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Main arrow Archive of previous Issues arrow ╣6 2014 (40) arrow Potential opportunities of reorganization of the Russian health-care system at the time of its transition within the compulsory health insurance system
Potential opportunities of reorganization of the Russian health-care system at the time of its transition within the compulsory health insurance system Print
Wednesday, 25 February 2015

Bogachevskaia S.A.1, Bondar V.Y.1,2, Bogachevskiy A.N.1, Letskin A.Y3.
1Federal Centre of Cardiovascular Surgery, Khabarovsk
2Far Eastern State Medical University, Khabarovsk
3 Regional clinical hospital ╣2, Khabarovsk

Abstract. The Russian healthcare system is characterized by high rates of doctor and hospital bed availability; however the resource potential is underused.

Reasons of ineffective health services include prolonged hospitalization with the cost of treatment varying several times across hospitals of different levels.

The purpose of the study. Widespread implementation of high-tech medical care in regions necessitates elaboration of a new approach to form development schemes, deployment of medical facilities network and revision of current nomenclature of facilities with due regard to regional peculiarities.

Methods and data. The authors analyzed performance results of seven healthcare facilities of the Far Eastern Federal district that provided treatment for acute coronary syndrome, and nine facilities providing high-tech cardiovascular surgery in 2011-2013.

Results. It is operation in full capacity of the regional vascular center (based at the Regional hospital ╣2, Khabarovsk) that gave an impulse to effective management of acute coronary syndrome and accounted for significant improvement of such care in the region in 2013.

Analysis of the facilitiesĺ performance in the Far Eastern Federal district that provide high-tech cardiovascular surgery shows that the main volumes of routine care in 2011-2013 were provided by the Federal Centre of cardiovascular surgery, Khabarovsk.

It is worth noting that limited hospitalization of non-surgery patients to the high cost surgery hospital beds for diagnostics and development of treatment plan (with the possibility of further surgery, or its rejection) makes a significant contribution to improving efficiency of hospital bed utilization and hospital performance on the whole.

Conclusions and recommendations. Thus, concentration of cardiovascular surgery resources within the highly specialized institutions significantly improves performance of a very resource-consuming cardiovascular surgery.

Organization of specialized regional institutions with differentiated objectives will improve quality of high-tech medical care and its accessibility. It is also advisable to divide the cardiovascular surgery care into specialties: emergency medical treatment of acute coronary syndrome should be provided in the majority of facilities, while routine cardiovascular surgery should be concentrated in a limited number of specialized hospitals depending on the regional needs and hospital capacity.

Keywords: regional specialized centers; high-tech medical care; reorganization of health care delivery; compulsory health insurance.


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