражданин должен принимать важные решения, которые оказывают существенное влияние на состояние его здоровья. Поэтому стратегии по повышению грамотности пациентов, их вовлеченность в процесс принятия решений и развитие самоменеджмента должны быть одними из фундаментальных стержней существующей системы ОСМС и политики здравоохранения. According to the Concept of the State Program for improving the health of the population for 2020-2025, as part of the further implementation of the compulsory health insurance system in the Republic of Kazakhstan, one of the main tasks of the state is to increase the joint responsibility of citizens for their health. The existing shared responsibility should encourage patients to develop self-help / self-management skills in order to better manage their own health. Purpose of the study. Analysis of the role of patients' self-management in the system of joint responsibility for their health. Material and methods. This review is based on WHO materials and articles of foreign and domestic researchers. Findings. Today, in the health care system of Kazakhstan, one of the main points is the joint responsibility of the state, the patient and the employer. After all, every citizen must make important decisions that have a significant impact on his health. Therefore, strategies to improve patient literacy, their involvement in the decision-making process and the development of self-management should be one of the fundamental pillars of the existing compulsory health insurance system and health policy.

BPJS Kesehatan Memberikan Jaminan Kesehatan Terhadap Pasien Atau Masyarakat

2021 ◽  
Vol 7 (2) ◽  
pp. 146-154
Author(s):  
Aidha Puteri Mustikasari
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
The State ◽  
Universal Health Care ◽  
Universal Health Insurance ◽  
Universal Health ◽  
Provide Health Insurance

Abstrak. Kepesertaan BPJS Kesehatan pada tahun 2020 tidak akan mencakup 90% penduduk Indonesia, namun rencana Universal Health Care Implementation (UHC) telah direncanakan sejak tahun sebelumnya. Di masa pandemi Covid, sejumlah besar status kepesertaan BPJS Kesehatan  dicabut karena terlambat, padahal masyarakat membutuhkan layanan kesehatan dan asuransi dengan kondisi yang ada. Kajian ini bersifat norma deskriptif , dibahas dalam konteks kepesertaan BPJS kesehatan, dan cukup  menggunakan prinsip asuransi dengan hanya memberikan jaminan kepada peserta, tetapi negara mengikuti kewajiban UUD 1945 yaitu memberikan jaminan kesehatan dan pelayanan kepada warga negara. Untuk mendukung keberadaan jaminan kesehatan universal, Indonesia perlu menerapkan formulir kepesertaan dan  sanksi untuk ketentuan wajib  peserta jaminan sosial yang efektif dan efisien. Abstract. BPJS Health membership in 2020 will not cover 90% of Indonesia's population, but the Universal Health Care Implementation (UHC) plan has been planned since the previous year. During the Covid pandemic, a large number of BPJS Health membership statuses were revoked because they were late, even though people needed health services and insurance with the existing conditions. This study is descriptive in nature, discussed in the context of BPJS health participation, and it is sufficient to use the insurance principle by only providing guarantees to participants, but the state follows the obligations of the 1945 Constitution, namely to provide health insurance and services to citizens. To support the existence of universal health insurance, Indonesia needs to implement an effective and efficient membership form and sanctions for mandatory provisions for social security participants.

A strategic and good governance perspective on handling patient complaints

2018 ◽  
Vol 31 (8) ◽  
pp. 923-934
Author(s):  
Sanna Pauliina Ryynänen ◽  
Risto Harisalo
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Good Governance ◽  
Care Organization ◽  
Content Type ◽  
Patient Complaints ◽  
Care Processes ◽  
Patient’S Rights ◽  
Strategic Goals

Purpose The patient complaint is one of the main procedures of exercising patient’s rights in the Finnish health care system. Such complaints typically concern the quality of care and/or patient safety. The purpose of this paper is to examine the types of patient complaints received by a specialized medical care organization and the kinds of responses given by the organization’s personnel. The organization’s strategy and good governance principles provide the framework for understanding the organization’s action. Design/methodology/approach This study’s data comprise patient complaints and the responses from personnel of a specialized medical care organization from the start of 2012 to the end of January 2014. The data were analyzed through qualitative data analysis. Findings The results show many unwanted grievances, but also reveal the procedures employed to improve health care processes. The results are related to patients’ care experiences, provision of information, personnel’s professional skills and the approach to patient complaints handling. The integrative result of the analysis was to find consensus between the patients’ expectations and personnel’s evaluation of patients’ needs. Originality/value Few prior studies have examined patient complaints related to both strategy and good governance. Patient complaints were found to have several confluences with an organization’s strategic goals, objectives and good governance principles. The study recommends further research on personnel procedures for patient complaints handling, with a view to influencing strategic planning and implementation of strategies of organizations.

scholarly journals Medical Care for Residents of Ivanovo, Kostroma and Yaroslavl Regions in Virgin Lands in 1954–1964 Years

2020 ◽  
Vol 20 (3) ◽  
pp. 405-410
Author(s):  
Andrei A. Rybin ◽  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Far East ◽  
The State ◽  
Present Stage ◽  
The Far East ◽  
Medical Institutions ◽  
Qualified Personnel ◽  
Unused Land

The problem of the introduction of unused land into agricultural turnover is currently relevant in society, since at the present stage the state is implementing a campaign to develop the uninhabited territories of the Far East of the country. During this period, a large number of studies on virgin lands were published, but today many questions remain open. In particular, the problem of medical care in the virgin lands is not sufficiently studied by historians. The article defines the stages of development of medicine in the areas of development of new lands, also considers the problem of lack of medical institutions and qualified personnel. Finally, medicine was developed in the virgin lands, in particular, it was possible to move from small medical stations to the polyclinic health care system.

scholarly journals International and Russian Experience in Primary Health Care Organization

2018 ◽  
pp. 146-148
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Health Care Organization ◽  
The United States ◽  
Evidence Base ◽  
Care Organization ◽  
Care Provision ◽  
Primary Health ◽  
Effective Instrument

In this study, they presented the analysis of current views on the important link in medical care provision to the population, namely, primary health care. According to the Alma-Ata Declaration on the organization of primary health care this type of medical assistance has made it possible to carry out reforms within this area in many countries, which has led to effective results (the reduction of infant mortality, the increase of life expectancy and a number of other indicators). In this paper, they performed the analysis of Russian and foreign sources of literature on the topic under study between 1978 and 2018. It has been established that primary health care is regarded as the most effective instrument of health protection than specialized medical care according to the experience of Russian Federation, a number of countries in Europe, Asia and the African continent, Australia and the United States. The performed analysis clearly shows that the experience of some countries demonstrates the correlation between the general coverage of primary health care and the achievement of public health indicative indicators. At the same time, the question is raised about the expediency of certain aspect replacement concerning the provision of specialized medical care by the doctors of general practice, i.e. primary health care. The obtained results can be interpreted as an evidence base for the necessity and an undeniable effectiveness of primary health care as a central link in the health care system.

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