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Table 3.
Integrative model for regional healthcare effectiveness assessment
| Factors affecting the health of the population | Measures aimed at improving public health | Efficiency assessment | Resulting effects |
|---|---|---|---|
| Factors that have a negative impact on public health | Using an interdepartmental, program-oriented approach at the macro, meso and micro levels to neutralize negative factors. An example of the contribution of regional healthcare: creation in the Sverdlovsk region of a system of medical and preventive measures to manage the risk to population health exposed to the influence of a chemically polluted environment [17]. | Assessment of the effectiveness of rehabilitation measures and development of recommendations for risk management | 75-80% of children who underwent biological prevention of the risk of developing environmentally related health disorders and 90-95% of children who underwent rehabilitation treatment improved their health indicators. Assessment of the economic effects of rehabilitation measures: prevented economic damage to public health for the period 2005-2015 amounted to more than 2 billion rubles, economic efficiency in 2015 reached more than 8.7 rubles for each ruble of costs [17]. |
| Attitude to the health of the person himself | Promotion and implementation of healthy lifestyle | Assessment of systemic prevention and healthy lifestyle level | High medical, social and economic efficiency of preventive medicine: (1:8) [18, p.117]. |
| Implementat ion of the state policy to preserve public health | The national priority project “Health” and other programs: increasing industry financing, improving the provision of modern equipment to medical organizations, increasing the scale of high-tech medical care, etc. | Multi-factor assessment of financial cost effectiveness in healthcare [19]. The integral indicator of expenses efficiency: the ratio of the integral indicator of service performance to the indicator of changes in costs (financing): Eint.cost=Iint. perf/Icost.chg | On the example of the antituberculosis service of the Sverdlovsk region: for the period from 2012 to 2017, achievement of high integral performance indicator of 2.8 due to improvements in the dynamics of indicators of morbidity, prevalence, disability, and mortality. The integrated cost effectiveness indicator indicates the efficient use of financial resources: Ec=2.8/1.29=2.2 The total economic effect of the decrease in the dynamics for the period from 2012 to 2017 of losses in morbidity, disability, and mortality due to tuberculosis amounted to 905.6 million rubles. |
| Healthcare system performance | Improving regional health planning and management, implementation of priority regional projects, interdepartmental target programs, innovative organizational, medical, and information technologies: improving medical and demographic indicators | The multidimensional economic impact in healthcare [20]. The index of “multidimensional economic impact in healthcare": (Emultidim.= E1 + E2 + E3 + E4) where (E1) – economic effect of treatment duration reducing in a 24-hour hospital; (E2) — economic effect from reducing the loss of morbidity; (E2) — economic effect from reducing losses due to temporary disability; (E4) — economic effect from reducing the loss of mortality of the workingage population. Integrative assessment of regional healthcare effectiveness Assessment of medical and demographic indicators dynamics. Calculation of the indicator of the absolute economic effect in the healthcare system as a result of reducing losses from morbidity, disability, and mortality at the level of society. |
On the example of the cancer service of the Sverdlovsk region: achieving a multidimensional economic effect for the period from 2013 to 2017 in the amount of 116.6 million rubles. Achievement of the absolute economic effect indicator in the healthcare system of the Sverdlovsk region for 20132017: 9,670.20 million rubles. |
Collections of statistical materials “Health status of the population and performance indicators of the healthcare system of the Sverdlovsk region” for 2012-2017”. URL: https://miacso.ru/index.php/937-sbornik-statisticheskikh-materialov, Federal Treasury Website URL: http://roskazna.ru/ (access date: 28.04.2020).
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