scholarly journals Formation of a Market Model in the Financing of Health Care in the Kyrgyz Republic

Author(s):  
Damira Japarova

Due to the collapse of the Union, there was a reduction in funding for health care costs, as well as deterioration in the infrastructure and quality of medical services. The transitional economy in the Kyrgyz Republic has identified additional features in the health system. The main ones are the low level of funding, the presence of the shadow market of medical services, inefficient structure and the prevalence of high-cost hospital treatment. The market mechanism is developing, however, without state regulation. The Kyrgyz Republic continues to reform its health-care system. The task was to improve the methods of their financing. New mechanisms for financing medical services have been introduced. Despite the reduction in the number of hospitals, the number of patients treated in hospitals has increased.

2009 ◽  
Vol 62 (5-6) ◽  
pp. 249-257 ◽  
Author(s):  
Dragana Milutinovic ◽  
Mirjana Martinov-Cvejin ◽  
Svetlana Simic

The number of patients' falls and injuries happening during their hospital treatment is a good quality indicator of safety of in-patients. A fall is of multifactorial etiology, and its causes are usually classified into intrinsic and extrinsic factors. According to Jenise Morse there are three categories of falls among inpatients: accidental, non-anticipated physiologic and anticipated physiologic fall. Fall induced injuries in clinical and hospital settings are mostly categorized into five groups: no injury, minor injury, moderate injury, severe injury and lethal injury. The number of in-patient falls can be reduced by implementing a prevention programme in order to improve the quality of the specific health care and health care in general. The key preventive strategies aimed at safe and efficient health care include: a regular assessment of the risk for falls using predictive scales, visual identification of patients at high risk for falls, communication with patients and education of patients, their family members and staff about fall prevention interventions.


Author(s):  
Magdalena Kwiatosz-Muc ◽  
Bożena Kopacz

Background: An increasing number of patients included in home mechanical ventilation (HMV) care has been under observation for many years. The study aimed to assess the patients opinion concerning the expected and perceived quality of care in an HMV system and a patient’s satisfaction with care. Methods: In 2017, patients treated with HMV were surveyed in Poland with the modified SERVQUAL questionnaire. Results: One hundred correctly completed surveys were analyzed. Patient Satisfaction Index was high. In every examined area, the expectations were statistically significant larger than the perception of the services. The biggest gap was in the tangibility dimension and the smallest gap was in the empathy dimension. Perceived respect and understanding for a patient’s needs are close to the expectations. Conclusions: The level of satisfaction with health care among patients treated with HMV in majority of investigated components is high. Moreover, the difference between perceived and expected quality of health care in the HMV system was relatively small in the opinion of the patients themselves. Further investigations with alternative methods are needed.


1999 ◽  
Vol 13 (7) ◽  
pp. 560-562 ◽  
Author(s):  
Colin Macarthur ◽  
Liisa Jaakkimainen

The objective of this paper is to review the principles, methods and issues behind the development of clinical practice guidelines. Practice guidelines have been defined as “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances”. The ultimate goal of guidelines is to improve patient outcomes; however, they may also be used as tools to decrease health care costs, improve medical education and enhance quality assurance. Evidence-based guidelines use explicit methods to link recommendations to the quality of the underlying research. Following development of the guideline, implementation and evaluation are key steps. The ultimate aim of guideline development is to influence physician knowledge, attitudes and behaviour.


PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 289-293
Author(s):  
Kathleen J. Motil ◽  
W. John Siar

With the emphasis being placed on comprehensive health care, outpatient clinics in major city hospitals have found it necessary to reevaluate their methods of health care delivery. An increasing number of patients who fail to schedule or keep medical appointments appear for crisis care, resulting in a higher cost of hospital operation due to unnecessary utilization of emergency rooms and the wasting of time of clerical and professional personnel, as well as poor quality of health care due to See the Table in PDF File sporadic clinic attendance. When comparing behavior patterns and attitudes of clinic patients under different methods of health care delivery, patient preferences become apparent.


Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Harn Shiue ◽  
Karen Albright ◽  
Kara Sands ◽  
April Sisson ◽  
Michael Lyerly ◽  
...  

Background: Alteplase (tPA) contraindications for acute ischemic stroke (AIS) were originally derived from the 1995 NINDS trial. Recently, a history of intracranial hemorrhage (ICH) and recent stroke (within 3 months) were removed as contraindications from the drug package insert, which could increase the number of patients eligible for IV thrombolysis. We sought to define the potential impact on outcomes and health care costs in this newly eligible population. Methods: Consecutive patients (March 2014 - April 2015) who presented with AIS to our Comprehensive Stroke Center (CSC) were retrospectively analyzed. Demographics and tPA exclusions were recorded. The annual number of discharges with primary diagnosis of ischemic stroke in the U.S. was estimated from the National Inpatient Sample (2006 - 2011). A previously reported value of $25,000/patient was utilized to calculate lifetime cost savings in patients receiving tPA. Results: During the study period, 776 AIS were admitted to our CSC (median age 64; 55,74, 51% men, 62% white). Seventy-six percent of our patients (n=590) had ≥1 tPA exclusions according to the NINDS trial. Among these patients, 11 excluded had history of ICH, 15 with recent strokes, and 1 both. Following the new package insert, the proportion of patients with ≥1 tPA exclusion fell to 73% (n=563). Given the 432,000 ischemic stroke discharges annually, a 3% increase in patients eligible for tPA could translate to treatment of 12,960 more patients annually and a lifetime cost savings of $324,000,000. Furthermore, we estimate that 1,685 of these newly eligible patients will experience a favorable functional outcome based on the results of the NINDS trial (13% shift analysis for mRS 0-1). Conclusions: Our results suggest that the new tPA package insert has the potential to increase national tPA treatment rates, decrease U.S. health care costs, and improve functional outcomes in eligible AIS patients. National guidelines need to be updated to reflect these changes.


2019 ◽  
Vol 5 (11) ◽  
pp. 85-91
Author(s):  
G. Оmоrоvа

This article discusses the dynamics of glaucoma prevalence in the Kyrgyz Republic. At present glaucoma is one of the pressing problems of modern health care, as it occupies one of the leading places among the causes of irreversible loss of vision. According to WHO glaucoma accounts for up to 5% of all eye pathology. By 2020, the number of patients will increase to 5.9 million and 5.3 million will lose sight due to primary glaucoma. The proportion of primary glaucoma among the causes of primary disability has been stable at a fairly high level from 20 to 28% over the years. The problem of glaucoma control requires improvement of the system of organization of early detection and dispensary observation of patients, which will contribute to control of the level of morbidity and quality of medical care. The article used data from the Republican Medical and Information Center of the Ministry of Health of the Kyrgyz Republic from 2014 to 2018. On the basis of a comprehensive analysis, the authors identified trends in the incidence of diseases of the eye and its appendages, glaucoma among adults, adolescents and children of the Kyrgyz Republic. The incidence of diseases of the eye and its appendages, glaucoma among adults, teenagers and children in dynamics from 2014 to 2018 has been studied. The share of glaucoma in the total number of diseases of the eye and its appendages among adults, teenagers and children is considered. Analysis of the dynamics of disease prevalence of the eye, its appendages, glaucoma, both among adults and teenagers, and among children under 14 years of age showed an increase in the indicator in 2015, 2017 and 2018. The proportion of glaucoma from the total morbidity of the eye and its appendages among adults and adolescents in the years under study averaged 6.4%, among children under 14 — 0.2%. It is necessary to strengthen measures for early detection, dispensarization of glaucoma patients, as well as to carry out information work among the population.


Author(s):  
Z. M. Mnushko ◽  
◽  
І. І. Parfyonova ◽  
І. V. Pestun ◽  
O. M. Draganova ◽  
...  

As the use of medicines in the provision of medical services is an important component, it is advisable to constantly update the knowledge of doctors and monitor regulatory and market changes in the field of pharmaceutical supply. The purpose of this work is to identify educational and practical issues in the pharmaceutical field, knowledge of which contributes to the proper management of the provision of drugs to the medical organizations, motivated choice, appointment, rational therapy of diseased – patients of the doctor. General information on providing relevant knowledge to physicians in the cycles of thematic improvement in health management and economics on a number of issues are presented, including: legal and marketing regulation of health care organizations and the population with medicines; state regulation of drug prices; determining the need for drugs and purchasing for budget funds; regulatory requirements for prescriptions; features of use, storage and accounting in inpatient and outpatient settings of narcotic, psychotropic drugs and precursors, etc. Given that the development of the pharmaceutical healthcare sector is influenced by the market mechanism, it is advisable to familiarize yourself with the marketing management of its subjects. It is shown that knowledge of the main issues of medical care of health care institutions and the population contributes to the quality of professional duties of organizers and specialists on the basis of legal regulation, rational use of drugs, compliance with existing restrictions and standards, and forms the principles of professional interaction and ethical communication between health professionals.


Author(s):  
Constantin Etco ◽  

One of the priorities of the health care system in Moldova is the medical services’ quality improvement. Th is article presents various defi nitions for health care quality and the principles connected with quality improvement. An important part in this article is allocated to the structure and main principles of total quality management in the health care system. Th is part reveals the problems of the commissions that are studying the quality of medical services in healthcare establishments.


Author(s):  
Faith Bontrager ◽  
Kimball P. Marshall

Purpose This paper aims to provide a literature review of corporate wellness programs to develop recommendations for effective internal marketing of healthy behaviors in work environments. Design/methodology/approach A review of research literature published since 2000 addresses corporate wellness programs’ justifications and best program design practices. Findings Corporate and employee benefits documented in the literature are reviewed and best practices from published literature are identified to guide the design of wellness programs. These include framing clear messages, alignment of corporate culture and business strategy with wellness program goals, senior leader support, clear objectives and evaluation, incorporation of peer support and enjoyable activities, utilization of effective priming for healthy choices and consideration of legal and ethical incentives. Research limitations/implications Further research is needed, including how to frame messages for diverse work groups, how to carry out effective program assessments, what types of marketing appeals are effective, what wellness activities lead to healthy behavior change and how is increased employee productivity related to quality of life. Additional questions include how priming encourages healthy behaviors, what promotes healthy workplace cultures and what social marketing appeals promote healthy behaviors. Practical implications Senior managers can implement findings to create effective wellness programs benefiting employees and firms through improved employee health and productivity and reduced corporate health-care costs. Social implications Effective wellness programs reduce overall health-care costs for society and provide improved participants’ quality of work, personal and family life. Originality/value This research uniquely applies internal marketing, social marketing and marketing exchange concepts to best practices from the wellness literature and applies these to recommendations for effective corporate-based wellness programs.


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