The Republican Center for Health Development summed up the rating of the activities of medical organizations, Research Institutes, Research and National centers (RI/NC) in 2017.
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Rating assessment of medical organizations of the republican, regional and city levels, providing medical care in the framework of the guaranteed amount of free medical care, regardless of ownership, held in each of the following groups: - regional hospitals for adults; - regional hospitals for children; - city hospitals for adults; - city hospitals for children; - organizations of obstetric aid of 2nd and 3rd levels of regionalization; - independent city polyclinics with a mixed population, family health centers; - oncological clinics; - psychiatric clinics and narcological clinics; - dermatovenerologic clinics; - tuberculosis clinics; - research institutes; - research centers.
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The rating assessment methodology of the activities was revised in 2018. The ball system was replaced with a star assignment from 5 to 1, in two categories: on clinical indicators and on management indicators, also an indicator of scientific activity is applied to national centers.
In the new edition of Methodology, depending on profile, 13 new indicators are included:
- Using of medical information systems;
- The presence of other international certificates for assessment of the activities of medical organizations;
- The ratio of average salary of doctor to 1 rate to the average monthly salary in regional economy (clinical, paraclinical departments, except administrative and management staff)
- The presence of supervisory board;
- Return of assets (ROA);
- The presence of a cooperative website;
- Growth rate treated Stationary replacing therapy (SRT);
- The presence of an official accounts in social networks;
- Level of satisfaction of medical personnel with working conditions;
- The presence of international accreditations (for Research Institutes, National Centers);
- Organizations of emergency medical care to service calls 4 categories of urgency;
- Possibility of electronic appointments to a doctor through egov;
The presence of patient navigation and routing scheme.
According to the results of the assessment, level of quality of medical care among hospitals for adults according to clinical indicators 53% of MOs (medical organizations) entered to the category of 5 stars and 38% entered to the category of 4 stars, 5% were entered to the category of 3 stars and below, according to management indicator from 170 ranking organizations 18 MOs or 11% entered to the category of 4 stars, 22% assigned 3 stars, 20% - 2 stars, 47% - 1 star.
Among regional hospitals for adults, according to management indicators, from 32 ranking organizations 6 of them or 19% entered to the category 4 stars, 41% - 3 stars, 23% - 2 stars, 19% - 1 star, according to clinical indicators, 9 MOs or 28% were assigned 5 stars, 41% - 4 stars, 31% - 3 stars.
Among regional hospitals for children, according to management indicators, from 13 ranking MOs 7% assigned 4 stars, 16% - 3 stars, 70% - 2 stars, 7% 1 star, according to clinical indicators 23% were assigned 5 stars, 16% - 4 stars, 61% - 3 stars.
Among city hospitals for children, from 15 ranking MOs, according to management indicators, 4 or 27% - 4 stars, 40% - 3 stars, 33% - 2 or 1 star, according to clinical indicators, 54% - 4 stars, 40% - 3 stars, 6% - 2 stars.
Among 17 Research Institutes/National Centers (RI/NC), according to management indicators to the category of 5 stars entered 4 organizations (24%), 4 stars were assigned to 6 RI/NC (35%), 3 stars – 3 organizations (17%), 2 stars – 2 MOs (12%), 1 star – 2 RI (12%), according to clinical indicators to the category of 5 stars entered 2 organizations (11%), 4 stars were assigned to 7 RI/NC (42%), 3 stars – 7 organizations (42%), 2 stars – 1 MO (5%), not a single organization was not assigned to the category 1 star.
From 25 maternity homes and prenatal centers (MH/PC) city significance, according to clinical indicators, 5 stars were assigned to 6 MH/PC (24%), 4 stars – 18 MH/PC (72%), only one maternity home were conferred 3 stars (4%); regarding to management indicators, to 5 stars category did not include any MOs, 4 organizations were conferred to the 4 stars category (12%), 3 stars were assigned to 10 MH/PC (40%), 2 stars – 9 MOs (36%), 1 star was conferred to 3 organizations (12%).
From 17 regional prenatal centers, according to clinical indicators 5 stars were assigned to: 6 PC (35%), to the category 4 stars included 7 PC (41%), 3 stars were assigned to 4 PC (24%), according to the results of 2017, according to the management indicators to the category 5 stars were not included any of MOs, the category 4 stars were assigned to 2 centers (12%), 3 stars – 7 PC (41%), 2 stars – 5 PC (30%), 1 star – 3 PC (17%).
In the rating evaluation of the quality of medical care for medical organizations providing primary health care 168 organizations participated, of which according to clinical indicators, to the category 5 stars were included 8 medical organizations, which is 4.7% of the total number of participated organizations; 4 stars were assigned to 30 medical organizations, which is 17.8% of the total participated organizations, 47 organizations were conferred 3 stars, which accounted 28%, to the category 2 stars were included 74 organizations or 44%, respectively, 5.3% are assigned to the category of 1 star (9 medical organizations), according to management indicator 5 MOs or 3% were conferred 5 stars, 4 stars – 24 MOs, this is 14.3% of total number of participated MOs, 52.3% MOs were included to the category 3 stars (88 MOs), 2 stars – 36 MOs (21.4%), respectively 9% was the category 1 star (15 MOs).
Brief conclusions:
To further improvement of positions in rating, medical organizations should pay attention to: passing national and international accreditation, the working of the internal audit and management, development of cooperative control, improving the system of training medical personnel, as well as implementing of digitalization, including medical information systems.
According to indicators, it is necessary to improve the quality and volume of stationary replacing medical care, improvement of high-tech medical services, including in regional institutions.
Rating assessment of medical organizations’ activity is considered as one of the components of the medical care Management process, such assessment provides an opportunity to monitor suppliers’ activity, and on the other hand by informing consumers about activity of suppliers, it motivates suppliers continuously improve performance indicators. For consumers of medical services rating assessment allows to determine the institution’s reputation and make conscious decisions about the preferred medical organizations for receiving medical care in a free choice.