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0According to the Ministry of Ecology and Natural Resources, Ukraine currently has 25 billion tons of hazardous industrial waste. They littered 160 thousand hectares of land, quite suitable for agriculture.
Despite the environmental situation, there are $ 3 environmental allocations per one inhabitant of Ukraine per year, whereas, for example, in Germany -50 times more.
Overall mortality is the highest in the Southeast and Central regions. Particular concern is the Dniprope-trovsk, Zaporizhzhya and Kharkov regions, where the metallurgical, coal, chemical, construction, and nuclear industries are located. In the Southeastern region, 483 kg of air emissions per inhabitant are 68% higher than the average for Ukraine.
The level of ionized radiation is higher in the Central region, as it has been significantly affected by the emissions from the Chernobyl accident. Moreover, in the future it can affect the health of the population through food and drinking water. The data given on the interrelationship between the levels of air pollution, the volume of wastewater and the mortality of the population of different regions indicate that these indices in the industrial region far exceed the averages in Ukraine. In particular, with lower average in Ukraine indicators of air pollution and wastewater in the Trans Carpathian and Kherson regions, the mortality rate is below the average for Ukraine. A high value of the correlation coefficient confirms the indicated: r 2-4 = 0, 59, r 3-4 = 0, 72.
An important factor in determining the health status of the population in certain areas (Zhytomyr, Kiev, Rivne, Chernigov) is the influence of the consequences of the Chernobyl accident. The mortality from diseases of the circulatory system in the contaminated regions is 14.6% higher than the average for Ukraine.
The above shows that the population of Ukraine lives not only in unfavorable, but in dangerous environmental conditions, which significantly reduces the quality of life. If on the average in the world of people 65 years of age 63% of people live, in Ukraine - 51%. 1/4 of all deaths in Ukraine are quite young people of working age. This is in conflict with WHO's recommendation in the framework of the European policy for
achieving health for all, according to which the life expectancy is expected to be at least 75 years. The rating place of Ukraine is the 70th among 191 countries of the world. In other words, the parameters of the possible life expectancy in Ukraine did not become expected, but rather worsened, which is the demographic aspect of national security.
Thus, the dynamics of demographic processes shows that with the change in socio-political and socioeconomic conditions, the deterioration of eco-biologi-cal factors in recent decades, the birth rate decreased by 51.6%, mortality increased by 53.0%, which is required in the new conditions for taking adequate measures , and therefore a scientifically based preventive strategy within the entire health system should be a priority, both at the regional and national levels, and professional assistance to preserve the health population and to prevent the harmful effects of negative factors on it, reducing the premature mortality is a function of the citizens and the task of the health care system and the rationale for the development and implementation of state programs.
References
1. Everybody business: strengthening health systems to improve health outcomes: WHO's framework for action. - Geneva: WHO, 2007. - 57 c.
2. Health Care Systems in Transition: Ukraine. Draft, 2010.
3. Nolte E. Does health care save lives? Avoidable mortality revisited / Ellen Nolte, Martin McKee. - London: The Nuffield Trust, 2004. - 139 p.
4. Robine J. M. Health expectancy indicators / J. M. Robine, I. Romieu, E. Cambois // Bull. WHO. -1999. - № 2. - P. 181-185.
5. Smith P. C. Performance measurement for health system improvement: experiences, challenges and prospects / Peter C. Smith, Elias Mossialos, Irene Papanicolas. - Copenhagen: WHO, on behalf of the European Observatory on Health Systems and Policies, 2008. - 21 p.
6. The evolving pattern of avoidable mortality in Russia / E. M. Andreev, E. Nolte, V. M. Shkolnikov [et al.] // International Journal of Epidemiology. - 2003. -№ 32. - P. 437-446.
АКТУАЛЬНЫЕ ПРОБЛЕМЫ МАРКЕТИНГОВОЙ ДЕЯТЕЛЬНОСТИ В ЗДРАВООХРАНЕНИИ
Ясинская Е.Ц.
кандидат медицинских наук, доцент кафедры социальной медицины и организации здравоохранения ВГНУ Украины «Буковинский государственный медицинский университет»
THE ACTUAL PROBLEMS OF MARKETING ACTIVITIES IN THE HEALTH CARE
Yasinskaya E. Th.
PhD, assistant the Professor of the Department of Social Medicine and Organization of Health Care of Higher State Educational Establishment of Ukraine "Bukovina State Medical University"
Анотация
В статье проанализированы актуальные проблемы маркетинга в здравоохранении, а также основные стратеги маркетингових исследований при оказании медицинских услуг.
Abstract
In the article analyzes the actual problems of marketing in the health care and also the main marketing research in the provision of medical services.
Ключевые слова: маркетинг, сегментация рынка медицинских услуг, маркетинговые исследования. Keywords: marketing, segmentation of the market of medical services, marketing research.
Marketing as a universal mechanism of the management system aimed at the fullest satisfaction of human needs, is directly related to various health sectors .At the same time, such aspects of the organization of health care as the attitude of the population to the medical care consumed, the dynamics of the demand for various types of medical care, the assessment of its quality, manufacturability and economic efficiency have never been analyzed and were not criteria for assessing the performance of the industry
In the foreign literature the problem of marketing in public health services is covered with respect to private and insurance medicine. As for marketing in the context of state regulation of health care this problem has been studied extremely insufficiently
The marketing system includes suppliers, marketing intermediaries and competitors, various public and state organizations, financial institutions, the press, legislative bodies; takes into account political, demographic, economic, scientific and technical and other spheres of public life.
Marketing in health care covers a set of organizational and economic functions associated with the implementation of a set of health-preventive, sanitary-hygienic and therapeutic services, medicines, therapeutic and rehabilitation products.
The American Medical Association defines marketing in healthcare as an integrated process of planning, economic justification and management of the production of health services, pricing policy in the treatment and prevention process, promotion of services (medical goods) to consumers, and the process of their implementation.
The market nature of relations in health care is confirmed by the existence of a shadow market of medical services, the existence of demand. The transition to market relations in health care is accompanied by a change in psychological stereotypes, both among the population and among medical workers.
Marketing in health care has its own distinctive features related to the specifics of consumer demand and the market of medical goods and services. Its opportunities are largely determined by the form of financing health care and paying for medical services (private, insurance, state), as well as the form of ownership of enterprises that produce medical products and provide medical services (private, municipal, state, charitable funds, etc.). At the same time, the state meets public health needs, and private medical business serves the solvent sector, which has the ability to pay for medical services from its own sources. Currently, in the public and private sectors, non-profit marketing also takes place. It is carried out by organizations and individuals acting in the public interest and does not seek to receive financial income. At the same time, for non-profit organizations in the field of healthcare, marketing can be directed not only to making a profit, but
also to meeting the needs of customers or creating an image of healthcare institutions.
As a rule, non-profit organizations serve market segments, commercial organizations consider unprofitable. This can create financial advantages for commercial firms, as they can concentrate their efforts on the most profitable market segment. For example, the provision of medical services to municipal health institutions in rural areas, where there is a small population and income level.
Marketing in health care can be divided into five areas: 1) marketing of health services; 2) marketing of medicines; 3) marketing of medical equipment; 4) marketing of medical technologies; 5) marketing of scientific ideas.
Marketing of health services (including health promotion activities) is important for building the population's motivation for health promotion and appropriate lifestyle, creating a healthy person's image, a healthy lifestyle system.
Analysis of medical statistics shows that, despite significant healthcare successes in certain areas, society as a whole is not getting healthier. Reduction of mortality from a number of diseases in developed countries is accompanied by demographic shifts (aging of the population, a decrease in the birth rate), which causes the growth of chronic pathology and disability. All this contributes to an increase in the need for medical services, presumably, and in the future will be races.
The purpose of marketing research is to obtain and analyze objective information, to develop forecasts of the development of the market of medical and preventive services, to optimize the strategy of providing health care, in solving the problems of creating a market for new services to more fully meet their demand for them. The organization of marketing researches is carried out according to specially developed methods. Medical marketing along with the analysis, control and demand forecast also involves demand management.
The segmentation of the market for medical services and determination of its volume are based on data on the number of patients being served and their average income, the level of medical expenses and medicines, and medical supplies. There is no single method for segmenting the medical services market. It is necessary to test the variants of segmentation on the basis of different variables, one or several at once, to find the most qualitative approach to considering the structure of such a market. The restructuring of the healthcare sector, taking into account its marketing functions, must also be carried out in accordance with the segments of the medical services market. State guarantees for the protection of citizens' health should cover those segments of the market that, for the health care provider, rely on the profitability associated with the un-sightliness of the sector. The interaction of all subjects
of the health system, especially in the system of compulsory medical insurance, the definition of their functions and consequently the formation of types and forms of the doctor's and patient's relations, is naturally associated with specific characteristics of the population as a consumer of medical services. And such characteristics are sex, age, marital status, occupation, level of education and income of various social groups, as well as belonging to a particular social stratum, lifestyle, personal and behavioral qualities.
The real stratification of society, it is necessary to determine the approaches to the specificity of the medical services market, its segmentation, especially in questions of the characterization of production relations in these segments. The process of classifying patients into groups with different needs and needs, characteristics or behavior was carried out in the activities of medical and preventive institutions and prophylactic institutions - the producers of medical services, on the one hand, and the elements of the market infrastructure, where medical assistance is realized and consumed, on the other. The market of medical services is a kind of a specific market where these services are offered and consumed. Marketing intermediaries are organizations that help the producer of goods and services in the promotion, marketing and distribution of his products among customers, provide communication between the producer and the consumer. These include trade intermediaries, firms, marketing services agencies, credit and financial institutions, insurance medical organizations.
The concept of marketing in health in the context of market relations and health insurance presupposes the emergence of new economic entities of health -health insurance organizations that provide a system of links between health facilities and consumers of medical services, accumulate funds for payment and pay for the provision of medical services, collect and analyze information coming from the market medical services, analyze and transfer it to the health facility.
The role of the state in this scheme is limited to creating conditions for the existence of the market for medical services and protecting the rights of their consumers, that is, the state provides a guaranteed minimum of medical care for all citizens and pursues a policy aimed at full satisfaction of the social needs of the population.
Healthcare reforms should be of practical interest to marketing as a form of organization and management of health care and provision of medical care to the public. It is necessary to carry out a number of organizational activities and studies on the practical use of marketing in both public health services financed from the budget and in the field of medical business. It is probably advisable to regularly conduct courses on marketing in health care, to identify new medical technologies
and to teach them practical practitioners of health care. With limited funds allocated for the purchase of foreign medicines and medical equipment, targeted advertising and new strategic marketing research are becoming important.
Restrictions on resources allocated to research in the field of health care necessitate thorough technical and economic expertise of each newly planned research, taking into account the stage of innovation of scientific results, as well as the possible commercial or social effect.
In addition, marketing in the field of health is a special business sphere in which the interests of the firm, receiving profits should not conflict with the interests of society and each individual. Regardless of the form of ownership, health care institutions need to use marketing in their activities, based on commercial and non-profit principles. Promotion of health services and medical products, medicines, medical technologies and new ideas should be based on free competition, which will contribute to improving health care and improving the quality of medical care.
Список литературы
1 Акопян, А. Маркетинговая деятельность и логистика на медико-фармацевтическом рынке / А. Акопян, Р. Дарсигова, Р. Бочкаев // Маркетинг. -2012. - № 3. - С. 84 - 89.
2 Александрова, О. Ю. Модель реформирования муниципальной системы здравоохранения / О. Ю. Александрова, И. В. Груздева // Экономика здравоохранения. - 2005. - № 9. С. - 17 - 20.
3 Алексунин, В. А. Медицинские услуги : специальные маркетинговые исследования / В. А. Алексунин // Маркетинг и маркетинговые исследования. - 2008. - № 5 (59). - С. 53 - 57.
4 Алексунин, В. А. Маркетинговое исследование рынка платных медицинских услуг Краснодарского края / В. А. Алексунин, С. А. Митьков // Маркетинг в России и за рубежом. - 2009. - № 5. - С. 74 - 80.
5. Чехун I. А. Надання платних медичних по-слуг: цивiльно-правовi аспекти / I. А. Чехун // Часо-пис Кшвського утверситета права. - 2010. - № 2. -С. 213-216.
6. Виноградов О. В. Державне управлшня ба-гатоканальним фшансуванням закладiв охорони здоров'я / О. В. Виноградов // Статистика Украши. — 2006. — №2. — С. 65 — 67.
7. Лехан В. М. Стратепя розвитку системи охорони здоров'я: украшський вимiр / В. М. Лехан, Г. О. Слабкий, М. В. Шевченко. — К. : Укр. 1нститут стратепчних дослщжень МОЗ Украши, 2009. — 34 с
