FORMATION OF CLUSTERS OF MEDICAL INSTITUTIONS AS AN ADMINISTRATIVE TOOL OF MANAGEMENT IN THE INDUSTRY OF HEALTH CARE IN THE CONDITIONS OF DECENTRALIZATION

Valentyna Kniazkova, Daria Huz, Olena Rudinska, V. Krylenko
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Abstract

The health care management system involves the application of administrative methods of managing medical facilities, which are a tool of state regulation in the field of health care. The transformation of the health care system through medical reform is aimed at providing citizens of Ukraine with equal access to quality medical services and reorienting the system so that the patient is at its center. The article examines the management of health care institutions in the process of reform, finds out the relevant issues of the infrastructural stage of the medical reform and the effective functioning of medical institutions in conditions of decentralization. Attention is focused on the transformation of the health care system in the form of the formation of clusters of medical institutions, which is proposed by the Ministry of Health of Ukraine and aims to improve the quality and availability of medical care through the creation of a new network of medical institutions in accordance with the principle of hospital districts. The structure of the cluster distribution of medical institutions within the framework of the medical reform and the characteristics of a capable network of medical institutions in the Odesa region are considered. The significance of the division of territories into hospital clusters in the process of balancing the advantages and disadvantages of decentralization and the maximum approximation to the modern European system of providing medical care is emphasized. A promising direction of further research on this issue is to solve the problem of «community hospitals», which are not included in the capable network of the hospital district (region) and, due to uncertainty, create a risk of reducing the availability and quality of medical care for residents of territorial communities.  
在权力下放的条件下,形成医疗机构集群,作为卫生保健行业管理的行政工具
医疗卫生管理制度涉及医疗设施管理的行政方法的应用,是国家在医疗卫生领域进行监管的一种工具。通过医疗改革改革医疗保健系统的目的是为乌克兰公民提供平等获得优质医疗服务的机会,并重新调整系统,使患者处于中心地位。本文考察了改革过程中医疗机构的管理,找出了医改基础设施阶段的相关问题,以及分权条件下医疗机构的有效运作问题。目前的重点是改革医疗保健系统,形成医疗机构集群,这是乌克兰卫生部提出的建议,目的是根据医院区原则,通过建立新的医疗机构网络,提高医疗保健的质量和可用性。考虑了医疗改革框架内医疗机构集群分布的结构和敖德萨地区有能力的医疗机构网络的特点。强调了将地区划分为医院群在平衡权力下放的利弊和最大限度地接近现代欧洲医疗保健体系过程中的重要性。关于这一问题的进一步研究的一个有希望的方向是解决"社区医院"的问题,这些医院不包括在医院区(地区)的有能力的网络中,由于不确定性,有可能降低领土社区居民获得医疗保健的机会和质量。
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