The main types of healthcare institutions. The legal status of medical institutions in the Russian Federation How paid medical services are provided

By order of the Ministry of Health and Social Development of the Russian Federation of October 7, 2005 No. 627, it was approved Unified nomenclature of state and municipal health care institutions ... Today, the names of all healthcare institutions must comply with this Nomenclature.

The unified nomenclature includes four types of healthcare facilities:

Treatment-and-prophylactic;

Institutions of a special type;

Institutions for the supervision of consumer protection and human well-being;

Pharmacy institutions.

Treatment-and-prophylactic institutions include:

1) hospital institutions;

2) dispensaries: oncology, tuberculosis, etc .;

3) outpatient clinics;

4) centers, including scientific and practical;

5) emergency medical institutions;

6) institutions for the protection of mothers and children;

7) health resort institutions.

Clinical institutions are medical and prophylactic institutions (hospitals, dispensaries, maternity hospitals and other institutions) used for teaching by higher medical educational institutions (faculties) or for scientific purposes by medical scientific organizations.

Hospitals ... There are the following types of hospitals: district, district, city (including children's), and other types. Hospital institutions are intended for the treatment of patients in a hospital setting (from Lat. Stationarius - standing, motionless). Hospitals can have a polyclinic (outpatient clinic). Here, emergency medical care is provided, as well as assistance to patients who need constant monitoring or the use of treatment methods that are impossible or difficult on an outpatient basis - at home or in a clinic (operations, frequent intravenous, intramuscular and other injections and other manipulations).

Distinguish monoprofile (specialized) hospitals dedicated to treating patients with a single medical condition (e.g. tuberculosis) and multidisciplinary - these are hospitals, which include various departments (for example, surgical, neurological, therapeutic, etc.).

The structure of the hospital usually includes an admission department, treatment and diagnostic, treatment departments, a pharmacy, a catering unit, etc. The functional duties of a nurse in a hospital depend on the profile of the department and the specifics of her work in it (a nurse of an admission department, a surgical department, a treatment room, a ward nurse, etc.).

Specialized hospitals, including rehabilitation treatment, gynecological, geriatric, infectious, narcological, oncological, ophthalmological, neuropsychiatric, psychiatric, tuberculosis.

Hospital - (from Lat. hospitalis, hospitable) a medical institution designed to provide medical assistance to military personnel. In a number of countries, civilian medical facilities are also referred to as hospitals.

Treatment-and-prophylactic polyclinic type institutions - these are polyclinics and outpatient clinics.

Polyclinic - a multidisciplinary medical and prophylactic institution designed to provide medical care to patients, including specialized; if necessary - for examination and treatment of patients at home.

In the polyclinic, doctors of various profiles (therapists, surgeons, ophthalmologists, otolaryngologists, cardiologists, etc.) receive visits, as well as diagnostic rooms (endoscopic, radiological, functional diagnostics rooms), a laboratory, a physiotherapy department, a treatment room.

The basic principle of operation of the polyclinic is territorial-district. The territory served by the polyclinic is divided into sections, to which the district doctor and the district nurse are assigned, with a certain number of the population.

The local doctor and nurse are responsible for carrying out all medical and preventive measures on the territory of this site. In addition, great importance is attached to the medical examination of the population.

Clinical examination - it is the organization of systematic monitoring of the health of the population, the study of working and living conditions, the identification of patients with chronic diseases.

The district nurse of the polyclinic helps the doctor during the admission of patients, maintains various documentation, explains to patients how to collect this or that material for laboratory research, how to prepare for instrumental and X-ray examinations, fills out statistical coupons, research referral forms, fulfills doctor's prescriptions for at home, or when necessary, teaches the patient's relatives the elements of caring for him.

In addition to the precinct, the polyclinic has procedural nurses, nurses of physiotherapy rooms, etc. At present, there are first aid rooms in the polyclinics: here a nurse measures the patient's body temperature and blood pressure.

Outpatient clinic - This is a medical and preventive institution, which, like the polyclinic, provides medical care to patients in rural areas. The work of an outpatient clinic, like a polyclinic, is built on a territorial-territorial principle, but unlike a polyclinic, there is a smaller amount of medical care. An outpatient clinic usually employs no more than five doctors.

The work of a nurse in an outpatient clinic resembles the work of a district nurse in a polyclinic, but requires from her even greater independence and responsibility.

Medical and sanitary part - a specialized health care institution designed to organize preliminary (upon admission to work) and periodic (during employment) medical examinations of workers with harmful and hazardous working conditions at large enterprises. Their activity is based on the principle of a shop division.

The structure of medical and sanitary units is different, they may include a polyclinic or an outpatient clinic, a hospital, health centers, a dental clinic, a dispensary, sanatoriums, children's health camps, etc.

The functions of the medical units are varied. In addition to providing outpatient medical care, treating patients in a hospital, the staff of the medical and sanitary unit carry out a lot of work but dispensary monitoring of the health of workers and employees through systematic preventive examinations, identify persons suffering from chronic diseases, all ill on an outpatient basis or in a hospital.

District (workshop) doctors and nurses, paramedics of health centers study the working conditions of workers and directly at the workplace, identify occupational hazards and take part in the development of a set of preventive measures aimed at improving the working and living conditions of the enterprise employees.

Health centers (doctors, paramedics) are structural units of health care institutions or organizations and are designed to provide first aid to workers, employees and students. The health center is not an independent medical and prophylactic institution, but is usually part of the polyclinic or the medical and sanitary part of the enterprise. The medical staff of the health center (doctor, paramedic, nurse) provides first aid and first aid, carries out the necessary procedures prescribed by the doctor of the polyclinic or the medical unit (injections, dressings), makes vaccinations, performs sanitary and educational work.

Ambulance stations- These are medical institutions designed for round-the-clock emergency medical care to patients at the prehospital stage for all life-threatening conditions (trauma, injury, poisoning, bleeding), as well as during childbirth. At ambulance stations, personnel work in teams of 2-3 people (a doctor and one or two paramedics).

TO institutions for the protection of mothers and children include antenatal clinics and maternity hospitals. Women's clinics, like polyclinics, work on a territorial-territorial principle. Here they carry out medical examination, identify and treat women with gynecological diseases, and also conduct dispensary observation of pregnant women.

The staff of antenatal clinics and maternity hospitals conducts extensive sanitary and educational work with pregnant and postpartum women. Nurses usually work in the treatment rooms of antenatal clinics and maternity hospitals, as well as in operating rooms, children's departments of maternity hospitals as ward nurses.

TO sanatorium-type institutions include sanatoriums (from Lat. sanare - to heal, to heal), dispensaries, recreation camps for children, sanatorium health grounds. The activity of these medical and prophylactic institutions is based on the use of mainly natural therapeutic factors (mineral waters, mud therapy) for the treatment of patients, as well as herbal medicine, physiotherapy and physiotherapy exercises.

In the sanatoriums, patients undergo outpatient treatment. Dispensaries organized at large industrial enterprises are used for treatment and preventive measures, as a rule, in their free time from work.

The work of nurses in sanatorium-type medical and prophylactic institutions resembles the work of nurses in polyclinics, hospitals, dispensaries, etc.

Nursing home (hospital) - a health care institution to provide qualified care for elderly and senile patients suffering from chronic diseases and for health reasons who do not need active treatment.

Hospice - a health care institution for the provision of medical, social, spiritual, psychological and legal assistance to incurable (non-curative) cancer patients and their families, both during the period of illness and after the loss of loved ones.

Leprosorium (from late Lat. lergosus - leper). Medical institution for patients with leprosy. In some countries (Brazil, India), leprosy is treated on an outpatient basis.

Clinics - treatment and prophylactic institutions (hospitals, maternity hospitals and other health care institutions) that are part of higher medical educational institutions, medical scientific organizations or subordinate to medical universities and scientific organizations are their structural subdivisions.

Questions for self-preparation for the practical lesson:

1. Structural levels of the healthcare system in the Russian Federation.

2. State organizational structures dealing with nursing issues.

3. List outpatient and inpatient medical facilities.

4. The main types of hospital medical records.

Legislative regulation of the legal status (status) of a medical institution is carried out both by federal laws and by-laws.

The fundamental norms defining the legal status of an institution (the general legal status of institutions in Russia) are contained in the Civil Code of the Russian Federation, which means an institution as a unitary non-profit organization created by the owner to carry out managerial, socio-cultural or other functions of a non-commercial nature (Article 123.21). An institution can be created by a citizen or a legal entity (private institution) or, respectively, by the Russian Federation, by a constituent entity of the Russian Federation, by a municipal entity (state institution, municipal institution).

Medical institutions as non-profit organizations, firstly, are called upon to perform socially significant functions, and secondly, they do not have profit as the main goal of their activities. Nevertheless, these institutions can carry out and profit-oriented entrepreneurial activity, but only insofar as it serves to achieve the goals for which they were created.

Thus, medical institution is a non-profit organization created by the Russian Federation, a constituent entity of the Russian Federation or a municipal entity, which carries out medical activities as the main (statutory) type of activity on the basis of a license issued in the manner prescribed by law.

Types of medical institutions:

1) official,

2) autonomous

3) budget.

Medical institutions of state, municipal, private health systems can carry out their activities only with a license for the chosen type of activity. The purpose of medical licensing is to assess the capabilities of a medical institution (organization) in terms of providing medical care in the volume and functions adequate to the level of training of personnel, the state of the material and technical base of the institution and its equipment.

All medical institutions are subject to compulsory state licensing, regardless of their form of ownership and organizational and legal status (federal, municipal, all subjects of private medicine).

The legal status of a medical institution determines various legal guarantees of its activities, the place, role and position of a medical institution in the health care system and sectoral management, as well as its basic rights and obligations.

The structure of the legal status of a medical institution includes:

a) the goals and objectives of the medical institution;

b) the functions of a medical institution;

c) creation, reorganization and liquidation of a medical institution;

d) organizational structure of a medical institution;

e) guarantees of the rights to operate a medical institution.

In modern conditions main task, which medical institutions are called upon in their activities, is to ensure the constitutional right of citizens to health care and medical care, which is expressed in the provision of timely, affordable, high-quality medical care.

Efficiency the work of medical institutions is largely determined by the provision of medical personnel, their professional training, rational placement and use, the organization of work of doctors, nurses and other personnel.

The legislation of the Russian Federation, regulatory legal acts and internal documents of medical institutions position the chief physician as an official person who represents his medical institution in all legal matters. In practice, the chief physician quite often gives his main powers to the deputy, remaining only a formal figure in the process of managing a medical institution.

One of the conditions for the effective functioning of medical institutions is budget financing in the required amount... For public sector medical institutions, there is a deficit in the allocation of funds, which is associated with the dependence of budget financing on numerous factors of a political, economic, and legal nature.

As a result, the low quality of available medical services, a lack of medical personnel and their inadequate qualifications and, accordingly, a deterioration in the quality of functioning of the state and municipal health care system as a whole.

The competence of a medical institution. In the course of its activity, a medical institution acts not only as a treatment and prophylactic unit, but also as an economic entity that has a material and technical basis for carrying out its main activities, in connection with which, in order to solve its inherent tasks and perform functions, it must have an appropriate scope of rights and responsibilities. Rights and obligations are one of the most important elements of the administrative and legal status of a medical institution.

Rights of a medical institution in relation to higher authorities and healthcare organizations, they are mainly due to the functions of improving the work of all its structural divisions and the medical organization as a whole. In this regard, the administration of a medical institution has the right to send applications to higher industry authorities with proposals to create new and transform existing structural units, services, specialized departments and offices, allocate staff units, obtain limited medical equipment, funds and limits for design work and construction. new facilities, the direction of highly qualified specialists to provide the population with specialized medical care, the direction of medical personnel for specialization and advanced training.

In relation to subordinate medical structures, the rights of a medical institution are mainly implemented in the process of providing them with organizational, methodological and advisory assistance.

The administration of a higher medical institution in relation to subordinate medical institutions has the right to: give orders and instructions, carry out the selection and placement of leading personnel, organize and conduct work checks, encourage or impose disciplinary sanctions on managers.

The peculiarity of the medical team is that, as a rule, the chief doctors, heads of departments, in addition to managerial, organizational work, carry out the execution of managerial decisions, i.e. directly provide medical assistance. At the same time, the activities of officials as participants in the management process are regulated by administrative and legal norms, and as participants in the treatment and prophylactic process - by labor law.

Problems of the efficiency of medical institutions. In modern conditions, the main task that medical institutions are called upon to solve in their activities is to ensure the constitutional right of citizens to health care, which is expressed in the provision of timely, affordable, high-quality medical care.

In order to ensure the rights of citizens to health care, the state has created and operates a system of state, municipal and private health care institutions, in which the rights of citizens to health care and medical care are exercised.

Unlike private (commercial) medical organizations with general (unlimited) legal capacity, public medical institutions are endowed with special (limited) legal capacity, i.e. a set of only such rights and obligations that are provided for by the constituent documents.

The activities of state medical institutions are not only carried out in accordance with the legislation of the Russian Federation, but are also constantly monitored by regional health authorities (committees).

These institutions provide their services both on a budgetary and on a commercial basis, depending on the type of medical service and the need for it from the patient. The list of free services is regulated by the annually adjusted federal laws on compulsory health insurance, as well as by the internal charter of each state medical institution.

Today, state medical institutions of federal and regional significance have a number of disadvantages related to their legal regulation and management problems, which include:

Insufficient funding of medical institutions from the federal budget, which leads to low wages of medical workers, the lack of the possibility of expanding the material, technical and technological base of a medical institution, a decrease in the quality of medical services due to the above factors;

Failure by many state medical institutions to comply with the compulsory health insurance program, which leads to patient dissatisfaction with the volume of services provided, massive patients' referral to commercial medical institutions, an increase in mortality among socially unprotected categories of patients;

A decrease in the birth rate due to distrust in health care and social policy of the state as a whole;

High level of corruption among the management of large state medical institutions; as a result, the irrational distribution of the working time of medical workers, a lack of material and technical means and medicines for certain categories of patients due to the commercialization of medical services, which is not included in the requirements of the regulatory framework of the medical institution.

The activities of municipal medical institutions are similar to the activities of federal institutions with only one amendment: municipal medical institutions are financed by the authorities of a particular region, which increases the likelihood of more rational use of budget funds.

(organizations) that are a public joint stock company (PJSC) are few in the total share of medical institutions in the Russian Federation. Observations show that it is these medical institutions that provide patients with the highest quality medical services.

Medical centers established at large enterprises - of municipal or federal significance, are fully financed by these enterprises and therefore it is in their interests to carry out their activities efficiently so as not to lose a source of funding. In such centers, the full range of medical services is most often provided. Employees who use the services of the center undergo annual medical examinations, and, if necessary, therapeutic and surgical treatment, both on an outpatient basis and in a hospital. At the same time, such centers rarely accept patients who are not employees of the parent company, if they have not received the appropriate license for this. These healthcare facilities cannot be classified as commercial because they do not charge patients for the provision of healthcare services.

Among the shortcomings of the choice by medical institutions of such an organizational and legal form as an open joint-stock company, we note the following:

Danger of liquidation in the event of liquidation of the parent company. This is due to the fact that not every PJSC has the opportunity to change its organizational and legal form in a short time, while it does not have enough material and technical base and human resources in order to carry out activities on its own;

Limited target audience with high quality medical services. This problem is relevant to a greater extent for patients who do not have the opportunity to use medical services in such centers. A situation is created in which the most qualified medical workers are not allowed into mass practice, which has a detrimental effect on the general level of health care.

Medical institutions that are non-public joint stock companies (NAO) are also few in number. Can be distinguished there are two main types of such medical institutions:

Specialized centers

Stationary multidisciplinary clinics.

Specialized centers, which may include narcological, ophthalmological, infectious disease centers, allergology centers, etc., provide patients with a limited range of medical services, which are planned within a specific medical specialization. Such centers have specific regulatory legal documents that govern their activities. The main question here is whether the center has been a commercial one since its inception, or whether a state-owned enterprise was reorganized into a non-state one.

Let us note a number of disadvantages of the choice by medical institutions of such an organizational and legal form as a non-public joint-stock company:

Instability of the organization's activities due to internal problems of management and division of powers;

The danger of bankruptcy during global financial crises;

Labor intensity in the preparation of statutory documents.

Private medical institutions(organizations), which are a limited liability company (LLC), are most common in the territory of the Russian Federation. Their massive appearance was due to the transition of Russia to a market economy, which made it possible to turn qualified medical care into a way of making money.

Today, this organizational and legal form is chosen for their activities for the most part by those medical institutions that have small premises, limited staff, and also offer services that do not require long-term hospitalization.

There are a number of disadvantages of choosing this organizational and legal form by commercial medical institutions:

Incomplete compliance with the requirements of regulatory documents developed for all medical institutions of the Russian Federation due to the lack of some management components. For example, we can say that supervisory authorities (SES, fire inspectorate) impose less requirements on limited liability companies due to the rather widespread practice of corrupt practices of medical LLC;

Inconsistency of the quality of medical services with the expectations of patients, inflated prices for simple medical services, which leads to a devaluation of the professionalism of medical personnel, as well as to a decrease in the image of the health care system as a whole. For example, many dental clinics form a surcharge on materials that is incommensurate with their cost. Also, in order to expand the target audience, multidisciplinary medical centers often offer those medical services for which they do not have qualified personnel or sufficient material and technical base;

A high level of competition, leading to frequent reorganization or liquidation of a medical institution due to bankruptcy or the imposition of administrative liability for poorly provided service. The instability of medical LLCs in the medical services market leads to a decrease in the level of responsibility for the life and health of patients, which has a detrimental effect on the overall level of healthcare quality.

Medical services provided by private medical institutions (organizations) are mainly regulated by civil law methods of influence in the framework of civil proceedings with reference to legislation on consumer protection. This situation can be explained by the fact that in the field of private medicine, it is planned to create competitive internal requirements of medical institutions (organizations) for the quality of medical services provided by them, which should ensure an increase in the efficiency of patient treatment.

Thus, we can conclude that modern organizational and legal forms of medical institutions require correction due to the fact that none of the above forms of institutions is ideal for carrying out medical activities on the territory of the Russian Federation.

The development of an innovative model of the organizational and legal form of a medical institution is the most urgent task of the Ministry of Health of the Russian Federation for the coming years.

Sales Generator

Reading time: 13 minutes

We will send the material to you on:

Issues discussed in the material:

• What types of medical institutions are there
• What are the advantages of private medical centers
• Should you open a private medical center?
• Which franchises of medical institutions are popular in Russia

In Russia today, the prevailing trend is a gradual transition from entirely public health care to commercial or public-private. Paid medical services are becoming an increasingly lucrative business. If you are interested in this industry and you are a beginner entrepreneur, then our material on what types of medical centers exist and which of them are most in demand and profitable will be useful to you.

Medicine is developing rapidly, which cannot but affect the methods of therapy and diagnostics: they are improving and multiplying. It is logical that the number of medical centers providing certain types of healthcare services is also growing.

A modern medical center is a combination of state-of-the-art medical equipment and the professionalism of the medical staff. These institutions are of different types and types and carry out different activities.

All medical centers and other medical institutions are classified primarily on the basis of their principle of operation and are divided into two large types:

1. State medical institutions. The patient does not pay for the medical examination and diagnosis, but he has to stand in a long queue.
2. Private. All services of medical centers of this type are paid: admission, diagnostics, appointments, etc. The advantages of these institutions are in an individual approach to each client and a more detailed examination.

People appreciate their own free time and the opportunity to consult a specialist more and more, therefore, commercial medical centers are more and more in demand. By the way, they also come in different types.

Classification of public medical institutions

• (from the Greek polis - city and klinike - the art of treatment). This is an independent city health care institution, which can be specialized or multidisciplinary, but sometimes polyclinics are part of joint hospitals or medical units. Provides qualified assistance to incoming patients and treats patients at home: those patients who are unable to get to the clinic have the opportunity to call a doctor and receive help at home. If necessary, patients are hospitalized.

The services of polyclinics usually cover the entire range of therapeutic and preventive measures, since doctors of all specializations conduct appointments, the polyclinic has medical and diagnostic rooms, and its own laboratory. There are clinics and first-aid offices: there blood pressure and temperature are measured for patients (this is done by a nurse).

• (from Latin ambulatorius - moving, mobile). This type of healthcare facility is designed to provide medical care (outside the hospital) to residents of a small settlement, such as an urban-type settlement or village, or an industrial enterprise.

Unlike polyclinics, outpatient clinics have a limited range of medical services, as well as the number of full-time employees: usually no more than five specialists work in rural outpatient clinics (therapist, surgeon, pediatrician, obstetrician-gynecologist). This type of healthcare facility serves fewer patients.

In rural areas, the functions of outpatient clinics are performed by feldsher-obstetric stations - the main structural units of the health care system in villages. The local principle of servicing the population makes it possible to detect patients, provide them with qualified medical care, monitor morbidity in the region, carry out disease prevention and conduct sanitary and educational work.

• For large industrial enterprises with a large staff of employees, there is its own analogue of an outpatient clinic - medical unit. Medical facilities of this type may include a health center, a polyclinic, a hospital and a dispensary. The activity of this type of medical center is subordinated to the needs of the main enterprise.
• Health center is an element of other types of health care facilities - medical units or polyclinics established at industrial enterprises, at a construction site, at a school, college or university.

In addition to providing first aid to those suddenly ill, injured or poisoned, health centers also carry out planned measures (treatment-and-prophylactic and sanitary-hygienic) aimed at preventing disease and reducing the incidence rate. Health centers can be headed by doctors (and then called doctors), paramedics, or nurses (paramedics).

• - a highly specialized type of medical center. In this type of medical institution, only gynecological diseases are treated and prevented, and the condition of pregnant women is monitored.

A mid-level medical worker - a midwife helps the doctor in the process of receiving patients, takes care of the patronage of pregnant women and conducts training for them (on caring for children, personal hygiene measures, etc.), conducts sanitary and educational work, is responsible for fulfilling medical appointments.

• To provide the population with urgent medical care in case of emergency, there are ambulance stations working 24 hours a day. The head of the ambulance team is usually a paramedic. He independently goes to calls to patients, carries out hospitalization and provides emergency care.

If specialized medical care is required, an ambulance team under the guidance of a qualified doctor leaves for the patient. The paramedic assists him in transporting the patient and providing him with urgent assistance.

Most ambulance stations have their own vehicles equipped with the latest technology, and can urgently provide qualified medical care, including special and intensive care, right at the patient's home or on the way to the hospital.

All these types of medical centers and hospitals form an outpatient clinic that performs the following tasks:

1. Providing qualified medical care outside the hospital (in a polyclinic or at home).
2. Conducting clinical examination of the population.
3. Implementation of prevention to reduce morbidity, death and disability.
4. Conducting examinations of temporary disability.
5. Conducting educational work, sanitary and hygienic education.
6. Promotion of a healthy lifestyle.

Where outpatient medical care is insufficient, stationary types of medical centers are connected.

• (from Lat. dispense - to distribute) is an independent medical facility that has a special specialization and operates in a dispensary format.

This type of healthcare facility performs the following functions: early detection and registration of patients suffering from diseases of a certain group; regular dynamic monitoring of them; providing them with special medical care; development of recommendations for patients to improve the environment in everyday life and at work; research of morbidity, search for its causes; preventive actions; sanitary and educational activities.

That is, the dispensary is designed to monitor and treat a certain contingent of patients.

The Russian health care system provides for such types of dispensaries as anti-tuberculosis, endocrinological, cardiological, neuropsychiatric, oncological, narcological, skin-venereal, anti-throat, medical and physical.

• Hospital- a large hospital of a stationary type, offering patients highly qualified treatment and care using the latest advances in medicine, technology and pharmaceuticals.

Hospitals are city, regional, republican, etc. City hospitals can be:

1. Multidisciplinary (intended for the treatment of patients with various diseases).
2. Specialized (focused on diseases of a certain type, be it tuberculosis, infectious, mental, etc.).

Residents of rural areas are served by republican and regional hospitals, providing them with specialized, polyclinic, inpatient medical care, as well as consultations.

• Clinic differs from other types of inpatient medical centers in that it deals not only with the treatment of patients, but also with scientific research, as well as training for nurses and doctors.
• Hospital is called a hospital serving only military personnel and war invalids.

• Sanatorium(lat. sanatum - to heal, to treat) - inpatient medical facility, specializing in the aftercare of patients. As a rule, sanatoriums are arranged in resort areas, in regions with a favorable climate, in places where there are sources of mineral water and healing mud.

Types of commercial medical centers

As for private medical centers, the following types of these health facilities are most common:

1. Multidisciplinary clinics providing a full range of medical services within a specific specialization. The choice of those who need a comprehensive examination of the body usually falls on multidisciplinary clinics.
2. Specialized clinics. They deal with problems belonging to one specific area of ​​medicine: gynecological, cardiological, etc.
3. One Doctor Centers- these are medical centers in which one well-known renowned doctor leads the reception of patients.

Some people who have had a negative experience of interacting with paid clinics are extremely hostile to them - as organizations that go to great lengths for the sake of profit. However, among the commercial medical centers there are institutions for which, first of all, it is important to help the patient and solve his problems.

Therefore, it is so important for the patient to choose the right clinic. Pay attention to how long it has been in operation, what customer reviews are about it. And, of course, do not think of a private medical center as something like a collection of wizards who can instantly heal you of any disease as soon as you pay the money.

Benefits of private health centers

The times when people were forced to undergo treatment in district polyclinics are long gone: today we have a choice between public and private medicine. You can now consult about poor health, be examined and receive appointments in private clinics, which are represented in a wide variety.

Private health centers are gaining popularity as people pay more and more attention to their health and quality of life. The success of commercial medical institutions depends on the effectiveness of the methods and technologies used, the competence of the workers and the care for each client.

There are many private clinics specializing in female reproductive problems, family planning, congenital abnormalities, aesthetic and cosmetic services. Centers for obstetrics and gynecology, family medicine clinics are in a separate category.

In such medical centers, patients can count on examination by all specialists, tests and other types of procedures at a convenient time and without any queues.

Many clinics are not limited to a narrow specialization and are multidisciplinary, providing services to both adults and children. The staff of such medical centers has doctors of various fields: therapists, surgeons, traumatologists, otolaryngologists, etc.

Among the commercial clinics there are 24-hour and seven days a week. The ambulance team goes to the specified addresses at any time of the day or night to provide assistance to the sick and, if necessary, hospitalize.

Clinics of aesthetic medicine are in great demand among the fair sex. In addition to plastic surgery, rejuvenation procedures, etc., these medical centers, for example, solve problems with the condition of the hair. Trichology is a relatively young branch of medicine, which is actively developing and developing its own technologies.

For commercial medical centers of all kinds, one thing is important - a polite and attentive attitude towards each patient. The interaction of the client with the clinic begins with the administrator, who must observe professional communication etiquette. As for the doctors, their duty is to clarify all symptoms as soon as possible and to prescribe the appropriate treatment. The conditions in the clinic also matter: patients strive for safety and comfort.

How are paid medical services provided

There are several types of paid services of medical centers - these are rehabilitation, preventive, medical and diagnostic assistance.

If desired, a contract is concluded with the patient for the provision of any of these services. Usually, contacting a paid clinic is as follows:

1. On the day of initial admission for a new patient, a medical card is entered at the clinic's registry and a contract for the provision of paid services is signed in duplicate, as well as all the required attachments to it and consent to the processing of personal data.
2. During the appointment, the attending physician performs a physical examination of the patient and his questioning about the symptoms. Then the doctor explains how the diagnosis will be carried out and what are the likely treatment programs, what will happen if not treated, what complications and risks should be feared, what stages the therapy will consist of, how much it costs (roughly). After that, informed consent for treatment is drawn up and, if necessary, a preliminary treatment plan is approved.
3. The consent document and the client's medical record describe in detail all the services provided.
4. The patient, with the participation of nurses and doctors, undergoes all types of procedures prescribed by his plan at the medical center, in the premises of the medical center itself and using the necessary equipment.
5. If the safety of certain measures and procedures is questionable (for example, a patient is allergic to any drugs, he is drunk or suffers from an acute infectious disease), the medical center does not provide services to him.
6. If in the course of treatment or diagnosis it is discovered that the treatment plan needs to be changed or supplemented for medical reasons, then the patient's prior consent is taken. The refusal of the patient from additional interventions is also documented, explaining to him the possible consequences.
7. The patient signs a medical card and annexes to the contract, which reflects all the features and conditions for providing him with assistance.
8. After that, the patient must pay at the registry for all paid services (or issue an IOU, if at the moment he does not have the entire required amount). In commercial medical centers, doctors are not allowed to pay personally for services under any circumstances.
9. The initial appointment ends with the issuance of a reminder voucher to the patient for the next or repeated appointment, with the date and time (if this appointment is necessary).
10. If the patient's condition changes during the period of therapy, he should inform the attending physician about this and come to the appointment as soon as possible in order to eliminate the problems that have arisen.

The provision of medical care on a commercial basis always ends with payment through the registry and the signing of a strict accountability form. If the patient, having made an advance payment in advance, refuses to continue the treatment, the clinic makes a recalculation for the services already provided and returns the remaining money to him within ten working days (in the same way that the patient made the payment, or otherwise - by mutual agreement).

Medical center: how to open and not burn out

Maintaining health remains one of the most important issues today, so the opening of medical centers (of any kind) is a relevant and demanded line of business.

State-owned health care facilities - both for adults and for children - have two main pain points: low level of service and insufficient comfort.

This is due to limited budgets, which are not enough for the purchase of new modern equipment, repair of offices, etc. Due to wear and tear of technology, diagnostics are becoming less accurate and reliable, and this is very critical when it comes to human health or even life. In addition, the patients of state clinics are forced to stand in queues for hours, imbued with a depressing mood.

The clients of private medical centers are mainly wealthy people who can afford to overpay for the service in order to receive quality service, accurate diagnosis and attentive care.

Therefore, one of the main issues when creating a private medical center is the formation of a favorable, comfortable environment for patients. The clinic development plan should include appropriate measures and steps.

1. Is it worth doing this?

After evaluating the level of free medicine, you will be convinced of the relevance of private clinics. The majority of the Russian population is ready to invest in their health and use paid medical services.

Your goal as a business leader is to provide potential consumers with a high level of service, comfortable conditions and competent doctors. A medical institution that has a license and qualified doctors in the state will never be left without clients, especially if you correctly draw up and systematically implement a business plan.

Almost everything will depend on the choice of the type of medical center: the size of the room, the types of equipment and materials, the specialization of the personnel.

The following highly specialized commercial clinics are most in demand today:

• dental;
• urological and gynecological;
• cosmetology;
• narcological.

However, you can approach the choice of direction more creatively and open such a specific health care facility, such as, for example, an acupuncture room or a hirudotherapy clinic. One of the promising niches is pediatrics, which has been actively developing in the past few years.

General medical centers are also popular - their target audience includes people suffering from a wide variety of ailments. But the opening of such a medical center will require more substantial investments.

3. Premises for a medical center

Finding a room for a clinic is a very important step for a business owner. It is better to choose central areas, highways with a dense flow of people, buildings near metro stations, public transport stops. At the same time, be prepared for the fact that rent in the center is more expensive than in the outskirts.

The area of ​​the premises is determined by the profile of the medical institution. For example, 25-30 m 2 will be enough for a dental office (of which 14 m 2 will be occupied by the office itself, 6 m 2 by a sterilization room, and the rest of the space will be left for visitors waiting for an appointment). In terms of the area of ​​the premises, there are special sanitary standards that must be observed.

The premises can be rented or purchased as property. Buying real estate to open a medical center will not be cheap (from 10 to several hundred million rubles).

The optimal room size for a medical center is 150-200 m2. It must be electrified, equipped with ventilation and water supply systems, and have a bathroom.

In addition to medical and treatment rooms, the clinic must certainly have a reception and a corridor through which you can freely walk to any of the rooms.

One of the most significant items of expenditure is the purchase of various types of medical equipment. High quality medical equipment has never been cheap. So, the prices for ultrasound machines start at 160 thousand dollars, and for a device for analyzing analyzes you will have to pay 10-70 thousand dollars.

Patients expect competent and accurate diagnostics, so there is no need to skimp on equipment. However, you can buy foreign used equipment. It will serve your clinic for many years.

Here is an approximate list of equipment without which a multidisciplinary medical center that offers different types of services cannot work:

• analyzers;
• scales;
• magnetic hanger;
• thermostat;
• centrifuge;
• water bath;
• drying cabinet;
• tiles with a heating surface;
• shakers;
• microscopes;
• devices for measuring physical parameters;
• mixing devices;
• muffle furnace, etc.

A multidisciplinary medical center offering services in the field of therapy and diagnostics to the population needs the following types of special equipment:

• MRI tomograph, which examines internal tissues and organs.
• Angiographic installation (to study the state of blood vessels and heart).
• X-ray apparatus for layer-by-layer imaging, which does not require turning the patient over (required when examining patients with severe injuries).
• An ultrasound machine that allows you to examine any internal organs and obtain three-dimensional images.
• Digital mammography, with the help of which they carry out contrast diagnostics of the mammary glands with suspicion of pathology.
• Electroencephalograph for examining the cerebral cortex and finding the affected areas.
• An endoscope, necessary for examining organs for pathologies and obtaining color images. With its help, the effectiveness of therapy is checked.
• Artificial ventilation system to maintain breathing in patients with lung damage. In modern devices there is the possibility of dosing oxygen supplied to the lungs (in order to prevent overdose), and adding drugs in the form of fine mixtures.
• Holter heart monitor, which measures blood pressure, heart rate and other indicators. The device accurately displays all existing rhythm disturbances, which is necessary for a correct diagnosis.
• Dialysis machines.
• An electrocardiograph, ideally the latest three-channel, recording three lines at the same time (this allows for a more accurate diagnosis).
• Defibrillator.

This is the most basic set of equipment. In addition to it, for the full-fledged operation of the clinic, gurneys (with adjustable height), medical chairs, stands for droppers, gynecological tables (equipped with electric regulators of the patient's body position) may also be required. If surgical operations are to be performed in a medical facility, a modern operating table will be required.

And, of course, no medical center can do without special cabinets for storing medicines and instruments, without surgical lamps and some other auxiliary types of accessories and equipment.

The main thing to look at when recruiting personnel for a medical institution is whether applicants have a specialized diploma and a medical category. If the candidate for the position has work experience abroad and knows foreign languages, this will be an additional advantage.

A qualified healthcare professional has at least three years of work experience. Professionals, whether they are doctors or nurses, are highly valued: as a rule, patients go to the clinic precisely for the sake of a good doctor, and not for the sake of equipment, etc., and the level of work of the staff determines the reputation of the medical center. It will take a couple of weeks at best to assemble a team of real professionals, but be prepared for the fact that you will have to recruit staff for several months.

In parallel with the recruitment of personnel, it is necessary to draw up work schedules. Please note that the influx of customers at different times of the day is uneven.

When employees are hired, a new challenge arises for the head of the clinic - to retain qualified workers (through decent wages and other means of motivation).

6. What documents are required to legally open a medical center?

When the premises of the required size, corresponding to sanitary standards, have been selected, it is still necessary to obtain a license for the provision of medical services.

To make this possible, the medical center must purchase certified equipment and hire specialists with the appropriate level of qualifications.

After that, you need to collect the following package of documents:

1. The agreement of the founder of the enterprise.
2. The company's charter, which lists all of its owners.
3. Receipt for payment of state duty.
4. Application for registration of a company with the tax office.

Obtaining licenses for operating activities and for medical cards of patients costs from 50 thousand rubles.

The licensing process can take up to a year. If you contact a lawyer with experience in such cases, the issuance of a license can be expedited.

To reduce the tax burden on a medical institution, it is possible to provide benefits to pensioners (this is also an additional way to expand the clientele: elderly patients will be interested in a clinic where they are promised discounts).

Taking all this into account, the total costs of registration, launching and starting the development of a medical center can be up to 25 million rubles. If the founder of the clinic does not have enough of his own funds, he can take out a loan for business development or turn to investors. In both cases, you will have to draw up a detailed business plan that includes all cost items and profit forecasts.

8. Additional features and risks

The financial plan for the development of the clinic must certainly include a risk assessment. If you remember them at every stage of the work and take them into account in the business plan, the risks will not turn into a headache for the manager and a threat to the continued existence of the business.

So, what can be a risk for a private medical center:

• There is no room with the required characteristics.
• The investment and purchase of equipment will be too expensive.
• The competition in the market will be very fierce.
• There will not be enough competent doctors and especially junior medical personnel.
• The population will not go to a private clinic due to distrust of paid medicine.

All these risks are not fatal, it is quite possible to work with them if you think over your actions in advance and reflect them in the marketing strategy.

Medical center franchise

Establishing a medical center by purchasing a franchise is one of the most reliable ways to start a business. The risks are minimal.

The owner of a company operating under an already promoted brand can immediately count on clients, even in the first months of work.

The franchisor provides all types of support - from consulting and financial planning to advertising, personnel training and building business processes. The franchisee is only required to comply with the agreements specified in the contract.

One of the prerequisites for starting a franchise business (in particular, a medical center of one type or another) is maintaining the corporate identity of the brand, a certain set of services provided and, most often, pricing policy. Of course, these requirements impose some restrictions on the franchisee, but they guarantee him a stable result and assistance in business development from the franchisor.

The 4 most famous franchises in Russia:

Array (=> 27 [~ ID] => 27 => 11/19/2019 20:53:56 [~ TIMESTAMP_X] => 11/19/2019 20:53:56 => 1 [~ MODIFIED_BY] => 1 => 11/19. 2019 20:53:56 [~ DATE_CREATE] => 11/19/2019 20:53:56 => 1 [~ CREATED_BY] => 1 => 6 [~ IBLOCK_ID] => 6 => [~ IBLOCK_SECTION_ID] => => Y [~ ACTIVE] => Y => Y [~ GLOBAL_ACTIVE] => Y => 500 [~ SORT] => 500 => Articles by Maria Plechikova [~ NAME] => Articles by Maria Plechikova => 12516 [~ PICTURE] = > 12516 => 11 [~ LEFT_MARGIN] => 11 => 12 [~ RIGHT_MARGIN] => 12 => 1 [~ DEPTH_LEVEL] => 1 => Maria Plechikova [~ DESCRIPTION] => Maria Plechikova => text [~ DESCRIPTION_TYPE ] => text => Articles by Maria Plechikova Maria Plechikova [~ SEARCHABLE_CONTENT] => Articles by Maria Plechikova Maria Plechikova => stati-marii-plechikovoy [~ CODE] => stati-marii-plechikovoy => [~ XML_ID] => => [~ TMP_ID] => => [~ DETAIL_PICTURE] => => [~ SOCNET_GROUP_ID] => => /blog/index.php?ID=6 [~ LIST_PAGE_URL] => /blog/index.php?ID=6 => /blog/list.php?SECTION_ID=27 [~ S ECTION_PAGE_URL] => /blog/list.php?SECTION_ID=27 => blog [~ IBLOCK_TYPE_ID] => blog => blog [~ IBLOCK_CODE] => blog => [~ IBLOCK_EXTERNAL_ID] => => [~ EXTERNAL_ID] => )