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Управление системой длительного ухода за пожилыми людьми в Казахстане в контексте эффективных практик развитых стран

Управление системой длительного ухода за пожилыми людьми в Казахстане в контексте эффективных практик развитых стран

Abstract

The article provides an overview of the world management practices of the long-term care for senior citizens. The authors establish a logical connection between the functions, tasks and objectives of the system, which allowed them to estimate the Kazakhstan model of management with the best practices of developed countries (OECD). For each function of management possible options of applied methodical approaches for solving problems of the system were revealed and a comparative analysis of domestic and foreign systems was made. As a result of comparison of the institutional long-term care systems the factors that inhibit solving of the problems and achievement of the goals of the system, reduce its economic and social effectiveness were identified. Such factors in the function of resources formation as the absence of insurance mechanisms and social payments are violates the principle of joint and several liability of the state, citizen and family for decent long-term care of elderly and senior citizens. In the function of planning the central issue is the use of demographic criteria when entering the system, which is not conducive to a fair and efficient allocation of its resources, because there is no adequate assessment of the client's needs in hours of care. Quality standards of services in Kazakhstan are focused on customer’s food, personal and maintenance of existing infrastructure, but not on the content of the service and rehabilitation equipment which is required for its rendering. Authors of the article propose measures aimed at transforming the system in terms of its effectiveness and fairness.

Представлен обзор мировых практик управления системой длительного ухода за пожилыми гражданами. Авторы устанавливают логическую связь между функциями, задачами и целями системы, что позволило им сравнить казахстанскую модель управления с наиболее эффективными практиками развитых стран мира (ОЭСР). По каждой функции управления выявлены возможные варианты применяемых методических подходов к решению задач системы и сделан сравнительный анализ отечественной и зарубежных систем. В результате сравнения институционального устройства систем длительного ухода выявлены факторы, которые препятствуют решению задач и достижению целей системы, снижают ее экономическую и социальную эффективность. Такими факторами в функции формирования ресурсов являются отсутствие страховых механизмов и соплатежей, что нарушает принцип солидарной ответственности государства, гражданина и семьи за достойные условия длительного ухода пожилых и престарелых граждан. В функции планирования центральной проблемой является применение демографического критерия входа в систему, что не способствует справедливому и эффективному распределению её ресурсов, так как отсутствует адекватная оценка потребностей клиента в часах ухода. Стандарты качества услуги в Казахстане ориентированы на питание клиентов, штат и поддержание действующей инфраструктуры, но не на само содержание услуги и требуемое для её оказания реабилитационное оборудование. Авторами статьи предлагаются меры, направленные на трансформацию системы с позиций её эффективности и справедливости.

Keywords

УПРАВЛЕНИЕ, СИСТЕМА ДЛИТЕЛЬНОГО УХОДА, СПЕЦИАЛЬНЫЕ СОЦИАЛЬНЫЕ УСЛУГИ, ФОРМЫ ПРЕДОСТАВЛЕНИЯ УСЛУГ, СОВМЕСТНЫЕ ПЛАТЕЖИ, СТАНДАРТ УСЛУГИ

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    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    0
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Average
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
bronze