DOI: http://doi.org/10.15350/24097616.2020.1.11

Valeriya S. Novikova – Master’s  student of  Department of quality management, standardization and documentat management, Reshetnev Siberian State University of Science and Technology, Krasnoyarsk, Russian Federation, Е-mail: onlymiss@mail.ru

Elena V. Zamiralova – Candidate of economic Sciences, associate Professor, associate Professor of the Department of management quality, standardization and documentation management, Director of the Institute of full-time education Reshetnev Siberian State University of Science and Technology, Krasnoyarsk, Russian Federation, E-mail: zamiralova@mail.ru

Abstract. The quality of medical care directly depends on the volume and timing of its financing. Financing is allocated by territorial health insurance funds to medical organizations. In this regard, a special role is given to the process of planning the volume and cost of medical care, assessing its effectiveness, which was the purpose of this work. As a methodology, individual elements of a quality management system were applied – a process approach, monitoring and measurement of process indicators; as well as economic methods – the cost model of the process, process efficiency, economic effect, return on investment. The scope can be extended to other territorial health insurance funds located in the Russian Federation. The presented results are new for territorial health insurance funds due to the insufficient elaboration of the problem and the spread of the use of the quality management system in these organizations. Key results: estimated costs of the process “Planning the volume and cost of medical care”, determined its effectiveness; an algorithm of the process “Planning the volume and cost of medical care” was developed, indicators for monitoring the process were proposed and calculated, documents for collecting indicator data were identified; a procedure for creating a quality management system is proposed; the economic effect and return on investment are calculated.

Keywords: the process of planning the volume and cost of medical care, territorial health insurance funds, cost model of the process, quality management system, process approach, indicators for monitoring, economic effect, return on investment.

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For citation:

Novikova V.S., Zamiralova E.V.  Estimation of the influence of the effectiveness of the planning process on the quality of medical care on the example of the mandatory medical insurance fund. CITISE, 2020, no. 1, pp. 110-123. DOI: http://doi.org/1.15350/2409761.2020.1.11