CC BY
72
Section 4. Economy Population and Demography
Section 4. Economy Population and Demography
Muravyeva Nataliya Nikolaevna, PhD of Economic Sciences, Associate Professor of the Southern Federal University E-mail: natasha_2009@inbox.ru Volodina Kristina Yurievna, Master’s Degree Student Southern Federal University E-mail: torpille99@gmail.com
Versatility of aspects of the medico-social and economic role of health system
Abstract: The article clarifies the definition of the public health care and its role in the social sphere in the context of increasing value of quality of life due to the biological and socio-economic unity of health. Analyze of efficiency indicators of the Russian medical care organizations confirms insufficient consideration of the interrelation of public health institution with those of other social institutions and the lack of implementation of this interaction. The study of such complex concept as quality of medical care requires multidisciplinary approach which could involve revision of key principles of quality assessment of the health care system.
Keywords: health system, health system in Russia, public health care, health reforms, health system indicators.
Introduction. The actuality of the work is conditioned by the fact, that in Russia for a long time the role of the health system in public health care was seen narrowly clinically. The situation causes ailment numerical superiority over health; it requires a transformation of scientific views on the concept of individual and public health, from clinical categories to the medico-social and economic categories, proceeding from the principle of the highest social value of quality of life due to the biological and socio-economic unity of health.
The aim is to study the fact that the role of the public health care institute is not only in the restoration of health (to identify and treat patients, monitor risk factors and to develop mechanisms to prevent their impact on the population), but also to influence the building up health social sphere.
Research method. A number of interrelated factors is resulted in appealing to interdisciplinary approaches and methods, which provide research: state of the national health system; ‘opacity’ of social
reality; mastery of the modern research methods and theoretical achievements of world science; formation of an information environment characterized by blurring the boundaries between research and applied knowledge, and the synthesis of humanitarian and scientific approaches.
Medical sciences play a key role in the specific treatment outcomes. However, the complication of modern health care system objectively leads to the usage of tools and techniques of such sciences as val-ueology, history, political science, sociology, etc.
Valueology enables us to determine the health index, explore the quantitative and qualitative indicators of health. Valueology explains how to treat the individual’s health, how to develop a culture to be healthy in the process of personal growth, how to increase the reserves of the body, how to lead a healthy lifestyle — this is an important difference from the medical sciences, most of which deals with the matters of recovery. Namely healthy person and who is in transitional to the disease state of human
34
Versatility of aspects of the medico-social and economic role of health system
body is outside the scope of public health service as long as it does not go into a state of pathology.
History cannot be but included in this research area, associated with the modernization of public health care. The theme of ‘path dependence’ which occupies an important place in the work of representatives of health economics is an example.
Another problem also needs to be interdisciplinary analyzed. Processes of globalization and informatization of health economics reached such a level that the usual methods of state regulation are clearly insufficient.
It is logically to add the political science — the science of politics that is of the special sphere of human activity associated with power relations, with state-political organization of society and political institutions, for a more accurate assessment of the effects of certain events to this scientific community.
It should be noted that today sociologists observed unavailability of a large majority of society to solve problems of post-industrial modernization. Primarily, because of the incompleteness of social modernization in the Soviet period, as representatives of the Levada Center say, “Russian society is extremely poor on the level of their requests, living standards and forms of relationship. It is poor in the sphere of social relationships, forms of support, options for action”. And this situation naturally affects the health reforms.
Results and discussion. Disparity ratio between primary care and specialized care are noted by specialists in Russian healthcare system, namely the level of primary health care is extremely low and tends to worsen. In world practice, on the contrary, the following understanding of the laws is established: the higher the proportion of primary care physicians in the total number of doctors (lower proportion of specialists) is, the less money is needed to achieve the final results of functioning of a health system. The percent of health services doctors of precinct in Russia does not exceed 25%, in Western countries it is 45-55%. Note that magnetic resonance imaging and 2 computer tomographs were put into service in 2012 in Rostov-on-Don; this situation indicates the development of expensive types of medical care. Endoscopic, anesthesiology
and intensive care, surgery, sterilization equipment for functional diagnostics is bought. Medical health care institutions acquire economic traits of an enterprise providing services that leads to change the nature of economic relations arising in the activities of these economic agents [1, 9].
Population growth in the demand for medical care results in increased costs to the health system, but not always to a proper increase of its effectiveness [2].
Conducted by the World Health Organization analysis showed that Russia lags seriously behind the industrialized countries in the world in terms of funding, but much more in the final efficiency of health system indexes. Among these are:
1) health indicators, which are really affected by the industry sector;
2) rationality of the structure of providing health care and the system’s ability to respond adequately to the needs of the population — to guarantee the achievement of modern standards of healthcare providing, acceptable waiting for planned care period etc.;
3) distributive justice of funds (level of social protection for the most necessitous population groups) [3, 24-31].
The roots of this conflict lie in many aspects of medical and socio-economic role of the health care system, and as a result, in insufficient consideration of the interrelation of public health institution with those of other social institutions and the lack of implementation of this interaction.
Patient satisfaction is an indicator of the social health system effectiveness which reflects the social acceptability of the health care system and the impact on public health. Many authors consider the particular characteristics of medical care in evaluating patient satisfaction such as: relationship between the doctor and patient, physician qualifications, timeliness of providing health care, cost of services, medical effectiveness, continuity, comfort facilities, doctors and equipment medical service density etc [4, 11-22].
It is obviously that patient satisfaction cannot be used as the only criterion of socio-economic efficiency of the health system, so, for example, a subjective assessment of low availability voiced by
35
Section 4. Economy Population and Demography
consumers may be caused by insufficient activity of the patients.
Traditionally, in the market a consumer buys not only a product or service, but at the same time, receives information about the actual quality standards for this product or service. Let’s consider one of the factors — “absence of objective indicators of quality of medical care for patients, physicians and payers.”
Quality of health services as a result of the work of medical subject is established by three major components:
— quality of the process of providing medical care in a health institution, the result of which is the medical service;
— quality control ofhealth care, since managers define the service process technology as long as the criteria for its evaluation;
— quality of support during providing health services.
It is obviously that the quality of medical care is a complex concept which reflects different aspects of actions of the hospital staff in health care (including profile, psychological, managerial, scientific, economic, informational aspects etc.).
Conclusion. Based on abovementioned, we can conclude that an increase in the number of problems in the health care system requires an interdisciplinary approach to their resolution.
An assessment of customer satisfaction (which can be seen as a subjective criterion) is needed as well as assessment of consumer behavior in relation to the services of medical equipment (which is an objective indicator) is.
Thus, a multidisciplinary approach allows us to see health problems from different aspects, as the result of the economic, political and sociological research, substantially complement research of physicians and epidemiologists.
References:
1. Vishnevsky A. G., 2006. Russian Health Care: How to get out of the crisis. Report of the State University - Higher School of Economics. Moscow: Publishing House SU - HSE. 9 p.
2. Work results in 2012 in the field of “Health’’. URL: http://www.rostov-gorod.ru/?ID=24824
3. Predictors of satisfaction of primary health care services/Rousinova N. L. [etc.]//Medicine Sociology. 2006. № 2. P. 24-31.
4. Sharabchiev Y. T. The new paradigm of health: the reasons for the need for a paradigm shift//Medical News. 2005. № 3. P. 11-22.
5. Sheiman I. M. Theory and practice of market relations in health care. The State University - Higher School of Economics. - 2nd ed. Moscow: Publishing House HSE. 2008. 317 p.
36
