About this Journal Publication ethics Editorial Board Editorial Council Editorial Office For the Authors Contacts

News feeds

Journal in Databases

eLIBRARY.RU - ═└ËÎ═└▀ Ţ╦┼╩Ďđ╬══└▀ ┴╚┴╦╚╬Ď┼╩└

Google Scholar

Google Scholar

For authors' attention

Publication is free of charge

In aims to provide interconnection of publications in international scientific journals using Digital Object Identification - DOI, our editorial office incorporated the journal "Social aspects of population health" into international reference system CrossRef.

Since 2016 DOI will be assigned to all scientific articles published in our journal free of charge.

Also DOI will be assigned to all articles published in 2014 and 2015 free of charge as well
Main arrow Archive of previous Issues arrow ╣4 2011 (20) arrow Reforming of the system of administrative control at primary level in municipal public health.
Reforming of the system of administrative control at primary level in municipal public health. Print
Thursday, 01 December 2011

Guseva S.L.1, Kondratyev Yi.N.2, Puchkov K.G.3
1Municipal Health Center No.6, city of Samara, RUSSIA
2Clinical Hospital No.8 of Federal Medical Biological Agency, town of Obninsk, Moscow Region
3Federal Research Institute for Health Organization and Informatics of Ministry of Health and Social Development of the Russian Federation, Moscow

Summary. Efficiency of reforming primary care public health largely determines the scale of success in reforming all public health in general. Outpatient clinic is just an establishment of primary level in public health that provides for fulfilling the major amount of diagnostic, therapeutic, and preventive measures. The changes occurred in normative and methodological foundations of public health, as well as certain peculiarities in funding of medical establishments at primary level of public health prompted the necessity of bringing to them certain reforms.

Topical issues here include a transfer from linear functional structure of outpatient clinic to matrix type of organizational structure (which is considered of a more creative nature); reevaluation of role and scope of general practitioners incorporated in modern outpatient clinic; formalization of preventive measures at primary care stage; expediency of developing extra-budget units linked to municipal medical establishment for the purpose of acquiring additional source of funding.

Under the conditions of rigidly limited state funding and administratively fixed scope of provided medical care, stable position of budget-funded medical establishment could be reached only by optimization of expenditure, largely on the way of elevated organizational structural efficiency and also through attracted alternative sources of funding.

Implied by such changes introduction of differential wages aimed at stimulation of labor efforts is quite feasible ľ just under several different systems of public health funding, though virtually it depends upon personal qualities and the motto of a manager of a medical establishment.

Key words. Municipal public health, reform in medicine, outpatient clinic, funding.


  1. Alekseyev N.A. Metodologicheskiye podkhody k reformirovaniyu sistemy munitsipalnogo zdravookhraneniya [Methodological approaches to reforms of municipal health care system]. Problemy sotsialnoy gigiyeny, zdravookhraneniya i istorii meditsiny 2001;(4):22-24.
  2. Andersen B. Biznes-protsessy. Instrumenty sovershenstvovaniya [Business-processes. Tools for development]. Transl. from engl. Adler Yu.P., editor. Moscow: RIA Standarty i kachestvo; 2003. 195 p.
  3. Antropov V.V. Byudzhetnaya sistema zdravookhraneniya: tri varianta odnoy modeli [Budgetary health care system: three variants of one model]. Ekonomika zdravookhraneniya 2005;99(11-12):5-10.
  4. Bykova Zh.Ye. Ispolzovaniye metodiki ballnoy otsenki meditsinskikh uslug v kachestve stabilizatsionnogo faktora raskhodov na zdravookhraneniye [Usage of the method of ball assessment for medical service as a stabilizing factor for health care expenses]. Ekonomika zdravookhraneniya 2000;(5):12-15.
  5. Vissema Kh. Menedzhment v podrazdeleniyakh firmy [Management in companyĺs subdivisions]. Transl. from engl. Moscow: INFRA; 1996. 295 p.
  6. Vyalkov A.I. Upravleniye kachestvom - protsess nepreryvnyy [Quality control as continuous process]. Glavnyy vrach 2004;(8):6-8.
  7. Vyalkov A.I. Otsenka effektivnosti deyatelnosti uchrezhdeniy zdravookhraneniya [Assessment of health care facility efficiency]. Glavnyy vrach 2005;(3):25-33.
  8. Gordin V.E. Sotsialnaya politika i sotsialnyy marketing [Social policy and social marketing]. St. Petersburg: Gella-print; 1999. 437 p.
  9. Denisov I.N. Obshchaya vrachebnaya (semeynaya) praktika: perspektivy razvitiya [General (family) medical practice: prospects for development]. Glavnyy vrach 2004;(11):6-10.
  10. Donin V.M. Konkurentsiya v rossiyskom zdravookhranenii: gosudarstvennyye uchrezhdeniya i negosudarstvennyye meditsinskiye organizatsii [Competition in Russian health care: public and private health care facilities]. Menedzher zdravookhraneniya 2005;(6):10-15.
  11. Druker P. Praktika menedzhmenta [Management practice]. Transl. from engl. Moscow: Williams; 2000. 278 p.
  12. Zdorovye dlya vsekh: osnovy politiki Yevropeyskogo regiona VOZ. Obnovleniye 2005 g. Fakty i tsifry. ERB VOZ. Kopengagen-Bukharest [Health for all: The health policy for Europe. WHO Regional Office for Europe. Facts and Figures]. Updated edition 2005. Copenhagen-Bucharest. 2005. 5 p.
  13. Kemalov R.F. Aktualnost primeneniya kontseptsii marketinga v sisteme zdravookhraneniya [Actuality in implementing the marketing concept in health care system]. Menedzher zdravookhraneniya 2005;(12):68-71.
  14. Kucherenko V.Z., Tatarnikov M.A., Shamshurina N.G. Osnovnyye napravleniya reformirovaniya rossiyskogo zdravookhraneniya na sovremennom etape [Basic directions of Russian health care reforms at the present stage] Ekonomika zdravookhraneniya 2005;96(8):11-19.
  15. Kucherenko B.Z., Martynchik S.A., Zaporozhchenko V.G., Martynchik Ye.A., Polesskiy V.A. Metodologiya izmereniya i otsenki kachestva meditsinskoy pomoshchi: mezhdunarodnyy opyt [Methodology for measurement and assessment of medical care quality: international experience]. Ekonomika zdravookhraneniya 2005;(10):5-18.
  16. Michael E. Porter. Konkurentsiya [Competition]. Transl. from engl. Moscow: Williams; 2003. 608 p.
  17. Martynchik S.A., Filatenkova S.V. Planirovanie i otsenka effektivnosti byudzhetnykh raskhodov statsionara v ramkakh finansovogo menedzhmenta, orientirovannogo na rezultat [Planning and assessing the efficiency of budgetary hospital expenditures within the framework of financial management focused on a result] Sotsialnye aspekty zdorovya naseleniya [Online Scientific Journal]. 2010 [cited 2011 Jun 17]; 15(3). Available from: http://vestnik.mednet.ru/content/view/220/30/lang,ru/
  18. Pervichnaya mediko-sanitarnaya pomoshch: osnova dlya budushchikh strategicheskikh napravleniy deyatelnosti [Primary health care: the basis for future strategic directions of actions]. WHO. Geneva; 2003. 44 p.
  19. Pervichnaya mediko-sanitarnaya pomoshch i razvitiye kadrov zdravookhraneniya [Primary health care and development of human resources for health]. WHO. Geneva; 2003. 17 p.
  20. Profilaktika cherez pervichnoye zdravookhraneniye. Rekomendatsii dlya uluchsheniya kachestva raboty. SINDI [Prophylactics via primary health care. Recommendations for improving quality of work. CINDY]. WHO Regional Office for Europe. Copenhagen. 2003. 165 p.
  21. Richard L. Daft. Menedzhment [Management]. St. Petersburg: Piter; 2007. 864 p.
  22. Robert F. Bruner, Mark R. Iker, R. Edvard Frimen, Robert E. Spekman, Elizabet O. Taysberg. Kratkiy kurs M┬A [Brief course of M┬A].Moscow: Olimp-Biznes; 2005. 384 p.
  23. Ushakov I.V., Knyazyuk N.F., Kitsul I.S. Ot menedzhmenta kachestva k kachestvu menedzhmenta meditsinskoy organizatsii [From management of quality to quality of management of health care facility]. Menedzher zdravookhraneniya 2006;(1):14-18.
  24. Usovershenstvovannyye sistemy zdravookhraneniya spasayut zhizni. Osnovy Yevropeyskoy strategii VOZ po razvitiyu sistem zdravookhraneniya. [Advanced health care systems save lives. The basis of WHO European strategy on health care development]. WHO Regional Office for Europe. 2005;. 14 p.
  25. Khammer M., Champi Dzh. Reinzhiniring korporatsii: manifest revolyutsii v biznese [Reengineering of a corporation: Manifest of revolution in business]. Transl. from engl.. Moscow: Mann, Ivanov i Farber; 2006. 276 p.
  26. Chertukhina O.B. Prakticheskiy opyt reform munitsipalnogo zdravookhraneniya na primere g. Samary [Practical experience in reforming municipal health care system by an example of Samara-city]. Moscow: GEOTAR-MED; 2003. 118 p.

Views: 12745

Be first to comment this article

Write Comment
  • Please keep the topic of messages relevant to the subject of the article.
  • Personal verbal attacks will be deleted.
  • Please don't use comments to plug your web site. Such material will be removed.
  • Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button.
  • Keep in mind that the above process only applies if you simply entered the wrong security code.

Code:* Code

Last Updated ( Tuesday, 13 December 2011 )
< Prev   Next >
home contact search contact search