Subject The article examines whether it is possible to improve the operation of the health care system in order to preserve human and labor capabilities, increase the sectoral contribution to sustainable socio-economic development of regions. Objectives The study designs a comprehensive methodological framework for evaluating the regional health care system so as to determine the attainability of medical and social targets, economic effects, sustainable operations in the sector, considering that neither Russian nor foreign research provides an integral view of health care efficiency. Methods The methodology is based on concepts of the systems economics, sustainable development. It also includes a multilevel and integrative approach and employs a set of methods, such as multivariate-comparative, deterministic-factorial, structural analyses, econometric modeling. Results We propose applying a comprehensive set of metrics to evaluate the regional health care system, including medical, social efficiency, indicators of sectoral economic efficiency. We analyzed the performance of regional health care systems in the Volga Federal District and Ural Federal District from 2013 through 2017 and identified respective achievements and challenges. The article sets out a non-linear model for the optimal combination of medical services so as to ensure the relative economic efficiency of the health care system. Conclusions and Relevance Relying on the study, we infer that the medical and social efficiency has a non-linear dependence on its finance, organizational forms and the regional health care system influence each other. The findings may be used by constituent entities of the Russian Federation to conduct an integral evaluation of the regional health care system, determine whether sectoral resources are effectively used and how the health care system develops.
Keywords: socio-economic system, sustainable development, regional health care system, efficiency, effectiveness
References:
Kleiner G.B. [System economics as a platform for the development of modern economic theory]. Voprosy Ekonomiki, 2013, no. 6, pp. 4–28. (In Russ.) URL: Link
Golubetskaya N.P., Ushakova E.V., Chirkova T.V. [Possible scenarios for the innovative development of regional enterprises in the context of restructuring of the Russian economy]. Ekonomika i upravlenie = Economics and Management, 2018, no. 10, pp. 68–74. (In Russ.)
Nikonova A.A. [Evolution of innovation mode within economic dynamics]. Ekonomika i matematicheskie metody = Economics and Mathematical Methods, 2018, vol. 54, no. 4, pp. 3–28. (In Russ.)
Golubkov V.V., Yakovets T.Yu. [The forecast of demographic situation in Russia up to 2033]. Ekonomika i matematicheskie metody = Economics and Mathematical Methods, 2018, vol. 54, no. 4, pp. 71–87. (In Russ.) URL: Link
Molchanova N.P. Transformatsiya prioritetov sovremennogo zdravookhraneniya i ee vliyanie na praktiku okazaniya meditsinskikh uslug. V kn.: Sotsial'no-ekonomicheskaya effektivnost' upravleniya obshchestvennym zdorov'em: filosofsko-metodologicheskie osnovaniya [Transformation of the modern health care priorities and its effect on medical services. In: Socio-economic efficiency of public health management efficiency: Philosophical and methodological principles]. Moscow, TEIS Publ., 2018, pp. 48–54.
Figueras J., Robinson R., Jakubowski E. Purchasing to Improve Health Systems Performance: Drawing the Lessons. Buckingham, Open University Press, 2011, pp. 44–80. URL: Link
Berry L., Seltman C. Management Lessons from Mayo Clinic: Inside One of the World's Most Admired Service Organizations. McGraw-Hill Education, 2017, 304 p.
Drucker P.F. Innovation and Entrepreneurship. Harper Business, 2006, 288 p.
Girosi F., Meili R., Scoville R. Extrapolating Evidence of Health Information Technology Savings and Costs. Santa Monica, CA, RAND Corporation, 2005, 345 р.
Coker R., Atun R., McKee M. Health Systems and the Challenge of Communicable Diseases: Experiences from Europe and Latin America. Open University Press, 2008, 308 p.
Conceição C., McCarthy M. Public Health Research Systems in the European Union. Health Research Policy and Systems, 2011, vol. 9, iss. 38. URL: Link
Omachonu V.K., Einspruch N.G. Innovation in Healthcare Delivery Systems: A Conceptual Framework. The Innovation Journal: The Public Sector Innovation Journal, 2010, vol. 15, iss. 1. URL: Link
Gray A.M., Clarke P.M., Wolstenholme J.L., Wordsworth S. Applied Methods of Cost-Effectiveness Analysis in Healthcare. Oxford, Oxford University Press, 2010, 328 p.
Arkhipova S.V., Dvoinikov S.I. [Methodological aspects of evaluation of effectiveness in health care]. Menedzher zdravookhraneniya = Manager of Health Care, 2018, no. 10, pp. 23–30. (In Russ.)
Tatarkin A.I., Krivenko N.V., Kuznetsova N.L. [Dialectics of rational change management in regional social systems]. Ekonomika regiona = Economy of Region, 2015, no. 2, pp. 128–136. (In Russ.) URL: Link
Akindinova N.V., Chernyavskii A.V., Chepel' A.A. [Cross-country analysis of public expenditures structure and efficiency]. Voprosy Ekonomiki, 2018, no. 12, pp. 5–27. (In Russ.) URL: Link
Aleksandrova O.A., Komolova O.A. [Health care reform: Heads of medical organizations at the forefront of problems (Part 1)]. Narodonaselenie = Population, 2018, vol. 21, no. 4, pp. 96–108. (In Russ.) URL: Link
Son I.M., Leonov S.A., Savina A.A. et al. [Dynamics of morbidity indicators during the reform of the Health Care System of the Russian Federation from 2006 to 2016]. Menedzher zdravookhraneniya = Manager of Health Care, 2019, no. 2, pp. 6–13. (In Russ.) URL: Link
Kadyrov F.N. Ekonomicheskie metody otsenki effektivnosti deyatel'nosti meditsinskikh uchrezhdenii [Economic methods for assessing the performance of medical institutions]. Moscow, Menedzher zdravookhraneniya Publ., 2007, 458 p.
Orlov E.M., Sokolova O.N. [Efficiency category in the healthcare system]. Fundamental'nye issledovaniya = Fundamental Research, 2010, no. 4, pp. 70–75. (In Russ.)
Ulumbekova G.E., Ginoyan A.B. [The effectiveness of the regional healthcare systems in Russia (rating–2017)]. ORGZDRAV: Vestnik VShOUZ = ORGZDRAV: Bulletin of Higher School of Education, 2019, no. 1, pp. 4–12. (In Russ.) URL: Link
