No4-5(2) 2019
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DOI 10.37219/2528-8253-2019-4-04 |
Zabolotnyi D.I., Samokhodskyi V.M.
Rationale of the levels of intensity and differentiated cost of labor costs
of doctors in the hospital
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Zabolotny Dmitry I
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine. Director
Doctor of Medical Sciences, Professor, Academician of the National Academy
of Medical Sciences of Ukraine
E-mail: amtc@kndio.kiev.ua
https://www.scopus.com/authid/detail.uri?authorId=6701512931
Samohodskiy Viktor M.
Kirovograd Regional Hospital, Otolaryngology Department
Doctor of Medical Sciences, Professor
E-mail: VSamohodskiy@gmail.com |
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Abstract
Introduction: Due to the fact that Ukraine has not formally
established tariffs for medical services and their complexity factors and
the doctor’s remuneration system continues to exist on the basis of the
“equalization” principle, we propose a scientifically based mechanism for
determining the rate of labor intensity of hospital doctors and adequate the
level of increase salary in accordance with the DRG.
The purpose of the study: Because of, the level of labor of residents
of the inpatient departments of the inpatient department of health
facilities of the II and III levels is not the same, then based on the
analysis of the number of treated patients in accordance with the DRG, the
degree of complexity of the disease, their score, determine the level of
labor intensity of doctors and real the size of their wages.
Materials and methods: Based on the recommendations of the doctoral
dissertation and a number of innovative medical and economic standards,
analysis of a significant number of otolaryngologicalpatients, the use of
the CSG, DRG system, the distribution of patients with a degree of
complexity, their score, the algorithm for applying the above organizational
standards, criteria and standards, and the use of timing. The technology of
determining the individual level of the doctor’s labor intensity factors and
an adequate level of its material stimulation has been developed.
Results: Recommended technologies for using the aforementioned
prerequisites, the need to create appropriate computer programs to simplify
the analysis of individual doctors' work results, using the formulas
presented in the article made it possible to determine both the degree of
workload for a doctor and the level of possible increase in his salary.
Conclusions: The algorithm for determining the coefficient of labor
intensity of doctors and the mechanism for calculating the real cost of
their labor in the treatment of specific patients of varying degrees of
complexity can be used as a technological matrix for doctors of other
medical specialties, in the future it will increase the material incentives
of the latter at least to the level of family doctors. |
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Keywords
salary of a doctor, diagnostically-related groups, the degree of complexity
of diseases and surgery, scoring, workload intensity, labor costs |
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