Научно-практический журнал Медицинские технологии. Оценка и выбор
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Issue № 30 | 2017 (4)

Abstract

The article characterizes the main methods of payment for primary medical care (PMC). It presents a review of literature, as well as laws and regulations that determine the application and advantages of various payment methods. The need for risk control mechanisms is emphasized.

Keywords

methods of payment for medical care, standard capitation funding, asset holding, primary medical care (PMC).

For citations

Lukyantseva D. V., Zheleznyakova I. A., Tyurina I. V. Approaches to the Optimization of Primary Medical Care. Medical Technologies. Assessment and Choice. 2017; 4(30): 53–61.

Issue № 30 | 2017 (4)

Abstract

The present article is devoted to systematization of methodological bases, significance and possibilities of clinical audit in quality management of medical care. In particular, the application possibilities, strengths and weaknesses of various models of clinical audit in the field of radiation diagnostics are presented, and a model of the patient-oriented model is proposed. Developed and widely applied in the world practice, the standards in the healthcare sector (GCP, GLP, CMP, GNP) and the creation of quality systems on the ISO 9000 series confirmed the need for transforming approaches to health care. However, the rapid transition to work within the framework of standardized high-level systems requires a drastic change in the existing activities of clinics, which often cannot be performed without the infusion of a significant amount of additional resources. The consequence of this problem is that most clinics keep their work unchanged and this leads to low quality of medical services, medical errors, unreasonable diagnostic procedures. Thus, the imperfection of the existing mechanisms for monitoring the quality of care and the difficulties in moving to a standardized work determine the relevance of the selected study.

Keywords

quality of medical care, clinical audit, radiology.

For citations

Basarboliev A. V., Morozov S. P., Vladzymyrskyi A. V. The Role of Clinical Audit in Improving the Quality of Medical Care in Radiology. Patient-Centered Model. Medical Technologies. Assessment and Choice. 2017; 4(30): 46–52.

Issue № 30 | 2017 (4)

Abstract

The definitions of the term ’dispensary care’ in different sources and in different times reflect its significant distinctions from screening used in foreign countries. Initially, dispensary care was aimed to be much broader than screening; however, the meaning of the term changed over time and now it reduces to diagnostic examination comparable with screening. For further improvement, dispensary care should be clearly divided into two types, i.e. screening and active observation of certain groups of population. Organizational mechanisms of their implementation and optimal methods of payment should be developed.

Keywords

dispensary care, dispensary, dispensary observation, prevention, early diagnosis, screening.

For citations

Omelyanovsky V. V., Melnikova L. S., Avxentyeva M. V. On the Evolution of Terms «Dispanserization and Dispensary Follow-up»: History and Reality. Medical Technologies. Assessment and Choice. 2017; 4(30): 39–45.

Issue № 29 | 2017 (3)

Abstract

The article addresses the quality of clinical care of maxillofacial traumas. The experience of physicians of maxillofacial surgery units in inpatient facilities of Moscow region is described. The analysis of the results of organizational and methodical measures in maxillofacial surgery in 2016 is used to assess the effectiveness of the approaches to the care for patients with maxillofacial injuries in Moscow region.

Keywords

maxillofacial injuries, multiple injuries, difficult diagnosis, stepped care principles, system of medical evacuation, internal quality control in health care, quality assessment of organizational and methodical approaches to health care.

For citations

Nikitin A. A., Sipkin A. M., Akhtyamov D. V. Organizational and Methodical Approaches to the Management of Patients with Maxillofacial Traumas in Moscow Region. Medical Technologies. Assessment and Choice. 2017; 3(29): 59–64.

Issue № 29 | 2017 (3)

Abstract

This review deals with current situation and future of the mobile medical applications (mmApps) in Russia and entire world. We described a points of view from leading world healthcare regulators (e. g. WHO and FDA), main trends in control of use and quality requirements. Also we have analyzed publication activity about this topic since 2007 year and developed two classifications of mmApps, that was the first attempt to classify mmApps in Russia. Obstacles in use of mmApps in Russia are also observed.

Keywords

mHealth, electronic health, mobile medical applications, health technology assessment.

For citations

Soshnikov S. S., Gorkavenko F. V., Vladimirov S. K., Nochevkin E. V., Borisenko A. A., Kotlyar V. A., Frolkova A. B. Classification of Mobile Medical Applications, Principles and Ethical Standards for their Implementation in Clinical Practice. Medical Technologies. Assessment and Choice. 2017; 3(29): 53–58.

Issue № 29 | 2017 (3)

Abstract

The author discusses the problems of legal and normative regulation for the regional drug lists for provision of certain categories of citizens with medicines for outpatient treatment. The drugs included into such lists are financed from the regional budgets in the Framework of Regional Programs of State Guarantees of Free Medical Care/ The number of drugs included into the lists in different regions of Russia were compared as well as correspondence of regional lists with the vital and essential drugs list (VEDL) approved by the Government. Data on efficacy of drugs included into regional lists but not into VEDL were analyzed. There is great variability in the number of drugs included into regional lists between the regions. Besides discrepancy between regional lists and VEDL is obvious, being also different in different regions. Some regions with deficient Program of State Guarantees have much larger number of drugs in regional list if compared with VEDL, but the inclusion is not based on scientific evidence of efficacy. The article ends with recommendations how to improve the process of regional drug lists formation.

Keywords

regional drug list, Program of State Guarantees of Free Medical Care, Vital and Essential Drug List (VEDL ).

For citations

Sura M. V. Provision of Medicines for Outpatient Treatment Financed from the Regional Budgets in the Framework of Regional Programs of State Guarantees of Free Medical Care. Medical Technologies. Assessment and Choice. 2017; 3(29): 41–52.

Issue № 29 | 2017 (3)

Abstract

The article describes the main provisions of the Russian law concerning organization and payment for outpatient medical care. The authors disuss several problems, particularly the lack of a system of drug insurance, staff disproportions, lack of physicians responsible for the coordination of all stages of medical care, lack of effective mechanisms of encouragement of medical organizations to implement preventive measures, excessive financial penalties and insufficient funding of the primary stage of medical care.

Keywords

primary health care, outpatient facilities, organization of medical care, payment for medical care.

For citations

Lazareva M. L., Fedyayev D. V., Melnikova L. S. Legal and Regulatory Framework of the System of Payment and Organization of Outpatient Care in the Russian Federation. Medical Technologies. Assessment and Choice. 2017; 3(29): 31–40.

Issue № 29 | 2017 (3)

Abstract

The transfer of high-tech medical assistance for payment under insurance principles through the use of Russian Diagnostic-Related Groups (ruDRG) is due to the need to address one of the main objectives of public health policy – to increase the availability of high-quality high-tech medical care for the population of Russia. The solution of this task requires the development of not only scientifically based organizational approaches, but also the application of adequate financial mechanisms for reimbursing the costs of medical organizations providing this type of medical assistance in the compulsory health insurance system. The process of transferring VMP to insurance principles is associated with a number of problems, the solutions to which are discussed in this article. In this regard, the following tasks are of particular importance: updating the list of VMP for compliance with the criteria for referring to this type of medical care; problems of comparing the structure of the VMP with the principles of the formation of clinical and statistical groups; justification of the level of financial costs.

Keywords

high-tech medical care, specialized medical care, clinical and statistical groups, the nomenclature of medical services.

For citations

Brutova A. S., Obukhova O. V., Bazarova I. N. The Problems of Transferring High-Tech Medical Care to Russian Diagnostic-Related Groups (ruDRG). Medical Technologies. Assessment and Choice. 2017; 3(29): 22–30.

Issue № 28 | 2017 (2)

Abstract

The article describes a range of issues that arise during the implementation of private-public partnership in the field of health care. Possible solutions of the problems are proposed.

Keywords

private-public partnership, structuring, project administration, Samara Oblast

For citations

Navasardyan A. S. On Some Issues of the Implementation of Private-Public Partnership Projects in Health Care. Medical Technologies. Assessment and Choice. 2017; 2(28): 40–43.

Issue № 27 | 2017 (1)

Abstract

The article describes possible directions of concretization of the Program of State Guarantees fоr free Medical care for Russian Citizens within existing types, conditions and forms of medical care, the general approach to determining the direction of concretization of the Program of State Guarantees. The authors consider proposals on some types of care and present cost calculations for their implementation.

Keywords

healthcare financing, Program of State Guarantees, efficiency of healthcare system.

For citations

Fedyaev D. V., Lukyantseva D. V., Ignatyeva V. I. Аpproaches to Concretization of the Program of State Guarantees fоr free Medical care for Russian Citizens. Medical Technologies. Assessment and Choice. 2017; 1(27): 15–22.