The introduction in healthcare of new management principles and human resources management



Keywords: health care, medical business, medical management

Almost every educated person in our society knew the word «management». Management i. e. management or activity management people in various organizations aimed at the achievement of objectives, using work, intelligence, motives of behavior of people combined with the most efficient use of available resources. Management is a multifaceted dynamic process that supports the viability of each enterprise, institution, system. [1]

Human resources, when pertaining to health care, can be defined as the different kinds of clinical and non-clinical staff responsible for public and individual health intervention. As arguably the most important of the health system inputs, the performance and the benefits the system can deliver depend largely upon the knowledge, skills and motivation of those individuals responsible for delivering health services [1].

A new understanding of the principles and objectives of managers in the health system (work with people and for people).

A systemic approach aimed at changing the quality of healthcare for the better;

The ability to meet and exceed the expectations of the patient and the population.

Control functions are determined by the level of the control system. The control system of any object has 3 levels — strategic, tactical and operational. At the strategic level defines the goals and possible outcomes in the future. The tactical level allows to optimally identify the specific task, organization, phased implementation and monitoring of results. The operational level ensures the effective implementation of production processes with optimum use of available resources. In the last five years interest in health management has increased dramatically. Theorists and practitioners debating what should be the management of medical institutions. The greatest part of the works in this field devoted to the problems of management of medical institutions of the state form of ownership. [4] the Researchers agree that the management of medical institutions requires a special approach because of the specificity of marketed product — medical services. The social importance of the medical business dictates the use of special methods of management and marketing. Every year in the country is steadily increasing, the commercial sector of medical services and the population more adapted to their «serviceability». However, the mindset of much of the population still does not allow you to take paid medicine as fact.

As well as the balance between the human and physical resources, it is also essential to maintain an appropriate mix between the different types of health promoters and caregivers to ensure the system's success. Due to their obvious and important differences, it is imperative that human capital is handled and managed very differently from physical capital [1]. The relationship between human resources and health care is very complex, and it merits further examination and study.

Both the number and cost of health care consumables (drugs, prostheses and disposable equipment) are rising astronomically, which in turn can drastically increase the costs of health care. In publicly-funded systems, expenditures in this area can affect the ability to hire and sustain effective practitioners. In both government-funded and employer-paid systems, HRM practices must be developed in order to find the appropriate balance of workforce supply and the ability of those practitioners to practise effectively and efficiently. A practitioner without adequate tools is as inefficient as having the tools without the practitioner.

The introduction of management in health care means:

– New understanding of role of management at all levels of the health system (the achievement of the organizational goals, adaptation to a changing environment);

– The practical application of management theory to the healthcare system (balance between effectiveness and efficiency, efficient use of scarce resources);

Control (management) is a set of principles, methods, means and forms of enterprise management, directed on increase of efficiency of their activities and the needs of society. Management is the ability to achieve a certain goal, using intelligence and motives by affecting people. [2] Professional management is called a Manager. It organizes the specific work of employees on the basis of modern management techniques. In management there are always two sides: the management and control. The subjects of control are the people, functions and tasks which include implementation of management i. e. managers, bosses, organizers. For health, the Minister of health, for medical institutions — the chief doctors (in relation to the institution as a whole), their deputies (in relation to the unit that they oversee), heads of departments (relative to office), etc. the Object of control is what control — personnel, production processes and the entire health care system (or subsystem, separate subdivisions and institutions). [3]

The variation of size, distribution and composition within a county's health care workforce is of great concern. For example, the number of health workers available in a country is a key indicator of that country's capacity to provide delivery and interventions. Factors to consider when determining the demand for health services in a particular country include cultural characteristics, sociodemographic characteristics and economic factors.

Workforce training is another important issue. It is essential that human resources personnel consider the composition of the health workforce in terms of both skill categories and training levels. New options for the education and in-service training of health care workers are required to ensure that the workforce is aware of and prepared to meet a particular country's present and future needs. A properly trained and competent workforce is essential to any successful health care system.

The migration of health care workers is an issue that arises when examining global health care systems. Research suggests that the movement of health care professionals closely follows the migration pattern of all professionals in that the internal movement of the workforce to urban areas is common to all countries. Workforce mobility can create additional imbalances that require better workforce planning, attention to issues of pay and other rewards and improved overall management of the workforce. In addition to salary incentives, developing countries use other strategies such as housing, infrastructure and opportunities for job rotation to recruit and retain health professionals, since many health workers in developing countries are underpaid, poorly motivated and very dissatisfied [2]. The migration of health workers is an important human resources issue that must be carefully measured and monitored.

Another issue that arises when examining global health care systems is a country's level of economic development. There is evidence of a significant positive correlation between the level of economic development in a country and its number of human resources for health [4]. Countries with higher gross domestic product (GDP) per capita spend more on health care than countries with lower GDP and they tend to have larger health workforces [2]. This is an important factor to consider when examining and attempting to implement solutions to problems in health care systems in developing countries.

The main problem emerging areas of commercial health care is the lack of sufficient funding. For the development and competitiveness of commercial clinics require considerable investment, given the innovative nature of modern health care. Consumer demand for expensive high-tech medical services remains low, so the purchase of medical institutions of innovative equipment, facilities, training for medical staff are for most commercial clinics not only unattainable, but unprofitable solution.

Socio-demographic elements such as age distribution of the population also play a key role in a country's health care system. An ageing population leads to an increase in demand for health services and health personnel [3]. An ageing population within the health care system itself also has important implications: additional training of younger workers will be required to fill the positions of the large number of health care workers that will be retiring.

It is also essential that cultural and geographical factors be considered when examining global health care systems. Geographical factors such as climate or topography influence the ability to deliver health services; the cultural and political values of a particular nation can also affect the demand and supply of human resources for health [5]. The above are just some of the many issues that must be addressed when examining global health care and human resources that merit further consideration and study. When examining global health care systems, it is both useful and important to explore the impact of human resources on health sector reform. While the specific health care reform process varies by country, some trends can be identified. Three of the main trends include efficiency, equity and quality objectives.

Various human resources initiatives have been employed in an attempt to increase efficiency. Outsourcing of services has been used to convert fixed labor expenditures into variable costs as a means of improving efficiency. Contracting-out, performance contracts and internal contracting are also examples of measures employed.

Many human resources initiatives for health sector reform also include attempts to increase equity or fairness. Strategies aimed at promoting equity in relation to needs require more systematic planning of health services. Some of these strategies include the introduction of financial protection mechanisms, the targeting of specific needs and groups, and re-deployment services. One of the goals of human resource professionals must be to use these and other measures to increase equity in their countries.

Human resources in health sector reform also seek to improve the quality of services and patients' satisfaction. Health care quality is generally defined in two ways: technical quality and sociocultural quality. Technical quality refers to the impact that the health services available can have on the health conditions of a population. Sociocultural quality measures the degree of acceptability of services and the ability to satisfy patients' expectations.

Human resource professionals face many obstacles in their attempt to deliver high-quality health care to citizens. Some of these constraints include budgets, lack of congruence between different stakeholders' values, absenteeism rates, high rates of turnover and low morale of health personnel.

Better use of the spectrum of health care providers and better coordination of patient services through interdisciplinary teamwork have been recommended as part of health sector reform. Since all health care is ultimately delivered by people, effective human resources management will play a vital role in the success of health sector reform.

Conclusion

Healthcare of Uzbekistan is a special industry, with significant weaknesses, and fundamental dignity. The existing system of management of medical organization in Uzbekistan are gradually becoming obsolete and needs to be replaced with new, progressive, flexible system of healthcare management.

The Western model of medical management can partially be applied in the Uzbek conditions, helping to improve flexibility of response to the dynamics of the external environment.

Western methods should be applied not by direct copying, and implemented taking into account the historically formed peculiarities of health and be complemented by effective approaches, successfully implemented in the Uzbek practice.

An effective system of medical management based on the separation of powers of the chief physician and Director, will improve the availability and quality of medical care. Implementation of business management training of the health sector will enable to develop managerial capacity and to lead the management of the clinics to a new level.

References:

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