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CONCLUSIONS AND RECOMMENDATIONS

During dissertational research are received following osnovyonye results:

1. The author's item consists in vision of prospects of development regioyonalnoj systems of public health services from an embedding item in innovative architecture of national economy.

Are added and specified soderzhatelyonye aspects of regional system of public health services as spetsializirovanyonoj the branch directed on preservation of health and improvement of quality of a life of the population that is reached by formation and effective isyopolzovanija personnel, technological and financial potentials.

Possibility of transition of public health services on an innovative way razyovitija, first of all, is connected with its financing. The cores istochyonikami public health services financial provision are: off-budget means (fund of obligatory medical insurance, other funds); budget means (the federal budget, the budget of subjects of the Russian Federation, local budgets); other sources (means of citizens, charitable instalments, private enterprises, other sources). A priority source finanyosirovanija urgent innovations are private and state funds, intermediate term innovations the basic source of financing can consider credits from the commercial organisations, and for realisation dolgosrochyonyh innovations the basic source of financing will be gosuyodarstvo.

2. Regions act as object of an investment of economic resources for reception of economic results in the future in a kind not only growth vayolovogo a regional product, but also improvement of quality of a life of the population. Now regions require the organisation of an effective system of public health services which should include three obligatory directions: definition of problems; organizational actions, introductions; monitoyoring, correcting actions.

Management of regional innovative system of public health services represents interconnected on actions, problems and printsiyopam the uniform system directed on achievement qualitative harakteriyostik of the purposes of economic development of region. Offered kontseptualyonye positions of development of regional system of public health services on innovayotsionnoj to a basis promotes balanced sotsialnoyoekonomicheskomu to region and country development as a whole.

3. The analysis of fulfilment of indicators of the Government program of the Russian Federation «public health services Development» and an estimation of degree of achievement of the purposes gosudaryostvennoj programs, testifies that from 15 established general target indicators seven indicators have not reached the planned level in 2017. Positive results of achievement of planned significances tseyolevyh indicators of demographic indicators are noted: in decrease in an actual indicator of infantile death rate on 5,2 % rather zayoplanirovannogo level (5,5 against 5,8 on 1000 born live); in sniyozhenii an indicator of death rate from illnesses of blood circulation 584,7 on 100 thousand population concerning significance of a target indicator on 2,34 %; the indicator of death rate from a tuberculosis has decreased, having made 6,20 on 100 thousand population, and was essentially more low (on 41,46 %) significances of a target indicator (11,8 %); in reduction of death rate from road accident on 9,83 % concerning target significance (10,1 against 11,2 on 100 thousand population).

Level rasprostrayonenija consumption of tobacco among adult population (decrease fakticheskoyogo consumption from 31,0 % in 2016 to 30,50 % in 2017 has decreased, at a target indicator of 31,0 %). The cores not to achievements among indicators concern: obespeyochennost doctors on 10 thousand population; quantity of the average medical staff falling to 1 doctor; the relation of average wages of average and junior medical staff; an indicator expected proyodolzhitelnosti lives at a birth.

4. The analysis of the basic indicators of development of public health services: srednegoyodovaja a volume of employment in public health services, paid services to the population,
Expenditures on public account on public health services, the monthly average nominal added wages of workers of public health services, the investment into a fixed capital, directed on development public health services, etc. have revealed necessity of working out of a technique of monitoring of a condition and tendencies of development of system of public health services. The essence of a technique consists that on the basis of monitoring of the revealed four analytical indicators characterising system of public health services (financial a component, inveyostitsionnaja a component, scientific a component, hi-tech kompoyonenta) actions for stimulation innovatsiyoonnogo developments in the public health services, promoting formation of innoyovatsionno-investment model of development of branch and economic sisteyomy as a whole can be developed.

5. The basic problems of national system of public health services are: inefficient financing of the state system zdravoyoohranenija, that conducts to impossibility of observance of modern standards of rendering of medical aid; low volumes hi-tech mediyotsinskoj the help; absence of strategic planning and otvetstvennoyosti chiefs for achievement of results, irrational raspredeleyonie the public funds, a consequence low effektivnoyosti managements of public health services sphere at all levels; an imperfect infrastructure of medical aid. Having studied considered problems, the general transformation of system of public health services for vozmozhnoyosti is necessary will come nearer on quality of rendering of medical services to standards razyovityh the world countries.

6. As a result of the carried out research, the technique of an estimation of efficiency of regional system of public health services is developed. Given meyotodika it is presented in the form of consecutive actions for the purpose of definition and account of an integrated indicator of an estimation of a system effectiveness zdravoyoohranenija by means of indicators of an index of maintenance of quality of a life, inyodeksa investment maintenance, an index financial and economic
Maintenance, an index of material support, an index kadyorovogo maintenance. Each of the transferred resource blocks includes following indicators. Personnel maintenance of public health services: chisyolennost doctors on 10 000 persons of the population; number of average mediyotsinskogo staff on 10 000 persons of the population; a parity of average meyoditsinskogo staff and doctors of all specialities. Maintenance of quality of public health services: an indicator of infantile death rate; an indicator rozhdaeyomosti; a death rate indicator. Investment maintenance zdravoohraneyonija: investments into a fixed capital per capita; investments in osyonovnoj the capital, directed on public health services development. Finansovoyoekonomichesky maintenance of public health services: gross national product per capita; gosuyodarstvennye costs for public health services; the monthly average nominal added wages of workers of public health services. Financially - technical maintenance: number of the hospital organisations; Number of the ambulatoryono-polyclinic organisations; number of hospital cots.

On the basis of account of each separate integrated index rasschiyotyvaetsja a cumulative integrated indicator of an estimation of efficiency siyostemy public health services which are defined as an average geometrical of products of private indexes. The result received integrated inyodeksa allows to evaluate level of system of public health services of region (low, average, above an average, high).

7. The analysis of fulfilment of a government program «Development zdravoyoohranenija» in Kursk area testifies that against decrease in death rate from illnesses of system of blood circulation, death rate from tuberkuleyoza, death rates from road accident fulfilment of target indicators of the program is observed not. The comparative analysis with regions of the Central area Chernozemnogo (Belgorod, Voronezh, Tambov, Lipetsk, Oryol oblayosti) testifies that the best indicators on death rate demonyostriruet the Belgorod area, and the worst - the Oryol area. Also it is necessary to notice, that in the Belgorod area the greatest prodolzhiyo
telnost lives (73,2 years in 2016), in the Oryol area the lowest proyodolzhitelnost lives (71,0 years). The Kursk area shows program average indexes «public health services development».

8. Approbation of the offered technique of an estimation of a system effectiveness of public health services on an example of Kursk area testifies that the Kursk area had the best indicator in 2012 (0,136), further nabljuyodaetsja both decrease, and its growth and in 2016 it has reached 0,109. Among all regions TSFO the Kursk area on an integrated indicator Kursk oblayosti takes 13 place. Among regions TSCHR the greatest integrated pokayozatel estimations of a system effectiveness of public health services is shown by Voyoronezhsky area (0,182). The Belgorod, Kursk, Lipetsk areas also matter an integrated indicator above unit. Significance pokazayotelja estimations of a system effectiveness of public health services of the Oryol area below unit (0,093).

9. For increase of efficiency of regional system zdravoohrayonenija with koordinirovannym use of all resources of region tselesoyoobrazno creation regional medical klastera under which predyolozheno to understand the complex structure uniting territorially concentrated and functionally interconnected branch mediyotsinskie establishments, combining management scientific and industrial dejayotelnosti, rendering of modern medical services.

We consider, that klasternyj the approach in public health services strengthens vzaimoyosvjazi between participants klasternoj systems for access simplification to noyovym to technologies of optimum distribution of risks, a joint exit on foreign markets for an effective utilisation of knowledge and the cores fonyodov, decrease transaktsionnyh costs at the expense of trust between participants klastera. It is necessary klastera to connect strongly all elements among themselves, using the logistical approach in management, for optimisation materialyonyh streams and minimisation of all expenses.

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A source: LOBACHYOV VSEVOLOD VLADIMIROVICH. EFFICIENT CONTROL REGIONAL SYSTEM of PUBLIC HEALTH SERVICES. The dissertation on competition of a scientific degree of a Cand.Econ.Sci. Kursk - 2018. 2018

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