Financial and economic mechanism for the development of primary health care (regional experience)

Author(s):  N.N. Zubareva, candidate of Sciences, associate Professor, Belgorod National Research University, Belgorod, Russia, nzubareva73@mail.ru

Issue:  Volume 47 № 1

Rubric:  Regional and municipal economy

Annotation:  The article reveals regional practice of applying the financial and economic mechanism for primary health care development. In the article, the mechanism is understood as the device of the development processes of this type of assistance. There are also described approaches to the budget formation of the general medical practice office (a separate therapeutic area) from the allocation position of its revenue and expenditure parts. The main principle of the budgeting process in primary health care is defined as "conditional" local fund maintenance at the level of a general practitioner (district therapist) with the existing partial fund maintenance in polyclinics and general district hospitals. The focus for providing assistance to the population is concentrated in the "Budgeting" block of the territorial medical information system, the main users of which are doctors of the outpatient level. As a part of the financial and economic mechanisms for the development of primary health care in regional medical organizations in 2019, it was possible to ensure savings of 8% within the micro-budgets of general practitioners’ offices and therapeutic areas by reducing costs: - on diagnostic services (when re-equipment was done in accordance with the standards and procedures of general practitioners’s workplaces and district therapists, these specialists have the opportunity to conduct part of the diagnostics independently); - on medical care provided by particular specialists; - on the maintenance of general medical practice offices, paramedic and midwifery centers by reducing the cost of utilities after the construction of energy-efficient facilities and major repairs of existing ones (in 2019, the savings were about 1% of keeping all offices and paramedic and midwifery centers in the region, in monetary terms - about 3 million rubles). The use of the region's financial-economic development mechanism of primary health care, aimed at optimal use of available financial, material and human resources leads to positive medical and economic effects and contributes to the high quality health care to the population.

Keywords:  medicine, health care, general practitioner, therapeutic area, fund maintenance, budgeting, micro-budget, regional medicine, Belgorod region.

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