Problems medication management software hospital care under the compulsory medical insurance
Science Articles / / August 12, 2017
Information systems and technologies have become part of the daily activities of medical institutions.The range of their job functions is significant: from diagnostic and therapeutic procedures to the accounting-financial and statistical operations.The success of the information technology used is based on a large volume of standard procedures for processing information and use of the automated system jobs of doctors and other health providers.
Currently does not require, in our opinion, evidence of the fact that an effective professional activity of doctors - professionals, agencies, institutions and health services is impossible without high-quality information support based on computer systems and new information technologies.
work to create a common information space was carried out on the basis of the City Clinical Hospital №1 in Togliatti, Samara region in the last five years.As a result, established and put into practice a corporate multi-user automated information sy
pursued informatization of the hospital work program has promoted in the hospital of modern economic methods of management, providing hard accounting and control the use of limited material and financial resources.She also contributed to introduction of new medical patients diagnosis and treatment technologies, the introduction of less expensive forms of organization and health care methods such as hospitals day stay at the hospital (including at our hospital) at outpatient clinics of the city, at the enterprises,at home.
not despite the positive trends in the development of the organization, there are obvious problems and contradictions in the planning of hospital expenses and payment of stationary medical aid in system OMS Samara Region:
- CHI rates for 1 day bed for medicines and supplies provided spend 16, 0 - 20.0 rubles, depending on the profile of the department.In terms of hospitalization is 250-300 rubles.This standard does not reflect the actual cost of medicines, so hospital institutions have to cover these costs from the MHI funds at the expense of other items, to increase the share of expenditure on medicines by means of entrepreneurial activity, but they are insufficient and some of medication, patients are forced to buy dueown funds;
- although there is a list of essential medicines, required for use in the process of care, but is not approved by the regional health authorities standards for determining the minimum set of drugs to provide quality patient care through existing nosology;
- there is no clear justification algorithm peer review assignments of certain expensive drugs.
actual consumption of drugs in the City Clinical Hospital №1 Togliatti 1 bed-day is five times higher than the norm stipulated by the approved tariffs and OMC was:
- in 1999 - 63.8 rubles;
- 2000 g.- 81.5 rubles;
- in 2001 g.- 89.9 rubles;
- in 2002 g.- 163.4 rubles.
in 2002 compared to 2001 increased by 58% the cost of medicines for business and 50% in the CHI system.
Improper planning for medical support requirements inpatients leads to a redistribution of financial flows.There is a cost overrun of business on medicines and underpayment other item of expenditure.
With the constant rise in prices of medicines, increasing the tariffs of utility bills, an increase in the minimum wages of medical personnel a decrease in the share of the MLA in financing the process of providing inpatient care.Tariffs for payment of hospital care in the system of compulsory medical insurance in the past five years, only indexed by a coefficient.In reality, the share of funds allocated by compulsory health insurance for inpatient care decreased from 70.6% in 1999 to 34.8 / o in total revenue structure City Clinical Hospital №1 of Togliatti in 2002.
organized system of regional planning of health care volumes, its value can be created only by a complex regulatory framework of health care standards, standards of time, the duration of inpatient treatment standards, norms consumption of medicines, medical devices and supplies.
monitoring and capacity planning of health care and its quality becomes a very real process in the work of medical institutions using medical and economic standards of health care, namely health care models.Information and computer technology allow such control to make an effective, objective, rapid and less expensive.Instead of an ad hoc assessment of quality of care it is possible to carry out continuous monitoring, ie monitoring all health facilities provided in health care, in the end, go to the health care quality management system.
To perform a full medical and economic expertise of the quality of care offered to use an integrated, technology-based standards of care planning system (developed in Krasnodar ITC author Kalinichenko VI) regarding the standardization and regulation of treatment costs.
Krasnodar model of medical services not focused on any - any specific health care facilities, and disease (specific forms), health care technology under which must be guaranteed to the patient regardless of the place of receipt for all types of stationary medical institutions, organizations and enterpriseswithout limiting forms of ownership throughout the region.
developed and approved at the territorial level model of medical services, including the level of providing health care, adequate funding may not be below the level of security for the federal standard, which is currently absent, and when it is unknown.
Health insurance can not always provide opportunities for optimal development of the hospital, if not take into account the main thing - the actual cost of care.If an inaccuracy rates, in the absence of a reasonable differentiation is a significant deviation volumes of care that can be provided by the existing funding from the real needs.
Calculation of cost of medical services, combined with medical technology standards allows a cross-sectional plan ahead of expenditure of expenses for medical care, as well as makes it possible to consider the medical service as a commodity on the market.
introduction of models in the volume of inpatient care planning will improve the quality of care, dissemination of good practice, the implementation of the latest achievements of medical science and practice and change for the better funding system, which will lead to the improvement of the forms of medical care payments.