Застосування непараметричних методів оцінки ефективності діяльності закладів первинної медико-санітарної допомоги

Abstract

The medical reform carried out in Ukraine in recent years has led to the emergence of a number of managerial problems faced by the heads of health care institutions. Now they are forced to perform the entire scope of management functions, including the assessment and analysis of performance of the headed institutions. The article poses the problem of inconsistency of the arrays of primary data for assessing and analyzing the efficiency of health care institutions and secondary economic and statistical models of processing these data in order to useful information support regarding the actions of the management of institutions. The structure and content of primary data do not fit any model of further processing due to the non-compliance of the system for collecting arrays of primary data with the key requirements and principles of forming such arrays. The purpose of the article is to identify, on the basis of the calculation experiment, the key problems of domestic approaches to the formation of primary data for the use of non-parametric models for assessing the performance of health care institutions and to develop recommendations for solving these problems. To solve the tasks set, the world experience on the effective application of non-parametric models for evaluating the effectiveness of health care institutions was analyzed, the appropriate factual material was selected and a calculation experiment was carried out to establish a simple causal relationship between the indicators of evaluation of health care institutions, which are components of statistical accounting indicators approved by the State in this sphere. It is found that currently a very large number of indicators are used for evaluation, with excessive use of cost effectiveness indicators, while the statistical relationship of the behavior of indicators against each other is insignificant or absent altogether because the dominant principle of the selection of indicators is statistical availability and regularity of initial data. The main directions of solving the indicated problem are: changing approaches to the formation of primary indicators for the activities of health care institutions in general, necessarily basing not on the simplicity of their calculation, but on the requirements of models of further economic and statistical processing; structuring of the primary information base according to the directions of institutional interaction at the local level and uniform filling with appropriate and adequate assessment indicators by each of the directions.