THE STATE GUARANTEES PROGRAM OF FREE MEDICAL CARE: APPROACHES TO STANDARDIZE THE COSTS OF MEDICAL CARE
https://doi.org/10.17749/2070-4909.2017.10.4.053-060
Abstract
According to the current legislation, the standards of medical care lay the ground for the development of a program on state guarantees (SGP) to deliver free medical care to the citizens. While this standard provides an opportunity for calculating the costs of implementing the SGP, the past experience indicates the need for changes to produce new standards that would consider the “completed treatment” factor. The article proposes approaches to updating the standards and improving the methodology of cost calculation. In addition, this analysis is expected to help optimize the cost of medical care in various clinical and statistical groups.
About the Authors
Yu. A. Ledovskikh
Centre of Expertise and quality control of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Ledovskikh Yulia Anatolievna – MD, PhD, Chief of the Department of Methodological Support for Standardization, Center for Healthcare Quality Assessment and Control of the MHRF
Khokhlovskii per., 10-5, Moscow, 109028, tel.: +7(495)7831905
E. V. Semakova
Centre of Expertise and quality control of the Ministry of Healthcare of the Russian Federation; Russian Presidential Academy of National Economy and Public Administration, Federal State Educational Institution of Higher Professional Education
Russian Federation
Russian Federation
Semakova Evgeniya Vasilievna – Deputy Chief of the Department of Methodological Support for Standardization, Center for Healthcare Quality Assessment and Control MHRF; research fellow of Centre for health technology assessment of Applied economic research Institute RPANEPA.
Khokhlovskii per., 10-5, Moscow, 109028, tel.: +7(495)7831905; Vernadskogo prospect, 82-1, Moscow, 119571, tel.: +7(499)9569528, +7(499)9569529
M. V. Avksent’eva
Russian Presidential Academy of National Economy and Public Administration, Federal State Educational Institution of Higher Professional Education; Research Financial Institution of the Ministry of Finance of the Russian Federation, Federal State Budget Institution
Russian Federation
Russian Federation
Avxentyeva Maria Vladimirovna – MD, PhD (doctor of medical sciences), Leading research fellow of the Centre for health technology assessment of Applied economic research Institute RPANEPA, Leading research fellow of Centre for health finance of RFIMF and Professor of High school of healthcare administration of the Sechenov First Moscow state medical university.
Vernadskogo prospect, 82-1, Moscow, 119571, tel.: +7(499)9569528, +7(499)9569529
References
1. Perkhov V. I., Yankevich D. S. Menedzher zdravookhraneniya (in Russian). 2017; 9: 55-60.
2. Khal’fin R. A., Kakorina E. P., Vorob’ev P. A., Avksent’eva M. V., Luk”yantseva D. V. et al. Problemy standartizatsii v zdravookhranenii (in Russian). 2004; 9: 3-11.
3. The federal law “On the fundamentals of protecting the health of citizens in the Russian Federation” of November 21, 2011 N 323-FZ [Federal’nyi zakon «Ob osnovakh okhrany zdorov’ya grazhdan v Rossiiskoi Federatsii» ot 21.11.2011 N 323-FZ (in Russian)].
4. Federal Law “On Compulsory Medical Insurance in the Russian Federation” of 29.11.2010 N 326-FZ [Federal’nyi zakon «Ob obyazatel’nom meditsinskom strakhovanii v Rossiiskoi Federatsii» ot 29.11.2010 N 326-FZ (in Russian)].
5. For financial support of the program of state guarantees, it is necessary to approve the standards of medical care in a short time (in Russian). URL: http://audit.gov.ru/press_center/news/18265?sphrase_id=3715911. Accessed: 11.10.2017.
6. Decree of the Government of the Russian Federation of 8 December 2017 No. 1492 “On the Program of State Guarantees of Free Medical Assistance to Citizens for 2018 and for the Planning Period of 2019 and 2020” [Postanovlenie Pravitel’stva RF ot 8.12.2017 N 1492 «O Programme gosudarstvennykh garantii besplatnogo okazaniya grazhdanam meditsinskoi pomoshchi na 2018 god i na planovyi period 2019 i 2020 godov» (in Russian)].
7. Letter No. 11-7 / 10 / 2-8080 of the Ministry of Health of the Russian Federation, ФФОМС N 13572 / 26-2 / and on 21.11.2017 “On methodological recommendations on how to pay for medical care from the means of compulsory medical insurance” [Pis’mo Minzdrava Rossii N 11-7/10/2-8080, FFOMS N 13572/26-2/i ot 21.11.2017 «O metodicheskikh rekomendatsiyakh po sposobam oplaty meditsinskoi pomoshchi za schet sredstv obyazatel’nogo meditsinskogo strakhovaniya» (in Russian)].
8. Order of the Ministry of Health of the Russian Federation of November 6, 2012 No. 584н “On the approval of the standard of specialized medical care for spontaneous childbirth in the occipital presentation” [Prikaz Ministerstva zdravookhraneniya Rossiiskoi Federatsii ot 6 noyabrya 2012 g.№ 584n «Ob utverzhdenii standarta spetsializirovannoi meditsinskoi pomoshchi pri samoproizvol’nykh rodakh v zatylochnom predlezhanii» (in Russian)].
9. Order of the Ministry of Health of the Russian Federation of November 7, 2012, No. 687n “On the approval of the standard for specialized medical care in ankylosing spondylitis, psoriatic arthritis, other spondyloarthritis” [Prikaz Ministerstva zdravookhraneniya Rossiiskoi Federatsii ot 7 noyabrya 2012 g. № 687n «Ob utverzhdenii standarta spetsializirovannoi meditsinskoi pomoshchi pri ankiloziruyushchem spondilite, psoriaticheskom artrite, drugikh spondiloartritakh» (in Russian)].
10. Order of the Ministry of Health of the Russian Federation of December 20, 2012 No. 1266n “On the approval of the standard of specialized medical care for malignant neoplasms of the ovaries (germinogenous ovarian tumors, granulosostromal tumors” [Prikaz Ministerstva zdravookhraneniya Rossiiskoi Federatsii ot 20 dekabrya 2012 g. № 1266n «Ob utverzhdenii standarta spetsializirovannoi meditsinskoi pomoshchi pri zlokachestvennykh novoobrazovaniyakh yaichnikov (germinogennye opukholi yaichnikov, granulezostromal’nye opukholi» (in Russian)].
11. State register of maximum selling prices (in Russian). URL: https://grls.rosminzdrav.ru/pricelims.aspx. Accessed: 11.10.2017.
Review
For citations:
Ledovskikh Yu.A., Semakova E.V., Avksent’eva M.V. THE STATE GUARANTEES PROGRAM OF FREE MEDICAL CARE: APPROACHES TO STANDARDIZE THE COSTS OF MEDICAL CARE. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2017;10(4):53-60. (In Russ.) https://doi.org/10.17749/2070-4909.2017.10.4.053-060
Views: 990
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Email this article 