Avdeeva M.V.1, Vashchenkov V.V.2, Luchkevich V.S.1, Barkaeva V.A.1,2
1 North-Western State Medical University named after I.I. Mechnikov, St. Petersburg
2 Medical Center for Information and Analysis, St. Petersburg
Contacts: Marina Avdeeva,
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Abstract. Background. In the context of public health
reforming in Russia it is very important to implement systematic
monitoring of reforms’ effectiveness.
The purpose of the study: to analyze the global and Russian
experience in rating medical organizations and systematize criteria for a
comprehensive quality and performance assessment of the health care
system.
Methods: Content analysis, analytical, historical.
Results. Foreign countries gained more than a 50 year
experience in rating medical organizations, while Russia introduced this
practice in 2009 only. Modern classification of rating evaluation
parameters implies use of clinical and non-clinical performance
indicators, as well as subjective and objective assessment of quality
and efficiency of medical care with due regard to available resources,
quality of technology and performance results of health care facilities
according to the classical Donabedian triad approach. The Russian rating
system of medical organizations is quite compliant with the
international standards, but is under formation and adaptation in line
with the available opportunities.
Conclusions. The most promising direction for developing the
national rating system is provision of tools for mathematical
forecasting of risk, which is extremely important for making managerial
decisions at the level of the entire health care system.
Scope of application. Improving public health through managing quality and efficiency of medical care.
Keywords: rating scores, monitoring of customer satisfaction,
rating of medical organizations, ranking, unidimensional and
multi-dimensional ratings, independent quality assessment of medical
care.
References
-
Àvdeeva M.V., Lobzin Yu.V., Luchkevich V.S. Meditsinskaya
informirovannost' i udovletvorennost' zhiteley Sankt-Peterburga [Medical
knowledge and satisfaction of the citizens of St. Petersburg with
health preventive care]. Klinicheskaya i profilakticheskaya meditsina 2014; 51 (2): 14-18 (In Russian).
-
Àlekseev V.À., Borisov K.N. Upravlenie kachestvom ambulatornoy
meditsinskoy pomoshchi: izuchenie mneniya patsientov [Quality management
of outpatient care: the study of the of patients’ opinion]. Zdravookhranenie 2013; (8): 76-83 (In Russian).
-
Barskova G.N., Devishev R.I., Lokhtina L.K. Rossiyskaya praktika reytingovaniya meditsinskikh organizatsiy [Rating of health care facilities. Russian practice]. Sotsial'nye aspekty zdorov'ya naseleniya [serial online] 2014 [cited 2015 Mar 12]; 39 (6). Available from: http://vestnik.mednet.ru/content/view/520/lang?ru/ (In Russian).
-
Bertash S.A., Kakorina E.P., Stepanov I.M., Sheyman I.M., Shevskiy V.I.
Kontseptual'nye i metodicheskie podkhody k postroeniyu reytingov
meditsinskikh organizatsiy [Conceptual and methodological approaches to
construction of ratings of health care facilities]. Zdravookhranenie 2014; (4): 68-77 (In Russian).
-
Gadaborshev M.I., Levkevich M.M. Otsenka rezul'tativnosti deyatel'nosti
otdeleniya klinicheskoy bol'nitsy [Assessment of the efficiency of the
department in a clinical hospital]. Sibirskaya finansovaya shkola 2012; 94 (5): 23-28 (In Russian).
-
Zurnadzh'yants Yu.A. Formirovanie analiticheskikh pokazateley po
napravleniyam deyatel'nosti meditsinskogo uchrezhdeniya. [Formation of
analytical indicators of activities of health care facilities]. Vestnik Àstrakhanskogo gosudarstvennogo tekhnicheskogo universiteta. Seriya: Ekonomika 2010; (1): 178-187 (In Russian).
-
Informatsiya o formirovanii reytingov uchrezhdeniy,
predostavlyayushchikh sotsial'nye uslugi (na primere uchrezhdeniy v
sfere zdravookhraneniya) [Information about the formation of the ratings
for the agencies providing social services (for example, health care
facilities)]. [Online]. 2013 [cited 2015 April 20]; Available from: https://docviewer.yandex.ru/?url=yaserp %3A%2F%2Fwww.rosmintrud.ru%2Fnsok%2Fregions%2F2%2FRejtingi _meditcinskih_organizatcij.doc &lang=ru&c=55560ef7f3ff (In Russian).
-
Karachevtseva M.A., Mikhaylov S.M., Gurinov P.V. Organizatsiya i
rezul'taty ekspertizy kachestva meditsinskoy pomoshchi v statsionarakh
g. Sankt-Peterburga [Organization and results of examination of the
quality of care in hospitals in St. Petersburg]. Zdravookhranenie 2014; (10): 68-77 (In Russian).
-
Kim S.V. O metodike reytinga meditsinskikh organizatsiy i regionov po
zdravookhraneniyu. [On the methodology of rating of health care
facilities and the regions by health care ]. Eurasian Journal of Public Health [serial online] 2015 [cited 2015 May 2]; 4 (2). Available from: http://zdravconsult.ru /rating-medorg/ (In Russian).
-
Kuzhel' A.M., Okunev P.Yu., Strogonova O.B., Blinov A.V. Rezul'taty
pilotnogo sotsiologicheskogo issledovaniya urovnya udovletvorennosti
grazhdan meditsinskoy pomoshch'yu v ambulatornykh meditsinskikh
organizatsiyakh dlya vzroslykh Sankt-Peterburga [The results of pilot
sociological study of patients’ satisfaction with outpatient care in St.
Petersburg]. Menedzher zdravookhraneniya 2013; (6): 12-16 (In Russian).
-
Lindenbraten A.L. Metodicheskie podkhody k otsenke kachestva
organizatsii meditsinskoy pomoshchi [Methodological approaches to
assessing the quality of medical care]. Zdravookhranenie 2015; (1): 74-78. (In Russian).
-
Luchkevich V.S., Samodova I.L., Marinicheva G.N., Shakirov A.M.,
Shibanov E.N. Analiz effektivnosti ekologicheskikh i
mediko-ozdorovitel'nykh programm na osnove izucheniya kachestva zhizni
naseleniya. [Analysis of the efficiency of ecological and medical
recreation programs on the basis of studying the life quality of the
population]. Izvestiya Samarskogo nauchnogo tsentra Rossiyskoy akademii nauk 2012; 14 (5-2): 553-556 (In Russian).
-
O meropriyatiyakh po realizatsii gosudarstvennoy sotsial'noy politiki
[On measures for implementation of the government social policy]. Ukaz
Prezidenta Rossiyskoy Federatsii ot 7 maya 2012 goda ¹597. [Online]
[cited 2015 May 18]. Available from: http://www.kremlin.ru/events/president/news /15233 (In Russian).
-
O formirovanii sistemy reytingov meditsinskikh organizatsiy i
razmeshchenii ikh na saytakh organov ispolnitel'noy vlasti sub"ektov
Rossiyskoy Federatsii: [On formation of the ratings of health care
institutions and placing them on the sites of the executive authorities
of the Russian Federation]. Informatsionnoe pis'mo Minzdravsotsrazvitiya
Rossii ot 14 fevralya 2012 goda ¹14-3/10/2-1243. [Online] [cited 2015
May 18]. Available from: http://www.rosminzdrav.ru/documents/6913-informatsionnoe-pismo-minzdravsotsrazvitiya-rossii-14-3-10-2-1243-ot-14-fevralya-2012-g (In Russian).
-
Ob informatsii, neobkhodimoy dlya provedeniya nezavisimoy otsenki
kachestva okazaniya uslug meditsinskimi organizatsiyami, i trebovaniyakh
k soderzhaniyu i forme predostavleniya informatsii o deyatel'nosti
meditsinskikh organizatsiy, razmeshchaemoy na ofitsial'nykh saytakh
Ministerstva zdravookhraneniya Rossiyskoy Federatsii, organov
gosudarstvennoy vlasti sub"ektov Rossiyskoy Federatsii, organov mestnogo
samoupravleniya i meditsinskikh organizatsiy v
informatsionno-telekommunikatsionnoy seti «Internet»: [About the
information needed to carry out an independent assessment of the quality
of services provided by health care facilities , and requirements to
the content and form of information on the activities of health care
facilities placed on the official websites of the Ministry of Health of
the Russian Federation, authorities of the subjects of the Russian
Federation, local governments and health institutions in Internet
information and telecommunications network]. Proekt vedomstvennogo
Prikaza Minzdrava Rossii ¹956n ot 30 dekabrya 2014 goda. [Online] [cited
2015 May 14]. Available from:
http://www.rosminzdrav.ru/open/discuss/projects/21006 (In Russian).
-
Ob organizatsii raboty po formirovaniyu nezavisimoy sistemy otsenki
kachestva raboty gosudarstvennykh (munitsipal'nykh) uchrezhdeniy,
okazyvayushchikh uslugi v sfere zdravookhraneniya [On the organization
of work on the formation of an independent system for assessing the
performance of the government (municipal) institutions providing health
services]. Prikaz Minzdrava Rossii ¹810a ot 31 oktyabrya 2013 goda.
[Online] [cited 2015 May 16]. Available from: http://www.rosminzdrav.ru/documents /5363-prikaz-minzdrava-rossii-ot-31-oktyabrya-2013-g-810a (In Russian).
-
Ob organizatsii raboty po formirovaniyu reytingov gosudarstvennykh
(munitsipal'nykh) uchrezhdeniy, okazyvayushchikh uslugi v sfere
zdravookhraneniya [On the organization of work on the formation of the
ratings of government (municipal) institutions providing health
services]. Prikaz Minzdrava Rossii ¹503 ot 12 sentyabrya 2014 goda.
[Online] [cited 2015 May 17]. Available from:
http://www.rosminzdrav.ru/documents/8143-ob-organizatsii-raboty-po-formirovaniyu-reytingov-gosudarstvennyh-munitsipalnyh-uchrezhdeniy-okazyvayuschih-uslugi-v-sfere-zdravoohraneni
(In Russian).
-
Ob utverzhdenii metodicheskikh rekomendatsiy «Organizatsiya provedeniya
sotsiologicheskogo oprosa (anketirovaniya) naseleniya ob
udovletvorennosti dostupnost'yu i kachestvom meditsinskoy pomoshchi pri
osushchestvlenii obyazatel'nogo meditsinskogo strakhovaniya» [On
approval of the guidelines «Organization of the poll (survey) in
population about satisfaction with the accessibility and quality of
medical care in mandatory health insurance»]. Prikaz Federal'nogo fonda
obyazatel'nogo meditsinskogo strakhovaniya ¹118 ot 29 maya 2009 goda.
[Online] [cited 2015 May 16]. Available from:
http://docs.cntd.ru/document/902166028 (In Russian).
-
Ob utverzhdenii Metodicheskikh rekomendatsiy po provedeniyu nezavisimoy
otsenki kachestva okazaniya uslug meditsinskimi organizatsiyami [On
approval of Methodical recommendations on the independent assessment of
the quality of services provided by the health care institutions].
Prikaz Minzdrava Rossii ¹240 ot 14 maya 2015 goda. [Online] [cited 2015
June 16]. Available from: http://www.rosminzdrav.ru/documents/9072-prikaz-ministerstva-zdravoohraneniya-rossiyskoy-federatsii-ot-14-maya-2015-g-240-ob-utverzhdenii-metodicheskih-rekomendatsiy-po-provedeniyu-nezavisimoy-otsenki-kachestva-okazaniya-uslug-meditsinskimi-organizatsiyami (In Russian).
-
Pecherey I.O. O gosudarstvennom kontrole kachestva i bezopasnosti
meditsinskoy deyatel'nosti i kriteriyakh dostupnosti i kachestva
meditsinskoy pomoshchi [On State Control of quality and safety of
medical activity and the criteria of accessibility and quality of care].
Zdravookhranenie 2013; (6): 90-95 (in Russian).
-
Puchalskiy A.N. Metodologicheskie osobennosti formirovaniya
natsional'nogo reytinga meditsinskikh uchrezhdeniy [Methodological
features of the formation of the national rating of health care
institutions]. Meditsina i obrazovanie v Sibiri 2014; (3): 7-12 (in Russian).
-
Rozhkova E.V. Kachestvo meditsinskoy uslugi i ego otsenka [The quality of medical services and its assessment]. Sotsial'nye aspekty zdorov'ya naseleniya
[serial online] 2012 [cited 2015 May 15]; 23 (1). Available from:
http://vestnik.mednet.ru/content/view/389/lang,ru/ (in Russian).
-
Starchenko À.À. Dvuedinstvo sistem gosudarstvennogo kontrolya kachestva
i bezopasnosti meditsinskoy deyatel'nosti i kontrolya meditsinskoy
pomoshchi v ramkakh obyazatel'nogo meditsinskogo strakhovaniya [Double
-unity systems of the government control over quality and safety of
medical activity and control of medical care within the mandatory health
insurance]. Zdravookhranenie 2014; (8): 64-75 (In Russian).
-
Tarasenko E.À. Zarubezhnyy opyt vybora pokazateley kachestva
meditsinskoy pomoshchi dlya postroeniya reytingov meditsinskikh
organizatsiy: uroki dlya Rossii [International experience in selecting
health care quality indicators to rank healthcare organizations: lessons
for Russia]. Sotsial'nye aspekty zdorov'ya naseleniya
[serial online] 2014 [cited 2015 May 17]; 39 (6). Available from:
http://vestnik.mednet.ru/content/view/520/lang?ru/ (In Russian).
-
Kharlamova N.À., Chernova T.V. Reytingovaya otsenka meditsinskikh
uchrezhdeniy: teoriya i praktika [The rating assessment of health care
institutions: the theory and practice]. Rossiyskaya akademiya
meditsinskikh nauk. Byulleten' Natsional'nogo nauchno-issledovatel'skogo
instituta obshchestvennogo zdorov'ya 2013; (1): 346-349.
-
Chumakov À.S., Shoshin À.À., Magomedov À.T., Kachkovskiy D.V., Utkin
S.Yu. Obshchestvennoe mnenie kak forma kontrolya za mediko-sotsial'noy
effektivnost'yu zdravookhraneniya (metodologicheskie, metodicheskie i
takticheskie aspekty) [Public opinion as a form of control over medical
and social efficiency of health care (methodological, methodical and
tactical aspects]. Sotsial'nye aspekty zdorov'ya naseleniya [serial online] 2010 [cited 2015 May 20]; 15 (3). Available from: http://vestnik.mednet.ru/content/ view/221/30/ view/221/30/ (in Russian).
-
Austin J.M., Jha A.K., Romano P.S., Singer S.J., Vogus T.J., Wachter R.M., Pronovost P.J. National hospital ratings systems share few common scores and may generate confusion instead of clarity. Health Aff (Millwood) 2015; 34 (3): 423-430.
-
Canadian agency for drugs and technologies in health. Canadian
coordinating office for health technology assessment to Canadian agency
for drugs and technologies in health our history [Online]. 2006 [cited
2015 May 15]; Available from: http://www.cadth.ca/index.php/en/cadth/ corporate-profile/history.
-
Consumer reports: how we rate hospitals [Online]. 2014 [cited 2015 May 12]; Available from: http://www.consumerreports.org/health/resources /pdf/how-we-rate-hospitals/How%20We%20Rate%20 Hospitals.pdf
-
Donabedian À. The criteria and standards of quality. Michigan: Health Administration Press, 1982. 504 p.
-
Hernandez A.F., Fonarow G.C., Liang L.
The need for multiple measures of hospital quality: results from the
Get with the Guidelines-Heart Failure Registry of the American Heart
Association. Circulation 2011; 124 (6): 712-719.
-
Hospital consumer assessment of healthcare providers and systems [Online]. 2015 [cited 2015 May 20]; Available from: http://www.hcahpsonline.org/qaguidelines.aspx
-
O'Donnell J.C., Pham S.V., Pashos C.L, Miller D.W., Smith H. Technology Assessment: Lessons Learned from Around the World – An Overview. Value Health 2009; 12 (Suppl. 2): 1-5.
-
Ryan M., Scott D.A., Reeves C., Bate A., van Teijlingen E.R., Russell
E.M., Napper M., Robb C.M. Eliciting public preferences for healthcare: a
systematic review of techniques. Health Technology Assessment 2001; 5 (5): 1-186.
-
Sabik L.M., Lie R.K. Priority setting in health care: Lessons from the experiences of eight countries. International Journal for Equity in Health 2008; (7): 1-13.
-
Shrimpton B., McKie J., Hurworth R., Bell C., Richardson J. A focus
group study of health care priority setting at the individual patient,
program and health system levels. Monash University: Centre for Health
Economics; 2007. ð.16.
-
Skirbekk H., Middelthon A.L., Hjortdahl P., Finset A. Mandates of trust in the doctor-patient relationship. Qualitative Health Research 2011; (21): 1182-1190.
-
Woohyun C., Sunhee L., Hye Y.K., Myongkeun K. Setting national
priorities for quality assessment of health care services in Korea
[Online]. 2005 [cited 2015 May 12]; Available from: http://dx.doi.org/10.1093/intqhc /mzi018157-165.
Views: 16518
|