Compulsory Medical Insurance Fund Research Articles

Budgets of state extra-budgetary funds: legal regulation in the modern period

This article analyzes the legal features of the budgets of state extra-budgetary funds as targeted centralized funds. The legal status of state extra-budgetary funds as legal entities is characterized, and attention is paid to the issue of their organizational and legal form. It is concluded that the Social Fund of Russia, its bodies and divisions constitute a centralized system, however, the system of the Compulsory Medical Insurance Fund and territorial funds, which have significant powers, is decentralized. In addition, general issues of budgetary regulation of funds are considered: the procedure for drawing up and approving budgets, types of income and expenses that assume a targeted nature, the formation and approval of reporting documentation.

Economic efficiency of information management technology for the quality of dispensary observation in patients with coronary artery disease of the last access

Purpose. To economically substantiate the developed technology of information management of the quality of dispensary observation of patients with coronary heart disease using dynamic monitoring and evaluation of digital personalized data on the provided medical care.
 Materials and methods. To improve the efficiency of dispensary observation for angina pectoris, since 2018, the regional health care system of the Orenburg region has been implementing a technology for managing the quality of dispensary observation based on the analysis of big data on medical services and information integration “emergency medical care (EMC), hospital — Territorial Compulsory Medical Insurance Fund + Medical information-analytical center — polyclinic”. To assess the effectiveness of this technology in a group of angina pectoris patients with dispensary observation in the amount of 13,208 patients, we compared the results for 2017 and 2019. 
 the total cost of treatment per year in the polyclinic, EMC, and hospital, economic losses from deaths and financial costs per unit of efficiency. Angina pectoris patients without a myocardial infarction during the observed period of time was taken as a unit of effectiveness. The data were processed using linear statistics and parametric comparison methods. The Statistica 10 software package was used.
 Results. Financial costs for the treatment of angina pectoris for 2017 and 2019 did not differ significantly from each other. The economic losses from premature death have been almost the same over the years. At the same time, the financial costs per unit of efficiency in angina pectoris patients in 2019 accounted for only 76% of the same indicator for 2017, the difference in this indicator was significant.
 Limitations. To assess the effectiveness of information management technology, we analyzed the clinical and economic results of dispensary follow-up for two years in 13,208 patients with angina pectoris, which is a sufficient reference sample.
 Conclusion. The technology of information management of the quality of dispensary observation in coronary artery disease is cost-effective, manifested by a significant reduction in financial costs per unit of efficiency. The analysis of large databases of electronic data on medical services is a tool for economic evaluation of the effectiveness of healthcare management technologies.

Methodological approaches to assessing the effectiveness of financial and economic activities of a healthcare institution

The article reveals a set of issues related to the development of methodological and information support for evaluating the effectiveness of financial and economic activities of healthcare institutions. A critical analysis of existing approaches presented in regulatory and recommendation documents of various legal status, as well as a review of publications by Russian and foreign authors showed that for use in management practice, existing developments need to be improved, adapted to the socio-economic conditions of health care institutions, whose management needs an objective assessment not only of the medical component, but also an analysis the efficiency of using the entire range of resources generated within the framework of the state task, the sources of which are funds from the federal and regional budgets, the compulsory medical insurance fund and income from the provision of paid services. The directions of developing a system of evaluation indicators of effectiveness and efficiency, improving the information base for their analysis, control and forecasting are proposed.

ENDOSCOPIC TREATMENT FOR EARLY COLORECTAL CANCER

Relevance: In recent years, significant breakthroughs have occurred in the endoscopic treatment of cancerous and precancerous lesions of the gastrointestinal tract. Endoscopic mucosal resection (EMR) is a simple and effective method of treating most benign gastrointestinal tract lesions. However, with the introduction of endoscopic submucosal dissection (ESD) and full-thickness endoscopic resection (EFTR), the volume of lesions subject to endoscopic treatment has significantly expanded even in the colon. Currently, these methods are regularly used not only for the treatment of benign tumors but also for complex resection of early stages of colorectal cancer. For the first time in Kazakhstan, the presented article analyzed the cases of endoscopic removal of epithelial formations of the large intestine performed at an oncological clinic from 2020 to 2023.
 The aim was to evaluate the use of endoscopic treatment of early colorectal cancer.
 Methods: The article presents a retrospective analysis of 68 cases of endoscopic removal of epithelial formations of the colon performed from 2020 to 2023 at the Center of Expert Endoscopy and Interventional Radiology of the National Scientific Cancer Center (Astana, Kazakhstan).
 Results: In 2020-2023, 68 endoscopic extractions of colon tumors were performed, including 25 outpatient and 43 inpatient manipulations. Out of 43 inpatient cases, endoscopic dissection in the submucosal layer was performed in 9 cases, and endoscopic mucosal resection of tumors of the large intestine was performed in 34 cases. Morphologically, we found hyperplastic polyps in 11 cases, lipomas in 2 cases, tubulovillous adenomas with mild dysplasia – 43 cases, tubulovillous adenomas with severe dysplasia – 11 cases, carcinoma in situ – 3 cases, and adenocarcinoma with invasion – 3 cases.
 Conclusion: When detecting benign neoplasms with dysplasia and early colorectal cancer, minimally invasive technologies (EMR, ESD, EFTR) should be the first preferred treatment method and only if they cannot be performed and there is a high risk of invasion into the underlying layers, and therefore, if endoscopic treatment is not radical, clinicians should choose surgical radical treatment. Patients should be informed about the availability of the latest methods of local treatment in the Republic through the financing of the Compulsory Medical Insurance Fund (CMIF).

Drug Supply for Patients With Epilepsy Under the Program of State Guarantees in the Kyrgyz Republic

The article presents the results of the analysis of drug provision for patients with epilepsy in Kyrgyzstan under the preferential program of state guarantees within the framework of compulsory medical insurance. The purpose of the study: analysis of preferential drug provision for patients diagnosed with epilepsy in the Kyrgyz Republic. Materials and research methods. Research materials: information data of the Compulsory Medical Insurance Fund under the Ministry of Health of the Kyrgyz Republic. Research methods: content analysis, graphical and statistical methods. Research results. As a result of the analysis of preferential drug provision for patients with epilepsy in the Kyrgyz Republic, data were obtained on assessing the availability of drug therapy for patients in this group. Patients diagnosed with epilepsy in 2022 received a total of 37,616 prescriptions for a reimbursement of about 16.8 million soms. When comparing data with 2021, the number of prescriptions issued to patients diagnosed with epilepsy in 2022 increased by 7485 prescriptions nationwide, and the amount of reimbursement increased by 12.7%. The main number of preferential prescriptions for the analyzed period was issued to the category of insured citizens, persons with disabilities, disabled people. The largest number of preferential prescriptions for patients diagnosed with epilepsy was issued in the southern region of the country - in Osh and Jalal-Abad regions.

FINANCING OF THE HEALTHCARE SYSTEM

The article focuses on the need to achieve the medium-term strategic goals of the state policy of the Russian Federation in the field of healthcare, aimed at increasing life expectancy to 78 years by 2030; reducing mortality and increasing public satisfaction with medical care. The amounts of financing the activities of the healthcare system in the Russian Federation and in the Murmansk region are investigated. A comparative analysis of indicators that are indicative and reportable in the medium-term strategy for the development of the healthcare system of the Russian Federation for the period up to 2030, and in the Murmansk region as the territory of the Arctic zone; their dynamics is investigated. In addition, the structure and dynamics of changes in the amounts of funding from various sources of medical institution activity in the Murmansk region are investigated (the budget of the territorial compulsory medical insurance fund, the consolidated budget of the Murmansk region, the federal budget of the Russian Federation and the own financial resources of the medical institution), recommendations are proposed to improve the efficiency of using budgetary and extra-budgetary sources of funding. It is concluded that the degree of security of the health care system depends not only on the amount of funding, but also on the financial resources management system.

Organization of the stomy patient nutrition. Choice of food substrate

Feeding through an artificial fistula is used to organize the nutrition of patients with prolonged severe dysphagia. Gastrostomy is the most common operation to provide nutrition when oral intake is not possible. According to the information system of the St. Petersburg Territorial Compulsory Medical Insurance Fund, from 01.01.2015 to 10.20.2020, 2391 operations of imposing a nutritional fistula were paid. The choice of a food substrate for feeding an ostomy patient is difficult. Previously, pureed diets of mixed products were used; since 2000, in large hospitals, these diets have been replaced by branded enteral nutrition. The development of malnutrition, up to kwashiorkor and sarcopenia, has been noted in patients receiving an unbalanced pureed diet for a long time. The real properties of the blended diet do not allow it to be introduced into the gastrostomy without dilution with water. Blockage of gastrostomy tubes, due to the density of nutrition, is one of the frequent problems of such nutrition. On the contrary, branded enteral nutrition is fluid, well balanced in terms of the main food nutrients, vitamins and minerals, with a given energy value in small volumes of liquid. With long-term nutrition with commercial mixtures, intestinal dysbiosis develops with a loss of microbiota biodiversity. In the case of feeding a patient with a blended table, microbial biodiversity is preserved, a number of gastroenterological complaints and allergies or food intolerances to artificial nutrition ingredients are stopped. The choice of food substrate for the patient, its combination of wiped table and branded food is under study.

Способы оплаты первичной медико-санитарной помощи, специализированной (в том числе, высокотехнологичной) медицинской помощи в системе ОМС: логика наиболее актуальных изменений тарифной политики 2023 года.

The article discusses new methodological approaches to the methods of paying for medical care in the compulsory medical insurance system for 2023, including those approved by recently issued regulatory legal acts, as well as joint recommendations of the Ministry of Health of Russia and the Federal Compulsory Medical Insurance Fund (FOMS). The article analyzes the main reasons for changes in the tariff policy and their expected consequences in terms of increasing the motivation of medical organizations. It is noted that there is a need to revise the remuneration systems of employees of medical organizations (primarily state and municipal) in order to more closely link incentive payments with performance indicators used in determining the amount of payment for medical care, which is intended to become an important motivation tool for improving the availability and quality of primary health care and, as a consequence, reducing the need for specialized medical care. An overview of innovations in the payment of high-tech medical care is given.

Drug Provision of Persons Suffering With Iodine and Iron Deficiency Under the Additional Program of Compulsory Health Insurance in the Kyrgyz Republic

In recent years, interest in the problem of treatment and prevention of iodine and iron deficiency has increased, as their prevalence is becoming wider, and the clinical course is more severe. According to the results of medical and demographic studies, most of the country’s population is at risk of developing a deficiency in the intake of iodine and iron, which makes the treatment of iodine and iron deficiency conditions one of the most important medical and social problems for the health care of Kyrgyzstan. The purpose of the study is to study preferential drug provision for people suffering from iodine and iron deficiency conditions, within the framework of an additional program of compulsory medical insurance in the Kyrgyz Republic. Materials and research methods. Data from the Compulsory Medical Insurance Fund under the Ministry of Health of the Kyrgyz Republic. Content analysis, graphical and statistical methods. Research results. The main number of preferential prescriptions for iodine and iron deficiency under the Additional Program of Compulsory Medical Insurance was issued in the southern regions of Kyrgyzstan. The leaders in the number of prescriptions for iodine-containing preparations are preparations under the trade names Iodomarin and Iodbalance, and for iron-containing preparations — the preparation of the pharmaceutical company Sandoz (Republic of Slovenia) under the trade name Ferrum — chewable tablets. The categories of insured citizens “Pregnant women”, “Students” and “Children” have the smallest shares of preferential prescriptions for iodine-deficiency diseases. These categories of citizens belong to socially vulnerable segments of the population, where a low prescription for iodine-containing drugs can adversely affect their health, and also increases the possible risks of various malformations in the fetus. The results of this study will help assess the effectiveness of the functioning of the Additional Program of Compulsory Medical Insurance in the treatment of iodine and iron deficiency conditions, determine the amount of funding for this program in different regions of the country, as well as draw attention to the need for preventive measures and broader awareness of the population about the need for iodine and iron deficiency condition prevention.

The need for types of inpatient treatment and budget forecasting for lung cancer patients with a first established diagnosis

Creating a disease models based on real-world clinical data from the moment of diagnosis is an important task of the healthcare system, it allows to simulate the quantitative need for hospitalizations with various options for necessary treatment and calculate the approximate amount of necessary funding.The study aimsto build a model calculating the necessary volumes of medical care and funding for inpatient treatment of patients with lung cancer.Materials and methods.Anonymized data from the territorial compulsory medical insurance fund and the Department of high-tech medical care for all cases of lung cancer and metastases of any localization (ICD-10: C34 and C77-78) for residents of St. Petersburg, who received medical care from 2011 to 2020. Data from the population cancer registry database for all lung cancer patients in St. Petersburg since 2000.Results.More than 75 % of hospitalizations occur within 1 year from the moment of diagnosis: 68 % — chemotherapeutic treatment, 17 % — surgery, 3 % — radiotherapy. In the first year, 1 patient with stages I and II has an average of 2 hospitalizations, III and IV — 3. The calculated by the model number of hospitalizations in the 2 236 lung cancer patients in 5 years is 7 108. Payment for inpatient care based on the tariffs of the federal fund of 2022 and the number of newly diagnosed lung cancer diagnoses for five years will cost the healthcare system 1.1 billion RUR, and more than 74 % of this amount is the cost of 1 year of treatment. During the 5 years, surgery will cost 145 million RUR, chemotherapy — more than 898 million RUR, and radiotherapy — 37 million RUR.Conclusion.The developed on the real-world clinical data model can be used to calculate the necessary healthcare needs and its costs.

The analysis of application of telemedicine technologies in the Russian Federation in 2019-2022

Over the past five years, development of telemedicine was accompanied by many changes. Despite the need for remote medical care, development of telemedicine technologies was not uniformly intensive, both in different countries and in regions of a single state (such as Russia). The purpose of the study is to evaluate dynamics of volume of medical care and number of types of services using telemedicine technologies in regions of the Russian Federation. The retrospective analysis was applied to data retrieved from the Form of the Federal Statistical Observation № 30 of 2019-2021, from documentation of territorial programs of state guarantees of free medical care of population and tariff agreements in regions of the Russian Federation in 2021-2022 and from the Federal Telemedicine System in 2021. The study established that total number of telemedicine consultations increased in 2021 by 23% as compared with 2020. The percentage of consultations financed by the Compulsory Health Insurance Fund also increased from 6.95% in 2020 to 11.72% in 2021. The number of patients being on remote monitoring increased in 2021 up to 44% as compared to 2020. In addition, percentage of patients receiving medical care through remote monitoring and financed by the Compulsory Medical Insurance Fund increased from 6.55% in 2021 to 19.96% as compared with 2020. In the territorial programs of state guarantees for seven regions of the Russian Federation the number of types of telemedicine services fixed in tariff agreements increased in 2022 as compared to 2021. However, it decreased in ten regions. The most common medical care profiles for which telemedicine consultations in the "physician-physician" format were provided by Federal medical organizations in 2021 were: oncology (55 regions of Russia requested consultations on this profile), pediatrics (45 regions), and intensive-care medicine (39 regions). The telemedicine solutions are in high demand, as it is demonstrated by increasing both of volume of remote medical care and of percentage of consultations financed by the Compulsory Medical Insurance Fund. The COVID-19 pandemic had rather strong impact on development of telemedicine. The alignment of market for telemedicine services in public health sector began in 2021 and it is confirmed by decreasing of total number of consultation types in tariff agreements in 2022. In terms of remote interaction in "physician-physician" format, situation continues to be stable. In the nearest future one should expect more gradual development of telemedicine in Russia with appearance of individual initiatives in terms of pilot projects and experimental law modes.

Analysis of sources of financing of medical care in the Russian Federation

The subject of the study is the sources of financial support for state guarantees of free medical care to citizens in the Russian Federation. Particular attention is paid to the analysis of the composition and structure of the financial support of state guarantees of free medical care to citizens (including the volume of contributions received by the budget of the Federal Compulsory Medical Insurance Fund for working citizens and for non-working citizens). The authors also assessed the potential volume of MHIF budget revenues from the payment of insurance premiums and compared the results obtained with actual data. Research methods used: structural and dynamic analysis, synthesis, comparison, as well as graphical presentation of the results obtained. Based on the results of the study, it was revealed that contributions for the non-working population are paid from regional budgets. Taken together with the use of funds from the federal budget for the implementation of the program of state guarantees for the provision of free medical care to citizens, this allows us to conclude that the budgetary financial mechanism is predominantly used in financial support for the implementation of state guarantees of free medical care to citizens in Russia. In order to maximize the volume of funds for solving problems in the field of healthcare, as well as ensuring their more efficient use, the authors propose expanding the list of objects subject to insurance premiums, as well as a more reasonable approach to establishing various preferential regimes that reduce the volume of budget revenues of the Federal Compulsory Health Insurance Fund. The author’s calculations showed that the actual revenues of the MHIF budget are approximately half of the potential ones.

General taxes or insurance premiums: a comparison of funding sources for public health care in OECD countries

The subject of the study is a comparison of funding sources for public health care in OECD countries. The authors consider in detail the sources of financial support for the implementation of state guarantees for the provision of free medical care to citizens: transfers from state internal revenues (primarily general taxes: mandatory payments that do not have a target link) and insurance premiums (mandatory payments with a specific target link). The authors grouped the OECD countries depending on the share of sources of financial support for the implementation of state guarantees for the provision of free medical care to citizens. Particular attention is paid to the advantages and disadvantages of insurance and budgetary financial mechanisms for financial support for the implementation of state guarantees for the provision of free medical care. The main conclusions based on the results of the study are as follows: in the modern world, issues of improving the healthcare system as one of the key factors in improving the quality of life of citizens are being actively raised; no matter how actively the budgetary financial mechanism is currently used in the country, its use by public authorities in OECD countries is constantly increasing; the use of the budgetary financial mechanism, despite the existing shortcomings, has a number of advantages compared to the insurance one (primarily, due to the smaller direct impact during periods of reduction in the number of employees and wages, as well as economies of scale in the administration of revenues in the form of general taxes compared to insurance contributions). The results obtained can be used in the practical activities of the Federal Assembly of the Russian Federation, the Government of Russia, the Federal Compulsory Medical Insurance Fund, as well as public authorities from other countries when modernizing the state policy in the field of healthcare.

Information quality management of ambulatory outcome in patients with coronary artery disease

Highlights. Using the big data databases of provided medical services belonging to the Territorial Compulsory Medical Insurance Fund and the Unified State Healthcare Information System (USHIS), clinical and statistical analysis of ambulatory follow-up of patients with coronary artery disease was carried out, an algorithm was developed and the effectiveness of the presented information management technology was determined.Aim. To assess and justify the developed information management technology for the quality management of ambulatory follow-up of patients with coronary artery disease (CAD) based on monitoring and analyzing electronic personified data on medical services.Methods. In 2018 the Territorial Compulsory Medical Insurance Fund (TCMIF), the Medical Information and Analytical Center (MIAC) and healthcare organizations of the Orenburg Region implemented information management technology to assess the quality of ambulatory follow-up in patients with CAD, which is based on big data analysis of medical services and information integration “emergency medical services (EMS), hospital-TCMIF + MIAC-polyclinic”. To assess the effectiveness of the technology, the proportion of patients with myocardial infarction (MI), death from coronary artery disease, emergency hospitalizations and emergency calls for angina pectoris were compared. The study involved two groups of patients: 13 208 ambulatory patients with angina pectoris and 4017 patients without follow-up, according to the TCMIF reports in 2017. Out of the 13,208 patients with angina pectoris in 2019, 10,205 patients with continued follow-up presented with the same clinical endpoints. Patients with these unfavorable outcomes in proportion to the total number of patients in each group in 2017 and 2019 were compared as well.Results. The developed and implemented information management technology led to an increase in the number of ambulatory patients with angina pectoris from 63 to 69%, with MI from 78 to 87%, and a reduction of emergency calls and emergency hospitalizations of patients with angina pectoris in the region in 2017 and 2019.Conclusion. Information quality management of ambulatory follow-up of patients with coronary artery disease using electronic personalized data on medical services increases the number of ambulatory patients with angina pectoris and myocardial infarction, and decreases the number of unfavorable outcomes of patients with angina pectoris.

Оценка экономического бремени псориаза в республике Башкортостан

Psoriasis is one of the most common chronic dermatoses, leading to disability of patients. The damage from it is comparable to the damage from atrial fibrillation, lung cancer, breast cancer. P u r p o s e of our study was to determine the economic burden of psoriasis in the Republic of Bashkortostan, depending on the volume of costs for different treatment options. M a t e r i a l s a n d m e t h o d s . The paper calculates the economic burden of psoriasis in the Republic of Bashkortostan based on official data from the Medical Information and Analytical Center of the Republic of Belarus, the Territorial Compulsory Medical Insurance Fund of the Republic of Belarus and Bashkortostanstat for the period 2020-2021. R e s u l t s . There is increase in the number of patients with psoriasis in the Republic of Bashkortostan for the period 2012-2021. The total economic burden of psoriasis in the Republic of Bashkortostan is 896970909,00 rubles in year (66055,7 rubles per patient), including: for all types of treatment, taking into account the funds of the patients themselves, 559028692,5 rubles are spent, for temporary disability benefits 300293897,6 rubles, disability benefits 37648318,9 rubles. The largest proportion of patients regularly treated for psoriasis are patients receiving therapy both in a hospital and in a polyclinic (42,1%). The allocated volumes of high-tech medical care, as well as genetically engineered biological therapy in the Republic of Bashkortostan are insufficient to provide all patients in need with these types of assistance. One third of patients with psoriasis (33,6%) do not seek treatment from dermatovenereologists. C o n c l u s i o n . The results obtained indicate the need for further detailed study of the issue of economic costs associated with the prevalence of psoriasis in the Republic of Bashkortostan, the development of measures to reduce the incidence of the population, risk factors and relevant policy documents for the resource provision of medical care for patients. The medical, social and economic efficiency of the measures will be expressed by improving the quality of life of patients, reducing the economic damage from temporary disability and disability.

ИННОВАЦИОННЫЕ ФИНАНСОВЫЕ ТЕХНОЛОГИИ РАЗВИТИЯ ЭКОНОМИКИ РОССИИ

The proposed innovative financial technologies for the development of the Russian economy, harmoniously combining the interests of working citizens, owners and the state, make it possible, at quite achievable growth rates of gross domestic product (enterprise revenue) by 3% per year, to ensure a 48% increase in wages of working citizens over 10 years, which will practically end poverty. Increase contributions to the development fund from one employee by 1,843.07 rubles. On average, for a workforce of 100 people, 2,211,684 rubles will be allocated for development per year, with a number of 1,000 people, 22,116,840 rubles will be received, in which, first of all, the owners of enterprises and the entire workforce are interested, since this ensures the growth of their incomes and the possibility of constant modernization and updating of technological equipment and production new competitive products. First, to stabilize, and starting in 2028 to increase contributions to the Pension Fund of Russia and the Federal Compulsory Medical Insurance Fund and income tax, income tax and value added tax receipts and bring this growth to 2.5% by 2030, which will allow the state to solve many social problems. To reduce contributions to the Pension Fund of Russia by 2030 by 13.01% to 8.99% and the Federal Compulsory Medical Insurance Fund by 5.1% to 0%, which will significantly reduce the cost of goods, works and services of all Russian enterprises. When switching to the innovative financial technologies proposed in the article, almost 4 trillion steering wheels will accumulate on the pension and medical accounts of Russian citizens in the first year of implementation. And by 2026, 74 trillion rubles. Providing citizens with 2% per annum, banks will be able to lend to enterprises at 2.5% with a 25% margin, providing the Russian economy with huge, long-term and cheap financial resources.

ИННОВАЦИОННЫЕ ФИНАНСОВЫЕ ТЕХНОЛОГИИ РАЗВИТИЯ РУДНИКА «СЕВЕРНЫЙ» АО «ЭЛЬКОНСКИЙ ГОРНО-МЕТАЛЛУРГИЧЕСКИЙ КОМБИНАТ»

The proposed innovative financial technologies for the development of the Severny mine of the Elkonsky Mining and Metallurgical Combine, harmoniously combining the interests of working citizens, owners and the state, make it possible, at quite achievable growth rates of gross domestic product (enterprise revenue), to ensure a 4.08-fold increase in wages of employees over 5 years, to increase contributions to the development fund over 5 years in 16.32 times, in which, first of all, the owners of enterprises and the entire workforce are interested, because this ensures the growth of their income and the possibility of constant modernization and updating of technological equipment and the release of new competitive products. In addition, deductions to the Pension Fund of Russia and the Federal Compulsory Medical Insurance Fund and income tax, income tax and value added tax over 5 years will increase by 4.26 times, which will allow the territorial authorities to solve many social problems.

ИННОВАЦИОННЫЕ ФИНАНСОВЫЕ ТЕХНОЛОГИИ РОСТА ЗАРАБОТНОЙ ПЛАТЫ И ОТЧИСЛЕНИЙ НА РАЗВИТИЕ РУДНИКА «СЕВЕРНЫЙ» АО «ЭЛЬКОНСКИЙ ГОРНО-МЕТАЛЛУРГИЧЕСКИЙ КОМБИНАТ»

The proposed innovative financial technologies for the development of the Severny mine of the Elkonsky Mining and Metallurgical Combine, harmoniously combining the interests of working citizens, owners and the state, make it possible, at quite achievable growth rates of gross domestic product (enterprise revenue), to ensure a 3.86-fold increase in wages of employees over 5 years, to increase contributions to the development fund over 5 years in 10.58 times, in which, first of all, the owners of enterprises and the entire workforce are interested, because this ensures the growth of their income and the possibility of constant modernization and updating of technological equipment and the release of new competitive products. Increase contributions to the Pension Fund of Russia and the Federal Compulsory Medical Insurance Fund and income tax, tax on profit and value added tax for 5 years by 4.26 times, which will allow territorial authorities to solve many social problems.

Principles of laboratory service management in modern conditions

Introduction. Today, the medical laboratory is focused on operational efficiency and cost control. Our work presents the experience of transforming laboratory practice, its informatization and reorganization of the management model. Purpose of the study. Creation of a management model for fast, economical and high-quality testing in laboratories of various levels to provide Muscovites with laboratory services in full. Materials and methods. An assessment of the resource support of clinical diagnostic laboratories (CDL) of the Moscow City Health Department (MCHD) number of attached population and the need for tests, made it possible to develop and implement concepts for their centralization in the outpatient clinic link, unify the nomenclature of laboratory studies and tests, create a unified reference book of laboratory studies (IF) for the centralized laboratory service (CLS) of the unified medical information and analytical system (UMIAS), develop a plan for the development of a quality management system based on international standards and begin the activity on the standardization of laboratory services through accreditation of medical laboratories in the national accreditation system, manage centralized large-scale screening for SARS-CoV-2; implement sequencing technology (NGS) for genomic surveillance. Results. The MCHD laboratory service is built according to a 3-level system. There is a complex IF EMIAS. Laboratory studies are computerized, test results are transferred to the personal account and the patient’s electronic medical record. A single information space has been created for all CDL MCHD. The tariffs for laboratory services of the registry of the Moscow City Compulsory Medical Insurance Fund (MCCMIF) have been changed, the list has been optimized. Under the control of spending, the productivity of laboratories has increased. Moscow’s needs for laboratory services have been met. Research limitations. The scenario of managerial approaches was carried out in a strategic partnership with MCHD, proved to be viable only in the conditions of the city of Moscow. Conclusion. The problems of precision medicine have been solved and the sustainable provision of laboratory services to the population by the clinical diagnostic laboratories of the MCHD has been ensured.

Current trends in the functioning of the Territorial Compulsory Medical Insurance Fund of the Republic of Dagestan

Current trends in the functioning of the Territorial Compulsory Medical Insurance Fund of the Republic of Dagestan