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Main arrow Archive of previous Issues arrow ¹3 2011 (19) arrow Mode of remuneration and the system of operation on self-supporting basis: their influence on indicators of operation activities of municipal medical establishments for treatment and prevention
Mode of remuneration and the system of operation on self-supporting basis: their influence on indicators of operation activities of municipal medical establishments for treatment and prevention Print
Thursday, 29 September 2011

Summary. Working remuneration is considered to be one of the major tools to stimulate inclination of the employed staff for maximal labor efforts. Current underfunding of public health makes quite topical the development and introduction of novel modes of remuneration concentrating around certain endpoints of the whole job activities of METP.

The experience of municipal establishment of Skhodnya-locality hospital is of interest, as concerns new organizational economic model of operating METP on self-supporting basis, implying own holding of material funds. This model has been realized through the system of working remuneration along end-results of the whole job activity of the establishment. These endpoints were evaluated upon certain criteria and indicators for the efficiency and quality of medical care (EQMC). This was made with specifically taking into account the existing conditions of underfunding of METP operating under the developing system of obligatory medical insurance.

Principles of fund-holding and operation on a self-supporting basis are quite practical for separate hospital departments and even for certain individual practitioners in outpatient facilities. In particular, remuneration - in accordance with the intrinsic costs - for para-clinical investigations and procedures provided by the staff of diagnostic, auxiliary, and maintenance units arises here from actually received general fares by therapeutic units.

The pathway of remuneration on the basis of obtained end-results of the whole job activity of an METP provides for verified evaluation of economic efficiency of operation of individual departments or practitioners in accordance with quality of the efforts applied.

The indicator of intensity of work only ranks with other indicators determining efficiency and quality of medical care (EQMC). The method of estimating remuneration on the basis of end-results of job activity is also highlighted in this Paper.

Medical economic and statistical results, as well as expert assessment of EQMC in the municipal establishment of Skhodnya-locality hospital have been compared to those of the municipal establishment of Khimki-town hospital. Both municipal establishments have been of the same locality, only with Khimki-town hospital making the estimation and charging of the staff wages upon the system of wage rating. This comparison has proved the efficiency of operation of the municipal establishment of Skhodnya-locality hospital.

The hence proposed model of organizational economic model of a METP could provide for stable finance position any METP, inspire readiness to introduce single-channel funding, support the capacity to deliver high-grade medical care.

Key words: quality grade of medical care, medical establishment, treatment and prevention, whole job activity, end-result, remuneration mode, economic efficiency, operation on self-supporting basis, fund-holding, saving of resources. 

References

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  2. Mikhaylova N.V., Komarov Yu.M., Fedorova L.A. MS ISO serii 9000:2000 kak metodologiya obespecheniya kachestva meditsinskoy pomoshchi. Metody menedzhmenta kachestva [MC ISO pattern 9000:2000 as methodology guidelines for safeguarding high-grade medical care. Certain techniques in managing quality of services]. Vrachebnaya gazeta 2001;(3-4).
  3. Tikhomirov A.V. Otpravnyye nachala ideologii reformirovaniya zdravookhraneniya [Rudiments of ideology of reforming of public health]. //Zdravookhraneniye 2006;(4):37-42.
  4. Fedorova L. A., Mikhaylova N.V., Komarov Yu.M. ISO 9000:2000 zolotoy standart kachestva meditsinskoy pomoshchi [ISO pattern 9000:2000 as a golden standard of quality of medical care]. Meditsinskaya gazeta 2001;6219(91).

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Last Updated ( Monday, 17 October 2011 )
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