STRATEGY TO IMPROVE HEALTH INSURANCE BASED ON THE QUALITY OF MEDICAL CARE

Abstract

Issues of improving the health insurance through the creation of quality systems of care are discussed. Particular attention is paid to the identification of medical errors, and that was the aim of this work. Despite the complexity of the process of objectification, examines possible solutions to this problem, and the impact on the risk of the insurance business are analyzed. The prospects of normative-legal and information-mathematical strategies to identify medical errors are considered. In particular, issues of professional liability insurance, which allows a civilized manner to resolve conflicts between doctors and patients, are examined. At the same time, the direct use of this approach meets with incomprehension medical staff a number of provisions, such as the subject of insurance, the allocation of responsibility between the performers of medical appointments, as well as mechanisms of the effect of the law on the reduction of medical errors.

Today, it seems more practical use of information-based approaches for identifying medical errors. It is emphasized that the starting point of the work to improve the quality of care are the technologies of identifying and addressing its root causes. We consider some

formal algorithms, “Deming wheel,” the organizing principle of the sample survey method, the method of screening sheet, the method of histograms, Pareto charts and others. Note that the process of approach adversely affects its efficiency. Therefore, the most promising should recognize the use of ontological ideas about the dynamics of the pathological process and its standardization.