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2АНАЛ1З ТЕНДЕНЦ1Й ЗМ1Н В МЕНЕДЖМЕНТ СОЦIАЛЬНОÏ В1ДПОВ1ДАЛЬНОСТ1 ЗАКЛАД1В ОХОРОНИ ЗДОРОВ'Я УКРАШИ
Волинець 1.Г.
Волинський нацгональний унгверситет 1мет Лес1 Украшки, м. Луцьк
Януш Я.А.
Волинський нацгональний унгверситет 1мет Лес1 Украшки, м. Луцьк
здобувач освти освтнього ргвня маггстр
TRENDS CHANGES ANALYSIS IN SOCIAL RESPONSIBILITY MANAGEMENT OF HEALTH
CARE INSTITUTIONS IN UKRAINE
Volynets I.,
Lesya Ukrainka Volyn National University, Lutsk phD, associated professor Yanush Y.
Lesya Ukrainka Volyn National University, Lutsk
Master student DOI: 10.5281/zenodo.7408536
АНОТАЦ1Я
Виокремлено теоретичш аспекти сутносп менеджмент сощально1 ввдповщальносп 3aKiaAÍB охорони здоров'я. Систематизовано основш напрямки сощально1 ввдповщальносп з метою здшснення яшсного уп-равлiння. Видiлено основш суб'екти управлiння соцiально вiдповiдальнiстю на piBrn держави. Здiйснено аналiз шлькосп закладiв у системi охорони здоров'я протягом останнього часу. Наведено сукупнють захо-дiв, що запроваджено у перюд вiйни з метою надання як1сних медичних послуг усiм верствам населения.
ABSTRACT
The theoretical aspects of the essence of social responsibility management of health care institutions are highlighted. The main areas of social responsibility are systematized for the purpose of qualified management. The main subjects of social responsibility management at the state level have been identified. An analysis of the number of institutions in the health care system was carried out recently. A collection of measures is given, which was implemented during the war to provide high-quality medical services for community.
Ключовi слова: Менеджмент сощально1 ввдповщальносп, заклади охорони здоров'я.
Keywords: management of social responsibility, healthcare institutions.
Problem statement. The world trends of enterprise management refer to the introduction of social responsibility principles, which ensures the development of all systems in society.
Crisis situations, the pandemic etc. have slowed the implementation of the set of values by health care institutions management, which can increase social responsibility toward internal and external stakeholders.
Analysis of recent researches and publications. Valitova Sh., Grishnova O., Buleev I., Brukhovetska N., Kolot A. devoted their works to social responsibility management. Methods of analysis and evaluation for social responsibility were formulated and improved by the following scientists: Bayura D., Berezina A., Buyan A., Vorobey V., Vorona O., Mazuryk O., Pinda Y., Chernykh O. A number of scientific sources testify to the relevance of the research topic in terms of providing medical and social assistance to patients in health care Institutions (Gnezdilov A., Gryshchenko E., Lekhan V., Martynenko A., Krukov S., Tchaikovska V, etc.). In literature and in practice, the theoretical and applied principles of social responsibility management in the health care system have not been properly grounded, the identification of the directions of social responsibility measures and indicators of their level assessment is not systematic enough.
The purpose of the article is to form theoretical principles of management social responsibility in health care institutions and to assess changes in this
process at the state level.
Presentation of the basic material. Social responsibility management or management of social responsibility is the source of corporate social responsibility. In other words, modern management principles should help to form a complex of actions aimed at ensuring safety and development of internal subjects (welfare of employees, shareholders) and the external environment of the enterprise (development of society, preservation of environment) in particular, and humanity in general, without violating the values and rules on which the corporate culture of the enterprise is based.
Social responsibility should be shown to employees of the enterprise, partners and counterparties, as well as to the community, society and the state. This is what confirms the multivector phenomenon of social responsibility of conscious management. That is, it is possible to identify internal and external directions of social responsibility.
We offer the following structure of the subsystem of social responsibility management in the system of corporate culture: providing safety of labor and health care; motivation and development of staff; subsystem of personal perception and formation of favorable psychological climate; support of integrity; quality and safety of medical services; providing environmental services.
We have identified social responsibility management subjects in the health sector at the state level (see fig. 1).
Ministry of Health
A
Public Health Center
National Technical Group of Experts on Immunoprophylaxis
Social liability management entities at the state level
National blood system
N.
s
State Service for Medication and Drug Control in Ukraine
Fig 1. Subjects of social responsibility management in the health care at the level of the state
The main areas of social responsibility management at the state level in the health care are follows:
1. Saving and strengthening of public health, so-cio-hygienic monitoring of diseases, epidemiological surveillance and biological safety, group and population disease prevention, fight against epidemics and strategic management in the field of public health.
2. Formation and realization of the policy in the field of immunoprevention on the basis of scientific researches, modern approaches and evidence medicine (functioning of National Technical Group of Experts on Immunoprophylaxis).
3. Ensuring equal and uninterrupted access for patients to quality and safe blood components in sufficient quantity.
4. Control of quality and safety of drugs, including immunobiological medications, medical equipment and products of medical purpose and circulation of narcotic drugs, psychotropic substances and precursors and counteraction of their illegal circulation.
5. Regulation of proper management with medical waste.
6. Creation and implementation of medical and technological documents on standardization of medical care in the system of the Ministry of Health of Ukraine.
7. Ensuring continuous professional development of medical and pharmaceutical workers.
8. Regulation of rights and duties of both patients and medical/pharmaceutical workers.
9. The creation of experts group, a group of specialists in various fields in medicine, whose opinion is listened to by the medical community and whose opinion is taken into account by the Ministry of Health for decision-making.
It should be noted that during 2018-2020 the number of health care facilities remained practically unchanged, namely the number of hospitals in 2018-2019 was 1,7 thousand health care facilities at the end of the year and 1,6 thousand institutions at the end of 2020. Figure 2. also analyzed the dynamics of the number of medical outpatient and polyclinic establishments in thousands at the end of the year. Their number has been growing steadily since 2018. This can be explained by improved funding for primary care and increased functions of general practitioners, family doctors, and, accordingly, the expansion of the network of outpatient and polyclinic facilities.
In the system of analysis of health care facilities, the important criterion is not only the number of institutions, but also the conformity of medical staff to the number of population in a given region.
Health care institutions system in 2018 -2020 yy.
14,0
12,0
10,0
3,0
6,0
4,0
2,0
0,0
I
2018 2019 2020
■ The number of hospitals in the end of the year; thousands
■ The number of outpatient-polyclinic institutions in the end of the year;
Fig. 2. Analysis of the network of health care institutions in Ukraine
Fig. 3 Analysis of the number of doctors of all specialties by region Note: Formed according to the data of the Ministry of Health of Ukraine at the end of the year; thousands.
The number of doctors of all specialities in region in the end of the year, according to the data of the Ministry of Health of Ukraine
Kyiv
Chernivtsi region Khmelnytskyi region Kharkiv region CyMCbKa Poltava region Mykolaiv region Luhansk region Kyiv region Zaporizhzhia region Zhytomyr region Dnipropetrovsk region Vinnytsia region
5 10 15 20 25 30
2020 2019 2018
0
From Fig. 3, it is possible to conclude that the number of doctors remains relatively stable in all regions of Ukraine, but the number of students of medical universities grows annually. To explain this regularity can be a significant emigration of doctors abroad, experts estimate that during 2020-2021 the country lost 66 thousand doctors and medical workers. On the 1st January, 2020, there were 33707 doctors and 35 specialists of the average medical staff in Ukraine. The largest number of doctors is in Kyiv and Kharkiv region, which can be explained, first of all, by a wide network of hospitals, institutions (the number of hospitals in Kyiv was 27.8 thousand at the end of 2019, and in Kharkiv region - 21.8 thousand), as well as the number of scientific institutions and institutes in these regions. The smallest number of doctors is marked in Lugansk region, which is explained by the beginning of fighting on this territory since 2019, according to the Ministry of Health, the number of doctors in 2018 was 10,0 thousand at the end of the year, whereas in 2020 - 2,1 thousand at the end of the year. Similar decline can also be observed in Donetsk region from 19.8 thousand in 2010 to 5.7 thousand in 2020.
According to official data of the Ministry of Health, since the beginning of the full-scale war in Ukraine, 127 medical institutions have been destroyed and 884 health care institutions have suffered damage.
Thanks to active assistance from international organizations, 62 institutions were restored. An example of such cooperation is the signing of a memorandum between the Ministry of Health and Project HPPE, within the framework of cooperation 2 buildings of the Irpin Central Hospital, as well as medical institutions and communal pharmacies in Chernihiv and Kyiv region were restored. In addition, 450 pharmacies were destroyed, 41 stores destroyed. Unfortunately, these figures are growing every day.
As a result of changes in the environment, several decisions were made at the level of social liability management entities at the state level, which will affect the next state and work of health care institutions. Namely: Stop of planned hospitals and reserve for wounded.
The document, among other things, provided: To suspend the planned hospitalization, prepare additional surgical teams to help the injured, to provide emergency medical care in full. Given the complexity of logistics, the department recommended increasing the provision of telemedicine assistance and conducting medical and social expertise on a simplified procedure and in absentia.
In addition, the procedure for providing medical services to temporarily displaced persons is prescribed. At the beginning of 2022, the population of Ukraine was about 40 million people. Due to a full-scale war,
mass migration is observed: According to the UN refugee Office, since February 24, more than 10 million people have left our country, more than 4 million of them have already returned.
For the optimal distribution of resources, the Ministry and the State Medical Procurement of Ukraine are now working on the introduction of an e-Stock electronic system, which will contain data on the availability of drugs and medical products in medical institutions throughout the country. These services will be published, updated in real time and contain information about centralized procurement for budgetary funds, purchases of international organizations, the program "affordable medicines", purchases for regional budgets, etc.
Despite the war in Ukraine, the medical reform started in 2017, in particular, has reached the turn of its infrastructure stage. On July 19, the Law No. 2347-IX, which provides for the unification of the network of health care facilities in each oblast in the hospital district, which will be divided into clusters in turn.
According to the types of provided medical care, optimal clinical routes of patients and stress on health workers, the hospitals will be general, cluster or super-cluster. Now, recall, the division goes to the city, district and regional, which often duplicate functions of one.
According to the innovations, each health care institution will have a defined function. Base services will be provided in general hospitals as close to the patient as possible, and highly specialized or narrow-profile services will be provided in cluster and supercluster hospitals.
Such an approach provides medical facilities with equipment that meets their level of service and make use of resources more efficient.
Despite the difficult circumstances in which
Ukraine was found, its health system carries out effective management of social responsibility both at the state level and at each individual institution.
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