Health planning. Determining the needs of the population in outpatient and inpatient care. General provisions of the healthcare system of the Russian Federation Determining the needs of the population for inpatient care

This is a perceived objective need for

receiving medical services and preventive

service, formed under the influence of conditions

life in a specific historical framework of development

society.

Under current conditions, the need for health

is in first place.

The health needs of the population are met

public health and healthy lifestyle.

Factors affecting the population's need for MP:

1. The level of morbidity of the population.

2. Morbidity structure.

3. The structure of the population, demographic features.

4. Socio-psychological characteristics of the population.

5. The degree of development of medical science.

Demand - seeking medical care, reinforced

given the opportunity to satisfy these services;

this is the number of medical services that are willing to purchase

number of patients for a certain period according to a certain

The demand for medical services has always been, is and will be.

Demand is a type of market relations.

If there is demand, there is supply and vice versa.

Types of demand:

1. Negative Demand: This is the negative demand for

vaccinations, health screenings.

2. Lack of demand - for health services.

3. Hidden demand - for non-traditional services

medicine.

4. Falling demand - for a decrease in attendance

physicians of a particular specialty.

5. Irregular demand - an irregular load on

polyclinic doctors by seasons of the year.

6. Full demand - complete and timely

satisfaction of the need for medical services.

7. Excessive demand - overcrowded branches

in hospitals, queues to the doctor.

8. Irrational demand - for smoking, alcohol.

Supply - the number of medical services that

can be provided within a certain period

time in the given territory to the data of health facilities.

Price is the monetary value of the service.

The price of medical services includes: payment costs

work of medical staff, profit and

expenses for medical and diagnostic services.

Healthcare Marketing:
E then a system of principles, methods and measures based on

based on a comprehensive study of consumer demand

body (patient) and purposeful formation

manufacturer's medical service offerings

(HCI); this is a comprehensive planning process,

economic justification and management

production of medical and pharmaceutical

services and products, pricing policy in the field

treatment and prophylactic process,

promotion of services and products to consumers,

and management of their implementation.

Marketing is based on the following key

concepts: need, need, desire, demand,

product, exchange, market.

Customer Orientation - Core Essence

marketing.

Medical marketing is characterized by

the concept of social and ethical marketing, that is

medical organization should not only the most

fully and effectively meet the needs of consumers

body, but also maintain and improve health

and well-being of both individual citizens and

society as a whole.

Planning in health care.

This is one of the most important management functions, a task

which is to find the optimal ratio

between the population's need for DILI and the possible

the possibilities of its satisfaction at a certain stage

development of society.

The health plan is an integral part of the state

plan for the socio-economic development of the country,

aimed at the most rational and efficient

use of material, labor and financial

resources to achieve results.

Types of plan: Territorial, sectoral, current

(up to 1 year), promising (up to 5 years), complex.

Planning principles:

1. Regional planning: implementation

planning at the regional level, taking into account priorities

and priorities of the region.

2. Scientific plans: the validity of the indicators of the plan,

which should be based on data characterizing

trends in morbidity and the needs of the population in MP.

3. Reality of plans: feasibility of plans based on

on knowledge and balance of needs in MT and economic

region opportunities.

4. Relationship between current and long-term planning.

5. Optimal combination of industry and territorial

planning.

Planning methods:

1. Analytical: used for comparative evaluation

initial and achieved level when drawing up a plan

and analysis of its implementation; determine security

population with medical staff, hospital beds, etc.

2. Comparative: makes it possible to determine the direction

development processes (morbidity, mortality).

3. Balance: allows you to identify imbalances during

implementation of the plan (balance of personnel training and growth of health facilities).

4. Normative: used when drawing up a plan for

the basis of the balance method; norms and norms are used

tive needs of the population in the MC, the need for beds

by total number and by specialty, staff

medical staff, medical and special equipment, soft inventory,

furniture, household equipment, transport, numbers

APU, percentage of hospitalization, length of stay in

hospital, the number of laboratory tests.

5. Economic and mathematical.

The main sections of planning in health care:

1. Development of a network of health care institutions.

2. Demand and training of medical personnel.

3. Investment in the construction and equipment of health facilities.

4. Logistics.

5. Financing (budget) of all health care-I and its sections.

Methods for planning medical beds:

The required number of beds is determined by performance indicators

hospital bed, the percentage of selection for inpatient treatment

and the incidence rate.

K=A x R x R/D x 100 or G/F; where K is the required number of beds

per 1000 inhabitants, A is the incidence rate per 1000 inhabitants,

P is the percentage of selection for hospitalization, R is the average duration of

the rate of stay in bed, D is the average annual bed occupancy,

G - volume of hospitalization, F - turnover (function) of the bed.

Methods for planning medical positions:

The need for medical positions is determined by the number of

to the quality of the population, the incidence of the population per 1

resident, functions of a medical position.

V \u003d L x N / F; where in - required amount medical

positions of this specialty, L - standard number

visits per 1 inhabitant per year, F (B x C x D) - the function of medical

position, H is the average annual population.

Teaching aid

Irkutsk, 2004

MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

GOU VPO IRKUTSK STATE MEDICAL UNIVERSITY

PLANNING IN HEALTH CARE.

IN OUTPATIENT CLINIC

AND HOSPITAL MEDICAL CARE

Teaching aid

Irkutsk, 2004

The teaching aid has been prepared by:

Gaidarov G.M. – doctor of medical sciences, professor, head

Department of Public Health and Health

GOU VPO IGMU

Kulesh D.V. – candidate of medical sciences, assistant of the department

public health and health care

GOU VPO IGMU

Reviewers:

Abashin N.N. - Candidate of Medical Sciences,

First Deputy Executive Director

public institution territorial fund

compulsory medical insurance of citizens

Irkutsk region

Kuptsevich A.S. - deputy chief

Health Administration Administration

Irkutsk region

Planning in health care. Determining the needs of the population in outpatient and inpatient medical care (educational manual). - Irkutsk, 2004. - 28 p.

The training manual reflects the main approaches and principles in planning medical care for the population in present stage, determining the needs of the population in outpatient and inpatient medical care. The manual is intended for students of medical and preventive, pediatric, medical and preventive faculties of the Medical University, interns, clinical residents of the department.

The teaching aid is printed by decision of the Central coordinating council IGMU.

TOPIC: “PLANNING IN HEALTH CARE.

DETERMINING THE NEEDS OF THE POPULATION

IN OUTPATIENT AND POLYCLINIC AND INPATIENT MEDICAL CARE"

INTRODUCTION

The place of the lesson is the department.

The duration of the study of the topic is 4 hours.

The purpose of the lesson: to study the basics of planning in health care; know the basic principles and methods of planning; study the definition of the need for outpatient and inpatient care.

Specific tasks:

The student must know:

What is planning in health care at the present stage; planning principles; types of plans and methods of planning; what are the units of measurement of the capacity of outpatient and inpatient medical institutions and the main indicators of the plan in health care; what is outpatient care case.

The student must be able to:

Calculate planned indicators and determine the need for outpatient and inpatient medical care.

Implementation plan

First stage of the lesson:

Introductory word of the teacher (the topic of the lesson according to the thematic plan practical exercises, defining the purpose and objectives of the lesson) - 5 min.

Test and oral control on questions to the topic of the lesson - 45 min.

Conclusion of the teacher on the results of the survey. Pay attention to the main sections of the topic - 15 min.

Second stage of the lesson:

Mastering the methods for calculating the main planned indicators of the work of an outpatient and inpatient institution. Independent work with educational, teaching aids, solving situational problems. Calculation of planned indicators and determination of the need for outpatient and inpatient medical care - 75 min.

Summing up the results of assignments, control of the final assignments of students - 15 min.

Discussion of the material. Discussion - 30 min.

Health planning

From a technological point of view, planning consists in the development of systems of plans that reflect various aspects of the activities of medical institutions or the development of healthcare in a certain area. From the socio-economic side, planning consists in taking into account the social laws of development, economic and other interests of healthcare entities.

Planning is the process of making and executing decisions on the use of the resources of an industry or organization by performing basic tasks to achieve the main goal.

The basis of the planning system is the definition at all levels of government - from federal to institutional - interrelated strategic goals, strategic objectives and strategic priorities for the development of health care.

The purpose of planning at the present stage is to create a normative and legal basis to implement the healthcare development strategy, which includes, among other things, ensuring the highest possible level of access to medical care for the population in modern socio-economic conditions by increasing the efficiency of healthcare.

Basic principles of health planning

at the present stage:

1. End-to-end planning principle for all levels: federal, subject of the Russian Federation, municipal, institutional.

Thus, the higher level offers the lower level the main parameters for planning and coordinates them with it, taking into account the formation and implementation of state (municipal) orders, local climatic, geographical, socio-economic, sanitary-hygienic, political and other conditions. After that, these parameters become the basis for planning at both levels).

2. Availability of a unified system for the Russian Federation of social standards, norms and regulations used for healthcare planning.

So, for example, the standards for the volume of medical care are the necessary volumes of medical and organizational measures, as a result of which it is possible to prevent the occurrence of diseases, ensure recovery in acute diseases and achieve remission in chronic diseases (for example, the average length of a patient's stay in bed, the function of a medical position, protocols for managing patients - standards, etc.). On the federal level when planning state guarantees, federal basic standards for the volume of medical care are established, which are then detailed at the level of the constituent entities of the Russian Federation, taking into account local characteristics, in the form of territorial standards for the volume of medical care (for example, the number of bed-days per 1000 population in the provision of inpatient medical care or the number of visits to 1000 population in the provision of outpatient medical care).

3. Continuity of the planning process based on a combination of strategic and current planning.

Strategic planning health care - determination of goals, objectives, priorities, procedures, volumes, conditions for the health care activities of the Russian Federation, its constituent entities, municipalities and individual medical institutions for a period of several years.

Current healthcare planning - determining the procedure and conditions for the implementation of strategic healthcare plans for the next year for all levels (federal, subject of the Federation, municipality and a separate medical institution). In the process of current planning, the implementation of strategic plans is monitored and, if necessary, they are adjusted. Thus, the principle of continuity of the planning process in health care is implemented.

At the stage of current planning, the constituent entities of the Russian Federation, municipalities assess the progress of the implementation of the strategic plan, primarily from the point of view of providing state guarantees in providing citizens with free medical care. Discrepancies with the strategic plan are revealed. Their causes are analyzed, based on the results of the analysis, proposals are made to eliminate the causes of discrepancies or to clarify and adjust the strategic plan. Then a detailed quarterly planning of the implementation of the tasks of the strategic plan for the current year is carried out.

One of the tools for the implementation of state guarantees in the provision of medical care to citizens at the stage of current planning is the state (municipal) order.

State order - a state assignment to regional medical institutions for the provision of free medical care to citizens of the Russian Federation living in the territory of a constituent entity of the Federation, containing the types and volumes of medical care provided with financial resources for their implementation from the regional health budget and compulsory medical insurance.

Municipal order - the volume of medical care planned to be provided to residents of the municipality within the framework of the Territorial Program of State Guarantees at the expense of the budget and compulsory medical insurance.

Plan- this is a document that defines the essence, sequence, direction and tactics of the activities of specific performers, at specific times and in specific areas of activity.

Plans are:

1. promising (for a long period);

2. current (operational, monthly and annual);

3. plans for the activities of institutions;

4. development plans (construction, repair, reconstruction);

5. comprehensive plans;

6. plans-tasks for the object;

For certain types of healthcare institutions, the main indicators of the plan are the following:

For a fixed network - "hospital bed";

For outpatient clinics - "number of visits per shift";

For an ambulance station, “number of calls per year”;

For a blood transfusion station, “the amount of blood collected

For the center of the state sanitary and epidemiological

supervision – “population served”

The most commonly used planning methods are:

1. analytical (used to assess the initial and achieved levels when drawing up a plan and analyzing its implementation);

2. comparative (part of analytical method) - makes it possible to determine the direction of development processes, for example, morbidity, mortality, etc.;

3. balance method (allows to identify an imbalance, for example, training and growth of the network of healthcare facilities);

4. normative (to determine the need for normative indicators based on the use of the balance method);

5. experimental (calculation of indicators based on the experiment);

6. economic and mathematical methods are used when necessary to scientifically substantiate the optimal options for the plan;

7. other special methods.

In health care, traditionally planned:

1. the need for personnel;

2. production activity(production (planned) indicators);

3. prospects for financing.

Determining the needs of the population

AND STATIONARYMEDICAL CARE

Teaching aid

Irkutsk, 2004

MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

GOU VPO IRKUTSK STATE MEDICAL UNIVERSITY

PLANNING IN HEALTH CARE.

DETERMINING THE NEEDS OF THE POPULATION

IN OUTPATIENT CLINIC

AND STATIONARYMEDICAL CARE

Teaching aid

Irkutsk, 2004

The teaching aid has been prepared by:

– doctor of medical sciences, professor, head

Department of Public Health and Health

GOU VPO IGMU

– candidate of medical sciences, assistant of the department

Public Health and Health

GOU VPO IGMU

Reviewers:

– Candidate of Medical Sciences,

First Deputy Executive Director

state institution of the territorial fund

compulsory medical insurance of citizens

- deputy chief

Health Administration Administration

Irkutsk region

Planning in health care. Determining the needs of the population in outpatient and inpatient medical care (educational manual). - Irkutsk, 2004. - 28 p.

The teaching aid reflects the main approaches and principles in planning medical care for the population at the present stage, determining the needs of the population for outpatient and inpatient medical care. The manual is intended for students of medical and preventive, pediatric, medical and preventive faculties of the Medical University, interns, clinical residents of the department.

The teaching aid is printed by decision of the Central Coordinating Council of ISMU.

TOPIC: «PLANNING IN HEALTH CARE.

DETERMINING THE NEEDS OF THE POPULATION

IN OUTPATIENT AND POLYCLINIC AND INPATIENT MEDICAL CARE"

INTRODUCTION

The place of the lesson is the department.

The duration of the study of the topic is 4 hours.

The purpose of the lesson: to study the basics of planning in health care; know the basic principles and methods of planning; study the definition of the need for outpatient and inpatient care.

Specific tasks:

The student must know:

The student must be able to:

Calculate planned indicators and determine the need for outpatient and inpatient medical care.

Implementation plan

First stage of the lesson:

Introductory word of the teacher (the topic of the lesson according to the thematic plan of practical classes, determination of the purpose and objectives of the lesson) - 5 min.

Test and oral control on questions to the topic of the lesson - 45 min.

Conclusion of the teacher on the results of the survey. Pay attention to the main sections of the topic - 15 min.

Second stage of the lesson:

Summing up the results of assignments, control of the final assignments of students - 15 min.

Discussion of the material. Discussion - 30 min.

Health planning

Planning is the process of making and executing decisions on the use of the resources of an industry or organization by performing basic tasks to achieve the main goal.

Target planning at the present stage is to create a regulatory and legal framework for the implementation of the healthcare development strategy, which includes, among other things, ensuring the highest possible level of access to medical care for the population in modern socio-economic conditions by increasing the efficiency of healthcare.

Basic principles of health planning

at the present stage:

1. End-to-end planning principle for all levels: federal, subject of the Russian Federation, municipal, institutional.

2. Availability of a unified system for the Russian Federation of social standards, norms and regulations used for healthcare planning.

So, for example, the standards for the volume of medical care - these are the necessary volumes of medical and organizational measures, as a result of which it is possible to prevent the occurrence of diseases, ensure recovery in acute diseases and achieve remission in chronic diseases (for example, the average length of a patient's stay in bed, the function of a medical position, protocols for managing patients - standards, etc.). ). At the federal level, when planning state guarantees, federal basic standards for the volume of medical care are established, which are then detailed at the level of the constituent entities of the Russian Federation, taking into account local characteristics, in the form of territorial standards for the volume of medical care (for example, the number of bed-days per 1000 population in the provision of inpatient medical care or number of visits per 1000 population in the provision of outpatient medical care).

3. Continuity of the planning process based on a combination of strategic and current planning.

Strategic health planning - determination of goals, objectives, priorities, order, volumes, conditions for the healthcare of the Russian Federation, its constituent entities, municipalities and individual medical institutions for a period of several years.

Current health planning - determination of the procedure and conditions for the implementation of strategic health plans for the next year for all levels (federal, subject of the Federation, municipality and individual medical institution). In the process of current planning, the implementation of strategic plans is monitored and, if necessary, they are adjusted. Thus, the principle of continuity of the planning process in health care is implemented.

One of the tools for the implementation of state guarantees in the provision of medical care to citizens at the stage of current planning is state (municipal) order.

Government order - a state task for regional medical institutions to provide free medical care to citizens of the Russian Federation residing on the territory of a constituent entity of the Federation, containing the types and volumes of medical care provided with financial resources for their implementation from the regional health budget and compulsory medical insurance.

municipal order - the volume of medical care planned to be provided to residents of the municipality within the framework of the Territorial Program of State Guarantees at the expense of the budget and compulsory medical insurance.

Plan- this is a document that defines the essence, sequence, direction and tactics of the activities of specific performers, at specific times and in specific areas of activity.

Plans are:

1. promising (for a long period);

2. current (operational, monthly and annual);

3. plans for the activities of institutions;

Average length of stay in bed in this case, it can be planned at the level of the standard for this indicator in the Program of State Guarantees for Providing Free Medical Care to the Citizens of the Region or the indicator actually established in this specialized department, provided that it does not exceed the standard for the State Guarantees Program.

The average number of days a bed was used. The planned indicator is calculated by the formula:

D= F x T,

F – bed turnover (planned);

T is the planned average duration of the patient's stay in bed (in days).

Planned indicators of the number of bed-days and the number of hospitalized patients can be calculated using the following formulas:

KD= M x T,

M= L x F ,

L - the number of estimated beds;

F – bed turnover (planned).

Definition of differentiated need

in hospital beds per 1000 inhabitants

Calculate both the total need for the bed fund, and for individual profiles of beds, including those for administrative territories.

AxRxP

k= ,

D x 100

Where k

Planning by First Determination

required number of beds

For this, several calculation options are used.

1 option:

Determination of the required number of beds based on the level of hospitalization. The calculation is carried out as follows.

H x R x T

To = ,

L x 100

P is the percentage of hospitalization;

Option 2:

Based on the number of treated patients and the planned bed turnover. The calculation is made according to the formulas:

F\u003d D pl / T,

where F is the bed turnover;

D - planned average number of days of work of a bed in a year;

T - The average duration of the patient's stay in bed (planned).

The required number of beds will be determined by the formula:

K = M f / F pl ,

M is the number of treated patients (actual);

F – planned bed turnover.

3 option:

Based on the number of bed-days spent and the average number of bed days per year. The calculation is carried out according to the following formulas.

(1) K = (M fxT pl) / D pl= KD / D pl; (2) K = KD f/ D pl ,

M f - the actual number of hospitalized (treated);

T - the average number of days the patient stays in bed (plan);

KD - the number of spent bed-days;

KD f – number of bed-days actual;

D; D pl - the number of days the bed is used per year (plan);

Calculation according to formula 1 is appropriate when the main estimated indicator (or indicator for which funding is made) is the number of treated patients. If it is necessary to determine the number of beds based on the indicators of the number of bed-days spent, then data on the actual number of bed-days and the planned number of bed days per year are used (formula 2)

Reference task

For an outpatient clinic:

Number positions outpatient doctors (in two ways: based on the number of attached population and based on the amount of work);

Scope of work (based on the number of full-time positions and the function of a medical position);

By hospital:

Calculate the required number of beds in the hospital in three ways: based on the level of hospitalization, based on the number of treated patients and the planned bed turnover, based on the number of bed days spent and the average number of bed days per year.

A) Calculation of the number of full-time posts of outpatient doctors , if it is known that according to the program of state guarantees, the rate of polyclinic visits per 1 inhabitant per year is 9.1, the population in the service area of the polyclinic is one person, the planned function of the medical position was 5,500 visits, and the number of visits in equivalent units was:

1. Based on the number of attached population:

LxH

(1) B = , Where

B - the planned number of posts of outpatient doctors;

L - the rate of outpatient visits per 1 inhabitant per year;

H - the number of the attached population or its contingent (women, children, workers, etc.);

Ф - function of a medical position

B \u003d 9.1 * / 5,500 \u003d 20.1 medical positions

2. Based on the scope of work:

(2) V = P / Fpl, Where

B - the number of full-time positions;

П – total number of visits in equivalent units;

Fpl is a planned function of a medical position.

B \u003d / 5,500 \u003d 19.7 medical positions

B) Determining the scope of work in an outpatient clinic , if it is known that 20 local general practitioners work in the polyclinic, the time limit for 1 visit is 15 minutes, the doctor’s annual working time budget is 1,810 hours, and the planned function of a medical position is 5,500 visits:

1. Based on the number of full-time positions and the function of a medical position.

(3) N n \u003d 60 / N in, Where

N n is the doctor's workload per hour;

N c - the norm of time (time spent) for 1 visit;

60 is the number of minutes in 1 hour.

N n = 60 / 15 = 4 patients per hour

(4) F \u003d N n x B x K, Where

Ф - planned function of a medical position;

N n - Doctor's load rate per hour;

B - The annual budget of the working time of the position (in hours);

K - The coefficient of using the working time of the position (0.923).

F = 4 * 1,810 * 0.923 = 6,682.5 visits

(5) Scope of work = Fpl x V, Where

Scope of work - number of visits

Fpl - planned function of a medical position;

B is the number of medical positions.

Scope of work = 6,682.5 * 20 = visits

C) Calculation of the cost of the doctor's working time for one case of outpatient services, if it is known that the patient who applied for medical help to the local general practitioner initially called him to the house, and then visited him in the clinic 2 more times. At the same time, the actual data on the time spent on visiting a doctor by patients for the previous reporting period in this health facility was: again in the clinic 12 minutes, initially and again at home 30 minutes.

(6) T \u003d t 1 + t 2 + t 3 + ... + tn

Where, T - time spent on one case of outpatient services;

t 1 - the time spent on the initial visit (appeal) depending on the place of medical care (in the clinic or at home);

t2, t3, …tn – time spent on return visits depending on the place of medical care (clinic or at home).

T \u003d 30 + 12 + 12 \u003d 54 min. doctor's working hours for one case of polyclinic service

D) Calculation of the planned performance indicators of the therapeutic department of an inpatient medical facility, if it is known that in the current reporting period this department is not planned to be closed for repairs, the average downtime required to prepare a bed for the next patient is 1 day, the average duration of a patient's stay in a bed in accordance with the territorial standard was 13.7 days, and the number of beds in accordance with the estimate was 60:

N-tp

(7) F = ,

T+tn

Where F is the bed turnover;

N - number calendar days in the planned period;

tp is the average number of days of downtime associated with the planned closure of a bed for repairs;

T - the average duration of the patient's stay in bed (in days);

tn - the average downtime required to prepare the bed for the next patient (in days).

F = (365 - 0) / (13.7 + 1) = 24.8 patients

(8)D= F x T ,

where D is the average number of days of bed operation (planned);

F – bed turnover (planned);

T - the average duration of the patient's stay in bed (in days) - the standard for the State Guarantee Program.

D \u003d 24.8 * 13.7 \u003d 339.8 days

(9) M= L x F ,

where M is the planned number of hospitalized patients;

L - the number of estimated beds;

F – bed turnover (planned).

M = 60 * 24.8 = 1488 patients

(10)KD= M x T,

where KD is the number of bed-days in the planned period;

M is the planned number of hospitalized patients;

T is the average duration of planned stay in bed (in days).

CD = 1 488 * 13.7 = 6 bed days

E) Determining the differentiated need for hospital beds per 1000 inhabitants Ndistrict,if it is known that the rate of referral per 1000 population was 1324, the selection rate for hospitalization was 25%, the average number of bed days was 320 days, and the average planned number of days the patient was in bed was 14.0 days for all hospitals operating in the district :

AxRxP

(11) k = ,

D x 100

Where k – the required number of average annual beds per 1000 inhabitants;

A - the level of negotiability (morbidity) per 1000 population;

R - the percentage of hospitalization or the percentage of selection for hospitalization from among those who applied;

P - the average planned number of days the patient stays in bed;

D - the average planned number of bed days per year.

k =* 25 * 14.0) / (320 * 100) = 14.5 beds per 1000 population N - district

E) Calculation of the required number of beds in the hospital, if it is known that the number of people served by the hospital was people, the percentage of hospitalization was 21.6%, the actual average number of days the patient was in bed was 13.5 days, the planned one was 14.0 days, the actual average number of days the bed was 332.8 days, planned - 335.0 days, the actual indicator of the number of hospitalized patients was 4,985 people, and the planned bed turnover was 23.5, the actual indicator of the number of bed-days in the hospital was bed-days:

H x R x T

(12) K = ,

L x 100

where H is the population;

P is the percentage of hospitalization;

T - the average number of days the patient stays in bed;

D is the average number of days a bed is in operation per year.

K = * 21.6 * 13.5) / (332.8 * 100) = 204.7 beds

(13)K = M f / F pl ,

where K is the required number of beds;

M - the number of treated (hospitalized) patients (actual);

F – planned bed turnover.

K = 4,985 / 23.5 = 212.1 beds

(21)K = ( M f x T pl) / D pl \u003d KD / D pl,

where K is the required number of beds;

M f – the actual number of hospitalized (treated)

sick;

T pl - the average number of days the patient stays in bed (plan);

KD - the number of spent bed-days

D is the number of days a bed is used per year (plan);

K =* 14.0) / 335 =/ 335 = 208.3 beds

(22) K = KD f / D pl ,

Where K is the required number of beds;

KD f – number of bed-days actual;

D pl - the number of days of bed use per year is planned.

K \u003d / 335 \u003d 208.6 beds

Tasks for independent work

1. Calculate the required number of beds in the CRH hospital N district, if it is known that the number of people served by the hospital is 52,125 inhabitants, the percentage of hospitalization of the population according to the referral rate is 24%, the average number of days in a bed is 14.3 days and the average number of days a bed is in a year is 326.

2. Calculate the number of full-time posts of outpatient doctors, if the standard for the number of visits per inhabitant per year under the state guarantees program is 9.1, the population attached to the polyclinic is 16,470, and the planned function of a medical position is 5,500 visits.

3. Calculate the required number of full-time positions if the planned function of the medical position of the district general practitioner in the polyclinic was 5,500, the number of visits to the polyclinic for diseases was 5,000, for preventive examinations, 5,000, home visits, 1,000 and consultative visits, 250. Working time costs on average, per visit is 15 minutes in the polyclinic for diseases, 30 minutes for preventive examinations, and 37 minutes for home visits. and for a consultative visit to the polyclinic 23 min.

4. Calculate the planned function of the medical position of a neurologist in a polyclinic at a consultative appointment for adults, if the annual budget of the neurologist's working time is 1,778.7 hours, and the average working time spent on a patient's consultative appointment is 25 minutes.

5. Determine the differentiated need for maternity beds in the territory of the municipality N , if the birth rate was 9.1 per 1000 of the population, the coverage of all women in labor with hospitalization was 98%, the average length of stay of puerperas in the hospital was 8.6 days (taking into account the pathology of pregnancy and childbirth) and the average number of days of bed work was 300 days per year .

6. Calculate the planned indicators of bed turnover, the number of hospitalized patients and the number of bed-days of the municipal hospital of the city N (according to bed profiles), where there are 4 departments: therapy for 40 beds, surgery for 60 beds, pediatrics for 45 beds and gynecology for 40 beds. Recommended as a planned indicator, the standard for the average number of days of bed work for therapy was 340 days; in surgery, pediatrics and gynecology - 330 days. Territorial standards for the average duration of a patient's stay in a therapeutic bed amounted to 13.7 days; on a surgical bed - 9.9 days; on a pediatric bed - 10.9 days; on a gynecological bed - 7.7 days.

7. Calculate the required number of beds in a hospital-type facility by all possible ways in general and by bed profiles, if it is known that this health facility actually has three departments (general therapy for 45 beds, pediatrics for 40 beds and gynecology for 35 beds). The actual number of hospitalized patients in the previous reporting period (year) in therapy was 1,283, in pediatrics - 1,011 and in gynecology - 1,810. 10.9 and 7.7 days, and the actual indicator of the number of bed-days spent by patients over the past year was recorded in therapy 16,108 (it should be noted that for 14 days in the 3rd quarter the therapeutic department of the hospital did not function due to repairs), in pediatrics 12,917 and gynecology 10,812 bed days. Evaluate the result.

8. In polyclinic N in the prior reporting period, one case of outpatient care was, on average, made up of one initial home-based visit and three follow-up visits, one of which was also home-based. Calculate the cost of the working time of the local general practitioner for one case of outpatient care, if the recommended time standards were: for the initial medical and diagnostic visit in the clinic - 18 minutes, at home - 30 minutes; for a second visit to the clinic - 12 minutes, at home - 30 minutes.

9. Calculate the planned volume of work in an outpatient clinic if it serves 14 urban areas with a recommended workload rate for a local general practitioner of 4 people per hour and an annual working time budget of 1,663.2 hours.

10. Calculate the planned indicators of bed turnover, the average number of days of bed operation, the number of hospitalized patients and the number of bed-days of a children's hospital with an infectious profile for 50 beds in the future reporting period (year), if repair work with closure is planned within 49 days of the second half of the year of beds, and the territorial standard for the average duration of stay of a sick child in an infectious bed was 9.4 days.

11. Determine the differentiated need for hospital beds per 1000 inhabitants N oblast, if the incidence of 1,100 per 1,000 inhabitants (urban and rural population) is predicted for the planned year, the selection rate for hospitalization is 24.6%, the average number of bed days per year for all hospitals is 325 days and the average number of days of stay patient in bed - 14.6 days.

test questions

1. What is planning and what does it mean from a technological and socio-economic point of view?

2. What is the main goal of planning in health care at the present stage?

3. Name the basic principles of planning in health care.

4. What are the standards for the volume of medical care?

5. What is strategic health planning?

7. What is ongoing health planning?

8. Define the state and municipal order in health care.

9. What is a plan? List the main types of plans.

10. Name the main planning methods most often used in healthcare.

11. What measures of the plan in health care do you know?

12. What does the traditional planning of the polyclinic work include?

13. What is the function of a medical position and what is the method of its calculation?

14. What methods are used to plan the number of full-time positions of doctors in an outpatient clinic and what is the method of their calculation?

15. How is the scope of work planned in an outpatient clinic?

16. What is meant by outpatient service case?

17. What are the units for measuring the capacity of outpatient and inpatient facilities?

18. What are the main planned indicators of the work of the hospital with the method of their calculation.

19. How to determine the differentiated need for hospital beds per 1000 inhabitants?

20. List the ways in which the required number of beds in a hospital can be determined, and provide a calculation method.

Test tasks

001. What is the basis of the health planning system?

a) determination at all levels of strategic goals, objectives and priorities for the development of health care;

b) creation of a unified regulatory framework for the implementation of the healthcare development strategy;

c) improving management efficiency;

d) increasing the efficiency of the use of industry resources.

002. Strategic planning is:

a) linking the staff of doctors to the amount of funding;

b) the process of making and executing decisions on the use of the resources of the organization to perform some basic task and achieve goals;

c) determination of goals, objectives, priorities, procedures, volumes, conditions for the healthcare of the Russian Federation, its constituent entities, municipalities and individual medical institutions for a period of several years.

003. What is meant by the state order in health care?

a) a state task for regional medical institutions to provide free medical care to citizens of the Russian Federation residing on the territory of a constituent entity of the Federation, containing the types and volumes of medical care provided with financial resources for their implementation from the regional health budget and compulsory medical insurance funds;

b) the volume of medical care for regional and municipal institutions health care at the expense of the state budget;

c) the volume of medical care planned to be provided to residents of the municipality within the framework of the Territorial Program of State Guarantees at the expense of the budget and compulsory medical insurance.

004. What is the purpose of planning at the present stage?

A) creation of a regulatory framework for the implementation of a healthcare development strategy, which includes, among other things, ensuring the highest possible level of access to medical care for the population in certain socio-economic conditions by increasing the efficiency of healthcare;

b) the continuity of the planning process based on a combination of strategic and current planning.

005. Current planning is:

a) determination of the procedure and conditions for the implementation of strategic health plans for the next year for all levels (federal, subject of the Federation, municipality and individual medical institution);

b) determination of goals, objectives, priorities, order, volumes, conditions for the healthcare of the Russian Federation, its constituent entities, municipalities and individual medical institutions for a period of several years.

006. What is meant by a municipal order in health care?

a) an order for the provision of medical care to residents of the municipality in accordance with the Program of State Guarantees at the expense of the regional budget;

b) the volume of medical care planned to be provided to residents of the municipality within the framework of the Territorial Program of State Guarantees at the expense of the budget and compulsory medical insurance.

007. Which of the following is not a principle of planning in health care at the present stage?

a) a cross-cutting principle;

b) the existence of a unified system of social standards, norms and norms for the Russian Federation used for healthcare planning;

c) democratic centralism;

d) continuity of the planning process.

008. What is called a plan when planning the need for personnel, production activities, prospects for financing in health care?

a) determination of goals, objectives, priorities, order, volumes, conditions for the activities of medical healthcare institutions for a period of several years.

b) a document that defines the essence, sequence, direction and tactics of the activities of specific performers, at specific times and in specific areas of activity.

009.Which of the following is not one of the options for planning by first determining the required number of beds?

a) calculation based on the level of hospitalization of patients;

b) calculation based on the number of treated patients and the planned bed turnover;

c) calculation based on the number of bed-days spent and the average number of days of bed operation per year;

d) determination of the differentiated need for hospital beds per 1000 inhabitants.

010. What is the measure of plan indicators in an outpatient and inpatient medical institution?

a) number of calls per year and hospital bed;

b) population served and hospital bed;

c) number of visits per shift and hospital bed;

d) population served and number of calls per year.

011. "Medical position" is a unit of measure of power:

a) a hospital

b) a joint hospital;

c) polyclinics;

d) non-integrated hospital.

012. The average downtime for a general somatic bed should not exceed:

a) 0.5 days

b) 1 day

c) 2 days

d) 3 days

013. What is the unit of measure for the capacity of a hospital?

a) a visit

b) bed-day;

c) a hospital bed;

d) call an ambulance.

014. Which of the following is not one of the ways to calculate the number of staff positions in an outpatient facility?

a) calculation based on the number of attached population;

b) calculation based on the scope of work;

c) calculation according to the formula

015. Which of the following is not used in determining the need for inpatient medical care for the population?

a) calculation of the scope of work based on the number of full-time positions and the function of the medical position;

b) determination of the differentiated need for hospital beds per 1000 inhabitants;

c) planning by first determining the required number of beds;

d) calculation of planned indicators of the volume of activity of hospitals in hospitals;

e) calculation by formula.

016 What is an outpatient service case?

a) the totality of visits performed at each visit of the patient to a specialist doctor;

b) the totality of visits made by all patients of the polyclinic to all medical specialists per shift;

c) one visit to the doctor when the patient seeks medical care;

d) each visit of a patient receiving outpatient treatment in a polyclinic to an outpatient doctor.

017. Which of the following is not the main planned indicator of the work of the hospital?

a) the function of a medical position;

b) the average number of days a bed is operated per year;

c) bed turnover;

d) all of the above.

018. Which of the following does not apply to the main methods of planning in health care?

a) analytical;

b) comparative;

c) sociological;

d) normative;

e) experimental;

019. Which of the following parameters is not used to determine the differentiated need for hospital beds per 1000 inhabitants according to the formula?

a) the level of negotiability (morbidity) per 1000 population;

b) the average planned number of days the patient stays in bed;

c) the average level of planned bed downtime;

d) the percentage of hospitalization or the percentage of selection for hospitalization from among those who applied;

e) the average planned number of bed days per year.

Main

1. Public health and health care: Textbook. for stud. / Ed. , . - M.: MEDpress-inform, 2002. - 528 p.

2. , Luchkevich medicine and healthcare organization. In 2 t. - St. Petersburg, 1998.

3. Social hygiene (medicine) and healthcare organization. Ed. Acad. , 1998.

Additional

1. economic analysis and planning of activities of medical institutions: Labor indicators. Production activity. Financial condition. Drawing up estimates. – M.: International Center financial and economic development, 1999. - p. 198.

2. et al. Methodological approaches to the development of strategic and current plans healthcare in the Russian Federation. - M.: TsNIIOIZ, 2000. - p. 136.

3. Lectures on the organization and economics of health care. Scientific publication. / Under the total. ed. , R. Schiff - Yekaterinburg: "SV-96". 2003. - 352 p.

INTRODUCTION ………………………………………………………………………….3

Healthcare planning ………………………………………………4

Determining the needs of the population

in outpatient care ……………………………………..7

Determining the needs of the population in stationary

medical care …………………………………………………………..11

Standard task ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Tasks for independent work ……………………………………………20

Control questions ………………………………………………………….22

Test tasks ……………………………………………………….………23

Download abstract Information about work

State educational institution higher professional education

Chita State Medical Academy

federal agency for health and social development

Department of Public Health and Health

Course work

in the discipline Public health and healthcare

Health planning. Determining the needs of the population in outpatient and inpatient care

Introduction

Health resources in any society are always limited, so the issues of their more efficient use are key. At present, there is a situation in the Russian Federation when state obligations to provide the population with free medical care of the required volume and quality are ensured. financial resources no more than half.

The lack of financial and other resources will not be overcome in the near future. Under these conditions, the role of financial planning methods in health care is growing as a procedure for bringing the level of consumption of health care resources by the population in line with the existing limited economic opportunities.

State and municipal medical institutions exist solely at the expense of health care expenditures planned in the budgets of all levels and funds of compulsory medical insurance. The correct combination of these sources, the use of the most effective, optimal mechanisms for bringing these funds to medical institutions are among the most important tasks of healthcare organizers.

On average, in the Russian Federation, budgetary funds account for the prevailing share in total health care expenditures - 60% or more. The use of these funds is carried out according to the budgetary-estimated principle. However, the mechanisms for using funds from the two main sources (budget and CHI) are different. With all the evidence of greater efficiency and expediency of the insurance principle of spending money on paying for medical care, the budget-estimate principle continues to be preserved. At the same time, it is also obvious that with a lack of funds in any industry in any field of activity, it is necessary to consolidate funds, use them in the direction of the "main blow", to solve the most significant tactical and strategic plan tasks. The implementation of these principles is possible through the expansion of competent financial planning in health care.

Rational planning allows not only to concentrate resources on priority areas, but also to implement an integrated approach to solving the most pressing health problems based on intersectoral interaction.

Subject of research: principles, tasks, directions and methods of planning in the field of healthcare.

Object of research: articles, normative materials and documents, as well as the works of Russian and foreign authors on the issues of health planning and economics.

Purpose: to study the planning mechanism at health care enterprises.

Make a literature review

Explore theoretical aspects health planning;

Analyze the economic methods of planning the activities of a medical institution;

Consider the main problems in health planning;

Study and analyze the results of your own research.

· Conclusion. Conclusion.

Research materials: articles, normative materials and documents, as well as the works of Russian and foreign authors on the planning and economics of health care.

1. Healthcare planning as a branch of the economy

Planning as an integral part of economic management is a set of methods and tools that allow you to choose the best development option that provides effective use resources.

Planning is divided into:

1) by level:

Federations (state planning),

Industries (industry planning),

Regions (regional planning),

Individual organizations, enterprises, institutions;

2) by the time factor:

current,

promising,

target;

3) by methods:

balance,

Regulatory.

Planning only “from the achieved level” (determining future changes based on existing trends, subject to their persistence and past experience), is acceptable if the society is not in the process of profound changes and is satisfied with the state of the social sector (in particular, the organization of the health care system). However, there is always the danger of repeating the mistakes made and the inevitable conflict with changing needs and new opportunities.

In order to achieve the most rational use of limited resources, it is necessary to determine their return as accurately as possible, compare it with costs, and compare various options for development programs in terms of costs and benefits.

Health planning is the substantiation and development of the population's need for medical care, drug provision and sanitary and anti-epidemic services in accordance with the possibilities of their satisfaction.

Lisitsin Yu.P. gives the following definition of healthcare planning: “health planning at the present stage should be considered as a specially created multifactorial subsystem of healthcare management, having dynamic goals, a multi-sectoral goal-forming complex and functional links between elements both within healthcare and with other industries.”

2. Basic principles, types and methods of planning

Basic principles of planning the health care system of the Russian Federation:

Security social guarantees the population in obtaining the necessary medical care, and first of all, the implementation of the State Guarantees Program;

Compliance of health care resources with the needs of the population in medical care.

The development of health care should take place under the following conditions:

The unity of the goals of the system development at different levels of organization and management, both for the current period and for the future;

Efficient use of material, financial, labor and other resources of medical institutions;

Strengthening the material and technical base of medical institutions;

Improving the quality and efficiency of medical care.

The command economy was characterized by directive health care planning, when the comprehensive plans included sections: a plan for labor (number and fund wages), maintenance plan; investment plan (construction and equipment of medical institutions); plan for labor resources (needs, training, advanced training).

In the context of decentralization of the management system and demonopolization state system health care, the content and methods of planning have changed from a directive to a recommendation. However, the normative method of planning has been preserved using the relevant norms and standards (load norms for medical personnel - the number of patients per 1 hour of outpatient admission; norms for the average annual bed occupancy in a hospital; staff standards etc.).

Specificity Russian economy is determined by a high level of differentiation of economic, social, demographic indicators of the development of regions. Strengthening spatial heterogeneity makes it difficult to pursue a unified policy of socio-economic transformations, leads to the disintegration of the national economy, weakening the integrity of society and the state.

A significant factor contributing to overcoming the disintegration of the Russian economy is the use of the program-target method of planning, which is successfully used in various sectors of the national economy, including healthcare. Importance state regulation The development of regional health care is due to the significant stratification of Russian regions both in terms of demographic characteristics and in terms of the level of public investment in the industry, which is reflected in the table in the Appendix to this course work.

Program-targeted planning for the development of regional health care has been practiced on the territory of all subjects of the Russian Federation since 1998 and is regulated by government regulations published annually. However, due to the heterogeneity of the main financial program indicators for the constituent entities of the Russian Federation, the effectiveness of program activities will also be different.

Relevance economic evaluation effects from the implementation of regional targeted programs increases with a change in the procedure for granting citizens of the Russian Federation state social assistance(monetization of benefits). With acceptance federal law dated August 22, 2004 No. 122-FZ "On State Social Assistance" there is a need to unify the principles of organization and mechanisms for the implementation of medical and economic control of drug care, preferential prosthetics provided certain categories citizens under the aforementioned law.

So, in market relations, the role of optimal planning increases, when, in order to most fully meet the needs of the population in healthcare services, taking into account the state of the material, technical and resource base, the option of further development of the system is chosen.

To this end:

1) complex indicators are analyzed:

Material and technical base of medical facilities in the region;

Standards for providing the population (children and adults) with medical care;

Population health and its dynamics;

Financial, material and labor resources health care of the region;

Clinical examination and preventive work etc.

2) questions are being studied:

Further development of medical care in its main types, taking into account the demographic characteristics in the region;

Development of health insurance (CMI and VHI);

Implementation of resource-saving technologies;

Improving the health management system;

Improving the quality of medical care for the population.

3. Economic methods of planning the activities of a medical institution

The transition to economic methods of industry management involves a change in approaches to planning at the level of healthcare facilities. When saving budget planning ( systematic process drafting, reviewing, approving and executing the budget) instead of the usual volume indicators reflecting the number of visits, bed-days, etc., crucial acquire financial regulations.

Advantage economic methods planning in that they create material incentives, affect wages medical workers. At the same time, complex indicators of quality and effectiveness are needed, which most fully characterize the goals facing the medical institution and its divisions.

Planning the work of health facilities is to determine:

1) the main goals and functions of health care facilities and indicators, the implementation of which contributes to the achievement of these goals;

2) types and volumes of medical care, taking into account the level of morbidity and age and sex structure of the population served;

3) the need for financial and material resources and calculations of financial standards;

4) maximum volume indicators of activity, taking into account the planned volumes of financing from all sources.

The indicator of the volume of outpatient care is expressed in the number of visits per 1000 population:

P \u003d AhKp + D + P;,

where P is the number of visits to doctors in total (per 1000 population); A - incidence rate (per 1000 population); Кп - coefficient of repeated visits (per 1000 population); D - number of dispensary visits (per 1000 population); P; - number of preventive visits (per 1000 population).

The indicator of the volume of inpatient care is expressed in the number of bed-days per 1000 population. The needs of the population for inpatient care - the required number of average annual beds per 1000 population (K), are determined as follows:

1. K \u003d A x R x P / D x 100

where A is the incidence rate (per 1000 population); R is the percentage of selection of patients for hospitalization; P - the average duration of the patient's stay in bed; D - average annual bed occupancy (number of bed-days).

2. K = Q x Pp / D x Pp

where Q is the total number of bed-days spent by patients in the hospital in the reporting year; P is the population in the reference year; D - an indicator of the average number of days of bed use in the billing year; Pb is the population in the reporting year.

where Y is the hospitalization rate (per 1000 population); P - the average duration of the patient's stay in bed.

The indicator of the volume of emergency medical care is expressed in the number of calls per 1000 population.

The most important stage of planning is the analysis of the system of providing medical care to the population according to the following parameters:

The degree of accessibility for the population of medical care within the framework of the territorial Program of state guarantees;

The quality of medical care;

Efficiency of use of existing capacities of health facilities.

Accounting and spending in budget institution carried out in accordance with the duly approved budget of income and expenses. It is the main planning and financial document of health facilities, compiled for a year on the basis of operational network and production indicators in accordance with economic classification budget expenditures of the Russian Federation: 100,000 - current expenses; 200,000 - capital expenditures; 300,000 - provision of loans (budget loans) minus repayment.

Cost planning according to the estimate is made on the basis of the volume of activity of the medical facility for the past period on the basis of labor, material and financial norms of expenses. Then, justification and calculation of the amounts of expenses for each economic classification code are carried out.

The main document for determining official salaries medical workers are tariff lists, which, together with the staffing table, are compiled simultaneously with an estimate for each position of all structural divisions and institutions in general.

4. Application of business planning in the health system

The commercialization of health care, which is expressed in an increase in the volume of paid medical services, the introduction of various organizational and legal forms of entrepreneurship and the development of private medical practice, predetermines a change in the economic status of a medical organization. Now both the patient and the health facility are participants in the medical services market. Under these conditions, the importance of such a direction of activity of an independently managing service-producing organization as business planning increases.

A business plan is a clearly structured document that describes all the main aspects of the activities of a medical organization from the moment it is created to its design capacity; it includes the development of the project goal, the assessment of the actual economic indicators medical organization, market analysis and customer information, definition competitive strategy to achieve the set goals. A well-written business plan increases the organization's chances of obtaining funds from a prospective investor.

The business plan is developed for 1-5 years. The sequence of drawing up a business plan:

A decision is made to implement measures to improve an existing medical organization or to create a new organizational and legal form (for example, a medical autonomous non-profit organization);

The own capabilities of health facilities in the implementation of the project are assessed;

Medical services are selected, the provision of which will be the goal of the project;

The possibility of a market for these medical services is being explored;

A place is chosen for the implementation of the intended activity;

Developed:

Production plan;

Marketing plan;

Organizational plan;

Financial plan;

Analyzed possible risks from this project;

A summary of the business plan is compiled, which in the final text becomes the first section of the document.

A well-developed business plan helps healthcare facilities develop, strengthen their position in the medical services market, and predict their economic development in the future.

To develop an effective plan, it is necessary to analyze the external environment and the actual state of the medical institution.

External environment: prospects for the development of health care and the market for medical services, the state of competition, consumers of medical services, trends in the development of the external environment that are not controlled by the medical organization, but have an impact on its activities.

Internal environment: marketing, finance, production activities, human resources, administrative activities.

Analysis external environment allows you to evaluate both the dangers from the outside, which may complicate the activities of the health facility, and the opportunities that can help achieve the intended goals. Analysis internal environment aimed at identifying strengths and weaknesses medical institution, identification of areas for improvement.

If a medical organization decides to introduce paid medical services or expands their list, the following work to collect information should precede the preparation of a business plan:

Sources and volumes of financing are being studied;

The amounts of underfunding are determined for all sources;

The material and technical base of the institution is being studied;

Personnel are characterized and evaluated by qualification, age, length of service;

The assistance provided is analyzed by type, quality, timeliness and accessibility;

The types of services offered to the population for a fee are determined;

The demand of the population is being studied;

The plan is determined by the volume of activities;

The expected income is determined.

5. Major challenges in health planning

As you know, the strategic task of the national project "Health" is to improve the quality and accessibility of medical care. This is precisely what measures are aimed at strengthening the material and technical base and improving the skills of primary care personnel, raising wages for specialists in the district service, creating centers high technology, vaccine-prevention, etc. The implementation of a set of such large-scale measures cannot but require changes in planning and evaluating the results of activities in the healthcare sector.

One of the main planning tools is the widely used system of state (municipal) orders-tasks for the performance of certain volumes of medical care. At the same time, it is also obvious that the planning methods used are far from perfect. This fully applies to the specified orders-tasks, on which special hopes are placed in connection with the proposed expansion of the organizational and legal forms of medical organizations. It is advisable to identify the main problems in this area, as well as to outline possible ways their decisions.

In order to make the analysis of the situation with the formation and implementation of state (municipal) orders-tasks more complete, we will name the reasons why given form planning today is dominant in domestic health care. It:

Ensuring the constitutional rights of citizens to receive free medical care;

Ensuring a coordinated flow of resources to the industry from the CHI system, as well as from the budgets of all levels;

Alignment of financial conditions for the functioning of state and municipal health care in various regions;

Development of outpatient care and reduction of inpatient care;

Differentiation of medical care financed from the budget and from compulsory medical insurance;

Determining the compliance of the volume of state guarantees for free medical care with the allocated resources.

The experience available in many regions allows us to formulate a list of the main problems that need to be addressed now, and not transferred to the conditions when medical organizations of new organizational and legal forms appear, and private medicine will participate on a common basis in the implementation of the Program of State Guarantees for the Provision of Russian Federation Citizens Free Medical Care Federation.

These problems include the following:

Imperfection of the regulatory framework for the formation of orders-tasks for the provision of medical care;

The need to ensure the constitutional rights of citizens to free medical care, regardless of the amount of resource support for the order;

The need to choose and unify the optimal method of paying for medical services (fund maintenance, global budget, system of diagnostically related groups, etc.);

The need to increase the availability of medical care;

The lack of effective mechanisms to ensure the coordination of the activities of medical organizations of various subordination in the formation and implementation of orders-tasks;

Mismatch between the interests of the customer and the contractor;

Orientation of health care managers only on volumetric (resource) performance indicators;

Absence in orders-tasks of specific tasks for the development of preventive medicine;

Absence effective methods control over the execution of orders-tasks.

Probably, most of the questions that need to be answered are related to the imperfection of the regulatory framework for planning activities in the health sector.

The materials of the study were articles, normative materials and documents, as well as the works of Russian and foreign authors on the issues of health planning and economics.

Materials from the following medical journals were analyzed:

- "Issues of Economics and Management for Healthcare Managers";

- “Chief. doctor";

- "International Medical Reviews";

- "Health".

Research method: analytical.

Results of own research

In view of the impossibility of considering the topic of planning on the example of a specific medical institution due to the closeness and inaccessibility of this financial information, we will consider this topic on the example of the Russian Federation.

After analyzing the methodological and normative literature on planning in the healthcare sector of the Russian Federation, I found out the following:

For the next two years, the tasks of the industry will be:

Conclusion

The formation of state policy in health care and the provision of medical care in modern conditions is primarily associated with providing the population of the Russian Federation with guaranteed, free medical care of the required volume and quality and makes new demands on the creation of new forms of industry management, significantly increases the role of planning.

During the transition to market economy the search for effective mechanisms to improve health care is one of the most urgent tasks. Of great importance in providing affordable, free medical care to the population is the correspondence of the volume of guaranteed medical care to their financial support. The analysis of scientific sources, the regulatory and methodological framework, as well as the experience of implementing the state order in the healthcare system indicate the need to develop theoretical and practical foundations for its implementation, in particular, planning algorithms and tools aimed at optimizing the work of medical institutions, the effective use of available limited resources.

An analysis of the existing literature data showed the absence of clear technologies for assessing the effectiveness of program-targeted planning for the development of Russian health care and recommendations for its further improvement. Since in the domestic literature there is practically no information on approaches to the choice of performance criteria medical programs, as well as systems of economic measurements of quality processes in health care.

Thus, the planning and evaluation of the results of the activities of medical organizations require serious changes, and the strengthening of the resource base of health care, which is expected in the coming years, is a favorable factor for this. The first step in this direction may be the introduction of indicators of the quality of medical care, reflecting the state of health of the population, as the main planned indicators. The regions (municipalities) themselves may well take the initiative in this matter, without waiting for the relevant indicators to appear in the federal program of state guarantees. Undoubtedly, good prerequisites for solving these problems have been created by the development and implementation of the national project "Health".

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18. Chavpevtsov V.F., Kudrin K.L. The quality of medical care, problems and prospects for ensuring its guarantees in the compulsory health insurance system / V.F. Chavpevtsov, K.L. Kudrin // International Medical Reviews. 2003. V. 3, No. 3. S. 209-215.

19. Shipova V.M., Levin A.V., Methodological bases for planning the total volume of medical care and its specialized types. doctor - 2010.-5-p.15-27

20. Shamshurina N.G. Pricing and Profits - Journal of Healthcare 1, 2008.

In order to implement paragraph 2 of the set of measures to provide the health care system of the Russian Federation with medical personnel until 2018, approved by the order of the Government of the Russian Federation of April 15, 2013 N 614-r (Sobranie zakonodatelstva Rossiyskoy Federatsii, 2013, N 16, art. 2017), I order:

Approve the methodology for calculating the need for specialists with secondary vocational (medical) education in accordance with.

Minister

IN AND. Skvortsova

Application
to the Ministry of Health
Russian Federation
dated February 14, 2018 N 73

Methodology
calculation of the need for specialists with secondary vocational (medical) education

1. In order to provide methodological assistance in current planning, identifying a shortage or excess of medical workers with secondary vocational (medical) education (hereinafter referred to as nursing staff) in medical organizations, subordinate executive bodies state authorities of the constituent entities of the Russian Federation and bodies local government(hereinafter referred to as medical organizations), a methodology has been developed for calculating the need for specialists with secondary vocational (medical) education (hereinafter referred to as the Methodology).

2. When determining the need for paramedical personnel, the following may be taken into account:

availability of medical personnel (per 10,000 population) providing medical care on an outpatient basis to the population of a constituent entity of the Russian Federation, calculated according to the methodology for calculating the need for medical personnel;

availability of hospital beds in the constituent entities of the Russian Federation (per 10,000 population), calculated according to the methodology for calculating the need for medical personnel;

features of the provision of pre-hospital medical care by paramedical personnel, provided for by the procedures for the provision of medical care, approved by the Ministry of Health of the Russian Federation;

presence in the subject of the Russian Federation settlements remote (more than 300 km) from medical organizations that provide specialized medical care;

territorial features of the subjects of the Russian Federation (the location of the subject in the regions of the Far North and equivalent areas, specific gravity rural population);

volumes of medical care provided within the framework of territorial programs of state guarantees of free provision of medical care to citizens of the Russian Federation (hereinafter referred to as TPSG);

the age composition of the nursing staff working in medical organizations;

the presence in medical organizations of structural units: feldsher-obstetric stations (hereinafter - FAP), feldsher health centers (hereinafter - FP).

3. The Methodology uses the conditional division of nursing staff into groups, taking into account their functional duties:

"treatment group", including paramedical personnel working with doctors on an outpatient appointment, paramedical personnel performing an independent outpatient appointment (obstetrician of the examination room, paramedic of the FAP or OP, paramedic of the pre-medical appointment, etc.), paramedical personnel, providing medical care in stationary conditions, in a day hospital and emergency medical care;

"treatment and diagnostic group", including the nursing staff of diagnostic and auxiliary departments (offices) ( nurses in functional diagnostics, physiotherapy nurses, laboratory assistants of clinical laboratories, physical therapy instructors, etc.);

"management group", including paramedical personnel - heads of FAP - paramedic (nurse), heads of health centers - paramedic (nurse), medical statisticians, heads of offices, chief (senior) nurses, etc.;

"reinforcement group", including nursing staff, namely nurses, ward (guard) nurses, general hospital nursing staff, nursing staff of the admission department, providing assistance to students in educational organizations;

Specialists of the "treatment and diagnostic group" and "control group" are included in the "paraclinical group".

4. It is advisable to calculate the required number of nursing staff according to the algorithm for calculating the need for nursing staff:

Table N 1

Recommended Algorithm for Calculating the Need for Nursing Personnel

For emergency medical care	For primary health care	To provide specialized medical care
Determining the number of ambulance teams	Calculation of the number of doctors, taking into account the territorial coefficients	Calculation of the number of beds, taking into account the territorial coefficients
Determining the number of ambulance teams	Calculation of the number of paramedical personnel working with doctors on an outpatient appointment and on an independent appointment (taking into account the coefficients of the ratio of doctors and paramedical personnel)	Calculation of the number of nursing staff, taking into account the standard number of beds per position of nursing staff
Calculation of the standard for the number of paramedical personnel of the dispatching service	Calculation of the "reinforcement group" (taking into account the coefficients of the ratio of doctors and nurses)	Calculation of the "reinforcement group" (taking into account the coefficients of the ratio of nursing staff employed in auxiliary and main activities)
Calculation of the standard for the number of paramedical personnel of the "management group"	Calculation of the "paraclinical group" (taking into account the ratio to the average medical staff of the "treatment group")	Calculation of the "paraclinical group" (taking into account the coefficient of relation to the average medical staff of the "treatment group")
Calculation of the need for nurses		Calculation of the number of nursing staff in day hospitals
Calculation of the need for paramedical personnel - total
Comparison with the actual number of nursing staff, determining the deficit or surplus

5. Calculation of the need for paramedical personnel providing emergency medical care:

5.1. To calculate the need for paramedical personnel providing emergency medical care (hereinafter - EMS) to the population, it is recommended to use:

the average standard for the volume of ambulances (number of calls per 1 insured person), approved in the Program of State Guarantees of Free Medical Assistance to Citizens for the current and planned periods;

the estimated number of stations and / or departments of the ambulance service, approved by order of the Ministry of Health of the Russian Federation of June 20, 2013 N 388n "On approval of the Procedure for the provision of emergency, including emergency specialized, medical care" (registered by the Ministry of Justice of the Russian Federation on August 16, 2013 , registration N 29422), as amended by order of the Ministry of Health of the Russian Federation of January 22, 2016 N 33n (registered by the Ministry of Justice of the Russian Federation on March 9, 2016, registration N 41353), by order of the Ministry of Health of the Russian Federation of May 5, 2016 N 283n (registered by the Ministry of Justice of the Russian Federation on May 26, 2016, registration N 42283) (hereinafter - the order of the Ministry of Health of the Russian Federation of June 20, 2013 N 388n);

the estimated number of ambulance teams approved by order of the Ministry of Health of the Russian Federation dated June 20, 2013 N 388n.

5.2. To calculate the need for nursing staff, it is recommended to use the following indicators(form of federal statistical observation N 30):

number of calls;

number individuals paramedical personnel;

the number of medical visiting teams, including specialized teams;

the number of paramedic mobile teams;

the number of individuals of the dispatching service according to the staff list of stations (departments) of the NSR (if any);

the number of individuals of the "management group" out of the total number of individuals of paramedical personnel;

number of calls per 1 inhabitant (form of federal statistical observation N 30 / population of the subject of the Russian Federation);

the number of paramedical personnel per 10,000 population (form of federal statistical observation N 30 / population of a constituent entity of the Russian Federation * 10,000);

the number of calls per 1 insured person, established by the Territorial Program of State Guarantees of Free Provision of Medical Assistance to Citizens of a Subject of the Russian Federation (TPPG).

5.3. The number of paramedical personnel of mobile ambulance teams is recommended to be calculated according to the formula:

LFvb \u003d CHBx2 * KS * HF,

NChvb - the calculated standard for the number of paramedical personnel of mobile ambulance teams;

ChB - the number of visiting teams of the SMP;

KS is the shift coefficient of the work of mobile teams of the ambulance service;

To take into account the peculiarities of the constituent entities of the Russian Federation, it is possible to use corrective coefficients:

KS - to take into account the duration of the work of the ambulance mobile team when organizing work less than 24 hours a day. With a 24-hour work of the brigade, the coefficient can be equal to 1, from 9 to 12 hours - 0.5, from 6 to 8 hours - 0.25;

KV - to account for the number of SME workers older than working age. If the proportion of nurses at this age is less than 10% of all nurses at the station and / or department of the ambulance, then it is advisable to take the coefficient as 1; from 10% to 15% - 1.01; over 15% - 1.02.

5.4. The number of paramedical personnel of the EMS dispatch service is recommended to be calculated using the formula:

NChds \u003d NDSsmp * KDS,

NChds - the calculated standard for the number of paramedical personnel of the EMS dispatch service;

NDSsmp - the actual number of individuals of the paramedical personnel of the EMS dispatch service;

KDS - coefficient of presence of the dispatching service.

To take into account the peculiarities of the constituent entities of the Russian Federation, it is possible to use a correction factor for the availability of a dispatch service. KDS allows to take into account the presence of a single dispatch service for the NSR in the constituent entity of the Russian Federation. If there is no such service, then the CDS can be equated to 1. If there is a single NSR dispatch service, the CDS is equated to 0.3.

5.5. The number of paramedical personnel of the "management group" is characterized by the number of stations and (or) departments of the SMP (form of federal statistical observation No. 30).

5.6. The estimated standard for the number of paramedical personnel of the EMS (absolute number) is recommended to be determined by the formula:

LFsmp \u003d LFvb + LFds + LFgu,

NChsmp - the standard number of paramedical personnel of the ambulance service;

NChvb - the normative number of paramedical personnel of mobile ambulance teams;

NChds is the standard number of paramedical personnel of the EMS dispatch service;

NChgu - the normative number of paramedical personnel of the "management group" of the SMP.

5.7. The estimated standard of provision with paramedical personnel per 10 thousand population is recommended to be determined by the formula:

OBNPsmp \u003d LFsmp * 10000 / population of the subject,

NChsmp - the standard number of paramedical personnel of the ambulance service (absolute number);

OBNChsmp - provision with paramedical personnel of the ambulance service per 10 thousand people.

5.8. The deficit / surplus of EMS nurses can be defined as the difference between the calculated standard for the number of EMS nurses (absolute number) and the actual number of EMS nurses (absolute number).

6. Calculation of the need for nursing staff involved in the provision of medical care on an outpatient basis:

6.1. The basis for calculating the required number of nursing staff working with doctors, as well as performing independent outpatient appointments (examination room midwife, medical assistant FAP or FP, medical assistant of the pre-medical appointment, etc.), may be the availability of medical personnel per 10 thousand population.

The number of doctors (absolute number) should be determined by the formula:

ChVap \u003d ObV * ChN / 1000,

NVap - the number of doctors providing medical care on an outpatient basis;

Pv is the number of doctors per 10,000 people;

CHN - population.

Since the indicator of provision with medical personnel per 10,000 population already takes into account territorial and other coefficients that take into account the characteristics of each subject of the Russian Federation, then when calculating the number of nursing staff working with doctors conducting outpatient appointments, such coefficients may not be considered.

6.2. When calculating the required number of paramedical personnel performing independent outpatient appointments (examination room midwife, FAP or FP paramedic, pre-medical appointment room paramedic, etc.), it is possible to use information on the number of relevant rooms. The actual number of offices (structural divisions) is indicated on the basis of federal statistical observation form No. 30.

6.3. The calculation of the number of nurses in the "reinforcement group" for each profile of medical care provided on an outpatient basis, it is advisable to make on the basis of the ratio method, taking into account the recommended aggregated calculated ratios of the ratio of nurses and doctors.

6.4. The need for nurses in the "treatment group" includes the estimated number of nurses working with doctors on outpatient appointments and performing independent outpatient appointments (examination room midwife, FAP or FP paramedic, pre-medical reception room paramedic, etc.) , which is expedient to calculate taking into account the procedures for providing medical #.

6.5. The calculation of the number of nursing staff of the "treatment and diagnostic group" and "control group", as a rule, is carried out on the basis of the ratio method, taking into account the calculated ratio coefficients:

Table No. 2

	Recommended aggregated calculated ratios of the ratio of paramedical personnel and doctors engaged in the main and auxiliary activities
	paramedical staff working with doctors conducting outpatient appointments	paramedical staff working in self-administration rooms	amplification group nursing staff	nursing staff of the paraclinical group
	2	3	4	5
Total for the treatment and diagnostic group				0,17
Total by control group			0,06

The corresponding calculation coefficients are multiplied by the number of nurses in the "treatment group".

6.6. The estimated number of paramedical personnel involved in the provision or providing independent medical care on an outpatient basis may include the estimated number of paramedical personnel of the "treatment group", "treatment and diagnostic group" and "management group".

6.7. The basis for calculating the required number of nursing staff in day hospitals of medical organizations providing medical care on an outpatient basis and at home is the number of places in day hospitals.

6.7.1. It is advisable to carry out the estimated number of nursing staff by the number of day hospital beds on the basis of the ratio method, taking into account the recommended correction factors:

Table No. 3

	Standard value

	1,05
	1,03
2. Coefficients taking into account the proportion of the population of a constituent entity of the Russian Federation living in rural areas
for entities where at least 50% of the population lives in rural areas	1,11
for entities where 30% to 50% of the population lives in rural areas	1,05
3. Coefficients taking into account the volume of medical care within the framework of the TGGP, which is performed by medical organizations of federal and private ownership
for subjects in which from 5% to 10% of primary health care for TPSG is provided in medical organizations of federal and private ownership	0,98
for subjects in which from 10% to 20% of primary health care for TPSG is provided in medical organizations of federal and private ownership	0,95
4. Coefficients taking into account the population density of the subject of the Russian Federation
for subjects with low population density (lower than in the Russian Federation as a whole)	1,05
for subjects with a high population density (higher than in the Russian Federation as a whole)	0,83
5. Coefficients taking into account the presence in the subject of the Russian Federation of settlements remote (more than 300 km) from the regional (municipal) center, where specialized assistance is provided
for entities in which 30% to 50% of the population lives in remote settlements	1,15
for subjects in which more than 50% of the population lives in remote settlements	1,10
6. Coefficients taking into account the level of medical care
for subjects in which from 70% to 90% of medical care is provided in medical organizations of the 1st level	1,20
for subjects in which from 50% to 70% of medical care is provided in medical organizations of the 1st level	1,10
	1,74

The final correction factor is recommended to be multiplied by the number of nurses "by the number of seats" for each profile of medical care. To take into account the peculiarities of the constituent entities of the Russian Federation, it is advisable to apply the developed corrective coefficients to the number of nursing staff "by the number of seats." If the features of the subject of the Russian Federation satisfy the described condition, then the corresponding value of the coefficient from " normative value", if they do not satisfy, then the value of the coefficient is equal to 1. After filling in all the lines, the final adjustment factor for the subject of the Russian Federation can be calculated. The value of the final adjustment factor, as a rule, is calculated individually for each subject of the Russian Federation.

6.7.2. The estimated number of paramedical personnel involved in the provision of medical care in day hospitals may include estimated numbers paramedical personnel of the main groups.

6.8. The need for paramedical personnel may include the estimated number of paramedical personnel of the "treatment group", "treatment and diagnostic group" and "management group" engaged in providing medical care to the population on an outpatient basis, as well as the estimated number of paramedical personnel required to provide medical care in day hospitals.

6.9. To account for the number of nursing staff older than working age (women aged 55 and over, men aged 60 and over), it is recommended to apply the age load factor.

The calculation of the need for nursing staff, taking into account the age load, can be determined by the formula:

LFam \u003d Cham * KV,

NCham - the calculated standard for the number of paramedical personnel for the provision of medical care on an outpatient basis;

Cham - the calculated standard for the number of paramedical personnel for the provision of medical care on an outpatient basis without taking into account the age load factor;

KV - coefficient of age load.

CV is recommended to be used to account for the number of nursing staff older than working age. If the proportion of paramedical personnel older than working age is less than 10% of all paramedical workers of the station and / or department of the EMS, then the coefficient may be equal to 1; from 10% to 15% - 1.01; over 15% - 1.02.

6.10. The deficit or surplus of nursing staff providing medical care to the population on an outpatient basis, in day hospitals, can be defined as the difference between the calculated and actual number of nursing staff (absolute number).

7.1. The basis for calculating the required number of nursing staff providing medical care in hospitals is the provision of beds per 10,000 people.

The number of hospital beds (absolute number) is recommended to be calculated using the formula:

CHK \u003d ObK * CHN / 1000,

CHK - the number of beds in a round-the-clock hospital;

ObK - provision with beds per 10 thousand people;

CHN - population.

7.2. To determine the number of nurses providing medical care in hospitals, it is advisable to recalculate the number of beds per employee of nurses in accordance with the procedures for providing medical care.

7.3. To take into account the territorial and other features of the constituent entities of the Russian Federation, it is recommended to apply the recommended correction factors to the number of nursing staff in terms of the number of beds, which are selected from the "Standard value" based on the territorial characteristics of the constituent entities of the Russian Federation and the number of hospitalizations per 1000 population (hospitalization rate):

Table No. 4

Recommended Correction Factors	Standard value
1. Coefficients taking into account the location of the subject of the Russian Federation in the regions of the Far North and equated to them
for entities located entirely in the regions of the Far North and equated to them	1,05
for subjects in which less than 50% of the population lives in the regions of the Far North and equated to them	1,03
2. Coefficients taking into account the level of hospitalization of the population
for entities with a hospitalization rate of 195.5 per 1,000 population and above	1,00
for entities with hospitalization rates between 176.0 and 185.7 per 1,000 population	0,94
for entities with hospitalization rates between 166.2 and 176.0 per 1,000 population	0,90
for entities with a hospitalization rate of less than 166.2 per 1,000 population	0,84
Final correction factor	0,77

The total final correction factor is calculated automatically and is individual for each subject of the Russian Federation.

7.4. The need for "treatment group" nurses providing medical care in inpatient settings includes the estimated number of nurses by number of beds and "reinforcement teams" for each profile of hospital care.

7.5. The calculation of the number of nurses in the "treatment and diagnostic group" and "control group", as a rule, is carried out on the basis of the ratio method, taking into account the aggregated calculation coefficients:

Table No. 5

7.6. The basis for calculating the required number of nursing staff in day hospitals may be the number of places in day hospitals obtained by calculation.

7.6.1. It is advisable to determine the estimated number of nurses in terms of the number of day hospital beds, taking into account the aggregated calculated coefficients for the ratio of nurses.

7.6.2. The estimated number of nurses in terms of the number of seats is carried out taking into account the recommended correction factors:

Table No. 6

If the features of the subject of the Russian Federation satisfy the described condition, then in the column "for the subject of the Russian Federation" it is advisable to put the corresponding value of the coefficient from the "normative value", if they do not satisfy, then the value of the coefficient can be - 1. After filling in all the lines, it is preferable to calculate the final correction factor , which is calculated automatically and may be individual for each subject of the Russian Federation.

7.6.3. The estimated number of paramedical personnel involved in the provision of medical care in day hospitals includes the estimated number of paramedical personnel of the main groups.

7.7. The need for paramedical personnel includes the estimated number of paramedical personnel of the "treatment group", "treatment and diagnostic group" and "management group" employed in providing inpatient care to the population, as well as the estimated number of paramedical personnel required to provide medical care in conditions day hospitals.

7.8. To account for the number of nursing staff older than working age (women aged 55 and over, men aged 60 and over), it is recommended to apply the age load factor.

The calculation of the need for nursing staff, taking into account the age load, can be carried out according to the formula:

LFst \u003d Chst * KV,

NChst - the calculated standard for the number of paramedical personnel to provide medical care to the population in stationary conditions;

Chst - the calculated standard for the number of nursing staff to provide medical care to the population in stationary conditions without taking into account the age load factor;

KV - coefficient of age load.

The EF may take into account the number of nurses older than working age. If the proportion of paramedical personnel older than working age is less than 10% of all paramedical workers, then the coefficient can be equal to 1; from 10% to 15% - 1.01; over 15% - 1.02.

7.9. The shortage/surplus of nursing staff providing medical care to the population in inpatient and day hospital conditions is recommended to be defined as the difference between the calculated and actual number of nursing staff (absolute number).

8. The need for paramedical personnel to provide medical care to the population as a whole in the constituent entity of the Russian Federation may include the estimated number of paramedical personnel necessary for the provision of emergency medical care, medical care in outpatient and inpatient settings, day hospital conditions, and it is recommended to calculate according to the formula:

LF \u003d LFsmp + LFam + LFst,

NChsmp - the normative number of paramedical personnel for the provision of emergency medical care;

NCham - the calculated standard for the number of paramedical personnel for the provision of medical care on an outpatient basis;

NChst - the calculated standard for the number of paramedical personnel for the provision of medical care in stationary conditions.

8.1. The estimated standard for the number of paramedical personnel per 10,000 population (provision with paramedical personnel per 10,000 population) is recommended to be carried out according to the formula:

OBNC \u003d LF * 10,000 / population of a constituent entity of the Russian Federation,

NCh - normative number of nurses (absolute number);

OBNP - provision with paramedical personnel per 10,000 population.

Document overview

A methodology has been developed for calculating the need for specialists with secondary vocational (medical) education.

It is intended to provide methodological assistance in current planning, identifying a shortage or excess of nursing staff in medical organizations subordinate to regional and local authorities.

The indicators that are taken into account when determining the need are determined. Among them are the data of the form of federal statistical observation N 30 "Information on a medical organization", the availability of medical personnel, hospital beds, the features of the provision of pre-hospital medical care by paramedical staff, the presence in the region of settlements remote from medical organizations. You can also take into account the territorial features, the age composition of the nursing staff, the presence of structural units in medical organizations.

The conditional division of nursing staff into groups is used, taking into account their functional duties.

It might be useful to read:

Health planning. Determining the needs of the population in outpatient and inpatient care. General provisions of the healthcare system of the Russian Federation Determining the needs of the population for inpatient care

Reviewers:

Definition of differentiated need

Planning by First Determination

B \u003d 9.1 * / 5,500 \u003d 20.1 medical positions

F = (365 - 0) / (13.7 + 1) = 24.8 patients

D \u003d 24.8 * 13.7 \u003d 339.8 days

M = 60 * 24.8 = 1488 patients

CD = 1 488 * 13.7 = 6 bed days

K = * 21.6 * 13.5) / (332.8 * 100) = 204.7 beds

K = 4,985 / 23.5 = 212.1 beds

K =* 14.0) / 335 =/ 335 = 208.3 beds

Methodology calculation of the need for specialists with secondary vocational (medical) education

Recommended Algorithm for Calculating the Need for Nursing Personnel

Document overview

Methodology
calculation of the need for specialists with secondary vocational (medical) education