РАЗРАБОТКА РЕКОМЕНДАЦИЙ ПО ФОРМИРОВАНИЮ ТАРИФА ОМС ДЛЯ УХОДА ЗА НЕДОНОШЕННЫМИ ДЕТЬМИ

Abstract

Premature babies require special care and medical care, the cost of which is often quite high. In Russia, medical care for premature infants is provided in the system of compulsory medical insurance (CHI). However, the current tariffs do not correspond to the real situation. As a result, there is a shortage of funding for medical organizations, which directly affects the quality of services provided. The article is devoted to the analysis of recommendations on the formation of the compulsory medical insurance tariff for children born prematurely. The domestic and foreign experience is being investigated. An estimate of the costs of care, nursing and rehabilitation of premature infants is given. An important aspect in the development of recommendations for the formation of the CHI tariff is the participation of experts in the field of healthcare, including pediatricians, neonatologists, obstetricians and gynecologists and other specialists familiar with the problems of caring for premature babies. They can provide valuable information about the required level of medical care, possible complications and required resources. Based on the analysis of the costs of caring for premature babies in Russia, recommendations are formulated for the formation of compulsory health insurance tariffs: the inclusion in the tariff of the cost of all necessary procedures and medical services related to the care of premature babies; the determination of the tariff depending on the age and body weight of the child at birth, the presence of complications, the length of hospital stay, the level of medical services and qualifications of medical personnel; regular updating of tariffs taking into account changes in the cost of medical services and procedures; ensuring the availability of high-quality medical care for premature babies, despite their social status. In addition, the main factors affecting the cost of caring for premature babies have been identified. The developed recommendations can help improve the quality of medical care for premature babies and reduce the socio-economic burden on their parents.