DOI: 10.21045/2071-5021-2017-58-6-9

Uiba V.V., Stasevich N.Yu., Olenev A.S., Aliev A.K.
Institute of advanced training, Federal Medical and Biological Agency (FMBA), Moscow, Russia

Contacts: Stasevich Natalya, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
StasevichN.Yu., http://orcid.org/0000-0002-2965-4986
Acknowledgments. The study was supported by the Russian Federal Medical and Biological Agency.
Conflict of interests. The authors declare no conflict of interest.

Significance. Formation of new social and economic relations requires fundamentally different systems and mechanisms of management: management in the new context should be more adaptive to mechanisms of the market self-regulation. Healthcare system itself becomes qualitatively different and requires an innovative approach to manage a health care facility.

Problems of strategic planning and management are related with the evolving management systems where heads of health care facilities play a key role.

Purpose: to typologically classify heads of health care facilities making managerial decisions as a subject of the healthcare system.

Methods: the study used expert estimations, statistical methods, grapho--analytical method and simulation. The survey used sampling. A mixed sample was used.

Results. To identify typological features of head physicians of the Moscow health care facilities the survey used the following two questions: "What guides you in making administrative decisions?" and "What would do you do if job descriptions conflict with your experience?".

Responses to the second question helped to divide all heads of health care facilities into the following three groups:

1. The nonconformists (heads who can refuse performing a wrong in their opinion order and are ready to deal with the higher authorities for its change or cancellation (52%).

2. The conformists (heads who neither express a straight refusal to comply with superior orders nor rush to fulfill them (34%).

3. The capitulators (heads, unconditionally implementing any orders coming from above (13%). 

Conclusions. 1. Most heads consider reforming of healthcare a necessity; almost half of them believe that the reforms are being implemented in the wrong direction.

2. Most head physicians consider maintenance of compulsory health insurance the main direction of healthcare reforming, acknowledging however, that reforming should not be limited solemnly to this.

Keywords: head physicians; heads of health care facilities; compulsory health insurance; healthcare reforming; provision with resources; satisfaction of heads of medical institutions with their position.

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