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Конкуренция между страховыми медицинскими организациями, работающими в системах обязательного медицинского страхования зарубежных стран

Конкуренция между страховыми медицинскими организациями, работающими в системах обязательного медицинского страхования зарубежных стран

Abstract

Тема. В статье исследованы особенности конкуренции между страховыми медицинскими организациями, работающими в системах обязательного медицинского страхования зарубежных стран, за привлечение клиентов, в том числе конкуренции по качеству медицинских услуг (опыт Германии и Нидерландов). Цели. Определить место конкуренции по качеству медицинских услуг между страховыми медицинскими организациями, работающими в системах обязательного медицинского страхования зарубежных стран. Выявить условия развития конкуренции за привлечение застрахованных в данных системах. Методология. На основе абстрактно-логических методов исследования определены условия развития конкуренции за привлечение застрахованных между страховыми медицинскими организациями, действующими в системах обязательного медицинского страхования зарубежных стран. Результаты. Выявлено, что в системах обязательного медицинского страхования зарубежных стран (например, Германии и Нидерландов) созданы условия для развития конкуренции среди страховых медицинских организаций за привлечение клиентов. Такая конкуренция призвана стимулировать организации к поиску наилучшего соотношения цены и качества медицинских услуг, оказываемых в системе ОМС. Выводы. Сделан вывод, что в процессе создания условий для конкуренции между страховыми медицинскими организациями, действующими в системе обязательного медицинского страхования Российской Федерации, целесообразно учесть опыт Германии и Нидерландов в стимулировании конкуренции по качеству медицинских услуг между страховыми организациями, осуществляющими указанный вид страхования. Такая конкуренция наилучшим образом обеспечивает заинтересованность страховых медицинских организаций в повышении качества и снижении цены медицинской помощи, оказываемой застрахованным в рамках обязательного медицинского страхования.

Subject The article considers health insurance organizations operating in compulsory health insurance systems and vying for capturing the insured persons and health service quality (the German and Dutch experience). Objectives The study aims to determine the place of competition on health service quality among health insurance organizations of compulsory health insurance systems of foreign countries, to define conditions promoting the competition on attracting the insured persons in the said systems. Methods Using abstract and logical methods of research, I determined the place and conditions of competition on attracting the insured persons among health insurance organizations involved in compulsory health insurance systems of foreign countries. Results The findings show that the compulsory health insurance systems of Germany and the Netherlands have conditions for competition development among health insurance organizations on attracting clients. The competition serves to stimulate these organizations to search for the best balance of price and quality of medical services rendered within the compulsory health insurance system. Conclusions In the course of creating the conditions for competition among health insurance organizations operating in the compulsory health insurance system of the Russian Federation, it is advisable to use the experience of Germany and the Netherlands in the promotion of competition on health service quality among relevant insurance organizations. Competition will ensure, in the best possible way, the engagement of health insurance organizations in improving the quality and reducing the price of medical care delivered to the insured persons under the compulsory health insurance scheme.

Keywords

СИСТЕМА ОБЯЗАТЕЛЬНОГО МЕДИЦИНСКОГО СТРАХОВАНИЯ,COMPULSORY HEALTH INSURANCE,СТРАХОВЫЕ МЕДИЦИНСКИЕ ОРГАНИЗАЦИИ,РАМОЧНЫЕ ДОГОВОРЫ,FRAMEWORK CONTRACT,СЕЛЕКТИВНЫЕ ДОГОВОРЫ,КОНКУРЕНЦИЯ ПО КАЧЕСТВУ МЕДИЦИНСКИХ УСЛУГ,COMPETITION,HEALTH MAINTENANCE ORGANIZATION,HEALTH SERVICE QUALITY

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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