Risk-oriented approach of the organization of quality control and medical safety in the application of medical rehabilitation clinical and statistical groups

Abstract

In the last decade, the healthcare system has been undergoing reforms to ensure the effective use of budgetary resources given the steady increase in spending on the maintenance of medical institutions and implementation of state policy in healthcare. Improving the payment methods for medical care is one of the main tasks for the healthcare system.

Medical care payment in a clinical hospital is made using clinical and statistical groups. The work based on the Federal Center of Brain Research and Neurotechnologies of Federal Center of Brain Research and Neurotechnologies of Federal Medical and Biological Agency of Russia of Russia with clinical and statistical groups within the framework of medical insurance has been implemented since January 2021.

In total, 2,973 medical records of inpatients treated under medical insurance were analyzed for 2021. Special attention is paid to the analysis of the use of clinical and statistical groups for the profile “Medical rehabilitation.” The patterns that allowed increasing case efficiency have been identified. These measures helped optimize the expenses of the medical institution for the provision of medical care and preserve all opportunities for long-term growth and development.

Keywords

clinical and statistical groups / medical insurance / lexical control / expertise

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