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Abstract on the theme of master's work

Contents

Introduction

The importance of health in the life of each state can not be overemphasized. At present, the health care sector fulfills the functions assigned to it, primarily through financing and proper state regulation. The basis of the latter is the legal framework, which determines the legal status of bodies, institutions and officials in the field of health. It is through management that the system of organization and medical care acquires efficiency, which contributes to the fullest implementation of the tasks assigned.

Healthcare is a system of activities aimed at ensuring the preservation and development of physiological and psychological functions, optimal working capacity and social activity of a person at the maximum biologically possible individual life expectancy.

1. Actuality of the theme

In the context of health care reform, healthcare organizations face the challenge of managing on the basis of anticipating change in order to anticipate future trends and develop an appropriate strategy for sustainable and effective functioning. The lack of a strategic vision in healthcare organizations makes it difficult to forecast the results of activities, the possibility of timely making adjustments to the management process.

2. Goal and objectives of the study, planned results

The goal is to improve the theoretical and methodological framework and formulate practical recommendations for developing a strategy for managing the activities of the healthcare organization.

To achieve this goal, the following tasks are defined:

  1. Explore the theoretical foundations of strategic management in health care.
  2. Describe the characteristics of management strategies for the health organization.
  3. Propose a mechanism for planning and selecting a management strategy for the health care organization.
  4. Identify the most effective strategy for managing the healthcare organization's activities in the context of change.

Research Object : theoretical, methodological and practical aspects of the process of strategic management of healthcare organizations.

The subject of the research : the mechanism of the process of strategic management of the healthcare organization.

Planned results. In the course of the master's work, a strategy will be developed to manage the activities of the healthcare organization in the DPR, taking into account the current unstable crisis situation.

Scientific and practical significance. The theoretical significance of the results is to summarize the scientific information for selecting possible types of strategies in the health care system; determining the need for further improvement of approaches for choosing an effective strategy for managing the activities of the health care organization.

The practical importance of the master's work is to develop the most effective strategy for managing the activities of the healthcare organization.

Scientific novelty. The scientific novelty consists in justifying the theoretical and methodological basis for choosing a strategy for managing the activities of the healthcare organization in the conditions of carrying out changes in order to increase the efficiency of functioning.

3. Overview of Research and Development

The problem of choosing a strategy for managing the activities of the healthcare organization is very relevant and is the subject of research by many domestic and foreign authors.

3.1 Overview of International Sources

Many special studies and monographs have been devoted to theoretical and methodological aspects of strategic management. A huge contribution to the formation and development of this section of management science was made by J. Quinn, C. Andrews, M. Porter [8 – 9], F. Kotler [6], etc.

The notion and term of strategic management were introduced into the scientific revolution in the early 1970s to mark the differences between the management of current production processes and top–level management, the focus of which should be the external environment of the object management. Strategic management as a new approach to management was formed in 1970–1980. Strategic management is closely related to planning and economic analysis. In connection with this, the strategic management definition formulated by I. Ansoff [1] as an interlinked complex of planning the strategy for organizing and implementing the developed plans into life .

3.2 Overview of national sources

The studies summarize the main categories in the definition of strategy and strategic management as the main components of the economic activities of organizations.

In the opinion of Chernyshev M. [12]: A number of reasons led to a sharp increase in the importance of strategic management, the main ones being: accelerating changes in the environment; the emergence of new requests and changes in the consumer's position; increasing competition for resources; the emergence of new unexpected opportunities for business, discovered by the achievements of science and technology, etc. There is no strategy unified for all companies, just as there is no single universal strategic management. Each company is unique in its kind, and therefore the process of developing a strategy for each company is unique.

3.3 Overview of local sources

There are students on the Magisters Portal who also dealt with the problem of choosing a strategy for managing the activities of the organization during the writing of the master's work.

In the work of Braga K. the types of strategies are considered, the foundations for the formation of the principles for selecting an enterprise development strategy are given, and a number of recommendations are given on the formation of an enterprise development strategy for improving the management process [3].

In the study of the master Deminskaya Y. generalized approaches to the definition of enterprise development strategy, identified trends in the development of strategies, proposed the development of a strategy for the development of a machine–building enterprise [5].

However, in all the above sources, the problems of choosing a strategy for managing the activities of the healthcare organization in the light of changing conditions are not sufficiently reflected. In this regard, it is necessary to deepen the work on finding ways, developing and generalizing the results.

4. Strategic management in public health services

Strategic management is a system process that provides the creation of the concept of the organization's activities (strategies) and orientates all the subjects of the system and all activities to achieve strategic goals.

The management hierarchy includes 3 levels:

  • strategic;
  • tactical
  • online.

At the strategic level, a strategy is formed, which includes: analysis; forecast; planning; deciding what to do. The strategic level of management in health care includes:

  • Ministry of Health of the People's Democratic Republic
  • health authorities of the DPR
  • heads of independent medical organizations.

The tactical level of management guides the implementation of the strategy, which includes: planning and deciding how to do it. To the tactical level of management in health care are:

  • the heads of the main structural divisions of the health authorities
  • deputy heads of independent medical organizations;
  • heads of medical organizations that make up the medical association

At the operational level of management is carried out the management of the implementation of specific measures of the strategy, which includes: organization, regulation of work; accounting, execution control, analysis of the completeness of the implementation of activities.

The operational level in health care includes:

  • heads of grass–roots structural divisions of health management bodies: department department (management)
  • heads of structural units (departments) of medical organizations.

Strategic management includes:

  • system analysis of organizations' activities
  • Strategic planning
  • ensuring that operational plans are in line with strategic plans
  • the formation and management of organizational structures involved in the implementation of strategic plans
  • monitoring and evaluating the implementation of strategic plans [4].

The strategic goal of public health policy in the DPR is to improve people's health through the provision of affordable health care, as well as the development of a healthy lifestyle culture and the expansion of preventive measures. At the same time, the main priorities and tasks of state policy are determined.

The main priorities and objectives of public health policy are:

  1. Reduction of diseases, the spread of which is a particular threat to public health and national security:
    • Decrease in premature mortality:
      • from diseases of the circulatory system
      • from accidents (injuries and poisonings)
      • from malignant neoplasms.
    • Fighting diseases of particular importance to the demographic situation in the country (diseases that threaten the reproductive health of the mother and father, neonatal health)
    • Fighting diseases that pose a particular threat to the health of the nation (tuberculosis, HIV / AIDS, drug addiction, sexually transmitted diseases).
  2. Expansion of measures to prevent morbidity and health:
    • mass health screening of healthy people
    • development of the system of regenerative medicine.
    • the formation of a system of self–improvement of the population.
  3. Ensuring the availability of quality medical care to the public:
    • Strengthen PHC; development of the institute of general practitioner
    • Improving the structural effectiveness of health care by optimizing the network of medical organizations, reducing the hospital volume of medical care while developing inpatient substitution technologies
    • Development and implementation of modern methods of prevention, diagnosis and treatment of diseases, medical rehabilitation of patients in medical practice
    • Optimizing health care financing.
  4. Development of human resources.

5. Characteristics of strategies for managing the activities of the health organization

In order to develop competitive strategic solutions, system, integrated, integration, marketing, functional, dynamic, reproductive, process, regulatory, optimization, administrative, behavioral, situational and other approaches should be applied to the development process [2].

To date, there are the following problems in the planning and economic health care system:

  1. Strategic management is being introduced slowly in the organizations of the industry.
  2. At the regional level (meso level): when developing territorial programs, demographic indicators, the balance of the population's needs (demand) in types of medical care with the level of its financing, and the opportunities (proposals) of medical organizations to provide it are not fully taken into account.
  3. There are no rational forms of interaction between state and market institutions for resource provision of health care
  4. There is no strategic vision for implementing resource–saving technologies in the industry.

The development of the health care organization in conditions of change should be based on the introduction of strategic management to improve the management process, the planning system and economic support. To implement strategic management in the organization of health care, a choice of strategy is required [10].

As part of the development (growth) strategy, problems of planning in the industry under conditions of change are considered. Planning in the conditions of a regulated market of medical services – the need for an optimal combination of the role of planning and market regulators, maintaining the social orientation of goals and objectives, ensuring the balance of sectoral and territorial interests.

The system of state (municipal) assignments for the implementation of the volume of medical assistance within the framework of the program of state guarantees for the provision of free medical care to the population is one of the main planning tools at the macro, meso–, and micro levels [11].

At the meso– and micro level, when planning the activities of health organizations, the following problems exist:

  • imperfection of the regulatory framework for the formation of tasks for the provision of medical care
  • inadequate consideration at all levels of planning of the real needs of the population for medical care, depending on the structure of the incidence and sex and age composition of the population
  • the need to ensure the constitutional rights of citizens to free medical care regardless of the amount of resource support for the assignment
  • the need to increase the availability of care
  • the problem of matching the planned amounts of medical care to the amount of financial resources to provide this assistance
  • planning of the volume of medical care not in accordance with the needs of the population, but based on available financial resources, etc.

In order to improve the planning and economic health care system at the regional or municipal level (meso level), in the conditions of the change, the stages and methods of planning the volumes of guaranteed free medical care to the population of the territory and its resource provision are proposed.

6. The mechanism for planning and selecting a strategy for managing the health organization

Planning stages:

  1. Analysis and assessment of the demographic situation in the municipality (city, district), forecast its dynamics in the forthcoming planned year. When assessing the demographic situation, a description is given of the population, its sex–age composition, natural movement of the population, etc.
  2. Analysis and assessment of the incidence of the population according to the population's request for medical assistance, hospitalization of the population. When analyzing the incidence rate, its level and structure are assessed in different age groups of the population, etc.
  3. Analysis and assessment of disability of the population
  4. Analysis and assessment of cadres, material and financial resources of medical organizations of the municipality, prospects for their development in the coming year.
  5. Analysis and evaluation of medical organizations
  6. The goal and objectives, the priorities of the healthcare development of the municipal formation for the planned period are formed.
  7. The selection of health standards used in planning the volume of medical care provided to the population, the financial standards for the cost of medical care, taking into account its profiles and levels.
  8. Calculation of planned indicators of the volume of guaranteed free medical care to the population of the municipality, taking into account the population's need to receive it
  9. Calculation of the cost of financial costs for the implementation of the planned volumes of guaranteed free medical care to the population of the municipality in accordance with the recommended cost health standards.

Methods of planning the amount of guaranteed free assistance to the population:

  1. The analytical method allows for an in–depth and comprehensive analysis of the processes and phenomena occurring in the health status of the population and in public health.
  2. The comparative method is used for comparative assessment of health indicators of the population, resources and activity of health care institutions by comparing them with the average territorial (federal, regional), similar indicators of other administrative territories, in dynamics by years, etc.
  3. The balance method allows to assess and ensure the proportionality of planned capital investments and financial expenditures in the health of individual territories, the proportionality of the development of the network of health organizations
  4. The normative method is based on the use of a set of norms and norms of healthcare for the purpose of establishing indicators of the development of the network of health organizations
  5. Economic and mathematical methods allow us to scientifically substantiate the most optimal variants of health development plans, to make forecasts for the near and distant future.
  6. The extrapolation method is used to identify trends in indicator changes, allows the construction of predictions of population health dynamics and health development [10].

Calculation of planned indicators of the volume of guaranteed free medical care to the population of a municipal formation, taking into account the population's need for obtaining it:

  1. Calculation of territorial standards for the volume of inpatient medical care, taking into account the actual age structure of the population, the profile of hospital departments and the level of medical care
  2. Calculation of territorial standards for the number of outpatient visits to children and adults, the general population by specialty profiles
  3. Different methods of calculating volume indicators for the planned period.

    4. Along with traditional methods, an alternative method for calculating the volume of health indicators for the planned period is proposed, based not on the traditional approach to calculating the planned indicators depending on the population, but on the real need for emergency medical care, taking into account the level of injuries.

  4. Calculation of financial support for the planned volume of free medical care to the public.

Balancing can be achieved by setting health care tariffs that are adequate to the real costs of providing it, improving the effectiveness of existing mechanisms for financing health care and specifying state guarantees for free medical care.

As part of the strategy of sustaining (the stable functioning of a medical institution), a special role is played by establishing the necessary proportions in the production process and providing resources for medical services to achieve medical, social, economic efficiency.

Recently, scientists working on the problems of the development of economic theory have adhered to the concept of incremental planning, proposing instead of searching for optimal system parameters positions of bounded rationality.

According to Pavlov K. the development of the concept of rational structures and combinations of social elements [7] is one of the promising and very topical directions for the further development of economic theory. The principle of rational combination of economic models is the development of the provision on the optimal correlation of market and state methods of economic regulation.

The analysis will reveal the dependence of the level of development of health care and demographic indicators in countries with different socio–economic systems on the share of state participation in the financing of the industry and conclude that it is necessary to increase public investment of all types of medical services in the amount of at least 62% services. In this case, the financing gap will be 38%, which can be replenished by extrabudgetary sources (private, public).

According to the estimates of Sheiman IM. to ensure a 1% increase in population and the reproduction of labor capable of entering the production process, the country must ensure a 4 per cent increase in the gross national product. One can not ignore the fact that under the influence of a set of recommended measures, the death rate of the population and life expectancy [14] are significantly reduced.

An important role in ensuring national demographic security is played by the redistribution of financial flows within the health system in favor of those types of medical care that have the highest mortality rates of the working–age population and which are controlled factors. Thus, on the basis of the conducted studies, rational forms of interaction between state and market institutions for resource provision of health care have been identified and determined.

Conclusions

Thus, combining strategies when making changes allows to improve the planning system, management process, optimize costs, which ultimately contributes to the effectiveness of the health organization. In the long term, the healthcare organization can develop its own version of combining strategies, taking into account its uniqueness.

The proposed methodological approach to improving the system of planning and economic support of the industry allows health authorities in market conditions to study demand by types of assistance, suggesting, based on available opportunities, to forecast the development of the industry, using self–regulation mechanisms to plan all necessary technologies with optimal distribution by to improve the efficiency of the resource potential used in the sphere of medical services in the part of the state idents guarantees on the meso–level, at the micro level – to assess the real capacity of health institutions to implement the state guarantees free medical care to the population of the program by using the available resources.

It is revealed that combination of strategies allows to increase the effectiveness of the health organizations and the industry as a whole through a comprehensive solution of the problems: planning the volumes of medical services on the basis of modern industry norms and standards, reasonable cost norms for establishing the necessary proportions in the production process and resource support for medical services.

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