DEVELOPMENT OF FINANCIAL RESPONSIBILITY CENTERS FOR THE PURPOSES OF IMPLEMENTING THE TERRITORIAL COMPULSORY HEALTH INSURANCE PROGRAM

Abstract

The concept for the development of the healthcare system in Russia declares the provision of high-quality and affordable medical care, the priority of preserving and strengthening public health, including the creation of conditions for leading a healthy lifestyle and the formation of a responsible attitude of citizens towards their health. The level of economic development determines the possibilities for financing the provision of free medical care to citizens, therefore, improving the management mechanisms of a medical organization implementing a territorial program of state guarantees becomes a strategic task for the industry. The approaches used in the management of public medical organizations are underdeveloped, partly fragmented, and do not have a unified system of balanced indicators for assessing current activities, as well as the development and implementation of long-term goals. Some medical organizations, usually large ones, located in the administrative centers of the constituent entities of the Russian Federation, use modern management mechanisms to achieve financial sustainability (budgeting, analysis of performance indicators, identification of promising areas of development). The financial activities of medical organizations in the compulsory medical insurance system, depending on the result, allows for the development of the regional healthcare system or creates risks of decreased availability and quality of medical care, social tension due to the emergence of accounts payable for wages, work and services performed, discrediting regional executive authorities and the compulsory medical insurance system itself. The article will examine in more detail the mechanisms for managing the budgets of structural divisions, methods for forming such budgets, analyzing and monitoring their execution, assessing the performance of activities for use as methodological recommendations for anti-crisis management of small state medical institutions (district hospitals) located in small settlements serving a mixed population (adults and children).