Entering a medical clinic on the stock exchange: reflection in accounting and reporting

Medicine in modern Russia is as profitable business as any other. Of course, we are talking about private medicine. Therefore, medical organizations need to be able to plan their income and expenses, as well as be able to manage them. Many Russian private medical organizations adopt foreign experience, transferring to the “medical soil” the idea of “effective management”, which consists in the ability to increase revenues, reduce costs, and generate such a volume of profit that suits the shareholders. According to the market law of capital flow, shareholders who own shares of companies in one industry sell these shares (at the time when this can be done with the maximum possible profit) and acquire shares of companies in another industry that are more attractive for investors. It is possible to sell shares “from hand to hand” — from the previous owner to a new one, but the transaction in this case is carried out at a negotiated price that will not meet the criteria of the so-called fair price. A completely different matter is the sale of shares on an exchange, an observable (transparent) market. The transaction is reflected in the accounting and reporting, the only question is whether the profit from the transaction is reflected on the balance sheet of the medical organization in respect of the shares of which the transaction is being made.

Availability, prices and affordability of essential medicines: A cross-sectional survey in Hanam province, Vietnam

Objective To measure medicines’ prices, availability, and affordability in Hanam, Vietnam. Methods The standardized methodology developed by the World Health Organization (WHO) and Health Action International was used to survey 30 essential medicines (EMs) in 30 public health facilities and 35 private medicine outlets in 2020. The availability of medicine was computed as the percentage of health facilities in which this medicine was found on the data-collection day. International reference prices (IRPs) from Management Sciences for Health (2015) were used to compute Median Price Ratio (MPR). The affordability of treatments for common diseases was computed as the number of days’ wages of the lowest-paid unskilled government worker needed to purchase medicines prescribed at a standard dose. Statistic analysis was done using R software version 4.1.1. Results The mean availability of originator brands (OBs) and lowest-priced generics (LPGs) was 0.7%, 63.2% in the public sector, and 13.7%, 47.9% in the private sector, respectively. In private medicine outlets, the mean availability of both OBs and LPGs in urban areas was significantly higher than that in rural areas (p = 0.0013 and 0.0306, respectively). In the public sector, LPGs’ prices were nearly equal to their IRPs (median MPRs = 0.95). In the private medicine outlets, OBs were generally sold at 6.24 times their IRPs while this figure for LPGs was 1.65. The affordability of LPGs in both sectors was good for all conditions, with standard treatments costing a day’s wage or less. Conclusion In both sectors, generic medicines were the predominant product type available. The availability of EMs was fairly high but still lower than WHO’s benchmark. A national-scale study should be conducted to provide a comprehensive picture of the availability, prices, and affordability of EMs, thereby helping the government to identify the urgent priorities and improving access to EMs in Vietnam.

NON-ADHERENCE TO HEPATITIS C TREATMENT: A BRAZILIAN REPORT

ABSTRACT BACKGROUND: In Brazil, since 2015, the treatment of hepatitis C is provided by SUS (Public Health System) with direct-acting antiviral (DAA). OBJECTIVE: To describe the rate of non-adherence patients to hepatitis C treatment by DAA, investigating the epidemiological data in a large database from Curitiba, Brazil. METHODS: Retrospective study with patients treated between January 2015 and June 2019. Patients were considered adherent when received all medication doses during their treatment. The following data were evaluated: gender, age, type of treatment, period of treatment, presence of diabetes or HIV, previous therapy, originated from SUS or private medicine, fibrosis grade and HCV genotype. RESULTS: 1248 patients (56.8% males) were studied and 102/1248 (8.2%) were non-adherent to treatment. Age or gender not influenced significantly; 10.2% patients from SUS and 3.7% individuals from private medicine were non-adherent (P<0.0001; OR=2.9; CI95%=1.6-9.1); 13.1% patients were co-infected with HIV and among them, 15.9% abandoned treatment. Individuals without co-infection presented 7.0% of non-adherence (P<0.0001; OR=2.5; CI=1.5-4.1). All the other variables showed no differences in the adhesion rate. CONCLUSION: Our study showed that 8.2% of patients were non-adherent to HCV treatment, and that patients from the Public Health System and co-infected with HIV were significantly less adherent.

Law within medical practice

This chapter sets out the basic legal framework governing medical practice. Essentially it is the law of tort that governs NHS work, while contracts play a more significant role in private medicine. The chapter explains the NHS Indemnity that plays an important role in protecting NHS staff from personal liability under civil law.

Assessment of compliance with regulations on private medicine practice of specialised clinics in Viet Tri city, Phu Tho province, 2020

Objectives: To assess compliance with regulations on private medical practice and analyze some influencing factors at specialized clinics in Viet Tri city, Phu Tho province, by 2020. Research method: Cross-sectional descriptive study with analysis, combining quantitative with qualitative. Directly observed 30 private medical practice establishments, combined with in-depth interviews with professional responsible persons and 05 managerial staff. Results: The results showed that some facilities did not meet the criteria, including: 04/30 facilities did not meet the criteria for facility conditions; 10/30 facilities have not yet achieved medical waste treatment; 14/30 facilities lacked conditions of emergency transportation equipment; 13/30 facilities did not comply with the professional regulations as prescribed; There are two main factors that affect private medical practice: The irregular inspection and supervision and the person in charge of professional practice has not fully complied with the provisions of private medical practice. Conclusion: It is necessary to strengthen inspection, examination and propagation and dissemination of legal regulations to private medical practice facilities. Keywords: Private medical practice, private clinics, specialist clinics.

КРІ model impact on employee motivation and competitiveness of private healthcare facilities

The Constitution of Ukraine stipulates that an individual, his/her life, and health are the highest state social values. The authors highlighted that the health care system is the basis of social policy, national security, public health, and economic development. The current reformation of medical and legal reforms in Ukraine are fully covered by health legislation. In the context of these laws, the government promotes the development of private, communal, and state healthcare facilities. The authors noted that private medicine is snowballing in Ukraine, but the competitiveness of private health care facilities is insufficient in state medical reform. The study emphasized the absence of appropriate tools and mechanisms to motivate staff in private healthcare facilities. Based on the findings, the authors proposed introducing a set of evaluation indicators combined into a single integrated system – key performance indicators (KPIs), which would be the basis for calculating the bonus payroll. In turn, this system of material incentives should encourage medical staff to work effectively, be active, and initiative. The mechanism for developing a set of KPIs should be approved at the administration of the private health care facility. At the same time, medical workers of all levels must participate in KPIs elaborating. The indicators of medical care quality could be further used to improve healthcare, differentiated work assessment of medical staff, and healthcare facility in general, in accreditation and certification of private health care facilities. In the study, the authors formed and analyzed groups of indicators for different categories of the medical staff of private medical institutions. The obtained results showed that different bonus rates are needed to motivate employees at various levels to create an additional incentive to build a medical career. Thus, it could be argued that private healthcare facilities should develop motivation policy and strategy, revise system and forms of remuneration, improve the mechanism of motivation and incentives, focus on increasing competitiveness indicators in private medicine.

FEATURES OF THE FORMATION AND DEVELOPMENT OF THE MEDICAL SERVICES MARKET IN THE CONTEXT OF A PANDEMIC

The article examines the changes in the market of medical services in the context of a pandemic. The competitive advantages of medical institutions, the possibility of using paid and free services are being studied. The main directions of the development of private medicine, taking into account its mobility, are considered. The analysis of the medical services market for 2016–2020 years and development prospects for 2022–2025 years is carried out, the possibilities of using modern equipment, the role of which increases with the development of digital technologies, are revealed. The article notes that in modern conditions, the requirements for personnel are increasing and the cost of medical research is increasing. It is proposed to use private clinics within the framework of the CHI to relieve the public sector of medicine, which is overloaded during the pandemic

Financial controlling and modeling in cost management of a medical organization

The article reveals the current trends in the development of financial controlling for the purpose of managing the cost of a medical organization. Over the past decade, the development of the health system has been considered not only from the standpoint of public policy aimed at improving social health services, but also in terms of activating private medicine, the scope of which is steadily growing. The revival of investment in non-governmental health organizations for the development of quality medical services is provided by the growth of investment attractiveness of private medicine. A significant role in strengthening the investment image of such companies is played by a realistic assessment of the potential market value of the business, in the management of which a special function is performed by financial controlling. The article covers the organization and practical application of methods and models for assessing the market value of business and financial controlling functions in the cost management system of a medical company.

Telemedicine. “Childish” diseases or serious problems

For more than a century, attempts to use modern technologies for communication between doctors and patients who are far from medical facilities have continued. At first, this was actualized mainly for the diagnosis and treatment of emergency conditions and was very limited. Recent exponential progress of communication technologies and Internet in most remote places allow both providing quality consultation care and developing disease prevention programs, in particular screening. But, unfortunately, in traditional medical organization, these opportunities cannot be fully actualized. The search for optimal communication forms between a doctor and a patient is ongoing. There remain many unsolved problems of the interaction between state, insurance and private medicine. Nevertheless, the accumulated experience suggests that this very promising branch of medicine will be developed.