Modern Trends in Healthcare Management

The most important task of the Russian healthcare management under the conditions of hard constraints is to use financial, material and other resources effectively amidst overt competition for such resources. Evidently, as a result of the economic approach to solving the problem of the Russian healthcare reform, an effective united system was created and is in use. The system is based on unified standards and technologies and takes into account both the cost of a simple medical procedure and the whole industry’s need in finances.


There is a certain methodological tradition in theory and practice of developing healthcare organizations; it determines formation and functioning – three levels of management, which are organically connected with each other. The first one structures management relations in the object activity of healthcare. These relations organize the professional subject area of managing medical and social, health-improving and healthcare-maintaining technologies. It represents a foundation for other levels of management relations. The second level provides management relations with legal framework which determines functioning of healthcare this society. Finally, the third level is political; it determines the mission and purposes of the healthcare system. The relations of healthcare management in politics aim at developing and forming socially and economically acceptable forms of healthcare organization, which are adequate at the current stage of society development. From our point of view, this approach does not measure up the fast developing elements of market relations which fill out the organizational and economic structure of the Russian healthcare system under the conditions of limited resources.


Fast-emerging system of economic relations explicitly requires the fourth informational-analytical level of management which has practically formed in practice between the above mentioned second and the third levels. Making adequate managerial decisions today is impossible without economic analysis of the healthcare system resource base, from determining the cost of a simple medical manipulation in monetary terms to budgets and financial needs of medical facilities and territories on the whole.


It is quite understandable that the more complex the managed object (system) is, the more information a managing system transfers and receives in unit time. Medical facilities, particularly large ones, are rather complex systems with a considerable number of connections between components.  A considerable part of these connections only interferes with the management process, as they are set up by so-called “part-time” management systems which follow different purposes than those of “full-time” systems.  In general, a certain trend is observed at large enterprises of any industry – with no modern informatization means an enterprise is able to operate with only 15% of the information it has. Of course, such circumstances make it impossible to make optimal, and most importantly, well-grounded managerial decisions.


Beside technological, organizational and economic connections in the management system, the most important informative point in the definition of healthcare as an economic subsystem is such a significant type of connections in any management system as information connections – connections that are formed in the united information space.

From our point of view, information support of the management process at healthcare institutions is becoming more and more important. Because a medical institution is a complex of specific and non-specific subsystems closely related to realization of the main function, which emanates from the whole system of purposes of the healthcare system functioning. Beside functional and organizational-economic subsystem, it must also include an information subsystem. If functional subsystems maintain the content of medical-technological process and its stages and organizational-economic subsystems represent a form of their functioning and management, then informational-analytical subsystems ensure high productivity and support of information connection between the first two, which is vitally important for the system on the whole.


From the production approach perspective, product of a medical and diagnostic facility’s work amounts to a difference between a patient’s входным и выходным conditions.  This difference includes the shift in physiological parameters during the treatment process and reduction of ambiguity in assessing a patient’s condition during the diagnostic process. There is a different type of a customer in both cases of a patient’s condition change. The informational-analytical system allows determining the net cost of both simple and complicated medical procedures automatically, based on the data received at each intermediate stage of producing core products of a medical facility. Consequently, the medical facility management receives a powerful instrument enabling them not only to make sustainable management decisions, but also to demonstrate the real economic contribution of a specific medical facility to supporting and recovering employable population of the territory and the country on the whole. In this regard it’s worth pointing out that a medical institution is an aggregate of subsystems which provide the technologies of diagnostic, treatment, prophylactic, rehabilitation process on the whole and its parts (in-patient, outpatient-polyclinic, paraclinic, auxiliary departments, etc.) It must be a united informational-analytical system which is based on a modern hardware system and can provide any information (including costs) concerning the correspondence of a treatment process to the accepted standards.


To sum up, functioning effectiveness of the medical-technological subsystem is determined by the degree of optimizing all processes and links with the economic subsystem, which provides means of using technological processes from the perspective of resource using efficiency and maintains routing of information flows when the achieved organization and technology of the treatment process is considered optimal in terms of expended resources.


August 2009


Information package of the 7th International scientific-practical conference «Experience and Problems of Social-Economic Reforms in the conditions of society’s transformation: region, city, enterprise.»