On the issue of Moscow health care reforms: a review of publications

Abstract

The article presents review of scientific publications from databases of CyberLeninka and RSCI related to Moscow health care reforms within the framework of the Moscow State program "The Development of Moscow health care (Metropolitan health care) for 2012-2020". The analysis established that during reforms positive shifts in Moscow health care system occurred, expressed by significant improvement in material and technical base of institutions, implementation of new diagnostic and treatment technologies, increasing of salary of medical workers, implementation of information technologies. However, the Moscow health care system continues to encounter challenges from problems related to staffing (especially the district service), high workload of medical personnel, insufficient level of motivation and low level of qualifications of medical workers. The implemented system of general medical practice did not contribute into strengthening the role of district physician as coordinator of patient flows. The fragmentation and lack of continuity in functioning of health care institutions remains too. The hospital-replacing technologies, designed to compensate reduction in beds, have not received development in primary health care. because of lacking of economic incentives for institutions and low tariffs. The serious problems associated with shortcomings in organization of functioning of medical institutions are established that requires further improvement of methods of analyzing functioning of medical institutions and organizational activities at all levels, considering effectiveness of activities implemented.