Ilya Stepanov presented a report at REC-2023
Ilya Stepanov, a Junior Research Fellow at the International Laboratory of Digital Transformation in Public Administration, took part in a presentation at the Fifth Russian Economic Congress (REC-2023), held on September 11-15 in Yekaterinburg.
The Congress is organized jointly by the New Economic Association, the Institute of Economics of the Russian Academy of Sciences, the Ural State University of Economics, the Institute of Economics of the Ural Branch of the Russian Academy of Sciences, the Ural State Mining University, the Ural Institute of Management – a branch of RANEPA, the Central Economic and Mathematical Institute of the Russian Academy of Sciences and the Faculty of Economics of Lomonosov Moscow State University.
The report on the topic "Is the distribution of medical care volumes in the compulsory medical insurance system effective" presented an approach to assessing the effectiveness of planning and distribution of medical care volumes in the compulsory medical insurance system using indicators of the activities of medical organizations. The presented approach was tested on the example of inpatient medical departments of the neurosurgical profile of medical organizations of the Perm Region. The study used indicators of the activity of medical departments that characterize the quality of human resources, the processes of providing medical care (including the volume of medical services provided and the use of high-tech methods of treatment), clinical results of treatment.
As a data source, the author used digitally structured information provided by medical organizations, as well as a register of invoices for paid medical services at the expense of the compulsory medical insurance, including depersonalized data on patients, including the diagnosis and group of the disease, the initial condition of the patient, the duration of hospitalization, the cost of treatment at the rate and tariff coefficients, medical services rendered, the result treatments and others.
Based on the results of the assessment, the author concluded that there is a potential to increase the efficiency of spending compulsory medical insurance funds due to the expediency of redistributing the volume of medical care between medical organizations. The quantitative assessment of the increase in the efficiency of distribution was estimated at 30% of the level of distribution approved by the Territorial Commission of the Perm Region. However, the realization of this potential is limited by a number of factors, including the obligation of medical organizations to finance the wage fund for medical workers, due to the target values of the average wage level (twice the average wage level in the region's economy). Another factor is the specialization of medical organizations on individual diseases and the associated routing of patients.
Along with the economic estimates obtained, the study demonstrated the possibilities of using a data-centric approach in the management of the medical insurance system.