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«Public Administration Issues» Journal,

Post. address:
National Research University
Higher School of Economics
20 Myasnitskaya Str., Moscow 101000, Russian Federation
Location address:
of. 307, 4/2, Slavyanskaya sq., Moscow 109074, Russian Federation

Tel./fax: 7 (495) 772-95-90, ext. 12631

E-mail: vgmu@hse.ru 

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two-year impact factor for 2019: 2,631
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Research and educational journal
Published quarterly since 2007
ISSN 1999-5431
E-ISSN 2409-5095

Sergey Shishkin 1, Oleg Apolikhin  2, Svetlana Sazhina 1, Igor Shaderkin  3, Oleg Zolotukhin 4, Michail Prosyannikov  5
  • 1 National Research University Higher School of Economics, 20 Myasnitskaya Str., Moscow, 101000, Russian Federation
  • 2 Doctor of Science, Professor, Head of the Institute of Urology of the Hertsen FMRC MH RF, 51 3rd Parkovaya St., Moscow 105425, Russian Federation
  • 3 MD, Head of the Development Department of regional urology of the Institute of Urology of the Hertsen FMRC MH RF, 51 3rd Parkovaya St., Moscow 105425, Russian Federation.
  • 4 Chief specialist in urology DZ C. O., Head of the Department of urology and andrology, VSMA, Voronezh State Medical Academy named aft er N.N. Burdenko.10 Studencheskaya St., Voronezh 394036, Russian Federation.
  • 5 MD, Research Assistant of the development Department of regional urology of the Institute of Urology of the Hertsen FMRC MH RF, Institute of Urology of the HertsenFMRC MH RF, 51 3rd Parkovaya St., Moscow 105425, Russian Federation.

Improving effectiveness of the specialized medical care: the case of restructuring

2015. No. 2. P. 79–99 [issue contents]

The paper addresses the issues of organization of medical care in the Russian Federation and explores the case of specialized medical care restructuring. The new approach towards specialized medical care povision is suggested as an alternative to the prevalent understanding of the restructuring such as reduction of hospital beds, hospitals and their staff for financial reasons. The new approach includes (1) a four-level system of medical aid, (2) the expansion of disease prevention, (3) the introduction of standardized approaches in routine work, (4) a thorough quality control at all levels of medical care.

The pilot project of the restructuring of urologic medical care started in 2010 in Voronezh region. The empirical data were provided by the Institute of Urology (Moscow) and Voronezh Regional Health Department.

The implimentation of a new approach revealed poor performance of the primary medical care provision. The outcomes of the pilot project were an increase in detecting diseases and in the availability of specialized outpatient and inpatient care. The overcoming of the previous system’s flaws caused the need to increase health care costs. However, the introduction of new organizational technologies, providing urological care, resulted in lower unit costs by 21.7% over four years.

Experience of the structural reform presented in the article shows that in cases where inefficiency of the health care system is associated not only with unreasonably high costs for treatment of diseases, but also with insufficient or delayed detectability of diseases, introduction of new approaches to the organization of health care does not lead to saving costs, but to increasing effectiveness and efficiency of health care provision.

Citation:

Shishkin, S.V., Apolikhin, O.I., Sazhina, S.V., Shaderkin, I.A., Zolotukhin, O.V. & Prosyannikov, M.Y. (2015). Povyshenie effektivnosti spetsializirovannoi meditsinskoi pomoshchi: opyt strukturnykh preobrazovaniy [Improving effectiveness of the specialized medical care: the case of restructuring]. Public Administration Issues, n. 2, pp. 79–99 (in Russian).

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ISSN 1999-5431
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