Which medical organizations may not conduct an independent assessment of the quality of services provided. Quality of medical care Independent assessment of the quality of work of medical organizations

Each person applying to a medical institution (especially a paid one) wants to receive a full range of services, good attitude and thoughtful treatment. At the same time, many citizens, not having even basic medical knowledge, completely rely on the opinion of incompetent doctors, which can sometimes lead to even greater health problems.

So how do you understand that you are being treated incorrectly and you have come across a bad doctor? How to assess the quality of services provided, treatment, test results? And what methods to bring to justice doctors who simply pull money from a patient without providing real help? With the help of an independent medical examination of the quality of the provided medical care, which we will discuss in detail in our article.

Kinds

Currently, there are several types of medical examinations that study different areas and are carried out according to various schemes. These include:

Disability examination. Her tasks include establish and designate temporary disability, its terms and other important information about the reason that caused this very disability;
Medico - social expertise. Checks the services rendered to the population. It solves many different problems, but mainly concerns free treatment in a medical institution;
Military - medical expertise. Every citizen who was called up for service is well acquainted with it. This expertise aims to collect data on the military and conscripts, as well as to assess their state of health and fitness for service;
Forensic-medical examination. It is carried out within the framework of legal proceedings, the main task is to study the state of offenders. At the same time, both the physical and mental health of a person are studied;
Proficiency examination. It is well known to every person who needs a certificate or a medical book for work. Such expertise establishes whether a citizen is suitable for a particular job;
Examination of the quality of medical services. Her tasks include study of medical care already provided and analysis of all actions of the doctor.

Information

As you can see, almost each of the listed examinations is narrowly focused and deals only with certain issues. But the examination of the quality of medical services is the most diverse, it studies the result of the work of absolutely any doctors and at the same time allows you to directly influence these same doctors.

When needed

Checking the quality of medical services can come in handy in a variety of situations. As a rule, citizens resort to it in the following situations:

Dissatisfaction with the quality of medical services. In this case, the medical examination will assess the quality of services, compliance with the standards for their provision and other criteria that will help determine whether you received quality assistance or not;
Doubt about treatment. If it seems to you that you are being treated incorrectly, the methods of dealing with the disease are doubtful for you and you are not sure that the doctor can help you, then a medical examination will tell you whether your fears are true or not;
Doubt about prescribed drugs and procedures. If you think that you have been prescribed the wrong or ineffective medicine and prescribed procedures that are dangerous for the body, then an examination will help identify a violation;
Doubt about the diagnosis. An independent examination will allow you to check the competence of the doctor who made the diagnosis and decide whether the doctor made the right decision to treat the patient;
Preparation of documents for submission to the court. Quite often, disputes with a medical institution go to court, and in such cases, the conclusion of a medical examination on the quality of services provided will become key evidence;
Fixation of harm to health caused by treatment. Such a check is often carried out in order to fix the harm from improper treatment for the subsequent filing of a claim in court or opening a case on causing harm to health.

Information

At the same time, one should not think that the medical examination of the quality of services is to solve every minor health problem. It is needed to address serious issues, conduct comprehensive audits and identify significant violations in the provision of medical services.

Who conducts

Conduct medical checks on the quality of services provided by only specialized medical institutions that have licenses for such examinations. At the same time, one license is not enough - experts must also have equipment, as well as qualified specialists with permits. At the same time, the medical institution must be recognized as independent, for which it you will need to gain a certain work experience and pass a series of complex checks.

As a rule, even in small towns there are a lot of such institutions. But which one to choose is up to you. We recommend that you contact the specialized centers - there you can study your specific case in more detail and get advice from several doctors.

How to spend

In order to conduct a quality control of medical services, you will need:

Collect as many documents as possible from your previous medical facility. Anything will do, but it is best to provide an extract and notes from a card or other medical document that records the work of a doctor;
Contact the independent medical center you are interested in for a consultation. Find out if he can help you with the examination, how much the assessment will cost and how it will need to be done;
To make an agreement. This document will outline the main provisions of the future examination, as well as the rights and obligations of the parties. Then sign the contract, pay a fee for the services rendered;
At the appointed time, proceed to a medical examination, go through all the necessary procedures, take tests. In general, do everything that you do in a regular hospital;
After passing all the doctors, you will be issued a conclusion, containing a detailed report and conclusion of a number of experts, conclusion on the quality of medical services provided to you.

Information

This completes the check. You can use the opinion given to you as you see fit. It is mainly used to file claims to the hospital for a refund and compensation for harm, to be sent to the Ministry of Health and Rospotrebnadzor, to be submitted along with a statement of claim to the court.

The success of each private clinic as a whole depends on the level of quality of medical care. But the skills of employees necessary for work are not limited to medicine. A modern physician must be able to interact with the patient during treatment, respond to his fears and make the course of treatment as clear and comfortable as possible. Are you sure your doctor can do this?

The quality of medical care to patients - classification, specifics

What is a medical service? In fact, this is an action or a set of actions, the task of which is the prevention of diseases, their diagnosis and treatment, which take place in accordance with the procedure determined by law, and which have a very specific cost. The classification of medical services divides them into several types:

simple
complex
complex.

The standards for the quality of medical services are strictly controlled by the state, in fact, the state takes responsibility for assessing their quality (Order of the Ministry of Health No. 240 of 14.05.2015). A list of quality criteria for the provision of medical services has been adopted, based on which, at least once a year, public opinion on the quality of the provision of medical services and the work of a medical organization is assessed:

To what extent is the information provided about a private clinic or medical company accessible?
Is health care available to everyone?
Are patients satisfied with the conditions for enrolling in services?
Is the level of medical care high and what is the quality of medical services from the range of medical organizations?

The assessment of the quality of medical services delivery usually depends on various factors. The assessment takes into account the location of the clinic itself, the presence of a parking lot or a public transport stop near it. The quality of the repair, the availability of a working, accessible and understandable website of the clinic, the proximity of pharmacies, the presence of coffee machines or devices in the clinic, and other things are considered.

The components of the quality of medical services are well-organized medical care and customer-oriented service.

IMPORTANT!
The level of quality in the provision of medical services is an analogue of the ratio of the real volume of medical care provided to the client with the aspirations and expectations of the client himself. The assessment considers the achieved result of the last treatment, and the communication of the patient with the doctor, and the interior, and the conditions of the situation directly in the clinic.

Features of medical services

Periodically, there are situations in which the patient's expectations do not always coincide with the level of quality of medical care. However, when considering such a situation, remember that the impact of the service provided, taking into account its specifics, is always individual - each patient always perceives it in his own way. The peculiarity of the medical service lies in its very essence: it is not a retail product, and the doctor cannot show the procedure to the patient, and then actually perform it. Depending on the level pain threshold even an ordinary injection can be perceived differently by the patient.

Of course, any medical worker can easily describe the effect of any medication on a person or be able to describe the processes that occur during its action. The peculiarity of medical services is that it is really difficult to predict exactly how this drug will affect a particular patient. Thus, the nature of the medical services provided is heterogeneous and it is hardly possible to predict its results in detail from the point of view of the client.

A patient receiving medical care usually has some general ideas about what is included in the medical service for which he applied, and based on his feelings and compliance with his expectations, he evaluates the quality of medical services, their result or degree of usefulness . However, the doctor, in turn, does not always realize that he becomes the person responsible for the quality of medical services, that for the patient's money he is obliged to fully satisfy his expectations. Unfortunately, the assessment of the quality of a medical service formed by a patient and the assessment of the quality of the same service from the doctor's point of view do not always coincide. First of all, medical workers are guided by professionalism, the achieved result, the level of competence, safety and effectiveness of treatment. But patients - on the qualifications (from their point of view) of the provision of medical care and the processes occurring during the course of treatment.

In reality, one of the features of medical services turns out to be that it is almost impossible for a patient to determine the level of professionalism of the specialist he has consulted, but his final assessment will actually be formed from further changes in the patient’s state of health and from the conditions he receives medical services.

The interaction between doctors and patients directly affects the assessment of the quality of medical services. For example, if a clinic doctor diagnosed a patient who came to him and, without explaining anything to him after that, began the treatment process. As statistics show, in this case, a high degree of dissatisfaction with the quality of medical services in a patient is noted in half of the cases. Yes, perhaps the doctor did not make any mistake in the method of treatment he chose, but in this context, the patient frankly lacks the feeling of his influence on the choice best way treatment. And the absence of the patient's influence on what is happening, the fact that the patient is not actually given a choice, sometimes directly affects the assessment of the doctor's work. This also applies to the specifics of medical services.

Often, negative reviews about the attending physician and negative assessments of the quality of medical services arise because doctors use specialized terminology that is understandable only to them. As a result, vague words are sometimes perceived by patients as an attempt to deceive on the part of physicians.

RECOMMENDATION!
It is important for the patients of the clinic that during the treatment the doctor explains the specific need for the prescribed procedure. It is also important that the client's decision plays a major role. That is, in addition to the professionalism of the doctor, his ability to build the process of communication with his patients is important.

The modern patient considers the quality of medical services in the same way as the quality of the services he receives in other areas. He draws attention to:

treaty
availability of quality assurance
respect for his rights
own comfort
clarity in the description of services
clinic promotions
discounts
additional medical services.

It is important for a person to realize that the medical staff is really interested in him. Typically, patients are characterized by high personal awareness. Thanks to Internet resources, they can even make an independent diagnosis for themselves, choose a subsequent potential course of treatment, and determine the characteristics of the treating specialist they need. Based on this, the Internet reputation, and just the reputation of each doctor in a private clinic, depends on the degree of satisfaction of the patient and his friends or relatives.

THE EXPERT SAYS

Alexander Pikhotsky, PhD, head of quality control of the Alfa Health Center clinic network:

The quality of medical services is assessed by supervisory and regulatory authorities in the healthcare sector.

The medical organization exercises internal control over the quality and safety of medical activities in accordance with the orders of the Ministry of Health of Russia, Roszdravnadzor and Rospotrebnadzor.

When assessing quality, it is necessary to be guided by the Order of the Ministry of Health of Russia of the Russian Federation dated May 10, 2017 No. 203n "On approval of criteria for assessing the quality of medical care."

Quality controllers of medical care are:

*External*	*Internal*
Roszdravnadzor	Head of Department, Deputy Chief Physician for CER, Chief Physician
Rospotrebnadzor	Clinical expert, quality manager
Ministry of health of the region	Head of Quality Control Department
Insurance Company	Medical Director
Prosecutor's Office, Investigative Committee, Ministry of Internal Affairs	Doctor-specialist in the profile - "second opinion"
Judiciary	legal service

Clinical and expert work, medical commissions, clinical reviews and conferences are the basis for managing the quality of medical care - they help doctors in their professional activity follow the standards and procedures for the provision of medical care, clinical recommendations, and provide medical services of an appropriate level.

Responsibility for violations can be administrative, in some cases criminal, and, of course, there are reputational costs for the clinic and the doctor personally.

Rapid digitalization modern society, the active growth of informing the population about their rights, as well as judicial practice in the field of healthcare directly enhance the role of preventive measures of the management of a medical organization, aimed not only at post-control, but primarily at managing the process of providing medical services

An additional tool for monitoring and evaluating the quality of medical services provided at Alfa Health Center is an automated check of medical records in 1C with assignment of points based on the results of each doctor’s work and the department as a whole, which makes it possible to form a rating of a specialist doctor, as well as to identify and to prevent "weak" places in the activities of doctors and paramedical personnel. Also in the federal network of our clinics there is an institute of leading specialists in the most significant areas of medical activity (obstetrics and gynecology, dentistry, surgery, oncology, otorhinolaryngology, ultrasound diagnostics).

Regular training of doctors from different cities of presence of the Alfa Health Center network - webinars, online courses posted on the internal corporate portal informational resources(tests, complex clinical tasks), providing access to national and international clinical guidelines, online lectures, presentations by leading professors, attracting leading speakers to conduct master classes - all this increases the overall level of training of doctors, that is, it directly affects the quality of medical care. services.

The quality of medical care forms a professional environment and, at the same time, the environment itself affects the development and improvement of medical production, and the quality of medical services provided.

Modernization of the national health care system implies its accessibility, transparency, openness to the population, improvement of the quality of services provided. To track the current state of the sphere, the practice of independent evaluation is being actively introduced. Public control enables citizens to determine the level of service, identify problems in clinics and hospitals.

So what is an independent assessment of the quality of services provided by medical organizations? By what regulatory documents is it established and regulated? What are the rules and procedures for it? Who is involved in the assessment and what are the assessment criteria? We will answer these questions in this article.

What is an independent quality assessment?

The process of independent quality assessment (IQA) is established at the state level by the Federal Law "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation". Article 79.1. contains a brief description of this type of control. The purpose of the NOC is to obtain information about the services provided, to check to improve the quality of the activities of medical organizations. Direct examination of the ongoing medical activity and its level is not set by law as the task of monitoring. The criteria for evaluating an organization include:

Availability of information about the institution;
Comfort;
Time in queues for any service;
Polite attitude towards patients;
Qualification of employees;
Overall satisfaction with the service.

Thus, the purpose of the NOC is to inform citizens about the quality of medical services provided by the relevant organizations, as well as to improve the quality of the activities of such organizations. The NOC is carried out in medical organizations participating in the implementation of the program of state guarantees of free provision of medical care to citizens.

Legal regulation

The phenomenon itself was consolidated in Federal Law No. 323, as already mentioned earlier. The Ministry of Health in 2014 issued order No. 787n, which approved indicators that allow characterizing the criteria for evaluating the activities of medical organizations. The document describes in detail each of the indicators and the algorithm for its evaluation on a five-point scale. Separate provisions on the NOC contain the order of the Ministry of Health No. 269 of April 28, 2016. Methodological instructions for conducting are reflected in the act of the Ministry of May 14, 2015 No. 240. The submitted results are evaluated in accordance with the order of the Ministry No. 197 of the same year.

NOC procedure

A more complicated, but also affordable way is to fill out a printed form and send it to the body or its council (department, committee) responsible at the subject level for conducting an independent assessment of the quality of services provided. The easiest way to do this is in the medical organization itself. Since the activity of conducting public control by citizens is confidential, the disclosure of the personal data of the filler is excluded.

Evaluation criteria

General assessment criteria established by the federal executive body responsible for the development and implementation of state policy and regulatory legal regulation in the field of healthcare are given in the Order of the Ministry of Health No. 787n, published on November 28, 2014. It is in the named normative act the procedure for assessing each of the criteria presented in the table below is described in detail.

Table - Criteria for assessing the quality of medical services provided by law in 2014

Criterion	Main characteristics
Open access to information	Rating in the official register of institutions; Completeness of information about the organization on its website; The presence of feedback on the site; Percentage of Satisfied Services
Comfort, accessibility	Proportion of people who received a referral to a doctor after the first visit; Waiting time in days from the moment of making an appointment; Availability of an appointment with a specialist on the Internet, by phone and in other remote ways; Percentage of those who are satisfied with the conditions of stay, including among persons with disabilities
Delivery waiting time	Waiting for the examination from the date of its appointment; Percentage of patients admitted by appointment time; Share of consumers admitted for diagnostics on time
Competence	The share of good reviews about the courtesy of employees; Percentage of health workers who assessed the competence
Satisfaction with the services provided	The share of those satisfied with the activities of the organization; Percentage of those willing to recommend a medical institution

All of these criteria are given for outpatient monitoring. In general, for a hospital, they are almost identical. On the

What is an independent assessment of the quality of services provided by medical organizations?

Since June 2014, along with the Federal Law "On the Fundamentals of Public Control in the Russian Federation", provisions have been introduced on independent examination (assessment) of the quality of medical services.

According to him, an independent assessment of the quality of medical services is one of the forms of public control, which is carried out so that the citizens of our country have information about the quality of service in medical organizations, as well as to improve this quality.

It's important to know! An independent assessment of the quality of medical services is NOT CARRIED OUT in order to control the quality and safety of medical activities and the quality of medical care!

Who conducts an independent assessment of the quality of services provided by medical organizations?

Subjects of public control. Public control (in accordance with the aforementioned Federal Law No. 212) is monitoring the activities of state authorities, bodies local government, state and municipal organizations in order to verify, analyze and publicly evaluate their work.

In the case of an independent assessment of the quality of medical services in the Khabarovsk Territory, this function is entrusted to the public council under government agency executive power in the field of healthcare (Public Council under the Ministry of Health of the Khabarovsk Territory). Representatives of public associations and the medical association of the Khabarovsk Territory are involved in the work in the public council.

Which organizations are being evaluated?

Without fail - medical organizations participating in the implementation of the territorial program of state guarantees of free provision of medical care to citizens on the territory of the Khabarovsk Territory, regardless of their departmental affiliation and form of ownership.

How is an independent assessment of the quality of services provided by medical organizations organized?

Every year, until February 1, the Ministry of Health of the Khabarovsk Territory sends information about medical organizations participating in the implementation of the territorial program of state guarantees of free medical care to citizens in the Khabarovsk Territory to the Public Council under the Ministry of Health of Russia and to the relevant public councils at the regional level. Further, public councils approve the list of organizations for evaluation for the current year.

An interactive questionnaire for assessing the quality of services in a unified format is posted on the website of the Ministry of Health of the Khabarovsk Territory and on the websites of medical organizations. At the request of citizens, the same questionnaire in paper format is provided to them directly during a visit to a medical institution.

The results of the survey are sent to public councils, whose members analyze the results and provide them to the Ministry of Health of the Khabarovsk Territory along with proposals for improving the quality of work of each organization.

The Ministry of Health of the Territory considers the results and proposals, develops measures to improve the activities of medical organizations and posts information on the results of an independent assessment for the current year on its website.

Detailed information on the organization and conduct of an independent assessment is set out in the provisions of Article 79.1 of the Federal Law No. 323 and in methodological recommendations, approved by the Order of the Ministry of Health of the Russian Federation dated May 14, 2015 No. 240.

What are the criteria for independent evaluation?

openness and accessibility of information about the medical organization (completeness, relevance and clarity of information about the organization on its official website, etc.);
comfort of conditions and availability of medical services (the proportion of patients who managed to get a coupon at the first visit to a medical organization, the availability of appointments by phone, the Internet, etc.);
waiting time for the provision of medical services ( average term expectations of a diagnostic study from the moment of receiving a referral, the proportion of patients who got an appointment with a doctor at the time indicated in the coupon, etc.);
friendliness, courtesy, competence of medical workers (the proportion of patients who respond positively to contacts with the staff of a medical organization, etc.);
satisfaction with the services provided (the proportion of patients who are ready to recommend a medical organization).

How often can an independent assessment be carried out?

Not more than once a year and not less than once every three years.

What information should be provided to a medical organization for an independent assessment?

In accordance with paragraph 14 of Article 79 of Federal Law No. 323-FZ "On the Fundamentals of Protecting the Health of Citizens in Russian Federation"Medical organizations must provide conditions for an independent assessment of the quality of services provided, provide citizens with all information in an accessible form - at information stands and on their official website. The volume of this information is approved by Order of the Ministry of Health of Russia dated December 30, 2014 No. 956n.

Where can I see the results of the independent evaluation?

On the official website for posting information about state (municipal) institutions (bus.gov.ru).
On the official website of the Ministry of Health of the Khabarovsk Territory, in the "Public Control" section (zdrav.medkhv.ru).

Dear residents of the Khabarovsk Territory!

We invite you to evaluate the work of medical organizations in which you received medical care. To do this, go to the main page of the official website of the Ministry of Health of the Khabarovsk Territory (or the Ministry of Health of the Russian Federation) and click the banner"Independent assessment of the quality of services provided by medical organizations. Participate in voting" for further transition to the appropriate section and the choice of a medical organization.

In the summer of 2014, a new art. 79.1 "Independent assessment of the quality of services provided by medical organizations" (entered into force on October 21, 2014). In relation to autonomous healthcare institutions, such an assessment should be organized by their founders, doing this at least once every three years, and when conducting it, it is necessary to use indicators that characterize the general assessment criteria and established by the Ministry of Health. Let's analyze what these indicators are.

To the general criteria Law on Fundamentals of Health Protection relates:

openness and availability of information about the medical organization;
the comfort of the conditions for the provision of services and the availability of their receipt;
waiting time for the provision of medical services;
friendliness, courtesy, competence of employees of a medical organization;
satisfaction with the services provided.

Specific indicators are established by the Order of the Ministry of Health of the Russian Federation dated November 28, 2014 No. 787n “On approval of indicators characterizing the general criteria for assessing the quality of services provided by medical organizations” .

All indicators are divided into two large groups - they characterize the services provided in outpatient and inpatient settings. Moreover, although this is not directly stated in the order in question, information on one part of the indicators can be obtained by the assessment operator through the collection of administrative data and the method of observation (for example, visiting the website of an autonomous institution), and on the other part, which concerns the opinion recipients of services, the operator will have to conduct consumer surveys.

Outpatient service quality indicators

The quality of outpatient services should be assessed against five blocks of indicators. Let's consider them in more detail.

Openness and accessibility of information about a medical organization

1.1.Rating indicator on the official website for posting information about state and municipal institutions (bus.gov.ru). According to the federal law on non-profit organizations, autonomous institutions (like any other state or municipal institutions) are required to provide the Federal Treasury with a certain list of information (information on constituent documents, financial and economic activity plan, state or municipal task, etc.). In turn, the procedure for the formation of the specified rating is posted on the website bus.gov.ru in the section "Independent quality assessment system". By this indicator you can get from 0 to 1 point. The final rating is formed on the basis of five parameters that relate to the information contained in Indicators of structured information about the institution, and have their own weight coefficients. Namely, the indicator of publication on the site bus.gov.ru:

general information - has a weighting factor of 0.1. This includes the information provided in sec. 1 Indicators of structured information about the institution;
information about the state or municipal task - a weighting factor of 0.1. This information is defined 26, 27 And 31 Indicators of structured information about the institution;
data on the volume of services established in the state or municipal task - a weighting factor of 0.2. They are listed in paragraph 29 of the Indicators of structured information about the institution;
data on the quality of services established in the state or municipal task - a weighting factor of 0.2. They are defined in paragraph 28 of the Indicators of structured information about the institution;
information on plans for financial and economic activities - the weighting coefficient is the highest, 0.4. This information is listed in sec. 3 And 4 Indicators of structured information about the institution.

If information related to a particular indicator is published on the site, the institution receives 1 point, if not - 0. Intermediate points are multiplied by the appropriate weighting factors and added to obtain the final score. For example, if an autonomous institution published all blocks of information except the last one (according to the plan of financial and economic activity), the institution is assigned a total score of 0.6.

Note that the assessment in terms of openness and accessibility of information can be difficult and subjective in cases where certain information about the institution is posted, but is incomplete (the question arises whether to put 1 point here or 0).

1.2.Completeness, relevance and clarity of information about the medical organization posted on its official website. The information that can be posted on the site covers four items:
general information (for example, the address of the institution, its telephone number, the name of the head);
information about medical activities (for example, a list of medical services provided by the institution, the time of their provision);
information on medical workers(in particular, information about which categories the doctors of the institution have);
other information (state or municipal task of the institution, plan of its financial and economic activities, etc.).

Each position is assessed for the availability of information: if the relevant information is published, an intermediate score of 1 is given, if the assessment is “other cases”, the intermediate score is zero. Note that the assessment here, of course, can be very subjective, especially in terms of completeness and clarity of information.

Then the scores for each position are multiplied by their own weighting coefficient: to the indicator " general information”a coefficient of 0.2 is applied, to the position “Information on medical activities” - 0.5, the indicator “Information on medical workers” is multiplied by 0.2, and the position “Other information” is multiplied by 0.1. As seen, highest value in assessing the completeness, relevance and clarity of information about the organization has the second position.

The scores for each position are added together to form the total score. It is in the range from 0 (if zero is received for each position during evaluation) to 1 (if one is set for all positions). For example, if the institution's website contains only general information and information about medical activities, the total score will be 0.7.

1.3.Availability and accessibility on the official website of the medical organization of ways of feedback with consumers of services. The total number of points for this indicator is from 0 to 2. If the institution’s website has a form for submitting an electronic appeal to the institution, 1 point is assigned, if through the website the consumer can fill out and send to the institution a questionnaire to assess the quality of services provided in a medical organization - more 1 point In the absence of these opportunities on the site, the institution receives 0 points.

1.4.The share of service consumers who are satisfied with the quality and completeness of information about the work of a medical institution and the procedure for providing medical services, which is available on its premises. This indicator is measured as a percentage. If the share of consumers is less than 70%, 0 points are set, from 70% inclusive, but less than 75% - 1 point, from 75% inclusive, but less than 80% - 2 points, from 80% inclusive, but less than 85% - 3 points, from 85% inclusive, but less than 90% - 4 points. The institution will receive the highest score for this indicator (5 points) if the proportion of consumers satisfied with informing about the work of the organization is equal to or exceeds 90%.

1.5.The share of service consumers who are satisfied with the quality and completeness of information about the work of a medical institution and the procedure for providing medical services, which is available on its official website. This indicator is evaluated similarly to the previous one. It should be noted that the practical adequacy of this indicator may be doubtful if the indicated share of all consumers of services is determined, because a significant part of them (especially the elderly) may never visit the site of the institution due to lack of opportunities or interest. Therefore, it is more correct to determine this share from the number of those service consumers who visited the site.

2.1.The share of service consumers who made an appointment with a doctor (received a coupon indicating the time of appointment and the name of the doctor) when they first contacted a medical organization. Here the assessment is carried out in the same way as for indicator 1.4 (see above).

2.2.Average waiting time for a doctor's appointment since making an appointment (regarding the waiting periods established by the territorial program of state guarantees of free provision of medical care to citizens). The total number of points for this indicator is from 0 to 5. If the average waiting period is equal to the period established by the territorial program, the institution is assigned 1 point, if less than one day - 2 points, less than two days - 3 points, less than three days - 4 points. If the average waiting period is less than half of the established period, the institution receives the highest score - 5 points. The order in question does not say in which case the institution is awarded the lowest score (0 points), but it can be assumed that this occurs when the average waiting period is longer than the period established in the territorial program.

2.3. Availability of doctor's appointments. This indicator can be assigned from 0 to 4 points. If an institution provides consumers with the opportunity to make an appointment with a doctor by phone, via the Internet, in the institution's registry in person and by the attending physician at the reception during a visit, 1 point is assigned for each of the four listed methods used in the institution, and for not using one or another method - 0 points. For example, if an AC has the possibility of making an appointment only at the reception in person and by phone, it receives 2 points for this indicator.

2.4.The share of service consumers who are satisfied with the conditions of stay in a medical organization. It also applies the scoring algorithm developed for indicator 1.4 (see above).

2.5.Share of service consumers with handicapped health, satisfied with the conditions of stay in a medical organization. In this case, the measurements are taken as a percentage. If the share is less than 50%, 0 points are assigned, from 50% inclusive and less than 55% - 1 point, from 55% inclusive and less than 60% - 2 points, from 60% inclusive and less than 65% - 3 points, from 65% inclusive and less than 70% - 4 points. The institution receives the highest score for this indicator (5 points) if the specified share is equal to or exceeds 70%.

It should be noted that the concept of "disability" in the federal legislation is deciphered only in relation to the field of education. In particular, a student with disabilities means an individual who has deficiencies in physical and (or) psychological development, confirmed by the psychological-medical-pedagogical commission and preventing education without creating special conditions. Thus, in practice, when assessing this indicator, there may be discrepancies between approaches to which recipients of medical services should be taken as 100%.

Waiting time for the provision of medical services

Average waiting time for a diagnostic study since receiving a referral for it (relative to the waiting periods established by the territorial program of state guarantees of free provision of medical care to citizens) (indicator 3.1). It is calculated in the same way as the waiting time for a doctor's appointment from the moment of appointment (indicator 2.2).

In turn, when evaluating share of consumers of services that the doctor received at the time set by appointment (Indicator 3.2) and share of consumers who had a diagnostic test performed at the time set by appointment (indicator 3.3), a calculation methodology similar to the assessment of indicator 1.4 is applied.

Friendliness, courtesy and competence of employees of a medical organization

The scoring algorithm developed for indicator 1.4 is also used in the assessment share of consumers of services who positively assess the friendliness and courtesy of employees of a medical organization (Indicator 4.1) and their competence (indicator 4.2).

It should be noted that the competence of health workers is assessed separately from their friendliness and courtesy, since in practice these components of the quality of work of the institution's specialists may not depend on each other.

Satisfaction with the services provided in a medical organization

Similarly (as in relation to indicator 1.4), customer loyalty is assessed: share of service consumers who are satisfied with the services provided (Indicator 5.1) and ready to recommend a medical organization for medical care (indicator 5.2).

Quality indicators for the provision of inpatient services

When assessing the quality of inpatient services, five blocks of indicators are also used. Some of them repeat those established for outpatient services. In particular, indicators characterizing openness and accessibility of information about a medical organization , and the methods of their calculation are similar to indicators 1.1 - 1.5 of the first section. And indicators reflecting friendliness, courtesy and competence of health workers , are calculated in the same way as indicators 4.1 and 4.2 of the first section.

Comfortable conditions for the provision of medical services and the availability of their receipt

The assessment methodology used in relation to indicator 1.4 of the first section is also applied when studying two parameters: the share of consumers of services, satisfied with the conditions of stay in a medical organization , as well as food in it .

At the same time, the proportion of service consumers who have during your stay in the hospital, there was no need to pay for the prescribed diagnostic tests at your own expense , estimated in the following way. For a share of less than 90%, 0 points are assigned, from 90% inclusive and less than 95% - 1 point, from 95% inclusive and less than 100% - 2 points. The institution receives the highest score for this indicator (3 points) if the specified share is 100%. Similarly, scores are given for the proportion of service consumers who have during the stay in the hospital there was no need to pay for the prescribed medicines at your own expense.

Another indicator is the share of consumers of services with disabilities who are satisfied with the conditions of stay in a medical organization, - is assessed similarly to indicator 2.5 of the first section, which also applies to citizens with disabilities.

Waiting time in line for medical services

Average waiting time in the admission department of a medical organization. It is measured in minutes. If the average wait time is 2 hours or more, the institution receives a score of 0; from 75 minutes inclusive, but less than 120 minutes - 1 point; from 1 hour inclusive, but less than 75 minutes - 2 points; if from 45 minutes inclusive, but less than 1 hour - 3 points; from 30 minutes inclusive, but less than 45 minutes - 4 points. The institution receives the highest score for this indicator (5 points) if the average waiting time is less than 30 minutes.

FROM average waiting time for planned hospitalization from the moment of receiving a referral for it (regarding the waiting periods established by the territorial program of state guarantees of free provision of medical care to citizens). Here the evaluation algorithm developed for indicator 2.2 of the first section is applied.

Proportion of consumers of services hospitalized at the scheduled time of planned hospitalization. The assessment of this share is carried out similarly to the assessment of indicator 1.4 of the first section.

Satisfaction with the services provided in the medical organization

IN this block includes three indicators: the share of consumers of services, satisfied with the services rendered , ready to recommend a medical organization for medical care , as well as satisfied with the actions of the staff of the medical care organization . All of them are calculated similarly to indicator 1.4 of the first section.

Note that the presence of the last of these indicators distinguishes the assessment of inpatient services from the assessment of outpatient services. In fact, it is a private, clarifying parameter that characterizes the proportion of consumers satisfied with the services provided.

Thus, medical organizations have to be assessed on a large number of different parameters. When all conditions are met and maximum scores are obtained, outpatient care facilities can score 73 points, and inpatient care facilities can score 75 points.

the federal law dated November 21, 2011 No. 323-FZ “On the basics of protecting the health of citizens in the Russian Federation”.

See Federal Law No. 256-FZ of July 21, 2014 “On Amendments to Certain Legislative Acts of the Russian Federation on the Issues of Independent Assessment of the Quality of Services Provided by Organizations in the Sphere of Culture, Social Services, Health and Education”.