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Tuesday, 20 October 2015

Stasevich N.Yu.¹., Lassky I.A.²
¹ Russian Medical Academy of Postgraduate Education, Moscow
² City Clinical Hospital named after A.K. Eramishantsev, Moscow Healthcare Department, Moscow

Contacts: Natalya Yu. Stasevich, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Abstract. Significance. Ongoing restructuring of the healthcare system in Russia is focused on ensuring stable functioning of health care facilities, improving their health and social and economic performance, and should be implemented with active use of materials and equipment, financial resources and personnel, which, if necessary, can be redistributed to address priorities.

The purpose of the work was to evaluate the role of medical and organizational and economic technologies in assessing quality of health care and improving health on the basis of the comprehensive social and hygienic study.

Results. Introduction of the result-targeted reimbursement of the contracting health care specialists helped to bring about a social effect, manifested in a better labor discipline, significant (p <0.001) reduction in the number of administrative punishments (by 2.3 times), and violations of the labor discipline (by 4.1 times), and, on average, a double increase in salaries including an average increase in doctorsĺ salary by 34.2%, nurses ľ by 44.3% and paramedicals - by 80.0%.

Medical efficiency of the introduced differentiated reimbursement manifested in a reliable (p <0.001) 1.3 time increase in the share of patients who were discharged recovered (from 51.4% to 66.5%), and with improvements (from 16.8% to 22.3%) and a 1.5 time reduction in the number of patients who were discharged in a worsened condition (from 2.7% to 1.8%) and a 1.4 time decrease in deaths (1.5% to 1.1%), and a 1.8 time increase in the share of patients satisfied with quality of health care (from 52.9% to 94.1%).

Conclusion. To assess quality of health care it is advisable to use objective criteria, based on a comprehensive assessment of the facility and health indicators of its patients, and subjective assessment of quality of health care by staff and patients; though those criteria are affecting different characteristics of quality of diagnostic and treatment process, in general they aim at increasing the level and quality of health services allowing for a timely and comprehensive adjustment of medical and organizational, economic and medical technologies that are being implemented at health care facilities.

Keywords: program; quality of medical care; economic feasibility; technology.


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