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Concentration processes in healthcare
The industry-specific nature of healthcare does not contribute to a high concentration of both production and the market.
Consider the influence of concentration factors in the production of medical services. The technological features of medical services as products do not require large aggregates and equipment, as well as machine complexes. Natural and geographical conditions
volumes of consumption of raw materials and energy do not require concentration of industry enterprises. At the same time, enterprises providing medical services to the population should be as close as possible to the consumer, which justifies the existence of small enterprises.
As an example of concentration processes in the industry, we cite the State Institution "Intersectoral Scientific and Technical Complex of Eye Microsurgery" named after Academician S. N. Fedorov (hereinafter MTC "Eye Microsurgery").
In MNTK “Eye Microsurgery”, more than 1,200 eye operations are performed daily, which is more than 300 thousand operations per year.
High concentration and large volumes of production, combined with the use of advanced technologies reduce production costs, which allows to reduce the cost of operations (which are several times lower than the world ones in the MNTK).
Production is diversified, located at the junction of industries and includes:
1) the production of medical services,
2) the development of new equipment (together with the Institute of General Physics of the Russian Academy of Sciences, a series of excimer laser systems were developed and put into practice);
3) the design of mobile operational diagnostic modules;
4) fundamental research;
5) its own production base, where 26 types of artificial eye lenses, instruments, high-tech and expensive diagnostic and surgical equipment, apparatus, and various preparations are manufactured;
6) training center (educational services);
7) publishing center.
The boundaries and capacity of a medical enterprise are determined by its legal form, number of personnel, amount of capital, specific types and scales of activity, service areas, and production facilities.
For almost every concentration indicator used in material production, one can find an industry analogue (table 8):
A well-known way to reduce the production costs of a small medical enterprise, similar in concentration to the mechanism, is to create centralized services within the municipality (centralized accounting, catering, etc.) and within the region (diagnostic centers, inter-territorial centers).
The creation of territorial medical associations during the implementation of a new economic mechanism in healthcare can also serve as an example of concentration in the industry.
In 1987-1991, in several regions of Russia, a new economic mechanism (NHM) was introduced, which is a system of management, financing, planning and evaluation of the activities of medical institutions, which increases the efficiency of the system. One of the many mechanisms for improving efficiency within the NHM was the concentration of production through the creation of territorial medical associations (TMT).
TMO - the union of several outpatient and hospital institutions within the framework of a municipal formation of a rural (RTMO) or urban (GTMO) type. This facilitated the management of the industry, contributed to the optimization of planning and reduced the cost of services provided to the population (by reducing the cost of maintaining administrative and management personnel, support services, and specialization of production).
Table 8 -
indicators characterizing the size of the health care facility and the possibility of concentration
By the beginning of the third millennium, the concept of “medical-industrial complex” (IPC) is included in the thesaurus of health managers. This complex is a part of the health care system that is directly related to material and material production and the provision of material and material services used in the prevention and treatment of diseases, maintaining and restoring health. The development of the IPC concept is promoted by the theory of synergy.
A synergistic effect is an increase in the efficiency of activity as a result of combination, integration, merging of parts into a single whole. Synergy improves system functionality.
Factors of synergy at the level of the IPC and its components can be:
1) the concentration of previously dispersed resources,
2) the expansion and deepening of relations between the IPC subsystems,
3) the activation of one part of the system, due to the presence in the system of another subsystem acting as a catalyst,
4) the complementarity of the components of the IPC,
5) the functional specialization of medical-production activities in various subsystems,
6) the interchangeability of the structural elements of the IPC.
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Concentration processes in healthcare
- Ministry of Health and Social Development of the Russian Federation
Department of Health Care and Resort Development
Central Research Institute of Health Organization and Informatization. Resources and activities of healthcare institutions, 2009
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