Organizational structure of the wellness center. Structure of health care facilities

• Helps medical organizations to comprehensively approach the organization of therapeutic process, managing economic and financial activities in accordance with the legislation of the Russian Federation

Structure of a medical organization

Main primary documents

Maintaining mutual settlements

• Supported payment types

• Payment by completed case
• Payment for one-time visit

• Formation of registers for treated patients

• Under contracts with legal entities. persons
• Cash payment

• Support insurance programs

• Control insurance programs
• Coordination of medical services
• Accounting for warranty letters

• What gives

• Medical personnel work schedule
• Management of download specialists, cabinets and
• facial Foundation
• Patient queue management
• Control of the services provided by OMS, DMS
• Formation of registers for paying for treated patients
• Management of TMC.
• Maintaining mutual settlements
• Reporting

Abbreviated automation scheme

• Benefits

• Creating a single information space of the enterprise
• Patient flow control:
• Rational resource management
• Control of the passage of mandatory appointments
• SMS reminders and e-mail
• Centralized registration of services for OMS, DMS and cash
• Reducing the state of data entry operators:
• Loading the data of the assigned population from email. Documents
• Introduction of bar coding of primary documents
• Exception to duplicate data entry
• Reducing payment failures for treated patients
• Reduction of errors associated with the human factor
• Relatively not high cost

Full automation scheme

Full automation scheme

• What gives

• All advantages of abbreviated automation scheme
• Improving the quality of medical care at the expense of:
• Prompt access to medical records
• Application of treatment standards, control of their implementation
• Automated control for the provision of medical help at all stages of its provision
• Integration with medical equipment
• Maintaining electronic document management and its standardization
• Maintain EMK
• Cost reduction by excluding reuse of medical services
• Operational information on patient debts, control of mutual settlements
• The possibility of personalized accounting of services and spent on TMC treatment

• Classifier ICB10

• Classifier Disease Exodes

• Classifier for ordinary, complex and integrated services

Medical Classifiers

• Classifier specializations

• Purpose of specialization of inspection templates
• Monitoring the list of diagnoses available by specialization
• Control of services and medicines in specialization

Counterparties

• Two types of contract

• For medical services
• Purchase - sales

• Automatic binding of the patient to the "Individuals" contract when paying

Cabinets

• Note Division

• Assignment of the status "Post of the hospital department"

• Purpose Cabinet

Maintaining mutual settlements

Nomenclature

Nomenclature

• Shelf life series

References of medical services

• Handbook of "Medical Services"

• Handbook of "Uses"

Pricing

• Purpose of prices for each division of the organization

• Calculation from the basic type of price

• Use of pricing rules

• Appointment of a separate percentage of charge for Cito services

• Formation

• price lists

Medicinal pricing rules

• Purpose of Rules Rates Nomenclature Positions for Each Division

• Control minimum and maximum charge
• The corridor
• "Not change"
• The control
• minimal
• remain in warehouses
• Note
• formation
• order

Vaccine - Prevention

Diagnostics

Clinical Diagnostic Laboratory

Clinical Diagnostic Laboratory

Hospital

Pharmacy

Drug series accounting

• Single accounting in the context of parties

• The series is unique within the nomenclature position
• Automatic formation of the name of the series based on the data entered
• Ability to use the manufacturer's serial number
• Assigning the status "Do not use" a series
• Shelf life series

Order order of pharmacy assortment

• Flexible assortment management

• Registration of the order from one supplier or from different

• Various parameters of the latest supplier selection strategy

• Analysis of price lists suppliers

• Automatic creation of orders

The formation of the need for nomenclature

• Not getting to the minimum

• residue

• Minimal remnants

• By volume of sales

Move goods

• Ergonomic ART Storerovik

• Support for the work of order and cellular warehouses

• The possibility of revaluing the goods to move documents

• Filling tabular document

• Warehouse residues
• Reserves
• by request
• Reserves
• divisions

Accounting for medicines and materials

Maintaining economic activity

Exchange with other systems

Connecting shopping equipment

Volga State University of Telecommunications and Informatics

Description of the company's organizational structure

Performed: Ryaguzova Yu.S.

pIE-82 Group

Checked: Yurasova O.A.

Samara - 2010.

External and internal environmental environment.

To describe the organizational structure of the company, I chose a medical institution: "MMU city half-ka №6". This is a city clinic that provides medical services, such as: a planned and unscheduled inspection of patients, collecting biological material for analysis, medical examination.

The external environment is influenced by any enterprises and organizations, it should be understood as a combination of elements that make up two levels - macro (macroshrod) and micro (microse-yes). Macros it is formed from six elements, or media whose condition has an impact on the financial and economic, production and economic and other activities of the institution and creates probabilistic conditions for obtaining the desired results. These include political, or regulatory and law, economic, demographic, cultural, scientific and technological and natural environment.

Political, or regulatory environment : It has a direct impact on the municipal institution. The government fully regulates the conditions and development of medical institutions, it can both increase their number and reduce.

Economical wednesday: basically depends on the number of state subsidies for free treatment of pensioners and people with chronic diseases. The more such categories of citizens, the greater the demand for medical services. Also, the economic environment depends on the level of current income of the population, since most of the services are on a paid basis (half-ki income per month is approximately 50 thousand rubles).

Demographic wednesday: direct depends on the population. The larger the population, the greater the demand for medical services.

Cultural environment: it depends on the number of sports facilities: sports halls, stadiums, swimming pools, etc. The more such structures, the better the population is being developed physically and therefore the less the population needs medical care.

Scientific and technical wednesday: depends on scientific and technological progress. The better the equipment and medicines are delivered to the hospital, the better and faster doctors will be able to assist the population. The better the diseases will be studied, the less time will be spent on their diagnosis.

Natural wednesday: depends on environmental pollution (air, water, flora and fauna). The more the person contamizes with his own hands, the more it suffers from this: the acceleration of the development of diseases and the occurrence of pulmonary diseases.

Microsudes It is formed from six elements to which the organization itself are primarily organized by all types of resources required to provide services, competitive organizations, intermediaries, consumers of services, contact audiences.

Contact audience - Any citizens groups showing real or potential interest in services of clinics, its activities and thereby influence the relationship of the polyclinic to achieve the goals.

The purpose of this institution - ensure the provision of quality medical services and reduce the likelihood of the incidence of people.

Typology of organizational structures.

Management of this medical institution is carried out using the traditional linear structure. In this clinic, everyone is subordinate to the chief physician. The institution is then divided into sites where the manager is managed by the doctor, and he is subject to doctors, laboratory technicians and nurses.

Rice1. Linear management structure

Personnel management economy.

Allocate economic and non-economic systems incentive work activities:

Economic:The promotion method (wage increase, bonuses, etc.), punishment methods (fines, deductions), personnel service with a discount.

Not economic: The provision of free dining rooms, medical insurance of workers, the employee rating method (the best employee of the month receives a remuneration).

Human capital.

The organizations begin to attach increasing importance to the intangible characteristics of their employees, such as loyalty, the ability to establish relationships with consumers and the willingness to take risks, and also look for ways to formally evaluate. And realizing how expensive the potential of such human qualities, companies transform them into something more specific - human capital.

Supporters of the human capital management concept are confident that, measuring the widespread impact that employees apply to the financial performance of the organization, companies can choose, manage, assess and develop the capabilities of their employees in such a way as to transform their human qualities into significant financial performance of the company. Although this approach involves the search for the methods of quantitative assessment of what was previously considered intangible assets, specialists implementing such techniques note that similar approaches are already used in the business market.

The main way to increase the "human capital" in my medical institution is investing in it. However, investments are necessary, but far from the only condition for the formation of "human capital". A group of researchers adheres to the opinion that "human capital" can be formed in parallel and by itself without any investment (the so-called self-expression).

Also, at present, an increasing amount of their funds, the institution spends on improving the qualifications of its employees. The costs of general training in the same extent increase the productivity of the employee, both in the institutions producing it and in all others, training at the place of work related to improving productivity is special.

6.1.1 The structure of medical organizations is determined by the medical and technical task (task for design), taking into account their profile and power. A part of the divisions in the structure of a medical organization may be absent when transferring relevant functions to centralized organizations (diagnostic center, central sterilization department, laboratory center, laundry, sterils, clinical service, pathologist department, etc.).

6.1.2 Medical organizations intended directly for patients are divided into two groups: stationary and outpatient polyclinic. The composition of medical organizations with the hospital can be the following structural units: hospitals, advisory and diagnostic departments, medical departments, auxiliary, economic, service and household, premises of clinical departments, day hospitals

6.1.3 Consultative and diagnostic and therapeutic divisions are advisable to design centralized with the possibilities of using them both stationary and outpatient patients. To do this, separate inputs and expectations should be provided. In organizations up to 150 beds, the entrance and the expectations may be common, but with the division of use in time.

6.1.4. Ambulatory-polyclinic organizations include: Feldsher-obstetric items (FAP), rural medical ambulatory (su), offices of a general practitioner, territorial, departmental and specialized clinics, dispensaries, medical centers, reducing centers without hospitals.

6.1.5 As part of the ambulatory-polyclinic organizations can be the following structural units: branches of outpatient polyclinic reception, advisory-diagnostic, medical departments, day hospitals, auxiliary (including home assistance separations), household, residential.

6.2. Volume-planning decisions of buildings

6.2.1 The planning structure of the building should ensure the flow (sequence) of technological processes, optimizing ways to move the main streams of personnel, patients, hospital cargoes to minimize their length and convenience of patients, visitors and personnel.

6.2.2 Flows of materials with a high degree of epidemiological hazard must be maximally isolated from other streams using planning solutions or special equipment (closed carts, sealed containers for waste, passing sterilizers and washing machines, barrier washing machines, etc.). Packed cargo is allowed to transport the overall elevators.

6.2.3 End branches, openers, roblocks, resuscitation, laboratory, CSO, X-ray, should not be passing.

6.2.4 To ensure the protection of patients and personnel from in-hospital infections, various forms of spatial isolation should be used: reducing the power of the ward offices; division of walled offices on the section; restriction of the capacity of the chambers of one or two beds (including for the joint stay of the mother and the child); Individual labor chambers in generic branches, allocation of one or several single chambers to isolate patients. In addition, individual generic boxes may be provided for the receiving department; Reception diagnostic boxes;

6.2.5 At the entrance from stairs and from elevators to store sections, openers, resuscitation and intensive therapy sections, as well as in the laboratory research zone, you should provide a gateway or elevator hall.

6.2.6 To protect the testimony of diagnostic equipment from distortion of the functional diagnostic cabinets, it is not recommended to be placed adjacent (including above and under them) with electro-flashing cabinets, treatment of radiations, cabinets of magnetic resonance imaging and radiation therapy, as well as premises with Sources of vibration.

6.2.7 Premises in which work with sources of ionizing radiation is carried out, it is not allowed to be placed adjacent (including above and under) with chambers for pregnant women and children.

6.2.8 The premises of hydrogen sulfide and radon baths should not be located adjacent to the chambers. It is not recommended to place offices with X-ray and other complex equipment under premises with "wet" processes (showers, restrooms, washers, etc.). In case of impossibility of another planning solution, measures should be taken on waterproofing to exclude leaks.

6.2.9 For natural lighting of premises, planning solutions may provide for internal yards and atriums.

6.2.10 Natural, artificial and combined lighting of the main premises of medical organizations should be designed on Appendix N.

6.2.11 A free orientation of windows of premises on the sides of the horizon is allowed. The regulatory duration of insolation (SanPine 2.2.1 / 2.1.1076) must be ensured by at least 60% of the total number of the chambers of the medical organization. These chambers are not included in the chambers in which to protect against excessive insolation and sharp light, it is necessary to provide for sunscreen (postoperative and generic chambers, chambers of resuscitation and intensive care units, the chamber for the adhesion of newborns and premature). For day hospitals chambers, the duration of the insolation is not normalized.

In the premises of the permanent stay of patients and personnel focused on the southern Rumba horizon, it is also necessary to provide for sunscreen.

6.2.12 In divisions with the reception offices of patients, premises should be provided for the premises (place) for expectation at the rate of 5 m 2 per office or each place in the office (dental chair, couch, etc.). When using computer systems for regulating patient flows and during the reconstruction of buildings, the area can be reduced.

6.2.13 Area and dimensions Chambers must be determined based on the requirements of the patient's bed with three sides. To the beds of residential rooms of the sanatorium and the beds of the accompanying patient (mothers in the wards of the co-stay of the mother and the child, etc.) does not require a three-sided approach.

6.2.14 The distance from the end of the bed to the end of another bed or the wall of the chamber should be at least 1.2 m. The distance between the long sides of the next beds should be at least 0.8 m, and in the wards of reducing treatment, neurosurgical, orthopedical traumatology , burn, medical and social and chambers for patients moving with the help of wheelchairs - at least 1.2 m.

6.2.15 The size of the premises and corridors of therapeutic units should be taken on Appendix G.

6.2.16 Generic and operating departments, resuscitation and intensive care departments It is advisable to combine in one zone with the creation of a general duty service for these units (express laboratory, blood storage service, emergency sterilization, etc.).

6.2.17 SanPropuscans are designed separately for men and women. Surpropuscasters of three rooms (the storage room of the society clothing, the premises of the dressing of staff in sterile clothing, the premises of the collection of used clothing) should be provided for opersblocks, generic blocks, as well as sterile blocks of oncohematological and other branches in transplanting organs and tissues. SanPropuscarnesses from two rooms (the storage room of the society clothing and weakly) - in surgical resuscitation, resuscitation sections for newborns and premature. In other branches with high demands on the sanitary and epidemiological regime (therapeutic resuscitation, the celading section of the adhesion of newborns, etc.) provides for the gateway to wear overalls and washing hands. When storing the storage of rolling clothes, restroom and shower are provided. Showers are envisaged at the rate of one shower for 4 operating (but at least one) or 6 posts of duty personnel.

6.2.18 On the task of designing in the structure of the hospital, a room may be provided for carrying out religious rites with an area of \u200b\u200bat least 12 sq.m.

6.2. For recreation patients in chairs in recovery treatment departments, the light pockets of corridors are allowed.

6.2.20 In therapeutic, diagnostic and auxiliary premises of medical organizations The minimum width of the doorway is accepted on Table 6.1

Annex to order

TFOMS Perm Region

Table No. 1.

Structure of a medical organization

Registry code MO ___________

Sign of "Separate Structural Division" (1-rally)

Name of the Unit / Office / Plot / Point

Extra. Sign of separation

The level of providing MP

Sign of participation in the formation of costs MO:

Branch type

Conditions for the provision of MP in the registry (classifier V006)

View of the MP (Classifier V008)

MP profile (for the type of separation 1 - "therapeutic and prophylactic (hospital) (classifier V002)

Source of financing (0 - OMS, 1 - budget, 2 - not included in TP)

An attachment "allowed attachment" (for plots, paragraphs) (1-yes; 0-No)

MO providing SMP

divisions

departments

(1-PSO, RSC)

(1st, 2nd, 3-third)

1 is the main (income), 2 - auxiliary paraclinic (cost), 3- auxiliary (cost), 4 - Otherial auxiliary (cost)

office code, which consists of costs<*>

name

name

name

name

name

<*> For separation / sections / items, the cost accounting for which is not contained separately, the branch code is filled, as part of the costs, in accordance with the structure of the MO structure: 6 digits (XXYYZZ), where XX is the department code, yy - area code, zz - point code (for example, 010101 - separation code 01, area code 01, Code of paragraph 01).

Artist, tel.:

Table number 2.

Power of medical organization

as of _________________________

Name of the medical organization (short) __________________________________________

Registry code MO ___________

Section 1. Foundation of separations with type 1 - "Therapeutic and prophylactic (hospital)"
Department code	Name of the Unit / Office / Plot / Point	Nomenclature department<*>	Number of deployed beds	Profile Koyki<**>
	name		including OMS		name
	Department 1.		Stationary
	Department 2.		Stationary
	Department 3.
<**> All the profiles of the bed of this compartment are specified by several lines.

Artist, tel:

Section 2. Power (number of places) of compartments with type 2 - "Therapeutic and prophylactic (day hospital)"

Nomenclature department / point

Number of places

Number shift

Profile Koyki<*> (Classifier V002)

Sign of VMP

divisions

departments

name

including OMS

name

1 - has a VMM; 0 - does not have a VMM

Department of day hospital 1

Department of day hospital 2

Day hospital at APP

Day hospital with OVP №1

Day hospital in OVP

Artist, tel.:

		Section 3. Power (number of visits to shift) of separations with type 3 - "Therapeutic and prophylactic (APP)"
		Name of the Unit / Office / Plot / Point	Department / Point / Point Nomenclature<*>	Sign of Cabinet (1-there, 2-no)	Scheduled number of visits to shift	Number shift	Specialty<**> (Classifier V015)
	divisions	departments		name			name
			Department of APP 1.		Plot
			Department of APP 2.		Specialized
			Department of APP 3.		Center OVP
			Department of APP 4.		Health Center
			Department (Cabinet) APP 5		Emergency
			Department (Cabinet) APP 6		Prevention
			Department of APP 7.		Medical rehabilitation
			Department (Cabinet) APP 9		Stomatology
			Department of APP 10.		Women's consultation
			Department of APP 11.		Emergency room
			Department (Cabinet) APP 12		School-preschool
			Department of APP 13.		Radiological
			Department of APP 14.		LFK, Massage
			Department of APP 16.		Palliative
	<*> Filled on the basis of Appendix No. 2.
	<**> All specialties of this separation are indicated by several lines.
	Artist, tel:
	SECTION 4. Power (number of brigades) SMP
		Name of Division / Office / Point	Nomenclature department / point			Profile Brigades SMP<*>	Number of field brigades (shift)
	departments				name
				Substation 1.
				Substation 2.
				Department of SMP
		<*> It is indicated in accordance with the data of the forms of sectoral statistical reporting No. 40.
	Artist, tel.:

Annex to order

TFOMS Perm Region

Nomenclature of offices, plots, items of medical organizations

1. Handbook of the nomenclature of offices

	Nomenclature of structural units
	name		Name
	department		Stationary
	department		Anesthesiology and resuscitation
	department		Operating unit
	department		Medical rehabilitation
	department		Day hospital at hospitals
	department		Day hospital at APP
	department		Reception
	department<*>		Plot
	department<*>		Specialized
	department		Center OVP
	department		Health Center
	department<*>		Emergency
	department<*>		Prevention
	department<*>		Stomatology
	department		Women's consultation
	department		Emergency room
	department<*>		School-preschool
	department<*>		Radiological
	department<*>		LFK, Massage
	department<*>		Alternative medicine
	department
	department		Palliative
	department<*>		Laboratory
	department<*>		Radiation and radiological diagnostics
	department<*>		Functional tool diagnostics
	department<*>		Physiotherapeutic
	department<*>		Transfusiology
	department		Pathologanomic
	department<*>		Proponential
	department		Registry
	department		Squeezers
	department		Dairy kitchen
	department
	department		Laundry
	department		Sterilization
	department<*>
	department<*>		Aho Other (garage, plumbing, gas ventilation services, etc.)
	department<*>		Medical examination
	department<*>		Other generalized (honey. Archive, hostel, library, museum, etc.)
			Therapeutic
			Pediatric
			Complex
			Assigned
			Feldshersky
			Obstetric<**>
			Healthy health<**>
			Day hospital in OVP<**>
			Mobile FAP

<*> - separation (office);

<**>

2. Directory Nomenclature Plots

	Name	Decoding
	Therapeutic	the service of adults is carried out by a physician-therapist
	Pediatric	maintenance of the children's population is carried out by a pediatrician-pediatrician
		maintenance of an adult and / or children's population is carried out by a general practitioner (family)
	Complex	the plot is formed from the population of a medical organization with an insufficient number of attached population (a small-component plot) or population serviced by a doctor-a-therapist medical ambulance, and the population served by Feldsher-obstetric items (by paradise
	Assigned	maintenance of the adult population is carried out by a district physician-therapist of the workshop
	Feldshersky	maintenance of the population is carried out by Feldsher (obstetric) in the Feldsher-obstetric item
	Obstetric	service by a gynecologist or midwife of the female population in the polyclinic department

3. Handbook of the nomenclature of items

	Name
	Healthy health
	Day hospital in OVP
	Mobile FAP

<***> - Does not attach the serviced population.

Annex to order

TFOMS Perm Region

Instructions for filling out the form "Structure of a medical organization"

1. The form "The structure of medical organizations" is developed in accordance with:

Chapter 5 of the Federal Law -FZ "On the Fundamentals of the Health of Citizens in the Russian Federation";

Article 44 of the Federal Law "On Compulsory Medical Insurance in the Russian Federation";

Order of the Ministry of Health and Social Development of the Russian Federation N "On approval of the procedure for providing pediatric assistance";

Order of the Ministry of Health and Social Development of the Russian Federation H "On approval of the Regulation on the organization of the provision of primary health care for the adult population";

Order of the Ministry of Health and Social Development of the Russian Federation N "On Approval of the Nomenclature of a Coe's Fund for Medical Relations" (hereinafter referred to as the order of the Ministry of Health of the Russian Federation H);

Order of the Federal Fund for Compulsory Medical Insurance "On Approval of the General Principles for the Construction and Functioning of Information Systems and the Procedure for Information Cooperation in Compulsory Medical Insurance" (hereinafter referred to as the order of the FFOMS);

The Law of the Perm Territory -PK "On the territorial program of state guarantees of free provision of medical care for 2015 and for the planning period 2016 and 2017" (hereinafter - TP OMS).

2. The form of "Structure of Medical Organizations" Fills MO in accordance with the procedures for the provision of medical assistance, regulatory and legal acts in the health sector of the Perm Territory, License and Regulatory Documents MO (approved structure of MO, staffing, orders of the chief doctor, etc.) , copies of which are available on request in the TFOMS of the Perm Territory.

3. In the "MO code" field (Tables No. 1) indicates the registry number of MO - 6 digits: "59" plus 4 digits of the Code of the MO in the encoding of the TFOM perm rus.

4. In the Country Code "Division", "Department Code", "area code", "Point code" (Tables No. 1, 2) indicates no more than 2 digits code;

It is allowed to use a numbering acting in MO, provided the uniqueness of the codes within one MO and the uniqueness of the areas of sites (paragraphs) within one branch (section), respectively.

The Count Code "Division" is also filled with branches, plots, items included in this unit.

The Count "Department Code" is filled in obligatory: in the presence of departments, the department is indicated, unique for MO. In the absence of a separation level and simultaneous level in the structure of the level of separation and simultaneous presence of sections and / or points in the Code of Department, the conditional department of separation 99 is indicated, and the Count "Name of the Department" is not filled.

By the "area code" column at the "Point" level for:

- "FAP" is necessarily indicated by one of the codes of the site (in the absence of the chief doctor of attaching the FAP to one of the medical sections of MO, it is necessary to enter a string with a section "Feldshersky", assign the code to it and attaching all the data of the FAP to it) ;

- Healthcare, "Exit Specialized Consultative Brigade" indicates the area code - "0";

- "Day hospital in OVP" indicates the code of the corresponding section "OVP".

The organizational structure of enterprises is the distribution of responsibility and powers within enterprises (see Fig. 1.1.).

Fig. 1.1. General structure of a medical organization

This medical institution has four departments in the central office and one department in four branches. Head of the branch, chief doctor. He is responsible for the results of the mined employees, has the authority to hire and dismiss personnel (nurses, doctors, etc. medical workers).

The personnel department is responsible for working with clients. It includes: Customer Service Manager. The technical department is headed by chief engineer. He checks the work of all technical means and is responsible for the repair of equipment. The third department is financial. In the organization there are accountants that exercise all financial transactions. The Documentation Department is engaged in collecting and verifying insurance documentation for insurance companies.

Based on the main activities of this system, the following objectives are assigned to the employees:

Collection of documentation on insurance services provided for various time intervals;

Error analysis in the documents received;

The formation of the necessary reporting corresponding to the norms and rules of the organization and the insurance company;

Monitoring the integrity and safety of data used in data processes.

1.3. Functions of the department for working with documentation

In accordance with the main tasks, this system unit performs the following functions:

Organizes data collection from all branches;

Forms the necessary documents when working with insurance clients documentation in accordance with the rules and regulations;

Checks insurance documentation from branches of a medical institution;

Sends insurance documentation to branches of a medical institution;

Analyzes the insurance documentation for the number of permissible errors and services rendered;

Makes timely informing the management by writing reports;

The task of documentation staff is to verify the documentation for insurance documents that they receive from medical staff from the branch of the organization. Document collection is required for their adjustment and counting of issued, spent drugs and services. Documentation officers have the right not to accept documents and send to correction if the conditions of filling (incorrect coding of the drug, incorrect weight or quantitative data, incorrect service code).

Thus, an insurance documentation officer must perform the following tasks:

Collection of documents from the branches of the organization;

Verification and analysis of documents;

Drawing up error report in the documentation;

Delivery of documents with branch branch medical organization;

Analysis of all insurance documentation.

1.4. Forming a mathematical model of the problem of high costs in a medical organization

The main goal of any organization is profit, therefore, in this section, a mathematical model for profit for a private medical organization will be formed.

At the moment, this company serves 66% of the private medical services market in the city.

Profit is the difference between income (revenue from the sale of goods and services) and the cost of production and sales of these goods and services.

An increase in the profit of the organization is possible due to an increase in revenue and cost reduction. Consider the profits formula.

Consider this formula profit from the activities of this organization in more detail. Part of the revenue is formed from the service of private clients.

The organization provides private clients such services:

dentistry;

gynecology;

urology;

sexopathology;

medical cosmetology, plastic surgery;

ophthalmology.

Consider the formula:

Another part of the revenue is formed from the maintenance of insured patients, where part of the cost is repayable by the insurance company, and the remaining percentage (if any) is a patient.

Also, the state pays 20% on costs from business costs in medicine for private medical institutions (public financing programs and in the OMS system).

, where (1.5)

Wi - expenses for a medical institution (verification, improvement of the organization's processes);

, where (1.6)

B - the number of employee hours;

A - temporary taxation and inspection of insurance documents;

Zj - employee wages;

VC - variable costs;

FC - constant company costs.

, where (1.7)

Consider the parameter in more detail. When evaluating the volume of sentences, the employee tries to maximize its utility function depending on the main two variables: free time (TSV) and money (SS). This feature determines the preferences of the employee relative to various combinations of free time and money. The curves of indifference of the usefulness of this subject in the variable space (TSV), (SS) will be convex to the beginning of the coordinates, showing that in order to maintain the employee's welfare level at one level, it is necessary to compensate for the reduction of each additional hour of working time, more and more monetary compensation. Let the wage employee per hour constitute RR. Then the salary on the employee's day will be determined by this formula:

Then this function forms in the graphical representation of the "direct wage", where each point is a combination of free time and money. Suppose the employee utility function is equal to

We will write our "direct salary" equation in a more convenient form and repel the Lagrange function to determine the dependence of the quality of the employee, from the wage rate. Then the "direct wage" looks:

A Lagrange function is displayed in this way.

Find private derivatives of Lagrange functions by variables and:

Now we divide the first equation for the second, express through () and substitute to the equation for direct wages:

We see that if the function of the usefulness of the individual is the function of Kobba Douglas (the dependence of the production volume from the main factors of production - the cost of labor and the laid capital), then the amount of labor proposed L \u003d 24 - \u003d 24 - 8 \u003d 16 does not depend on the wage rate.

In other words, it is possible to clarify that when wage increasing the employee, the quality of labor cannot be improved, therefore, it is necessary to consider another parameter that will affect the company's profit.

Consider the influence of other parameters on the cost and take the derivative of such parameters as b (the number of employee hours of the employee is 8 hours) and A (total testing of insurance documentation).

Having considered these parameters can be concluded that the Z parameter (costs) depends nonlinearly from the parameter A - the overall time to check the insurance documentation. We define its minimum and maximum.

Fig. 1.2. Schedule of the dependence of profits from the total time to check insurance documentation (minimum)

Figure 1.2. Graphically displayed addiction Total time for checking insurance documentation from the organization's profits. Long checking documents will bring the minimum profit of the organization.

But if you reduce the overall time of checking insurance documentation, then the profit should potentially increase. What is displayed in Fig.1.3.

Fig. 1.3. Chart of the dependence of profits from the total time check of insurance documentation (maximum)

Thus, the profit formula for this company has the form:

After studying this mathematical model, we construct the solutions tree to select a further optimization parameter (Fig. 1.4).

Fig. 1.4. Tree solutions to reduce costs in the organization

At the current moment, we can conclude that it is necessary to consider the time for checking the insurance documentation. Reducing this parameter will result in increasing profits.

Social aspect of this problem.

With a decrease in the inspection time of the insurance documentation, this company will be able to increase the number of customers serviced, which will have a positive effect not only on the company's profit, but will provide people with timely medical help.