Features of consumption of goods and health services 0. Features of entrepreneurship in health care. Formation and development of the medical services market in Russia
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Federal Agency for Education
State educational institution
higher professional education
"Lipetsk State Technical University"
Humanitarian and Social Faculty
Department of Sociology
COURSE WORK
on the topic: Consumption of medical services as a sociological criterion of living standards
Lipetsk 2008.
Introduction
1.1 Criteria of living standards
Conclusion
List of used literature
Applications
Appendix 1. Profile
Appendix 2. Chart
Appendix 3. Rows of distributions and grouping tables
Introduction
The problem of health care is very relevant not only for modern Russia, but also for the whole world as a whole. In recent years, the problem of health care, the quality of "healthy life" has become an integral part of the changes undergoing the massive consciousness of people. Factors threatening the lives and health of people take more and more extensive sizes. Environmental catastrophes, herbicidal and pesticidal lesions of the human body, cancer diseases, bronchial asthma, allergies have gained enough visible images in the mass consciousness, one way or another the regulatory behavior of the individual. There is no doubt that some factors are so objective that a person cannot prevent them. However, in many areas related to health, the danger can be reduced to a minimum level. As far as the person himself strives to reduce this danger, as far as he understands it, can show a social portrait of the middle consumer of medical services.
The transition to the market economy caused fundamental changes in the composition of consumers of medical services in Russia. This is due to the economic polarization of social groups and layers of the population, which excludes the possibility of a monotonous campaign to the organization of medical care.
Starting from the second half of the twentieth century, there are significant changes in the assessment of the role of health in the life of every person and society. In 1948, the World Health Organization has determined the health "As a state of complete physical, mental and social well-being, and not just the lack of a disease or physical defect." This, in fact, was the beginning of the transition to an understanding of health and illness not only as a medical problem, but also as a common-valuable one. Indicators of health, physical and mental well-being began to be considered by social policies as cumulative indicators of the level of well-being (quality of life) of society as a whole and its individual layers.
The consumer of medical services is the population. Its composition, socio-demographic, psychological and economic characteristics largely define functions, the content of the activity and the mechanism of interaction of all subjects of the consumption of medical services. It should also be noted such characteristics as the gender, age, marital status, occupation, the level of education and income of social groups affecting the degree of health services and evaluating the activities of medical institutions. In addition, psychographic data is also played by an important role: belonging to a particular social layer, lifestyle, personal and behavioral qualities. Without this, it is difficult to definitely determine the degree of chance of the use of services in the field of medicine, the desire to acquire the status of a permanent client in a specific medical and preventive institution, the degree of need of medical services, including paid, and satisfaction or discontent with medical care.
By virtue of the importance and relevance of the health problem and the quality of life, articles and publications dedicated to the consumption of medical services, health and promotion of healthy lifestyle are not ceased to appear. This topic is widely designed both in Russia and abroad, and at the present stage has acquired a special meaning. Among Russian sociologists, the greatest merits in the studies of this problem belong to Yu.P. Lisitsin, I.B. Nazarova, A.V. Reshetnikov, G.I. Kartegorodtsev. Of great importance also have articles and monographs A.E. Ivanova, M.S. Poor.
As part of a sociological study, the object of which was the consumption of medical services by the population, representative data on the consumers of medical services in the city of Lipetsk (2008, the urban population was interviewed). The sample (randomized, 150 people) was created by the method of accidental selection of the population aged 18 and older. The study was aimed at fixing their own estimates and reactions of the population related to submissions about their health or unhealthy, to find out the circumstances and factors affecting these estimates, and as a result, to determine the relationship of health indicators with the overall level and quality of life.
This term paper consists of an introduction, conclusion and three chapters, the first two of which include the theory, and the third is the empirical part of the study.
Chapter 1. Lifetime of the population in modern Russian society
1.1 Criteria of living standards
Under the quality of life in modern concepts of quality abroad, they understand the comprehensive characteristics of the socio-economic, political, cultural and ideological, environmental factors and the conditions for the existence of the personality, the position of the person in society.
The concept of quality of life is a modern continuation of the intellectual searches started by Teiyar de Chain and V. I. Vernadsky, who introduced the concept of "noosphere" into the scientific use, which now became one of the terms of the dictionary in socio-economic statistics: "Noosphere - the sphere of reasonably organized interaction Society and Nature. The biosphere turns into a nosphor at the purposeful activities of mankind by implementing measures for rational environmental management. "
The concept of the quality of life, adopted in post-industrial societies, includes restrictions on meeting the needs of people who ensure the harmonious development of the noosphere. These restrictions include: environmental protection, concern for the safety of industries and products and maintaining the resource potential of the country.
At the same time, the central tasks in the concept of quality of life are proclaimed: ensuring the physical and moral health of society, the expansion of the use of environmentally friendly food products, harmonization of working conditions, etc.
In the book A.I. Subeto The quality management processes are conjugate with the survival of humanity, and the author himself determines as a system of spiritual, material, sociocultural, environmental and demographic qualities (components of life). This system identifies the level of the realization of human generic forces, the creative meaning of his life. Moreover, in accordance with the teaching on three types of quality - the subject-material, functional and systemic-social - the individual, and social quality of life, the variety of human needs, the potential of its comprehensive, harmonic, creative development is revealed.
Quality category becomes a symbol of progress and survival of civilization. At the same time, there is an overcoming of traditional ideas about the quality of goods, quality of labor, quality of work and quality products, widely used in quality management systems. Quality of life as a system includes human quality, quality education, culture quality, habitat quality (ecology), the quality of the social, economic and political organization of society.
In the 90s, the problem of protecting consumer rights and the interests of society is increasingly regarded from the standpoint of quality of life, and include in this concept, providing jobs, income that guarantees a certain level of well-being, a certain quality of medical care, major social services. In addition, the quality of life implies the opportunity for all members of society to participate in the adoption of vital decisions and the use of opportunities provided by social, economic and political freedoms.
Integral indicators of the quality of life are: Health as an indicator of the physical, mental, spiritual and social well-being of a person, the environment, the education system and its availability for the population, demographic indicators of life, the level of culture and various cultural meters of quality of life (availability indicators for the theater, music , Cinema, painting, libraries, etc.), a variety of "speech language" as a special indicator of the quality of culture of personality and intelligence. The quantitative characteristic of the quality of life includes its indicators such as the degree of satisfaction of needs, material, energy, labor and financial costs for the satisfaction of each type of the set of objective needs.
In the literature, the concept of "quality of life" and "standard of living" is often intertwined and replaced by each other, which is not quite correct. At the same time, the standard of living is defined as an indicator that characterizes the number and quality of goods and services consumed in the country.
Speaking about the quality of life, often easily passed to such quantitative characteristics of the standard of living as a consumer basket. This concept in the modern market of market terms means a set of representatives of representatives in the specified quantities with fixed prices. Determining the standard of living, the consumer basket is added to the mortality rate of the population, the general education level, etc., solving actually private problems of quality of life, and not giving a clear definition of the very concept.
In the most general education, the standard of living can be represented as a level of consumption of the population, characterized by both quantitative, and qualitative indicators: the volume of real incomes per capita, level and structure of food and non-food products and services, level and dynamics of prices for basic consumption items, apartment fee , shipping fees.
1.2 Health as an indicator of the quality of life of the population
Indicators of health and morbidity are used in relation to specific groups of healthy and sick people. This obliges to approach a person's lifestyle assessment not only with biological, but also from medical and social positions. Social factors are due to the socio-economic structure of society, the level of education, culture, production relations between people, traditions, customs, social attitudes in the family and personal characteristics. Most of these factors, together with the hygienic characteristics of life, is included in the generalized concept of a "lifestyle", whose share of the influence of health is more than 50% among all factors.
Biological characteristics of a person (gender, age, heredity, constitution, temperament, adaptation capabilities, etc.) are in the total share of exposure to health factors no more than 20%. Both social and biological factors affect the person under certain environmental conditions, the proportion of which ranges from 18 to 22%. Only a minor part (8-10%) of health indicators is determined by the level of activity of medical institutions and efforts of medical workers. Therefore, human health is the harmonious unity of biological and social qualities caused by congenital and acquired biological and social properties, and the disease is a violation of this harmony.
Health acts as a synthetic indicator of quality and standard of living. At the same time, in accordance with the submission of the World Health Organization, the category of health includes categories of physical, mental, spiritual and social health. An important indicator of health as an element of the quality of life is the level of self-informing behavior, that is, the responsible attitude towards the preservation and maintenance of their health. In this sense, health acts as a real human resource, which can be disposed of differently with different results.
At the beginning of the twentieth century, the concept of "quality of life" has become a subject of scientific research and has become more accurate - "quality of life associated with health." The quality of life today is a reliable, informative and economical method for assessing the health of the patient both individually and in the group level.
The World Health Organization has made a great contribution to the development of a scientific study of the quality of life - it has developed fundamental quality criteria for life:
· Physical (power, energy, fatigue, pain, sleep, rest);
· Psychological (positive emotions, thinking, study, concentration, self-esteem, appearance, experience);
· The level of independence (everyday activity, performance, dependence on drugs and treatment);
· Social life (personal relationship, social value of the subject, sexual activity);
· Environment (life, well-being, security, availability and quality of medical and social assistance, security, ecology, the possibility of learning, accessibility of information);
· Spirituality (religion, personal beliefs).
The main tool for studying the quality of life is profiles (evaluation of each component of the quality of life separately) and questionnaires (for a comprehensive assessment), which, in turn, can be general (evaluate health as a whole) and special (for studying specific nosologies). All of them do not appreciate the clinical severity of the disease, but reflect how the patient transfers its illness.
There are no common generally acceptable criteria and quality standards. His assessment is influenced by age, gender, nationality, socio-economic position of man, the nature of his work activity, religious beliefs, cultural level, regional features, cultural traditions and many other factors. This is a purely subjective indicator of objectivity, and therefore the assessment of the quality of life of respondents is possible only in a comparative aspect (the patient is healthy, patient with one disease - a sick other disease) with the maximum leveling of all third-party factors.
In medical practice, learning quality of life is used for various purposes: to assess the effectiveness of modern clinical medicine methods and various rehabilitation technologies, to assess the severity of the patient, to determine the forecast of the disease, the effectiveness of treatment. Quality of life is an additional criterion for the selection of individual therapy and workability examination, analysis of the cost and effectiveness of medical care, in medical audit, to identify psychological problems and monitor them in patients in the system of general practice, individualization of treatment (the choice of the optimal drug for a particular patient) .
It should be noted that assessing the quality of life can be a prerequisite when testing medicines, new medical technologies and treatment methods at any stage.
Currently, there is an intensive development of methods for determining the quality of life for the most common chronic diseases due to the recognition of the quality of life criteria inherently part of a comprehensive analysis of new methods of diagnosis, treatment and prevention, health initiatives, assessing the results of treatment, the quality of assistance provided, etc. There is a boom study of the quality of life around the world, and Russia has not remained aside. In Russia, the concept of studying the quality of life in medicine proposed by the Ministry of Health of the Russian Federation (2001) was declared a priority. However, the study of the quality of life in our country is not yet widely used.
Chapter 2. Medical Consumption
2.1 Feature medical services
The scope of services is one of the most promising, rapidly developing sectors of the economy. Practically, all organizations in one form or another provide services, and as the market is saturated, the demand for services is growing.
The service is to commit a certain activity or a combination of certain actions aimed at meeting the needs of others. It is often related to all types of useful activities that do not create material values, that is, the main criterion is the intangible and invisible nature of the product produced in this field.
Each particular type of medical care from an economic point of view has all signs of goods and acts in the form of medical services.
A medical service is a combination of necessary, sufficient, conscientious, expedient professional actions of a medical worker (performer, manufacturer of services) aimed at meeting the patient's needs (customer, consumer services).
In the narrowest sense, a medical service is a type of medical care provided by medical workers to public health facilities. In other words, a medical service is an event or a complex of diseases conducted with diseases or with the immediate threat of their development aimed at preventing the disease and restoring health that have independent, completed value and a certain value.
Health services are not an ordinary product, production and consumption of which are determined by the ratio of solvent supply and supply. This conscious blessing should be provided to a person by anything, no matter whether he is rich or poor, he is able to pay him or not: after all, if this is not provided, soon or later, all production ceases, because in modern conditions of the epidemic and All other attacks are able to destroy all humanity.
A medical service begins to act as a specific product that has the following distinguishing properties:
· Remote control (the patient who came to the doctor can not know the results of the visit in advance).
· Inseparalness from the source of the service (the patient who recorded to a certain doctor will not receive the service, if it falls due to the lack of this physician to another);
· Affection of quality (the same medical service doctors of different qualifications provide differently, and even one and the same doctor can help the patient in different ways depending on their condition).
A medical service, like any product, has a value, a monetary expression, which is the price. Services prices consist of two main elements: cost costs and profits.
A medical service can be detailed and simple. Under the detailed medical service is understood elementary, indivisible service. For example, for the hospital, detailed services may be considered to design the history of the disease, carrying out a specific type of bacteriological study of the operational block and others. If some detailed services provided by individual units of the institution (for example, the receiving office, bacteriological laboratory and others) will not be separated separately, the cost of the content of these units (the wages of their employees who consume material resources and other costs) must be taken into account in the overhead Cost of institution. When calculating the cost of a detailed service, it is necessary to use its technological standard in this institution (the time spent on this service, the qualitative composition of medical professionals producing this service, the types and number of medications consumed, drugs, etc.).
A simple service can be presented as a set of detailed services that reflect the technological process of medical care for this technology in a particular institution. Under a simple service, a complete case is understood by a certain nosology: for hospitals - treated patient, for outpatient polyclinic institutions - a complete case of treatment, with the exception of dental clinic, where the sacred patient is understood as an ambulance service and treatment. The list of simple medical services can be defined either by the institution itself, or is used by a list approved by the administration (or the health authority in the event of delegation of these rights) of this area in accordance with the medical and economic standards existing on it. When developing a list of medical services, an age factor may be taken into account, as well as the factor in the complexity of the provision of this type of service due to the presence of concomitant diseases, complications, etc.
As in any other, a number of characteristics can be distinguished in the medical service, which include:
· Subjects of services (patient - medical worker);
· Psychology of services (relationships of subjects of services);
· The materiality of the service (cost and material expression of the cost of customer satisfaction).
· Documentality of service (fixed long-term exhaustive information that gives an idea of \u200b\u200bthe quantitative and qualitative side of the fulfilled service).
According to the functional purpose, medical services can be:
· Medical diagnostic (aimed at establishing a diagnosis or treatment of the disease);
· Preventive (dispensarization, vaccination, physical recovery activities);
· Recovery rehabilitation (related to social and medical rehabilitation of patients);
· Transport (transportation of patients, in particular, using ambulance service);
· Sanitary-hygienic (measures associated with quarantine, suprosvevelopment, sanitary and epidemiological control and supervision).
Thus, it can be concluded that a medical service is a complex complex of elements, processes and services developing in time and space and possessing certain phasenost, staging and stagnation covering all types of work related to the preservation, implementation and practical implementation of medical care. .
2.2 Paid Medical Services
Since medical care in state medical institutions does not satisfy many, and improve its quality with the help of only complaints have not yet succeeded, people are trying to solve their problems with the help of paid medicine. In paid medical institutions, the population is extremely wealthy. In percentage, almost equal number of "fans" of paid medical institutions, according to our data, lives in regional centers, in the cities of regional subordination, in district centers and rural areas.
For paid medicine, people with different levels of health are treated. More those who have no major claims to health (first of all, young people under the age of 35). Less others, apparently, according to financial considerations, - the elderly. Paid medical facilities attract the following: quality of treatment, attention from medical staff, relatively low cost of services, qualifications of doctors, the presence of the necessary specialists in contrast to state medical institutions, service organization, lack of queues, better equipment. The main advantages fill the main disadvantages of state medical institutions relating to the quality of treatment and attention from the medical staff. If the respondents have real experience in obtaining therapeutic services in private medical institutions, they are five to eight times more often than the remaining respondents highly appreciate the quality of service in them in comparison with state.
The materials of the studies have shown that the most significant development of private medicine received in dental treatment: the ratio of appeals to the private and public sectors of this type of medical care is expressed in the ratio of 1: 4. As for inpatient treatment, it remains almost entirely in the conduct of state hospitals.
The key in the concept of "paid medicine" is "paid", i.e. Medical care for fee. Many this does not confuse, there is a small category of citizens pointing to the relatively low cost of relevant services. The development of the private sector of medical services causes concerns of the main mass of respondents primarily because paid medical services steadily displacing the guaranteed free medical care of the population. And this leads to the fact that for a significant proportion of people, qualified medical care becomes inaccessible.
But still, the question of whether paid medicine will eventually displace state, it is not worthwhile today. Judging by the surveys of about 70% of respondents have income below the subsistence minimum. All 2% live in full delivery; Few more than 20%, in their opinion, "quite satisfactory." Only a small part of respondents can contact paid institutions without limiting themselves at the same time.
According to surveys of 1994-1997, materially secured people in working age are mainly incomplete secondary education, work in commercial structures and live in various settlements. Thus, the resource base of paid medical care is limited and depends on the further development of the economy. But today it is functioning by restricting the needs of the population in clothing, food products, etc.: Developing paid medicine will contribute to improving medical care only the most secured segments of the population. Of course, such a phenomenon is possible only against the background of the limited financial resources of the population and the unsatisfactory quality of medical care in state medical institutions.
The research results suggest that the majority of the population has revenues only help biologically supporting life. Under these conditions, there can be no speech about paid medicine. In the current conditions, compulsory medical insurance is non-alternative, and it must be fully implemented.
It is worth noting that about half of the population, one way or another, pays medical services from their own pocket. Talk about free medical care under these conditions is not entirely correct. They pay doctors and in major cities, and in district centers, representatives of all professional categories, but not equally actively. More others - entrepreneurs, merchants and employees of the budget sphere, less - pensioners and unemployed.
Judging by the research data, both "shadow" paid medical services are preserved. And mostly they are common in the public health system. For example, in state and departmental polyclinics officially made a common fee for therapeutic assistance 23.8% of respondents, and informally (bypassing the cash register) - 7.4%, paid officially for the services of 3% doctors, and unofficially - 12.6%. There are many cases of "shadow" payments and in private polyclinics, as well as in private actors.
An expression of gratitude to the doctor for the rendered medical service in the form of a gift always existed. But today the situation is completely different. The market of illegal paid medical services can be explained by the low wage of the doctor, the inconsistency of the medical payroll system of medical staff. The second reason requires clarification. The remuneration of the doctor is carried out in accordance with a single tariff scale and largely retains the traditions of time when everything was state-owned, incl. Prices for goods and services. Today prices depend on market conditions, demand for goods and services.
2.3 Medical Insurance Concept
It can be argued that in the 80s, in our country there was a kind of health crisis, which manifested itself particularly sharply in the following directions:
1. Health crisis. If 20 years ago the group of healthy was approximately 30% of the total population, now no more than 20%. More than 25% of the population is hospitalized annually in hospitals, from each 100 born 11 have defects of the physical and mental state. The average life expectancy has decreased.
2. Financing crisis. If at the beginning of the 70s, health expenditures were about 10% of the GNP, now they amounted to less than 3% of the GNP.
3. The crisis of the material and technical base.
4. Crisis frames.
Adopted in 1989 "Regulations on the new economic mechanism in health care" was aimed at overcoming all these negative points. According to this document, it was assumed that, as the LPU was prepared for new management conditions in 1990-1991. In this position, general principles and forms of the work of the LPU were determined based on the use of economic management and transition methods mainly to the territorial principle of health management. It should be noted that the concept of incorporated in this document has significantly copied economic decisions regarding other sectors of the country's economy, to a low degree took into account the specifics of healthcare.
It seems that in general, the steps made in this direction were correct, but a sharp change of priorities in the conceptual development of the country, the transition to market rails, the adoption of the law "On Medical Insurance of Citizens in the Russian Federation" was largely radically radicalized and demanded new approaches to further development The entire health care system.
Medical insurance, as many authors celebrate, in a broad sense - these are new economic relations in health care in the conditions of the market, that is, the creation of such a health and social security system, which actually guarantees all residents of the Russian Federation freely affordable qualified medical care, regardless of their social status and income level.
The purpose of medical insurance is to improve the quality and expand the amount of medical care through a radical increase in healthcare allocations, decentralization of the health insurance fund management system, the material interest of medical workers in the final results, enterprises' economic interest in maintaining the health of the working and economic interest of each person in maintaining their health. It is so widely determined by a goal in the law on medical insurance.
Medical insurance is designed to guarantee citizens in the event of an insured event, obtaining medical care through accumulated funds and finance preventive measures. Such social protection can be implemented by creating a specialized monetary fund in a single order, in the formation of which would take part, ultimately, every citizen.
In this case, medical insurance takes the form of mandatory. The social nature of compulsory medical insurance, allowing each citizen to receive the same medical care, is achieved by the unequal contribution of each to the Creation of the Cash Fund to pay for this assistance. In other words, rich pays for the poor. It is in this that the principle of public solidarity is manifested, which built a system of compulsory health insurance in many European countries.
According to A.V. Telumukov, in democratic states the question of universal availability of medical care is based on a free individual choice, that is, the result of civil consent and has a solid economic, social and political framework. Under the economic basis, he understands a fairly high level of personal revenue: the readiness to redistribute part of the funds in favor of less successful fellow citizens organically follows from a high level of its own well-being. Social foundation means that decisions taken by people in the public sphere are formed by their own beliefs, views, concepts, beliefs. The political main public contract are the institutions of the legislative and executive authorities, which give the public contract the form of the law and implement it in the government policy. At the same time, the legislative, and the executive power is controlled by voters.
Currently, government liabilities for the provision of free medical care are not provided with financial resources. The basic OMS program has not yet been approved, and the territorial programs of the OMS are financed by only 40-60%. In the current economic situation, the preservation of government obligations to provide free medical care on a universal basis is almost unrealistic. Under the most favorable conditions (the fulfillment of the obligations of the state budget for compulsions on the OMS, attracting additional sources of financing) of financial resources to ensure the free of charge of all types of medical care will be not enough.
Nevertheless, today the OMS system is quite widely logged in. But unfortunately, the awareness of the regulations of the rights and privileges granted to them is very low, despite a set of activities aimed at bringing information about the OMS to the population. Only a minor part of respondents with confidence declares the knowledge of the rights guaranteed by the OMS system.
Awareness of the population on compulsory medical insurance is clearly insufficient. The predominant majority make up respondents who, in the presence of the insurance policy, have never enjoyed the right to choose a medical institution or doctor. These rights, which are the cornerstone of the OMS, are used by the insured very rarely. And not because the majority do not know about their right, but because health care institutions are not yet prepared for its implementation. The introduction of such a right assumed the emergence of competition between doctors and medical institutions, the struggle for the patient, which in turn should have led to improving the quality of medical care. So far, this has not happened, single cases of the implementation of the choice of medical institutions relate to the main cities. But even in the regional center, with its tradition of precinct service, it is almost impossible to implement this right. No less problematic is the opportunity to use the right to choose a doctor. There is simply no such possibility on the village, and if there is, it is unlikely that someone will decide to demonstratively preferring one doctor to another. In small settlements, people are usually familiar, and this kind of demonstration will lead to the exacerbation of relations. In the conditions of the deficit of medical staff, such actions can put in fairly complex conditions of the insured or its loved ones. In the city the possibility of realizing the right to choose a physician is quite large, but the mechanism of using this right has not yet been developed. Any attempt is associated with large organizational difficulties.
Widely convicted precision "reinforcement" was not overcome and replenished with territorial. Today, we sometimes face the reluctance of medical institutions to take patients living in other regions, despite the insurance policy. By providing medical care to the patient permanently residing in another area, the LPU receives payment from the local territorial Foundation of the OMS, and the one, in turn, bears unplanned losses, because Payment on another territory may not happen. On the other hand, LPU financing is not limited to means from the OMS Foundation, the share of budget funds is essential. They can also constitute a guarantee of timely and high-quality medical care to any citizen of the Russian Federation.
The previously established medical care system proceeded from the fact that all LPUs, doctors and nurses are equally good. Consequently, the entire population is in the same conditions. Almost this led to a peculiar consolidation of the population for a certain polyclinic or a district doctor who differed from each other on qualifications, work experience, personal qualities. The old system is essentially not reorganized. The most important point of compulsory health insurance is the creation of competition in the market - not implemented.
Thus, the system of medical care of the population in the conditions of the OMS firmly entered into the life of society, but so far only one face: as an additional source of financing. Other sides of the system did not receive proper development and most people are not yet known. The rejection of the OMS system part of the population can be explained, most likely, not its disadvantages, but the problems of socio-economic reform of society. Without understanding the essence of the OMS, the population connects the failures in social policy in general, and from the Savior of the situation that established in health care, the OMS system turns into the eyes of the population in the destroyer.
CHAPTER 3. Empirical part of the study
Object and subject research
Object of study: consumption by the population of medical services.
Subject of study:
o frequency of visits to medical institutions;
o the reasons for the abandonment of medical services;
o desire and reluctance to use paid medical services;
o Activity of participation in wellness activities;
o Government measures aimed at popularizing a healthy lifestyle.
The purpose and objectives of the study.
The purpose of the study: to identify the dependence of the quality and standard of living from the current state of medical services.
Research tasks:
o identify the frequency of appeals to medical institutions;
o identify satisfaction or discontent with medical care;
o determine the readiness or refusal to pay consumed medical services;
o Analyze the enlightenment of the population in health issues;
o Assess the volume of activities to promote a healthy lifestyle undertaken by the Local Government;
o Make conclusions about the degree of manifestation of the care of the population about their health.
Basic concepts: Interpretation and Operationalization.
Medical services
1. This is a combination of necessary, sufficient, conscientious, expedient professional actions of a medical worker aimed at meeting the needs of the patient.
2. These are individual events or a set of measures conducted with diseases or with the immediate threat of their development aimed at preventing the disease and restoring health that have independent, completed value and a certain value.
3. This type of medical care provided by medical workers of health care institutions, which has such distinctive properties as intimators, inherencebility from the source of the service, the frequency of quality.
The standard of living is the level of consumption of the population, characterized by quantitative and qualitative indicators: the amount of real income per capita, level and consumption structure of food and non-food products and services, level and dynamics of prices for basic items of consumption, apartment fee, shipping fees.
The quality of life
1. This is a comprehensive characteristic of the socio-economic, political, cultural and ideological, environmental factors and conditions of the human existence, the position of a person in society.
2. This is a set of parameters reflecting the measurement of the flow of life with an assessment of the physical condition, psychological well-being, social relations and functional abilities during the period of development of the disease and its treatment.
3. This is a combination of indicators of the overall well-being of people characterizing the level of material consumption (standard of living), as well as consumption of non-paid benefits. Life quality assumes: a) pure environment; b) personal and national security; c) political and economic freedoms; d) other conditions of human well-being, difficult to quantify.
4. This is a constantly evolving economic and philosophical category, which characterizes the material and spiritual comfort of the existence of people.
Positive and negative factors affecting consumption by the population of medical services
Positive:
o bad environmental and climatic conditions of the dream of residence;
o seasonal and astrometeorological indicators;
o epidemic of viral and other diseases;
o Stressful situations in the life of people;
o hereditary factors.
Negative:
o Preventive measures;
o self-treatment;
o Constant support for their health by making medicines;
o healthy lifestyle;
o seasonal changes associated with the fact that in the summer to the doctor are treated less often than in the cold season;
o Excessive employment of the population when the patient is constantly postponing a campaign to the clinic.
Research hypothesis.
Hypothesis Research:
o reduces the frequency of consumption of medical services among the population of the young and middle age, which is negatively affecting the quality of their lives;
o The prevailing part of the population trusts more private medical institutions than the state, but the level of income does not always allow them to use;
o The current state of healthcare sphere is estimated by the majority of the population as unsatisfactory;
o The activity of public participation in health events is extremely low due to the fact that the local administration is not paying enough attention to promoting a healthy lifestyle.
health quality health medical
Research Plan.
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September 2007 |
Determination of the topic of research, object and subject matter research, identification of goals and objectives |
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October 2007 |
Determination of the operationalization and interpretation of key concepts of research, constructing hypothesis |
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November - December 2007 |
Search for theoretical material |
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January 2008 |
Building a research plan |
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February 2008 |
Definition of sampling, tools and information collection methods |
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March - April 2008 |
Work with the practical part of the study, conducting survey |
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Analysis of research results, writing a report |
The sample - probabilistic, was created by the method of accidental selection of the population aged 18 and older. The study involved 150 people.
Methods for collecting information, characteristics of the toolkit.
Information collection methods:
o questionnaire survey;
o Document analysis.
Characteristics of the toolkit:
o questionnaire (150 copies);
o Explanations to the Anktyny List;
o Data processing program (Microsoft Excel, Microsoft Word).
The questionnaire consists of 34 questions, of which 24 closed issues (4 questions like "yes - no", 1 alternative question, 3 questions-scale), 2 open questions, 8 semi-closed issues. You can also highlight 1 question trap, 2 filter questions, 1 indirect question, 2 silencer.
The profile is divided into 5 semantic blocks:
1) frequency and causes of medical care for recently;
2) readiness to pay medical services;
3) assessment of the state of healthcare;
4) health status assessment;
5) Passport.
Research results.
The frequency of appeals to doctors to a certain extent correlates with the data of self-assessment of the state of health and the presence of chronic diseases in the respondents. However, this kind of dependence is corrected by the fact of the presence of a medical institution, its remoteness from the residence of respondents, the degree of satisfaction with medical care.
Over the past year, 57% of respondents appealed for medical help (diagram 1). At the same time, 24% appealed to treat the disease, the rest - on subjective reasons, such as the passage of compulsory vulture (12%) or receiving a sick leave or reference (19%) (chart 2). Most of the respondents in the last three years did not resist in sanatoriums (70%) did not lie in the hospital (59%) (charts 10 and 11).
Of course, there is a direct relationship between the frequency of treatment of medical institutions and health status. However, a minor (2.5%) number of citizens with an unsatisfactory assessment of the state of their health towards doctors never turns out and only 10% always appeals. The overwhelming majority appeals for medical attention only under serious illness (27%), in the event of a diagnosis of diagnosis (14.5%) or if it was necessary to obtain a sick leave (45%) (Chart 19).
Despite the general trend, a third of residents who have unsatisfactory health appeals to doctors rarely. Presumably, respondents either exaggerate the assessment of their health status as unsatisfactory, or really have serious illness, but the medical staff is not trusted and engaged in self-medication. However, as for the latter, judging by the data of the study only 10% consider such measures acceptable, and almost half of the respondents combine the receptions of self-treatment and prescribing doctors (chart 12).
So, the frequency of appeal to the doctor depends on a number of factors. Women are much more likely to handle medical institutions (the proportion of women evaluating their health as unsatisfactory, significantly more). The frequency of appeal to the doctor is also increasing in proportion to age.
Over the past few years, the frequency of appeals to the medical institution under deterioration decreased. 30% of respondents believe that they consume medical services in the same volume as before, 21% believe that they began to use them less often and 28.5% answered that they did not use them at all (chart 13). This is partly due to the fact that people are not satisfied with the level of medical care provided in the State Health System.
Medical care fully does not fully satisfy a third of the population, regardless of gender, education, age and occupation. This does not mean that the rest of this level fully satisfies. Judging by the polls, most of all complaints about the professionalism of medical personnel (15%), further - the organization of reception of patients (14%), the hygienic state of medical institutions (9%), the security of medical equipment (8%) and, finally, the availability of drugs ( 6%) (diagram 14).
Satisfaction or discontent with one or another medical service depends on various factors and, accordingly, varies within the limits of various socio-age groups. Despite the large percentage of dissatisfied with medical care, a third of the respondents quite arrange the existing form of compulsory health insurance (chart 24).
Since medical care in state medical institutions does not satisfy many, people are trying to solve their problems with paid medicine. Only 14% of the surveyed paid medical services did not use, 20% use them constantly and 41% from time to time (chart 5).
For paid medicine, people with different levels of health are treated. More those who have no major claims to health, less than others, apparently, for financial reasons, are the elderly. Paid medical facilities are attracted by the following: lack of queues (33%), higher quality treatment (30%), low confidence in state medical institutions (14%) and inhaling other exit in the event of the provision of services only for the fee or availability of the necessary specialists in contrast from state medical institutions (8%) (chart 6).
It should also be noted that most of the respondents are ready to pay for various types of medical services. At the same time, not everyone can afford to do it without prejudice to the material state. This state of affairs shows that health still plays a rather significant role in the life of the population. 54% of respondents chose health as a priority value, which is in third place after the family (92%) and children (84%) and are practically equal to material well-being (53%) (chart 26).
As the study showed, the choice of the value of health as the most important thing was as follows: 20.5% believe that "how much about health care, it will not be anyway." In concern about his health, 28% of respondents come from the fact that "Health is the most important thing in my life and I do everything with such accounting to not harm him." However, the majority (51%) in this regard occupies a more moderate position: "Health is important, but I do not want to limit myself in many ways" (chart 28).
Most respondents assess their health status as satisfactory (42%), 22% and 27% as good and bad, respectively, and only 5% say that their health is excellent, and 2% is very bad (chart 27). According to a survey of men with great optimism than women, assesses the state of their health. If the percentage of evaluating it as satisfactory among men and among women is about the same, then the proportion of men evaluating their health as good, much higher than the share of women.
An important point in the category of health definitions is the level of self-determining behavior, that is, a responsible attitude towards the preservation and maintenance of his health. Despite the way, 37% of respondents believe that a person (chart 20) is responsible for their health, the degree of self-sustaining behavior in relation to health is quite low. Speaking that the most negatively affects the state of health, respondents call subjective factors, such as poor ecology (34%), frequent stresses (30.5%), heavy work or study (28%), low quality health care services (19 %), poor nutrition (14%), no material tools for buying drugs (11%) (chart 16).
On the question of why people are so often sick, were also named mainly subjective reasons. 21% decided that this is due to the rare treatment for medical care, while 17%, as opposed to them, noted the low level of medical services as a decisive cause. 6% also called the lack of propaganda of a healthy lifestyle among the population (chart 18). However, the question of the desire to take part in a well-being event conducted by the administration, 48% answered that they were not interested, 28%, that they would like to do it and only 15% said that they had already participated in such promotions (Diagram 22).
150 people took part in the survey, among them 69 men and 81 women (chart 29). Prevailing age groups from 26 to 40 years, from 41 to 55 years and from 56 to 65 years (chart 30). Most of the respondents work, the profession of technical orientation prevail (charts 32 and 33). 28% on the question about their income says that "there is almost always enough money", 54% of respondents determines their income to the category "enough only to the most needed" and for 15% "money is never enough" (chart 34).
It should be noted that almost half of the respondents (47%) identified their standard of living as an average (chart 25). Undoubtedly, the standard of living detects an explicit relationship with the definition of their own health. The respondents, more satisfied with the state of their health, evaluated the quality of life in general at higher parameters. On the question of which improvements should be taken in the field of medical services, the following responses were obtained above, the following answers were obtained: it is necessary to improve patient reception systems in polyclinics (28%), reduce the cost of paid medical services and drugs (24% ), Provide medical facilities with better equipment (18%), increase the professionalism of doctors and nurse (16%), carry out more events that promote a healthy lifestyle (8%) (chart 15).
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Medical services are a kind of useful activity that does not create material values, they usually do not lead to ownership of anything. Although it happens that a person who receives a medical service, for example, in the form of dentold, also acquires the prosthesis itself (element of goods in the service).
An element of goods in the medical service may be an extract from the history of the disease, medical examination data, a doctor's recipe, etc. But the element of the goods in the service is still impossible to consider how the goods, in the full sense of the word, because the element of goods in the service inseparable from it and independent value, as a rule, does not.
Recently, in connection with the increase in the well-being of people and the development of new technologies, there is an increase in the number of medical services provided. Investments related to the provision of medical services are considered beneficial in developed countries with a market economy. And there are not only private investors who invest their money in the creation of medical organizations and receiving profit from this, but also the state, because A healthy person involved in the creation of GDP brings income, and the country is less spending money for treating diseases and payable benefits.
At the same time, some types of medical services require large capital investments, such as hospitals, sanatorium services, diagnostic centers, and other, for example, massage therapist services, dentist, reflexotherapist can do the relatively small initial investment of capital. But they all are distinguished by a high level of professionalism of workers.
An important component of the medical market is the definition of a service involved in it. But despite the development of health care and strengthening it in the economy, the generally accepted definition of medical services has not yet been developed, because Definitions that are of great importance in the economy in general may not always approach the problems of health economics, in particular. So, it is believed that the service is a change in the state of a person or a product belonging to any economic unit that occurs as a result of the activities of another economic unit with the prior consent of the first. However, if the patient is unconscious and he needs to provide medical care, then he cannot accept consent to its rendering, and even more so on its payment. Of course, the patient needs help, but the question arises, who will pay for it and in what volume?
When answering a question that makes the consumer, a seller or an enterprise, be interested in a certain product, we encounter on a very significant in the theory of exchange, but a few specific concept of benefit. Consumer benefits and manufacturer benefits.
Under the use of the consumer (patient), you can mean the subjectively estimated product ability to satisfy the needs of their own health. Each product has a well-known basic benefit that consists in its technical and functional features (quality in a narrow sense), it is necessary to distinguish additional benefits associated with features that are not affecting the existence or functioning of the product, for example, a heated energo machine emitter. This includes additional functions of the product (the possibility of using for unforeseeled purposes), as well as accompanying circumstances (purchase, payment, product elimination after use).
Finally, additional benefits include the peculiarities of the product that increase the degree of satisfaction and prestige of its user, and the product often acquires the character of a symbol of a certain social status.
However, the "benefit" or "favor" received from medical services is quite difficult to outlines. If you can still describe the basic health of the medical service, expressing in the deliverance of the patient from suffering, the additional functions of medical services are quite rare, although there are. So, for example, a person who treated in a sanatorium, any disease often acquires an increase in the overall level of health caused by the right nutrition, recreation and physical education regime. If a person is resting in a prestigious sanatorium (for example, in Baden-Baden), he supports some social status.
The benefits of the manufacturer of medical services (doctor, hospital), usually lies in the profit, enterprise growth, guarantees of further activities, optimal capacity utilization, prestige, improving the quality of patient health, etc.
There are a number of medical service definitions. All of them are the point of view of their authors, but only a few really reflect the essence of medical services. We analyze the definition: "The dental service is any activity or the benefit that one side (dental clinic, a dentist) can offer another (patient)" (L.N. Tupikov, S.E. Tupikov, 2002). We believe that such a definition does not sufficiently reflect the focus of the human health. So if a dentist will provide transport to the patient for delivering it to a reception or dental clinic selling the other side of the paste to clean the teeth (economic benefits) - it is unlikely to be a dental service.
The next definition characterizes the medical service already as "professional actions aimed at preserving or maintaining an optimal health level of individual" (A.V. Reshetnikov, 2003). Such a definition really reflects the orientation of medical services to human health. But, with undoubted correctness of this postulate, the definition of medical services should be laid down and such a concept as good. So S.I. Ozhegov in the dictionary of the Russian Language "determines the service as an action that benefits the other.
The provision of medical services, as it is neither paradoxical, but not always can be directed only to the preservation or maintenance of the optimal level of health of the individual. For a number of data, in the United States, about 2 thousand teenage girls per year will expose themselves operations to increase breasts, and in 1998 the number of such operations has doubled compared to 1992. The German magazine "Spiegel" notes that in Germany by approximate It is estimated annually from 300 thousand to 500 thousand cosmetic operations per year. At the same time, today cosmetic operations and laser grinding of the skin are already offered tooth physicians, gynecologists and dermatologists - in order to compensate for the reduction of fees from hospital cash desks. The number of customers affected by cosmetic operations increased 10 times compared to the eighties. Among them are patients with scars on the face, blinded after the operation, even a fatal outcome is recorded. There is a case of a coma after the removal of fat, as well as suicide after a failed cosmetic operation. All this clearly does not contribute to the preservation or maintenance of the optimal level of health.
A person may have a number of special needs, which he can satisfy with the help of medical services, incl. Get the services of cosmetic surgery: hymenoplasty (plastic of virgin splava); Circumcizia, carried out during the surgery of prepuciotomy at ritual cuts of extreme flesh (Muslims, Jews); Increase the volume of the breast (often for commercial considerations of the patient). Although direct medical testimony to surgery in the listed cases may not be, but these services have consumer usefulness for the patient. In some cases, the provision of medical services at the request of the client may apply to the latter, in the future, quite tangible harm to health, but subjectively, at some point in time, a person can benefit from this and he is ready to pay for it.
In connection with the foregoing, we (S.A. Stolyarov, 2003) so define a medical service: "A medical service is any professional action aimed at changing or maintaining physical or mental health, in order to benefit its consumer (patient), in one form or another. "
The world has a tendency to diversify the service sector. Many previously isolated types of services are beginning to be united within the framework of one company, incl. and in health care. Offering a range of services, LPU can increase its competitiveness, weaken the possible risks due to their diversification.
Often services merge into a single set of financial services. There is a unification of a variety of services within the framework of the business. Firms engaged in medical services are beginning to offer services for insurance of life and health, tourist services for the treatment and recovery of patients abroad, etc. The hospital can open a pharmacy kiosk, for the sale of medicines and medical equipment; conclude an agreement with an insurance company for the provision of paid medical services that are not included in the mandatory list of free maintenance; Suggest (for a fee) transportation of home recovering by their transport, etc.
Medical services, as well as a number of others, have 5 basic characteristics (Fig. 1.9), which distinguish them from the product, for example, medicines: no ownership; intangibility; continuity of production and consumption of services; the inability of services to storage; Quality variability.
Fig. 1.9. Properties of medical services
1. Lack of ownership. If a person acquired a product having a physical embodiment, he becomes its owner, which cannot be said about the service. Medical services People are forced to acquire throughout life. Consuming the service, a person has access to it throughout a limited period of time. Having an insurance policy in his hands, his owner can contact the doctor only for a certain period, which is paid by the patient.
2. Reasonable, the elusiveness or intangible nature of medical services, for example, a survey means that they are generally impossible to transport, store and packaging. And to demonstrate, see, try, or study them cannot be obtained for these services. At the same time, it is possible to evaluate medical services only after receiving them, and even with difficulty.
Unacceptable medical services causes problems, both their sellers and buyers. This means that potential consumers cannot see or touch many medical services before buying or using them. A typical question that they can ask themselves: "What can it be like?"
The patient is difficult to figure out and evaluate that it is sold, before purchasing the service, and sometimes even after it is received. He is forced to believe the seller of services for the word. For example, the patient who applied to the medical institution cannot not only see the process of diagnosis and treatment, but also to evaluate what has been done and is done correctly. Therefore, from consumers of medical services, it is necessary to have an element of hope and confidence in the service seller.
At the same time, the unacceptable complicates the activities of their seller. Enterprises providing medical services arise the following problems:
· It is difficult to show your goods to patients;
· Even more difficult to explain to patients for which they pay money.
The company can only describe the advantages that appear as a result of the provision of this service, and the patient's services themselves can evaluate only after their implementation (although not always).
To strengthen customer confidence, a medical enterprise, providing services, can take a number of measures:
· If possible, increase the tangibility of your service;
· To emphasize the importance of the service;
· Square attention to the benefits from the service;
· Attract some celebrity to promote your service.
Increase the materiality of the service, the presence of the goods element in the service in the most different form can make it more tangible. It may be modeling the future appearance of the patient on a computer before a cosmetic operation, as well as providing customers with information about employees, their experience and qualifications.
3. Inspection of production and consumption. The production and consumption of medical services is closely interconnected and cannot be broken in time (Fig. 1.10).
Fig. 1.10. Inseparation of production and consumption
medical services
With the inextricable relationship between the production and consumption of services, the degree of contact between the seller and the client may be different, for example, during the repair of the car, there is usually no need for the personal presence of the customer, but the provision of medical services is inseparable from the one who provides them. So, treatment in the hospital is impossible without medical personnel.
It should be noted that when selling medical services, there can sometimes be exceptions and a temporary gap between their sale and consumption may be observed. So a ticket to the sanatorium is usually sold earlier than a person will receive medical services, but their continuity of production and consumption is preserved.
4. Inability to storage services. The specificity of the production of medical services is that, unlike the goods, the services cannot be made and stored. You can only have a service when an order is received or a client appears.
An important distinguishing feature of medical services is their "imyarchiness". They cannot be saved for further sale and provision. Unoccupied hospital beds, rooms in a sanatorium, not provided medical services, cannot be restored. If the demand for services is becoming more suggested, it cannot be corrected, as when selling medicines, taking the goods from the warehouse. Similarly, if the power of services exceeds the demand for them, income is lost and (or) the cost of services.
5. Quality variability or heterogeneity. The inevitable consequence of the production of production and consumption of medical services is the variability of its execution. One of the most important indicators of medical services is their quality. It is customary to allocate three components of the quality of medical care: the quality of the structure, quality of technology, the quality of the result.
The quality of the structure involves the possibility of LPU to provide medical services at the proper level. This includes the qualifications of personnel, the presence of the necessary equipment, state of buildings and premises, medicinal provision, financing, etc.
The quality of technology characterizes the optimality of a complex of therapeutic and diagnostic measures rendered by the patient.
The quality of the result is the ratio of actually achieved results with actually achievable.
All components of quality are closely related to each other and have a great influence on each other. So the low level of structure of the structure is hardly ensured by an acceptable level of technology quality, and violation of diagnostic technology and treatment can lead to adverse results for the patient. So in the Altai Territory in 2003 there was the following case. In one of the dental offices, a dentist before extraction of the tooth produced local anesthesia to three patients with an aqueous ammonia solution instead of lidocaine. Even if there was a pharmacy error in the packaging of the drug, then the doctor's fault is obvious, because He produced anesthesia in the "conveyor mode" - put the injection and sent the patient to the corridor to wait "when the language numbers" (although the patient was supposed to be in a chair under the supervision of a doctor), after which the same manipulation and in the same mode he produced with the rest of patients . Result: Low quality structure (illiterate doctor) → Not compliance with the technology for providing services (lack of patient observation) → adverse results for the patient (tissue necrosis).
The quality of the service is pretty much depends on who provides it, as well as from where and when it is provided. In one hospital, treatment and service high quality, in another, located nearby - lower quality. Inside the hospital, one doctor is polite and executive, while the other is arrogant and damages the prestige of the LPU. Even the same specialist during the day provides services in different ways.
When buying a product, the consumer simultaneously receives information about certain standards for its use. The whole thing is a person who has a medical service. Sometimes even a highly qualified doctor may allow a coarse error. Expressions of the type "My life in your hands" very well describe this situation
In most cases, the quality of medical services can be expressed only descriptively, and it can only evaluate its consumer only after it is purchased.
To reduce the variability of medical services, it is necessary to identify the causes of this phenomenon. Most often their impermanence or quality variability is associated with the qualifications of the employee, in addition, variability can be caused by the lack of competition, weak training and training, lack of communications and information, the lack of regular support from managers.
In principle, the variability of medical services may be connected with the inappropriate personal features of the nature of the medical worker who are very difficult to reveal at the stage of staff selection.
Another importantly important source of the variability of medical services, of course, the person himself, his uniqueness, which explains the high degree of individualization of the service in accordance with the requirements of the consumer, this makes it impossible to make them the mass of their production. For example, an abnormally located appendix can deliver a surgeon to a mass of problems in appendectomy. At the same time, it generates the problem of controlling consumer behavior or at least accounting for behavioral factors when working with clients.
Another problem is the ambiguity of the evaluation of the result. For example, death can be estimated from two points of view. From medical workers, all efforts may be taken, but the patient may die due to the nature of the disease and the peculiarities of his body, while the doctor may assume that he did everything depends on him. From the side of the patient's relatives, accusations may be nominated (sometimes quite justified) that the doctor did not do everything for adequate treatment of the patient.
Questions for repetition
1. What is investing in the concept of "health" as a biological, economic, social category?
2. What is the social importance of health?
4. What are the economic resources and how are used to maintain and strengthen health?
6. What is the connection of health with the standard of living of the population, quality of life?
8. What does the concept of "healthy lifestyle" mean?
The main purpose of the economy as a farm is to provide people means of existenceand maintain the conditions of existence necessary people. Basic condition of existencea person is his health, so the maintenance of people's health is legitimately considered as one of the defining problems of the economy.
The means of existence in aggregate with the conditions of existence are designed to satisfy the needs of people, including such a fundamental as the need for health. Since the need for health can not be satisfied directly, by producing and providing, selling goods to the consumer called "Health",
the economy is able to satisfy this particular need only through services and goods that contribute to maintaining and improving health, preventing diseases and healing from them.
Given that the needs for services and health goods are manifested and are in direct relationship with other needs of people, states, societies and form an integral part of this general system of needs, consider human needs in general, highlighting the needs of the needs of interest to us. At the same time, we establish a place that occupy the needs of products and health services in the general system of personal, family, social needs.
All the fact that the person needs, what is required by him, without which it is difficult or even impossible to live, call needs.All people seek to saturate or, as economists say, satisfy their needs. Things, items, services, with which a person, family, people satisfy a variety of, numerous needs, is customary benefits.
The need for health undoubtedly refers to the number of the first vital needs, the satisfaction of which is the main task of health care and is provided by all its means, including economic. Therefore, health itself as a source of satisfaction of life needs, and medical methods and health care facilities should be considered as good.
Some needs of people, for example, in oxygen, water, partially warm, are satisfied from natural sources. Nature itself created the conditions of existence, thanks to which a person saturates such needs without much effort and costs, like animals. it freely received by all the benefitsfor which you do not have to pay money or pay difficulty, give out other things in return. The presence of such free benefits is a person owes nature. Caring for natural wealth, environmental protection, its restoration and there is a kind of fee for free benefits.
Natural sources in the form of fresh air, clean water, sunlight and heat are also free benefits that are conducive to preservation and health promotion. This and more people receive from nature in the form of natural medicines and treatments. As the availability reduces, such goods all relate to the categories are free. In addition, due to the unfavorable environmental consequences of the production and economic activity of people leading to environmental pollution, many types of natural benefits, without which people cannot do, become antibules that undermine human health.
But many other needs, especially in food, clothing, housing, movement, in spiritual benefits can only be satisfied with the help of the existence created by the people themselves. This, as mentioned earlier, economic benefits,which do not get people for free. They can be obtained only for money, through labor costs or in exchange for other benefits.
in urban transport and much more, for which all citizens or individual categories do not pay money? Yes, these are economic benefits for which there is no one who receives them, but other people in the person of the state, society. Similar benefits are known called public.
Actually, the free, natural benefits should be paid, spending efforts to pick up nature fruits by exercising environmental activities. So the clear boundary between paid and free benefits does not exist. Continuous increase in the needs of people, an increase in their diversity, on the one hand, and the limited possibilities of their satisfaction due to the insufficiency of available sources - on the other, lead to an increase in the share of economic benefits compared to free, non-economic. Even natural water and clean air are becoming increasingly available, increasingly you have to pay money for the good, formerly free. More and more benefits, a person is not directly from natural sources, but through the economy, economic activity. Creating people you need, good - this is the main economic process called production.
Created people productsand serviceshealth care is naturally to economic benefits. Even medicinal herbs and drugs of natural origin, treatment through the use of thermal sources, mud, mineral waters require preliminary efforts in the form of collecting, cooking, arrangement, packaging, transportation and other procedures. Separate types of natural treatments used are required to accompany the services of medical personnel. All this indicates the economic nature of goods in the form of goods and services used in health care.
The processes for the creation and application of treatments are so closely related to the economy that they are not called not to provide services, but health.
Consumption, application, use of goods, saturation of needs, the satisfaction of the needs in economic science is called consumption.The word "consumption" is necessary, therefore, to understand in the broadest sense, bearing in mind and eat food, and wearing clothes and accommodation in the house, and a trip to the car, and the service in the bath (service consumption), and reading a book (consumption spiritual benefits). Consumption - the final process, in the name of which it works, the economy works. Consumption is legitimate to consider the purpose of the economy, but with one substantial reservation. It is necessary to consume exactly as much as required for a full-fledged life, in volumes caused by the physiological needs of the body, the spiritual requests of the individual, rational, scientifically based norms. Otherwise, consumption is able to abandon the unrestrained, harmful consumerismthose. In consumption for consumption, and not in the name of satisfaction of needs. Consumer trends often lead to the accumulation of benefits in excessive amounts, over all measures, and besides also unused. The causes of consumerism are most often in greed, compliant, immigration of people.
Consumption of goods and health services fits into the general description of consumption, but at the same time has certain features. If we are talking about drugs,
special types of clothing and shoes for sick people, bandages, bandages, devices facilitating the performance of life functions, and other similar means, then consumption means in an economic sense use, application.Consumption of medical equipment means it usingin the processes of diagnosis and treatment. The same refers to buildings, premises, equipment, which generate basic means of health organizations.
It is more difficult to deal with the consumption of health services in the form of a variety of activities of medical and auxiliary medical personnel. In health care they are called treatment, care for patients. In the economy, the use of services, including medical, is customary called service consumption,under which the consumer is obtained by the consumer in the form of the results of the activities of persons providing him with help, assistance, treatment, maintenance.
In health care, the consumption of services is not always the final process in the full sense of the word. Services are completed by a certain type of production and medical activity or the stage of treatment. The rest, the final process, is the assimilation of the patient the results of treatment. The indirect analogy represents food intake, concluded, strictly speaking, its assimilation by the body. The only difference is that the results of treatment rarely absorb so quickly and reliably as food. Consumption of certain types of health care services, such as diagnostic, consulting, medical and health, expressly considered the final procedure of the relevant activities.
There is reason to talk about consumer trends in health care, watching the patients, and even more so pseudo-shared, ready to carry out the main part of life in medicinal institutions without need. Such a re-configuration (harmful consumerism) is manifested in an unlimited, not necessitated the need for health of the use or even abuse of medicines.
Many people need are saturatedin the sense that they can be satisfied sufficiently known tools. For example, a person is quite enough to consume a food diet with a calorie content of about 2500 kals. Consumption over this border of saturation becomes excessive and even harmful (other thing, people always want to consume more diverse, delicious food). Or is unlikely to have more two refrigerators in the apartment. But the need for knowledge is not limited to a clear border. The need for money, although there is a deliberate amount of money, is quite sufficient for human-free existence.
As for the needs for goods and health services, they should, in our opinion, attributed to saturated. Even the original need for health is saturated in the sense that the painless state of human health, whose body normally performs the functions inherent in it, may well be called the norm of health, sufficiently satisfying the need for it. Accordingly, the saturation of the need for goods and services of health care should be considered the possibility of obtaining them in quantity and composition, time and place defined by
the state of health and objectively necessary means of maintaining it. At the same time, the quality of methods and means of treatment, scientific knowledge of human health is not limited to a predetermined limit.
Are the needs of different people? Obviously, certain needs, such as food, clothes, knowledge, are peculiar to all people, others are not all, but only in need of them. The need for health is obviously inherent in all normal people, but needs in certain services and health products - those who are needing in them. It seems that the needs in the modern diagnosis of the state of the human body, hazardous diseases, in anti-epidemic measures, in sanitation and hygiene, are universal in medical and health procedures, distributed to all people (a few different degrees - depending on age, gender, state Health, regional features).
To a certain extent, the needs of a person, family, groups of people, society are distinguished. Therefore, allocate personal, family, group, public needs.
The needs for services and goods intended for the protection of human health, treatment are mainly personal, individual. The object of care, maintenance, satisfying medical needs is ultimately personality, man. The health of a separate person is the elementary cell, of which there is a level of health of families, social groups, the population of the region, countries. Therefore, the personal needs of a person in health care products form the basis of the entire needs system in services and health goods.
In addition, there are personal needs due to the fact that self-medicine is played a huge role in medicine, as well as homework - under the supervision of doctors or independent. Anyone needs a home first-aid kit in the form of a set of standard or individually intended medicines. Each person must have instruments for measuring temperature, and in some cases - special equipment, the choice of which is due to the nature of the disease. The presence of medical and health care products, sanitation and hygiene has become a sign of medical and even a common culture.
To the category of personal needs for health care, the presence of elementary, common medical knowledge, household background medical literature, the ability to recognize the signs of a suddenly emerged disease and provide simple urgent help. People prone to diseases or chronic patients need a means of calling medical care.
In special cases, individual patients can afford to satisfy the need for a personal physician; However, more often people use family doctors.
Family needs of a medical nature may exceed the amount of personal needs of each family member, as sometimes there are health problems and its protection related to the family as a whole (due to, for example, hereditary diseases, the dangers of the dissemination of a disease of one of the family members for the whole family). Separate funds
health care, medical physical education, drugs can be the object of the needs of the whole family or several family members. This fully refers to subjects of sanitation and hygiene.
With all the meaning of personal and family needs in services and health products, such needs can be met in almost full, at the regulatory level, only when they become part of group, social needs.For such an output there are convincing justifications.
First, the provision of medical services to an individually to everyone who needs a person at home, through personal treatment, it would require a significant increase in medical personnel, delivery of funds treatment to each individual, which would lead to a huge increase in the cost and cost of service.
Secondly, the provision of health care services in their public form allows you to focus medical and medical staff, medical equipment, diagnostic and treatment tools, to create favorable conditions for medical treatment and provision of other services within relatively narrow zone clinic and hospital hospitals. This greatly improves the quality and reliability of maintenance, treatment by giving it a comprehensive, comprehensive nature and ensuring sterility conditions. In addition, when collective, multiple maintenance, cost savings and the best use of the production potential of the clinics are achieved.
Caused causes are so significant that they give reason to talk about the social nature of the majority of health care needs. There is no doubt that the health of each person represents intrinsicness and for him personally, and for the state, society. It is clear that the processes of treatment of patients are personally oriented, mass treatment is rather an exception than the rule. But the needs for services and health goods are public in the sense that they are peculiar to almost all people and can be fully satisfied only with the use of social forms. Thus, the consumption of health care products is mainly massive social character, has a public nature.
This thesis is also supported by the consideration that the same diseases are characterized by many people with many specificity, tend to spread on a mass scale. Therefore, the treatment of one requires the treatment of many to the same extent to which treatment of many requires the treatment of each of them.
The public health requirement arises as a result of integration, compounds and interaction of personal and family needs with group, collective. Thus, the team of the vessel needs a ship's doctor and a medical point, the population of the village - in a small polyclinic, the city is needed by diverse clinics, hospitals, doctors, and the country as a whole is a comprehensive health system that allows you to meet the needs of the entire population.
In economic science, the need is usually divided into material and spiritual. Materialrefer to the needs of people in things, subjects, material values, while spiritual needs- This is a need for spiritual food in the form of knowledge, beliefs, cultural values,
information, information about the world, intellectual communication.
Needs in health care have both material and spiritual nature. Material and material needs include drugs, medical nutrition, therapeutic clothing and shoes, material treatment facilities in the form of materials, energy, equipment, vehicles, equipment, devices, premises, buildings, structures. The spiritual should consider the need for health science, in medical knowledge, in information about diseases and methods of their treatment, in consultations, health culture, healthy lifestyle.
This is quite obvious truths. But it is not always so easy to classify health needs, referring to obviously material or spiritual. The problem is not solved so simply in relation to the nature of health services in the form of basic types of medical and medical activities in the treatment of patients. The need for a removal operation or even replacement of organs and their parts is formally material in nature and is directly related to the application of physical effort. But it is inseparable from the spiritual need in the form of the initial establishment of the type of illness and the method of treatment. Studying the survey data of the patient, listening to his complaints, writing down the medicine, the doctor satisfies the most likely the spiritual needs of patients, but in the process of receiving drugs, the use of other physical treatments of treatment is materialized, acquire a real form.
The thing is that health itself combines inseparally related, interacting material and spiritual principles. Therefore, the need for health, and the need for providing its health care products is a comprehensive material and spiritual character. This connection is so strong that it is often not possible to divide the material and spiritual aspects of health services. Therefore, one of the most characteristic features of health care services, the needs of them and their consumption processes, which highlights the economy of health care in the category of very specific sectors of the economy and service sectors.
Usually, people's needs are customary to rank, establishing the measure of importance, the significance of a particular group of needs in the general hierarchy, often depicted in the form of "pyramid needs." Sociologists are quite often placed in the top of such a "pyramid" the need of people in self-realization, self-expression, self-affirmation, and in the foundation of it - the physiological needs considered as the simplest, not so significant and important. At the same time, the need for health and health care is not allocated as independent, and is included in the need for security and assistance.
If we proceed from the fact that the need for health and in its protection is of life character and without its satisfaction, other needs cannot be implemented, then this need deserves the highest place. But since health is initially present in a healthy body, psychologically people are not predisposed to be considered its highest value as long as the need for health does not become an adequate need for life. Only due to the loss of health comes awareness
the fact that physical and spiritual health is the main, the main vital value.
The economic features of medical services can be reduced to threelarge interconnected classification groups.
First group make up the features of health services , associated with the specifics of the very result of the professional activity of persons employed in the field of human activity under consideration.
What are these features?
1. The result of professional activities in health care,usually, embodied in the man itself.Material services - rather an exclusion for healthcare (for example, these are X-rays, electrocardiograms, recipes, on which the clinical and diagnostic thinking of the doctor recorded and which, being discharged, begin, like books, life, independent of the will and consciousness of the author, etc. .).
2.The service, as a sectoral health result, is always individual.Although it itself deals with millions of people, there is not only massive, but also of small-scale production in health. It is also impossible to produce health services in advance, so to speak, the future, and then wait for the emergence of the demand and realization of this peculiar product. The services of the health care services are not at all the services themselves, but only information about those services that can be rendered to patients.
Consumption of a significant number of health care services coincides with their production. The individuality of the provision of health services and the creative nature of many forms of medical activity leads to the fact that the necessary result (effect) can often be achieved only by the actions of a sufficiently limited range of specialists or even the actions of one person. Therefore, this feature of the manifestation of the results in health care leads to the fact that the local (local) health care services market is much more easily closed with their opposite - world market.
3. We considered result,despite all his individuality, may be diverse in its physical volume.In this regard, in health care is really the implementation of various options. We can imagine a doctor who dealt with only one patient - a personal doctor of some celebrity. In this case, the result of his work will be individual in the literal sense. However, to maintain their own qualifications and this doctor, obviously, it will be necessary to have more extensive practice.
Family medical sister, based on the multidimensional nature of its functions, should achieve the receipt of adequate needs of the results in a wider physical volume, dealing with a number of individuals of different ages (usually starting with school children) and social status. Having assisted to each family member, taking into account specific conditions, a family nurse can achieve the desired effect, only solving a wide range of professional tasks. It should also be competent in family planning issues, education of children, psychology and physiology of the child's development, problems of overcoming stress and emotional barriers, sexual behavior, knowledge of geriatria, etc.
4. The result of health care has a complex structure and can disintegrate on a lot of sub-over (or quasi-meters).Hence the importance of awareness that efforts both doctors of narrow specialists and general practitioners, as well as other categories of health workers, and other categories of health workers are needed to achieve overall results.
At the same time, it is advisable to dwell on the very concept of health as the result of medical activities.
Strengthening the health of the population is not only necessary, according to and, perhaps, the only possiblea universal indicator of obtaining a certain positive labor result of health workers in the form of a useful effect.Health is determined by a number of demographic and other factors. It is characterized by several basic groups of indicators. The first group includes such demographic indicators as the population, its composition, fertility, mortality, natural growth, and others. The second group consists of incidence of the population. And the third group includes indicators of the physical development of individual groups of residents. Many specific methods for assessing the results of medical activities and, according to the health of the population, are based on the definition of a number of medicinal and prophylactic indicators that are directly and more closely related to the difficulty of medical workers.
5. Efficiency in health care is not directly related to the amount of costs.
6. The result is varied by the deadline for the manifestation and need to repeat.The range of this diversity can be very significant: from the instantaneous achievement of the result, as it happens, for example, when removing pain sensations, and up to long-term, often painful, repeated with a certain frequency of medical influences, which only in their entirety can lead to achieving the goal.
7. The nature of the calculations for the achieved result (rendered service) may also be different.This is direct payment, and payment through budget funds, and payment from funds formed in insuranceorganizations.
Second groupdefinitions of the features of health care services associated with the expression of quantitative characteristics of its value . It is important to allocate a few points here:
1. The service can be provided as in the commodity (and it is in this case that it begins to possess the value parameters),so in the universal form. The trademark of health services, and, consequently, the initial market of medical services arose already in the era of ancient civilizations (6-8 thousand years ago). With the advent of the equivalent of the value, commodity relations in health care were transformed into commodity-money, which are dominant in the industry today, although the father of Medicine Hippocrat advised the doctor to "not too inherent herself. pottedthe attention is not on the abundance of funds in the patient and for their moderation, and sometimes he also treated for a gift, considering the grateful memory above minute glory. "
2. Definition the values \u200b\u200bof the cost of health care services can have several options,when choosing whom the doctor inevitably faces the need to solve an integrated clinical and economic task. -
3.the cost of the health care service is not a certain constant, this time and forever the magnitude.On the contrary, it tends to change, and more often towards the increase (especially, with long-term treatment).
4, Maybe,despite all the uncertainty and unpredictability of the medical and prophylactic process, creating economic standardsincluding a number of interdependent natural, cost and relative indicators and allow, at least approximately, to determine what the alleged process of treating or health care will cost.
Third groupfeatures related to the process of providing (production) health services.
These features are advisable to attribute the following features:
1. Availability of a large number of investors(Patient, Family, Enterprise, Employer, Public Organizations, Including Confresions, Insurance Companies, State and International Structures), paying the process of providing services. Only the joint use of various investment resources allows the process of providing health services in continuous, high-quality and efficient.
2. Manifold of economic relations,which are manifested during the provision of medical services and without the presence of the activities of the modern, which has been subjected to significant health care industries.
3. The dependence of the provision of health services from local climatic conditions,which may interfere or, on the contrary, be favorable for the implementation of the treatment or prevention of various diseases.
4. The presence of an active interconnection by the "patient-patient" line.In the process of providing health services, all known methods of impact on the subject of labor are used: mechanical, physical, chemical, biological, socio-psychological. The patient, as an object of medical influence, has the greatest activity thatmo can be directed both to the harm to him and good.At the same time, in the necessary cases, the conscious activity of the patient is turned off (anesthesia, hypnosis).
5.The possibility of territorial movementsin the process of providing health services, the industry also distinguishes the industry from many types of activity in the field of material production, where the process of creating goods is usually geographically occurring in one specific place.
6. In the process of providing health services exist ability to limit effortsachieve an intermediate result with the subsequent resumption of the service with the appropriate change in the conditions for the implementation of this process.
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Acting in a market economy, health care, like any other industry to a certain extent, is subject to the laws of the market.
In everyday life, the market is most often associated with a place where you can buy products, clothing, household goods, etc. This is the most ancient form of the market - a traditional place where buyers and sellers make deals. From the point of view of the economy, the market reflects the relationship, which make up between manufacturers, vendors, intermediaries and consumers of goods and services. There are many market definitions, but they all reduce the fact that the market is a set of economic relations manifested in the field of exchange of goods and services, as a result of which the demand, supply and price are formed in the context of competition.
The market of medical goods and services is a market segment that provides medical products and services to preserve and improving public health. It makes it possible to receive and provide medical services, guarantees their necessary volume and the appropriate level of quality.
The market in health care includes a whole system of interrelated markets: medical services, drugs, medical personnel, scientific research, medical technology, medical equipment, etc.
Distinguish the following basic concepts of the market:
. demand;
. sentence;
. service;
. price;
. competition;
. marketing.
Demand is one of the fundamental concepts of a market economy. For health care demand (need) is the number of medical goods and services that wishes and can acquire society (individual patients) during a period of time at a certain price.
There are the following types of demand in the market of medical goods and services.
Negative demand: on vaccinations, reception to the doctors of individual specialties, painful, expensive procedures, etc.
Hidden demand. When individual patients may experience the need to be satisfied with the help of the medical goods and services available on the market, for example: family doctor services, disposable medical products, service services, individual dining in the hospital, etc.
Falling demand. For example, recently fell in the syringes, the blood transfusion systems of reusable, hypotensive drugs of domestic production, so the market has reacted with an increased proposal for syringes and the blood transfusion systems of one-time use, imported drugs.
Irregular demand. These are seasonal temporary fluctuations. For example, the demand for sanatorium-resort treatment is higher in the spring-summer period than in the autumn-winter. Appeals to individual specialist physicians depend on the seasonality of some diseases (flu, ulcerative disease, viral hepatitis, etc.).
Excessive demand. In health care, there is an excessive demand for urgent medical care for festive and post-vacation days, when patients suffering from chronic diseases disrupt the diet, mode, abuse alcohol; The level of injury is increasing.
C \u003d n x n,
Where C is the demand for medical services;
N is the number of patients;
P is an indicator of the appeal of the population for medical services.
The following fundamental concept of the market is a proposal. The value of the proposal is determined by the number of goods and services that the manufacturer (seller) wishes and can sell at the given time at a certain period of time.
With regard to healthcare, a proposal is the number of medical goods and services that manufacturers may provide in a certain period of time. The proposal, other things being equal, also changes depending on the price change: as the prices increase the manufacturers (sellers) offer patients more products and services. When the price is falling, their interest is reduced and accordingly decreases the volume of goods and services produced by them.
A medical service is a structural element of preventive, medical and diagnostic, rehabilitation, sanatorium-resort, sanitary and epidemiological, drug, prosthetic and orthopedic and other types of assistance having a certain value.
The most complex object of standardization in health care is medical services. The need to standardize medical services is determined by the needs of the population in obtaining accessible and high-quality medical care, as well as the emergence of fundamentally new medical technologies, medicines, medical products, equipment.
Medical services are divided into:
. simple;
. Complex.
In terms of its functional purpose, medical services are divided into:
. prophylactic;
. diagnostic;
. medicinal;
. restorative rehabilitation;
. Service.
Manipulations, research and procedures as separate medical measures aimed at providing medical care, but not having independent completed prophylactic, diagnostic, medical or rehabilitation values \u200b\u200bare auxiliary elements of medical services. For example, the withdrawal of the organ at the donor, autopsy, etc.
Under the conditions and the place of rendering, medical services can be divided into houses provided at home, in outpatient polyclinic, hospital, sanatorium-resort and other health care facilities. Under a simple medical service is understood as an indivisible service, such as diagnostic manipulation, inspection of a doctor, etc.
A comprehensive service can be represented as a set of simple services reflecting the technological process of medical care in each particular institution in each particular institution.
In addition, the standard and individual medical services distinguish.
Standard medical services are mainly provided by unified technology for the overwhelming majority of patients and have relatively sustainable pricing.
Individual medical services have a wide range of manipulations of diagnostic, therapeutic procedures, a large set of medicines and medical products. They have differentiated price list prices that make up the individuality of the costs at their execution.
Specific features of medical services:
. intangibility;
. non-breakability;
. quality variability;
. ambiguity in assessing the result;
. Medical service This product is not only a manufacturer (medical worker), but also the consumer (patient).
Intangibility
The medical service cannot be seen, to hear, touch, appease until its consumption. A single patient will never be able to learn everything in advance about the consumer properties of the services provided to him. Any information about this, even emanating from the attending physician, will always be probabilistic. The assessment of the consumer properties of medical services is carried out, as a rule, at the level of subjective perception of their effectiveness (useful effect and side effects), sensations and emotional experiences of patients.Non-snack
Unlike goods of both medical and non-medical destinations, which are first produced, then some time can be stored in stock, or stand in the store for sale, the medical service is characterized by the fact that the process of its production coincides with the implementation process. Medical services are not subject to storage and accumulation for the purpose of subsequent implementation. It is impossible, for example, using the increased demand for one or another type of medical services; At first, accumulate, and then instantly "throw away" them from a warehouse to the market.Quality variability
Medicine is a creative process that is characterized by the high personality and non-standardity of a professional approach to the patient, and in the end, sometimes the unpredictability of the results. Despite the strict regulation of medical activities, in health care cannot be a single, depled approach to the treatment of patients, even with the same pathology, therefore, in diagnostic and prognostic aspects, the quality of medical services can fluctuate widely.It depends primarily on the qualifications of the medical worker, the equipment of the medical and preventive institution, the availability of medical care, the time and place of providing services, from the one who is its consumer, and many other factors.
Ambiguity in the evaluation of the result
The medical service can not always be assessed only positively. For example, when amputate legs to the patient, we will receive a positive medical effect: the patient stayed alive and can perform any work in specially created conditions, but it became disabled, and this is a negative social effect.Medical service is a product not only manufacturer (medical worker), but also the consumer (patient)
The quality of the medical service is formed as a result of the agreed actions of the medical professional and the patient's desire to benefit. The result of treatment will largely depend on how precisely the patient makes recommendations and appointments. Incompretation of medical treatment may also cause an adverse outcome, which does not depend on the level of qualifications of medical personnel, nor on the nature of its actions.
Medical goods and services, like any product, have a cost, the monetary expression of which is the price. In the market of medical goods and services, the price takes a central place in competitive exchange and serves as one of the tools for regulating this market.
The price is the amount of money for which the "buyer" can buy, and the "seller" is ready to sell this product or a medical service. The price is a kind of compromise of the economic interests of market participants.
Prices are powerful and at the same time flexible economic management lever.
Taking into account the fact that the price is organically related to the proposal and in demand, allocate the following concepts;
. demand price;
. Offer price;
. equilibrium price.
The price of demand is such a market price with such a state of demand and suggestions when the buyer's market is developing. At this price "Buyer" is able to buy a medical service or product. Above this limit, the price cannot rise, since patients will not be able to purchase it.
The price of a sentence is a market price with such a state of demand and suggestions, when the so-called seller market is developing. This is the price for which the "Seller" offers its service or product. At the same time, the price of proposals should recoup the cost of production of medical goods and services.
With equality of demand and supply on the market, the so-called equilibrium price is established. When the price is reduced, demand increases, as people want to acquire more products or services, and, on the contrary, with increasing price, demand can go to the decline.
Thus, the market mechanism provides a dynamic balance between supply and demand. The market in this case acts as a self-regulating system, an effective mechanism for the interaction of demand, supply and competition for the formation of prices, production and sales, as well as the level of consumption of goods and services. In addition, it provides an increase in production efficiency, product quality.
However, market self-regulation is not universal and should be complemented by state regulation mechanisms, which seems to be a fundamental idea of \u200b\u200bimproving market mechanisms in socially significant areas of the economy. This is especially true for the market for goods and services in health care.
The main link of the market mechanism is competition.
Competition is a competition between economic entities, the struggle for the markets for the markets of goods and services in order to obtain higher incomes, other benefits.
Competitive struggle for economic survival and prosperity - the law of a market economy. In the market of goods and health services, competitive participants can be:
. state, municipal health care institutions - on the implementation of the state (municipal) task on a competitive basis;
. organizations producing similar goods and services for health needs;
. Promotional doctors and pharmaceutical workers providing similar medical products or medical services.
The study of competitors, the allocation of their strengths and weaknesses is extremely important for the conquest of a certain share of the medical services market. Compare your services with competitors services, you can determine our competitive advantages, market positions.
Competitive advantages are unique, special features of medical organizations that distinguish them from others. It is they who help to make a profit higher than others producing and providing identical medical products and services. Defining competitive advantages, it is important to focus on patients, on their needs and be sure that these advantages are perceived by them as such.
The following competitive advantages can be distinguished:
. high reputation for the organization of health care;
. high quality medical goods and services provided;
. orientation on the patient, its requests and wishes;
. sufficient material and technical base, highly qualified personnel, modern equipment, sustainable financial support;
. the uniqueness of the offered medical goods and services;
. Reasonable prices for patients not exceeding or lower prices for similar medical products and services of other market participants.
Competitive advantages should be considered as the basis of the strategy of the behavior of participants in the market of medical goods and services, which is especially important in the context of the development of compulsory and voluntary health insurance.
For an effective organization of production and implementation of medical goods and services, knowledge of medical marketing is needed.
O.P. Schepin, V.A. Medic
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