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Copyright of Journal of Economic Research & Business Administration is the property of Al-Farabi Kazakh National University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. The problem concerning the activation of the measure of Compulsory Health Treatment (CHT) for subjects suffering from Eating Disorders (ED) represents a legal paradox that places health professionals in the position of frequently doubting the real usefulness of the measure within the hospital context. This issue is mainly related to anorexia nervosa, which puts the subject in a higher life-threatening situation than other EDs. Method and materials. To outline the current state of the art, the most recent national and international scientific publications concerning informed consent and CHT in EDs were searched. In addition, Italian rulings in various degrees of judgement were evaluated with the suggestion of a possible resolution of these issues. Results. The analysis of the literature showed that although a multitude of psychometric instruments has been created to identify the ability to give informed consent, there are still not all the elements necessary to identify the actual degree of disease awareness of ED subjects. An important factor could be the exploration of the person's interception, which has been seen to be very high in individuals with AN who are known not to experience the sensation of hunger. At present, reviews of the bibliography and judgments have shown that the measurement of CHT remains crucial if it is intended as a lifesaving treatment. However, it is evident that in terms of BMI, CHT is not a definitive intervention and therefore the adoption of this practice is necessary with extreme caution taking into account the person's actual ability to consent. Conclusions. Future studies will have the task of determining the psychic factors necessary to better understand the state of the person in his or her physical and mental wholeness, giving due weight to these characteristics and orienting knowledge in a practical sense to more profitable direct treatment for individuals with ED. [ABSTRACT FROM AUTHOR]

Infertility is a disease of the reproductive system characterized by lacked clinical pregnancy after 12 or more months of regular unprotected sex. To diagnose the causes and choose the tactics of infertility treatment, a personalized approach to each patient is required, which is beneficial for both the doctor and the patient. A comprehensive examination of patients is important from the point of pharmacoeconomics and clinical efficiency view. Here, a comprehensive diagnostics of the spouses resulting in birth of a healthy child is discussed.

Introduction. A clinical and economic study was carried out to assess the effectiveness of infertility treatment using assisted reproductive technology programs with preimplantation genetic testing (PGT) in patients with various reproductive disorders. Materials and methods. Twenty models representing discrete-time Markov processes are developed. A total of 10 possible paired scenarios for couples undergoing infertility treatment using assisted reproductive technology, depending on reproductive disorders and the use of PGT, were considered in the study. Results. The most cost-effective scenarios from the simulation results should be the use of PGT in the group of females aged 3742 years and in the group of females under 35 years with missed abortion. These scenarios are not only resource-efficient in terms of the willingness-to-pay threshold, but they also preserve compulsory health insurance funds still with meaningful clinical efficiency. The remaining scenarios are characterized by significant clinical efficacy and low cost per added live birth, except for the PGT use in the group of males with teratozoospermia, which is characterized by a minimum of added live births and a maximum cost per added live birth. Conclusion. The study results indicate the most optimal and economically feasible scenarios of PGT in patients depending on the infertility factor for implementation in the practical healthcare system of the Russian Federation.

Copyright of Journal of Academic Value Studies is the property of Asos Egitim Bilisim Danismanlik and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to study the potential for the development of financing the Compulsory Health Insurance (CHI) system in Russia.Material and methods. Оur research estimates the amount of funds available in the CHI system based on fractal analysis and ARIMA modeling. The proposed approach makes it possible to determine the critical amount of funds in the CHI system. Once the limit is reached, the chance of violating the economic security requirements will increase. Results. Аn increase in the volume of available funds in the CHI sector is expected in the mid-term perspective on the verge of quarter 1, 2023. The amount of funds required to pay for medical care for the respective period of time will increase by 0.77% quarterly.Conclusion. Gaining additional funds might be possible by optimizing the internal networks for generating cash flows in the CHI system, as well as applying additional ways of financing medical care (particularly Voluntary Health Insurance policies). It would be practical to redistribute the functions of financing health care between the Federal Fund for CHI and its territorial branches. It is essential to review the role of health insurance companies in monitoring the health care quality by improving the communication with citizens.

Copyright of Al-Hiqouq is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diagnosis-Related Groups (DRG) for the payment for biological therapy were created at the stage of the pilot project and their coefficients of input intensity were not revised since then. The expansion of the range of genetically-engineered biological drugs (GEBD) and the development of new indications for biological therapy and new groups of expensive drugs (like selective immunodepressants, SI) determine the necessity in the differentiated payment for the therapy with GEBD and SI. However, at the federal level, this will be possible only after the approval of the clinical recommendations.Aim. The study aimed to identify possible applications of different GEBD and SI within the current provider-payment model of the Russian diagnosis-related group in terms of bronchial asthma (BA) and inflammatory bowel disease (IBD) - Crohn's disease and ulcerative colitis.Materials and methods. The expenses on GEBD and SI for one case of hospitalization were calculated and compared with the imposed tariffs. For the evaluation of the possibility of the provision of an expensive treatment within the existing DRG model, the authors modeled the distribution of patients with BA and IBD by different pharmaceutical treatment plans in the current practice and cases of an increase in the share of indications of more expensive therapy. The authors identified the number of patients that could have been treated without an increase in the costs of compulsory medical insurance (CHI). The authors proposed the subgroups for the differentiated payment for the treatment of BA and IBD with GEBD and SI.Results. Few variants of treatment with GEBD and SI were characterized by the costs of drugs that would exceed an average payment rate for DRG st36.003 and ds36.004 in 2020. In the model, an increase in the share of patients that received the most expensive drugs of all the registered GEBD and SI in the RF for the treatment of BA and IBD did not lead to an increase in the costs for CHI. It is possible to maintain the initial volume of the financing and increase the number of patients that receive GEBD and SI due to a decrease in the number of hospitalizations. The authors identified approximate values of the coefficient of input intensity (CII) for the subgroups that can be formed for the differentiated payment for pharmaceutical treatment with GEBD and SI.Conclusion. Despite the fact that without the recalculation of CII, there were numerous changed introduced into DRGs st36.003 and ds36.004 “Treatment with GEBD and SI” and the spectrum of the associated clinical situations expanded, it was possible to maintain the possibility of the payment for the therapy with different drugs, including the most expensive ones without an increase in the costs for the CHI system. Still, the results of the present study indicate the necessity in the optimization of the system of payment for medical care with genetically-engineered biologic drugs and selective immunodepressants through the implementation of a differentiated approach to the payment at the federal level.

In this article, the authors describe some approaches to medicine price formation in the Republic of Moldova. Following the study, we can say that the health system of the Republic of Moldova (Moldova) is part of the social sphere, and medicines are an important element in the treatment of various diseases. Thus, at the same time with the reform actionsand development of the pharmaceutical sector, a high-priority issue is the price setting of medicines, which is influenced by a number of factors. The research was based on the multitude of normative acts and the specialized literature, where the priority problem was established - the development of the pharmaceutical sector. The authors, through this research, using the methods of observation, analysis and deduction, aimed to analyze the normative basis at national level and the literature, to distinguish some problematic aspects in the field, to estimate the current state of medicine pricing quality. In order to achieve this goal the authors used the following methods: analysis, observation, comparison, etc. The following indicators were analyzed in this paper: the indicators on healthcare expenditure in the consolidated budget; the fundraising mechanism to support the activity of the health sector; the dynamics of the development of the medical institutions network in the Republic of Moldova; the mechanism of supply and regulation of medicines.

Healthcare services are public services primarily provided by the Healthcare Network Plan designated providers. If it becomes necessary to engage additional healthcare facilities to meet the needs of insured individuals for a particular type of healthcare service that is covered by the compulsory health insurance, a contract can be signed with a healthcare provider who is not a part of the Healthcare Network Plan. In addition to that, a contract may also be signed with a legal entity or entrepreneur, under the regulations governing public-private partnerships, to exercise the insured individuals' right to healthcare, under the conditions prescribed by law. In this article, the author presents the possibilities private healthcare institutions and private practice have, as providers outside the Healthcare Network Plan, to provide healthcare services covered by compulsory health insurance.

The article is aimed at studying the prospects for development of health insurance in Ukraine, taking into account foreign experience. It is defined that reform of the health care system is an important condition in the course of European direction of Ukraine’s development. The priority in this matter is assigned to insurance medicine, in particular the introduction of compulsory national health insurance. To implement the modern health care model, we urgently need management and intermediary organizational structures (insurance organizations, foundations, insurance offices) and highly qualified medical personnel, which would provide appropriate attitude to the health of the insured persons. Analysis of health insurance in the socio-economic conditions of today’s Ukraine showed that it is at the initial stage of its development. The effective experience of the world countries in the sphere of insurance medicine proves that various models, compulsory health insurance systems have already been worked out and their high results have been proven. The introduction of a new model of health care financing in Ukrainian practice involves not the increasing financing, but changing the approach to resource management in order to use recourses more effectively. The main stages of implementing compulsory and voluntary insurance as a single complex should be: optimizing of compulsory health insurance rates; substantiating the optimal amount of insurance premiums for the unemployed population, pensioners and children; introducing more progressive cost-recovery methods; setting tax breaks; excluding the possibility of duplication of payment for medical services to be provided under compulsory and voluntary health insurance schemes; organizing the uniform standards and regulations for treatment and delivery of services.

During implementation of the reforms of the health care financing system in the Russian Federation, new proportions of sources of financial support for this key area were determined, on which the level of health of the population depends, affecting the socio-economic indicators of the development of the state. The fundamental factors, on which depend the volume and sources of financing of health care in the region, have been analyzed in the article. The role of the regional budget as a source of health care financing in more detail on the example of the budget of the Irkutsk region has been considered. Trends and prospects for the development of the health care financing system in the region have been identified.

Ce Corrigendum modifie l'article original «Les caractéristiques de la population couverte par le régime de l'assurance maladie obligatoire au Maroc». The Pan African Medical Journal. 2018;30:266. doi:10.11604/pamj.2018.30.266.13209.

There is no country in the world that can provide to all citizens all the benefits offered by modern medicine. In fact, the lack of financial resources with a continuous increase in health spending is a difficult challenge facing all countries of the world, including Serbia. The author deals with the analysis of the problems of unequal access to health services, insufficient health coverage, and the inability to exercise the rights of individuals on compulsory health insurance. Accordingly, the author points out how regulated health systems of developed countries, whose health funds contribute to a significant improvement in the health status of their citizens. Finally, a comparative analysis shows that there is no perfect health insurance system, but to strive for it, and some of the solutions that can contribute to improving the current state of health are proposed.

Copyright of Reforma (1694-5158) is the property of Kyrgyz-Turkish Manas University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Contrary to the number of unemployed or vacancies, the number of employees subject to social security contributions (SSC) for Germany is published after a time lag of 2 months. Furthermore, there is a waiting period of 6 months until the values are not revised any more. This paper uses monthly data on the number of people subject to compulsory health insurance (CHI) as auxiliary variable to better nowcast SSC. Statistical evaluation tests using real-time data show that CHI significantly improves nowcast accuracy compared to purely autoregressive benchmark models. The mean squared prediction error for nowcasts of SSC can be reduced by approximately 20%. In addition, CHI outperforms alternative candidate variables such as unemployment, vacancies and industrial production. [ABSTRACT FROM AUTHOR]

In this article, the authors describe some approaches to medicine price formation in the Republic of Moldova. Following the study, we can say that the health system of the Republic of Moldova (Moldova) is part of the social sphere, and medicines are an important element in the treatment of various diseases. Thus, at the same time with the reform actionsand development of the pharmaceutical sector, a high-priority issue is the price setting of medicines, which is influenced by a number of factors. The research was based on the multitude of normative acts and the specialized literature, where the priority problem was established - the development of the pharmaceutical sector. The authors, through this research, using the methods of observation, analysis and deduction, aimed to analyze the normative basis at national level and the literature, to distinguish some problematic aspects in the field, to estimate the current state of medicine pricing quality. In order to achieve this goal the authors used the following methods: analysis, observation, comparison, etc. The following indicators were analyzed in this paper: the indicators on healthcare expenditure in the consolidated budget; the fundraising mechanism to support the activity of the health sector; the dynamics of the development of the medical institutions network in the Republic of Moldova; the mechanism of supply and regulation of medicines. [ABSTRACT FROM AUTHOR]

The article discusses the changes in the Ordinance for the Elements of Consideration and Income on which Social Insurance Contributions Are to Be Paid and in the Health Insurance Act insofar as it concerns the calculation of health insurance contributions. Attention has been paid to some specifics in determining insurable earnings, their scope and elements in the various groups of insured persons. The paper looks into the specifics in determining employees' insurable earnings in the cumulative calculation of hours worked. A calculation example explains the way in which self-employed persons may correct the final amount of their insurable earnings for past periods. The article specifies the categories of health insured persons, as well as the new parametres of the amounts due for health insurance in relation to the changes in the minimum insurable earnings for 2019. [ABSTRACT FROM AUTHOR]

Acting on the basis of studying regulatory, legal and reporting documents in the field of high-end medical aid, review of operations of certain federal patient care institutions and results of the authors’ clinical studies, the authors attempted to assess the efficacy of a regular stage in high-end medical aid in the field of dermatovenerology at the expense of the federal budget. The article also provides a brief description of directions for further improvement of high-end medical technologies.

Authors analyzed the normative legal documents that at different stages determined the general procedure for organizing the provision of high-tech medical care and the sources of its financing. Statistical data on the provision of hightech medical care for the population of the Russian Federation on the profile of "dermatovenerology" are presented. The authors have shown in dynamics that since the release of high-tech medical care as a separate type of medical care (1992), there is the change in the number of medical organizations that provide this type of medical care in the Russian Federation. The authors outlined the main problems of low accessibility and provision of the population of certain subjects of the Russian Federation with this type of medical assistance. The list of nosological forms on the profile of "dermatovenerology" remains extremely insufficient for today, the severity of the course and approaches to treatment of which can be attributed to the number of high-tech medical care. The experience of the work of the federal medical organization in the provision of high-tech medical assistance on the profile of "dermatovenerology" is presented. Proposals have been formulated to improve the quality, availability and improvement of the model for providing high-tech medical care to patients with the most severe dermatoses. The analysis of the literature data, normative legal documents and the experience of the medical organization of federal subordination is presented. The review of step-by-step development and increase of accessibility of high-tech medical aid on the profile of "dermatovenerology" was conducted.

Purpose of the study is evaluation of clinical outcomes, embryological characteristics, pharmacoeconomic aspects of corifollitropina alpha application in the ART programs, conducted in patients older than 40 years at the expense of mandatory health insurance funds (compulsory medical insurance).40 ART programs at the expense of the compulsary medical insurance (OMS) were analyzed (20 patients whose controlled ovarian stimulation - COS was carried out using follitropinalfa, 20 patients, whose COS was conducted using corifollitropina alpha). We analyzed the data of the anamnesis, clinical and gynecological examinations, hormonal status, ultrasound scans, folliculogenesis parameters in stimulation protocol, number and quality of the oocytes, embryos. The effectiveness of corifollitropina alfa and follitropinalfa in patients older than 40 years is the same. Implementation of the ART programs using corifollitropina alpha is more pharmaeconomicly reasonable and saves budget money.

A report on the Consumer Engagement in Health Care Survey by the Employee Benefit Research Institute and Greenwald and Associates is presented. The survey reportedly involved an online survey of adults with private insurance in the U.S. The results revealed similarities and differences between high-deductible health plan enrollees and those enrolled in traditional health coverage and differences in consumers' attitudes and behaviors based on plan type.

In the face of increasing of the regional differentiation of the health systems and compulsory health insurance, the comparative analysis and efficiency assessment of their performance in the context of the subjects of the Russian Federation becomes particularly relevant. Therefore, the research is focused on the regional health systems and compulsory health insurance (CHI), and the subject matter of the study is the analysis of the system performance. In the article, the comparative analysis of the authors’ approaches to the formation of efficiency criteria of the performance of regional health systems and CHI, as well as to the development of a typology of the constituent entities of the Russian Federation based on these criteria is conducted. The authors propose a system of indicators to measure the economic, medical and social efficiency of the systems under consideration. Moreover, a set of indicators of economic efficiency forms two groups of indicators. The first group of indicators reflects the financial performance, and the second — the structural efficiency. A methodological approach to the formation of the rating for subjects of the Russian Federation according to the levels of efficiency, based on the procedures of cluster analysis and fuzzy mathematics are developed. A feature of the proposed approach to the construction of a typology of the subjects in terms of efficiency is the introduction of a reference subject with the national average performance indicators system that allows to qualitatively assess the effectiveness of regional health systems and CHI by comparing them with the «reference subject». The results of the empirical research have indicated a high differentiation of the subjects of the Russian Federation in terms of economic efficiency, have allowed to identify the subjects-outsiders. The theoretical and practical results can be used for the rational choice of priorities of the state policy in the field of the public health and CHI at the federal and regional levels.

Purpose of the study is assessment of the effectiveness of the ART programs funded by the Compulsory Health Insurance Fund among patients older than 40 years of age. 80 ART programs at the expense of the mandatory health insurance funds (40 patients at the age of 40 and older, 40 patients younger than 40 years) have been analyzed. We have analyzed the data of the anamnesis, clinical and gynecological examinations, hormonal status, ultrasound scans, parameters of folliculogenesis in stimulation protocol, number and quality of the oocytes and embryos. There’s a tendency of age-related decrease in number and quality of the embryos. The effectiveness of the ART programs in women of this age group is not high (20%), which requires an expansion of using the donor oocytes’cycles.

This publication shows the relationship of one of the three proposed financial and economic models of orthotics offices, assisting patients with different pathologies of the musculoskeletal system, depending on the category of the hospital. The models of orthotics offices subjected to the analysis differ by a financing source; the system of an assessment of the dominating and minor indicators of their functioning is developed. Possible economic efficiency of the work of this office, working in the compulsory health insurance system is shown in the group of patients (n = 30) with a fracture of the distal end of the radius, and has made more than 377 000,0 rubles per year (according to 2014).

Introduction: in Morocco, Compulsory Medical Insurance (CMI) entered into force in 2005. Insurance first covered health expenses of employees in public and private sectors, then of students. It was gradually expanded to independent workers. This study aims to determine the profile of the population covered by CMI in Morocco. Methods: We conducted a descriptive study of the population covered by CMI based on data collected from the National Health Insurance Agency in Morocco and from the Health Insurance funds. Results: A total of 8.428.218 persons were covered by CMI at the end of 2014, reflecting a rate of 34% of the general population. People having long duration disease (LDD) did not exceed 2.78% of the population covered by CMI. Active insured accounted for 81% of the population covered. In the private sector, gross salary of active affiliates ranged, on average, between $140 and $500 per month while gross salary pensions was less $280 per month. In the public sector, gross salary of active affiliates ranged, on average, between $280 and $825 per month while gross salary pensions ranged between $140 and $500 per month. Conclusion: Knowledge of the characteristics of the population covered by Compulsory Health Insurance in Morocco is necessary to ensure regulation and sustainability in the insurance sector. [ABSTRACT FROM AUTHOR]

Child and maternal health are the priority for every developed society. The purpose of this study is to present the principles and methods of financing health promotion and prevention activities for child and maternal health in Bulgaria general practice in the field of child and maternal health, at the level of Primary Health Care in Republic of Bulgaria. Document review of scientific papers, publications of World Health Organization, and normative documents devoted to the Bulgarian Health Care System was carried out. Here are presented the characteristics of the health promotion and prevention activities in Republic of Bulgaria. They are discussed on the basis of the on the basis of compulsory health insurance. The mechanism of Primary Health Care financing is based on the provisions of the National Framework Contract. The main purchaser of health services is the National Health Insurance Fund. The financing model incorporates the following financial components the capitataion and for service - financing of certain health promotion and prevention activity. Questions have been raised about the implementation of effective and accessible best practices for integrated promotion and prevention activities, which give opportunity for complete coverage of mothers and children. [ABSTRACT FROM AUTHOR]

Copyright of Der Moderne Staat is the property of Verlag Barbara Budrich GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper investigates competitive behaviour and scale economies of the health-care insurance market in the Netherlands over the period 1995-2012. We focus on the impact on the market structure of the 2006 health-care reform, which replaced the dual system of public and private insurance with a single compulsory health insurance scheme in which insurance providers compete for customers in a free market. We start with estimating unused scale economies and find that, after the health-care reform in 2006, unused scale economies at around 20 per cent are much higher than before the reform (4 per cent), pointing to a relative increase of fixed costs. Our interpretation of this change is that fixed costs increased after the reform, as insurers now have to monitor care providers and negotiate with them about lower prices or higher quality. To measure competition directly, we apply a novel approach that estimates the impact of marginal costs as an indicator of inefficiency on either market shares or net profits. Over time, competition in health insurance has increased significantly, but reform-induced market turbulences in 2006 caused a fall in the average level of competitive pressure. After the reform, competition continued to improve. [ABSTRACT FROM AUTHOR]

The right of an insured person to choose medical insurance company in the system of Compulsory Health Insurance concerning contradictions in the contents and potential problems connected with its realization is being analyzed in the article.

The right of an insured person to choose medical insurance company in the system of Compulsory Health Insurance concerning contradictions in the contents and potential problems connected with its realization is being analyzed in the article

The contribution is focused on health insurance in the Russian Federation, brings in comparative analysis of compulsory and voluntary health insurance.