scholarly journals Financing of the Program of state guarantees of free medical care: how to solve the deficit problem?

2021 ◽  
Vol 65 (6) ◽  
pp. 514-521
Author(s):  
Vladimir V. Grishin ◽  
Andrey V. Ragozin ◽  
Aleksandr A. Itselev ◽  
Svetlana A. Glazunova
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Value Added ◽  
Federal Budget ◽  
Working Population ◽  
Retrospective Data Analysis ◽  
Mandatory Health Insurance ◽  
The Russian Federation ◽  
Definition Of

Introduction. The critical problem of Russian health care is the deficit of funding for the program of state-guaranteed medical care for citizens of Russia. Purpose of the study. To search for solutions to the problem of financing the deficit of the program of state guarantees of free medical care in the Russian Federation. Material and methods. Retrospective data analysis was carried out to analyse the reasons for the deficit in the financing of the program of state guarantees of free medical care and search for solutions in the experience of other countries. Results. The analysis showed that the reasons for the deficit of the program of state guarantees of free medical care are the shortcomings of the mandatory health insurance (MHI) income system: linking contributions for the working population to the wages fund; the vagueness of the definition of the non-working population and the payment of contributions for its MHI by the constituent entities of the Russian Federation; non-participation of the solvent population in the co-financing of medical care; deficit of economic integration between the payment of MHI treatment and the health care system; the absence of formalized mechanisms for reimbursing the expenses of the MHI system by the federal budget to pay for aid in catastrophic situations. Discussion. The authors see the solution to the problem of the deficit of the program of state guarantees of free medical care in the modernization of the MHI income system: replacement of the MHI contributions paid by employers with an additional “medical” part of the value-added tax; replacement of the MHI contributions paid by the constituent entities of the Russian Federation for the non-working population with a targeted “medical” tax on retail sales; creation of a system of additional income based on the principle “the guilty person pays for causing harm to health”; recognition of the cost of medical care to the population in catastrophic situations as an unconditional obligation of the federal budget. Conclusion. a systemic solution to the problem of the financing deficit of the program of state guarantees of free medical care for the citizens of Russia seems to be the modernization of the MHI income system.

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
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Subsequent Development ◽  
Outpatient Basis ◽  
Drug Supply ◽  
Military Health ◽  
Drug Insurance ◽  
Insurance System ◽  
The Russian Federation

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.

scholarly journals Legal regulation of telemedicine in the health care system of the Russian Federation: state and prospects for improvement.

2019 ◽  
Vol 21 (3) ◽  
pp. 15-22
Author(s):  
N V Allamyarova ◽  
E G Sanakoeva
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Russian Federation ◽  
Legal Framework ◽  
Legal Regulation ◽  
Legal Documents ◽  
Current State ◽  
The Russian Federation ◽  
Care System

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.

scholarly journals Analysis of personnel resources of doctors according to «dentistry» profile in units providing medical care in outpatient and inpatient conditions

2020 ◽  
Vol 24 (1) ◽  
pp. 55-60
Author(s):  
L. E. Smirnova ◽  
V. G. Butova
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care System ◽  
Russian Federation ◽  
Dental Care ◽  
Health Workers ◽  
Dental Hygienists ◽  
The Russian Federation ◽  
Care System

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.

scholarly journals Development of voluntary medical insurance in the Russian Federation

2019 ◽  
Vol 100 (5) ◽  
pp. 796-801
Author(s):  
E V Arsentyev
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Russian Federation ◽  
Medical Insurance ◽  
Insurance Policy ◽  
Labor Migrants ◽  
Voluntary Health Insurance ◽  
Legislative Framework ◽  
The Russian Federation

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.

scholarly journals Citizens' Rights to Health Protection and Medical Assistance, Guaranteed by Article 41 of the Constitution: Problems of Enforcement

2019 ◽  
Vol 3 (1) ◽  
pp. 97-103
Author(s):  
Ольга Фадеева ◽  
Olga Fadeeva
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Medical Personnel ◽  
Right To Health ◽  
Health Protection ◽  
Medical Specialists ◽  
Medical Graduates ◽  
The Russian Federation ◽  
The Right

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.

Amendments to the Constitution of the Russian Federation: Dictated Necessity and Consequences in the Conditions of the Modern World

2021 ◽  
Author(s):  
V.V. Chuksina ◽  
◽  
K.A. Mirvoda ◽  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Local Governments ◽  
Health Care Systems ◽  
Modern World ◽  
Depth Analysis ◽  
Care Systems ◽  
The Russian Federation ◽  
The Impact

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.

The evaluation of epidemiology and the availability of medical care for patients with retina diseases in the Russian Federation

2020 ◽  
pp. 26-36
Author(s):  
I. V. Laricheva ◽  
◽  
I. M. Son ◽  
E. S. Yastrebova ◽  
V. V. Neroev ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Macular Degeneration ◽  
Russian Federation ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Complete Evaluation ◽  
Age Related ◽  
Number Of Patients ◽  
The Russian Federation

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.

Payment for medical care based on per capita standards: organization and accounting

2020 ◽  
pp. 7-15
Author(s):  
Elena Nikolaevna Dombrovskaya
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Russian Federation ◽  
Financial Support ◽  
Primary Health ◽  
Organizational Mechanism ◽  
Medical Institutions ◽  
The Russian Federation ◽  
Per Capita

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.

scholarly journals Key indicators of therapeutic and diagnostic activities of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, in 2012–2017

2019 ◽  
pp. 81-89
Author(s):  
K. K. Rogalev ◽  
P. K. Kotenko ◽  
S. G. Kireev ◽  
G. Yu. Sokurenko
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Russian Federation ◽  
Federal Budget ◽  
Medical Institution ◽  
High Tech ◽  
Saint Petersburg ◽  
Physical Examinations ◽  
The Russian Federation ◽  
Radiation Medicine

Relevance. Arrangement of the medical support for the EMERCOM of Russia specialists and employees needs constant monitoring and analysis of activities of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia (NRCERM) as the leading multidisciplinary medical institution of the EMERCOM of Russia.Intention – To analyze NRCERM activities (2012–2017) on specialized primary care, including high-tech care, at outpatient, day-time and inpatient hospitals.Methods. Results of health care and treatment in the NRCERM were assessed (2012–2017): 787,057 out-patient cases, 3,782 day-time cases, and 79,572 inpatient cases.Results and Discussion. In 2017, volumes of specialized primary care in outpatient hospitals was 156.6 % compared to that in 2012. The proportion of this type of health care paid for by the federal budget varied from 44.3 to 57.0 %. The most popular types of specialized primary care were internal medicine, neurology, gastroenterology, otolaryngology, ophthalmology, gynecology, surgery, urology and dentistry. The proportion of individuals who underwent preventive physical examinations in 2012–2017 amounted to 22–23 % among the whole number of outpatient visits, with 95.4 % of them were EMERCOM of Russia employees and 4.6 % – patients who paid themselves or were paid for. NRCERM mobile medical teams performed prevention physical examinations of employees of the EMERCOM of Russia in the Republic of Crimea and the city of Sevastopol: 1431 and 2070 individuals were examined in 2015 and 2016, respectively. The number of patients in the day-time NRCERM hospital increased to 1059 individuals in 2017. In 2017, volumes of specialized primary care increased to 191.9 % compared to 2012, with maximums in 2015 and 2016. Inpatient specialized primary care within the federal budget decreased from 63 % in 2012 to 28 % in 2017. Volume of inpatient care increased progressively due to programs of obligatory and voluntary medical insurance and self-paying. The proportion of surgery patients among all the in-patients increased from 35 % in 2012 to 58.4 % in 2017. In the NRCERM as a whole, the average duration of patient’s stay in a hospital decreased from 9.9 days in 2012 to 8.0 days in 2017, which is considerably less than in the Russian Federation (11.7 days) and Saint Petersburg (11.3 days). The bed turnover in the NRCERM increased owing to both therapy and surgery departments, with maximums in 2015 (29.0) and 2016 (28.8). This parameter increased in 2017 compared to 2012 (27.5 vs 13.9; 197.8 %). In 2017, number of operations increases compared to that in 2012 up to 258.6 %, with related increase in anesthesia procedures up to 274.1 %. High tech surgeries considerably increased (3.5-fold) in 2017 compared to 2012. The proportion of high tech surgeries was 14.2 % in 2012 and 18.7 % in 2017. The NRCERM mortality rates in 2012–2017 were 0.4–0.5 % which is considerably less than in the Russian Federation (1.77 %) and in Saint Petersburg (2.49 %). In cause-of-death structure, the following diseases dominated: circulatory diseases (40.3 %), neoplasms (29.8 %) and, third, traumas (10.4 %) – a total of 80.5 %.Conclusion. Within NRCERM activities, volumes of specialized primary care increased, including high tech care, in outpatient, day-time and inpatient settings. Besides, intensity of medical-diagnostic process increased, with low hospital mortality rate due to optimized organizational structure of medical institution, improved performance of outpatient and inpatient departments, introduction of innovative medical technologies.

scholarly journals On the issue of the criminalization of the obstruction of medical care committed against a health worker

2021 ◽  
pp. 213-216
Author(s):  
Dina Garaeva
Keyword(s):  
Medical Care ◽  
Health Worker ◽  
Russian Federation ◽  
Medical Profession ◽  
Criminal Code ◽  
Care Providers ◽  
Medical Worker ◽  
Medical Assistance ◽  
The Russian Federation ◽  
Definition Of

The article justifies the need for the recent criminalization of obstruction of medical assistance in the Russian Federation. A study of these innovations is necessary because of their lack of theoretical and practical study. The preconditions for the criminalization of the offence was studied, the medical profession was assessed from the point of its victimization, the definition of the concept of «obstruction» was investigated, the contradiction between the name of the new article and the range of medical care providers was indicated. Removing the reference to medical worker as the only subject of medical assistance from the article 124.1 of the Criminal Code of the Russian Federation was proposed.

Sign in / Sign up

Export Citation Format

Share Document