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Health care integration in the Russian federation: conceptual framework, evaluation, and new instruments
Высшая школа экономики
,
2013.
No. WP BRP 10/PA/2013.
Sheiman I., Shevski V. undefined.
Fragmentation in organization and discontinuities in the provision of medical care are problems in all healthcare systems, whether it is the mixed public-private system in the USA, national health services in the UK, or insurance-based ones in Western Europe and Russia. In all of these countries, a major challenge is to improve integration in order to improve efficiency and health outcomes. This article assesses issues related to fragmentation and integration in conceptual terms and argues that key attributes of integration are teamwork, coordination, and continuity of care. It then presents a summary of integration problems in Russia and presents the results of a large survey of physicians concerning the attributes of integration. It is argued that the characteristics of the national service delivery model do not ensure integration. The Semashko model of service delivery, although designed as an integrated model, has been distorted under pressure of the process of specialization of care. It is also argued that larger organizational forms of service provision, like policlinics and integrated hospital-policlinics, do not have higher scores of integration indicators than smaller ones. Proposals to improve integration in Russia are presented with the focus on the regular evaluation of integration and fragmentation, regulation of integration activities, enhancing the role of PHC providers, and economic incentives
Keywords: primary health careинтегрированные методы оплаты услугпрограммы управления хроническими заболеваниямифондодержаниекоординация медицинской помощипреемственность леченияhealth policymedical service integrationcoordination of carecontinuity of careфрагментация/интеграция медицинской помощисовместная работа поставщиков медицинских услуг
Publication based on the results of:
Sheiman I., Shevski V., Health Policy 2014 Vol. 115 No. 2-3 P. 128-137
Fragmentation in organization and discontinuities in the provision of medical care are problems in all health systems. A major challenge is to strengthen integration in order to enhance efficiciency and health outcomes. This artickle assesses issues related to fragmentation and integration in concptual terms and argues that key attributes of integration are teamwork, coordination and ...
Added: March 9, 2015
Sheiman I., Shevski V. undefined., Health Policy 2014 No. 1 P. 1-10
Fragmentation in organization and discontinuities in the provision of medical care are prob-lems in all health systems, whether it is the mixed public-private one in the USA, nationalhealth services in the UK, or insurance based one in Western Europe and Russia. In all ofthese countries a major challenge is to strengthen integration in order to ...
Added: January 28, 2014
Sheiman I., / Высшая школа экономики. Series PA "Public Administration". 2014. No. WP BRP 18/PA/2014.
Many countries have recently started the search for new payments methods with the specific objective to encourage integration in health care delivery – teamwork of providers, their coordination and continuity of care. This paper suggests the typology of three major integrated payment methods – pay-for-performance, episode based bundled payment and global payment. A brief overview ...
Added: September 26, 2014
Sazhina S. V., Shevski V. undefined., Sheiman I. et al., Электронный научный журнал "Социальные аспекты здоровья населения" 2021 Т. 67
Strengthening providers integration to improve health indicators is an important direction of healthcare development. Comparison of the 2012 survey and 2020 survey suggests some improvements in interaction between district physicians and outpatient specialists, however its level is hardly adequate. Interaction between district physicians and emergency care providers in polyclinics has improved. Interaction between polyclinic and ...
Added: March 17, 2021
Sheiman I., Менеджер здравоохранения 2012 № 7 С. 32-40
В статье обосновывается актуальность проблемы интеграции медицинской помощи. На материалах по ведущим зарубежным странам анализируются организационные, экономические и информационные механизмы интеграции с акцентом на те из них, которые имеют отношение к практике российского здравоохранения. ...
Added: January 28, 2013
Shevski V. undefined., Sheiman I., Вопросы государственного и муниципального управления 2013 № 3 С. 24-47
В статье рассматриваются вопросы преодоления наметившейся в мировом здравоохранении тенденции к фрагментации действий отдельных медицинских служб, утрате их нацеленности на координацию и обеспечение преемственности лечения пациентов на разных этапах. Решаются задачи измерения фрагментации в российском здравоохранении и определения главных механизмов ее преодоления – организационных и экономических. Используется метод социологического исследования. Собраны данные, характеризующие оценку врачами ...
Added: November 14, 2013
Sheiman I., Shevski V., / НИУ ВШЭ. Series WP BRP Series "Public and Social Policy". 2017.
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Sheiman I., Shishkin S., Shevsky V., Risk Management and Healthcare Policy 2018 No. 11 P. 209-220
This paper addresses the major developments in primary care in the Russian Federation under the evolving Semashko model. The overview of the original model and its current version indicates some positive characteristics, including the financial accessibility of care, focus on prevention, patient lists, and gatekeeping by primary-care providers. However, in practice these characteristics do not ...
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Sheiman I., / НИУ ВШЭ. Series WP BRP Series "Public and Social Policy". 2019.
The objective of the paper is to explore the role of maximum waiting times targets in improving access to health care in the context of the country with limited financial resources. The study indicates that most of targets in Russia are unrealistically low, while institutional and operational arrangements for their implementation have not been built. ...
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Sheiman I., Вопросы государственного и муниципального управления 2016 № 4 С. 143-164
The paper addresses state policy in the area of primary health care payment methods in the system of mandatory health insurance in Russia. The need for the transition from physicians’ visits reimbursement to capitation payment is substantiated. It is argued that the current payment method hinders disease prevention activities, chronic disease management, ...
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Sheiman I., Шевский В., Вопросы государственного и муниципального управления 2019 № 1 С. 111-135
В статье рассматривается проблема соотношения концентрации рынка медицинских услуг и интеграции деятельности медицинских служб, измеряемая показателями, характеризующими совместную работу врачей, координацию клинических действий и преемственность лечения в амбулаторных и стационарных условиях. Обзор зарубежного опыта показывает значительные масштабы концентрации, главной формой которой является формирование в ведущих западных странах крупных больничных и амбулаторно-стационарных объединений. При этом интеграционные мероприятия проводятся ...
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Mordvinova M., Endaltseva A., Journal of Communication in Healthcare: Strategies, Media, and Engagement in Global Health (Великобритания), Francis&Taylor 2015 Vol. 8 No. 4 P. 325-334
Smoking regulation constitutes a challenging issue for both developed and developing countries that aim to improve their state of public health and constituent wellbeing. Anti-smoking information and communication campaigns accompanying regulation acts can either enhance or sabotage national policy initiatives. This is especially salient in countries like Russia, where smoking is one of the top ...
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Stepanov I., Головщинский К. И., / Высшая школа экономики. Серия WP8 "Государственное и муниципальное управление". 2011. № 04.
Настоящий препринт содержит первоначальную версию создания системы фондодержания в Удмуртской Республике, а также пакет проектов нормативных правовых актов, которые необходимо утвердить для создания системы фондодержания. Документы носят типовой характер и могут быть интересны организаторам здравоохранения, работающим на региональном уровне. ...
Added: March 20, 2013
Sheiman I., Shishkin S., Markelova H., Health Policy and Planning 2014 P. 106-114
While many countries have increased the opportunities for patient choice of provider, there is debate to what extent this has had positive effects on efficiency and quality of healthcare provision. First, some conditions should be met to exercise such choice, of which the most important is the provision of reliable data on providers’ performance to ...
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Sheiman I., Journal of Pharmaceutical Care & Health Systems 2016 P. 1-10
Many countries have recently started the search for new payments methods with the specific objective to encourage the integration in service delivery. This paper suggests their typology. A brief overview of these methods in the USA and Europe, including Russia, indicates that there is still no strong evidence of their effects on integration and other ...
Added: June 14, 2016
Vlassov V., The Lancet 2016 Vol. 388 No. 10053 P. 1813-1850
Background
In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015).
Methods
We applied statistical methods ...
Added: September 25, 2016
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В статье обосновывается актуальность проблемы интеграции медицинской помощи. На материалах по ведущим зарубежным странам анализируются организационные, экономические и информационные механизмы интеграции с акцентом на те из них, которые имеют отношение к практике российского здравоохранения. Ключевые слова: фрагментация медицинской помощи, интеграция медицинской помощи, интегрированные методы оплаты услуг, программы управления хроническими заболеваниями. ...
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Relatively little is known about differences in the quality of engineering education within and across countries because of the lack of valid instruments that allow for the assessment and comparison of engineering students’ skill gains. The purpose of our study is to develop and validate instruments that can be used to compare student skill gains ...
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