S.A. Martynchik¹, O.V. Sokolova¹, S.V. Filatenkova^2
1Sechenov First Moscow State Medical University, Moscow
² Policlinic #6, Federal Security Service of Russia, Moscow

Abstract. The article focuses on legal, organizational and economic prerequisites for transition of medical facilities to result-oriented budgeting.

The aim of the study was to identify new approaches to create and mobilize financial resources, to ensure their targeted and effective use in the context of budgeting reforming.

Results. The authors showed that one of the key steps of the budgeting reforming is modification of legal status of budgetary facilities.

The article shows that transition to facility budgeting based on diagnostic-related groups is feasible and reasonable.

Payments based on diagnostic-related groups ensure targeting of financial resources to every institution depending upon its specialty and forms of health care delivery. This method also develops non-expenditure mechanisms in healthcare.

The authors recommend that the following actions be taken to develop mechanisms of intelligent use of financial resources in budgetary facilities:

- to develop methodological approches to determine standard cost per completed case based on principles of diagnostic-related groups according to the type and number of nosological forms with due regard to case specifics and complexity, applied technologies of treatment and their cost;

- to determine technological and basic standard costs per completed case of care delivery to ensure transition to a more effective and up-to-date pricing;

- to develop new principles for program budgeting and methods for planning and forecasting budget as well as its execution;

- to develop new approaches to organize budgeting, improve planning and tariff regulation aimed at intelligent use of facility resources.

Conclusions. The authors’ recommendations include the following:

1. Introduction of a single-channel financing of healthcare facilities;
2. Transition from estimate-based planning and financing to result-oriented budgeting;
3. State control over extra-budgetary financial resources.

Keywords: diagnostic-related groups of diseases; completed case; result-oriented budgeting; state (municipial) facility; medical insurance company.

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