Sectoral structure of health care
The sectoral structure of health care means the division of the health care sector into certain relatively independent parts, branches, characterized by the specific activities, produced (provided) services. The sectoral structure of the material production branches, such as industry, agriculture, construction, transport, is formed by the separation of parts, called subbranches.
The main feature of a subbranch is the production of products of a certain type or the implementation of a specific type of activity, which is characterized by a specific feature.
Thus, industry is divided into mining and processing, agriculture – into crop and livestock production, construction – into housing, production, civil (administrative), transport – into passenger and cargo. The number of sub-sectors into which the industry is divided can be very different depending on the necessary and reasonable detail.
Due to the significant diversity of types of health care services and the lack of a single sign according to which such services can be divided into groups of relatively homogeneous composition, the formation of a universal, statistically justified sectoral structure of health care (health care economy) is difficult. At the same time, by analogy with other branches of economy, structural components, components of the health care sector can be separated.
So, depending on a way of rendering of services and a form in which their final result, effect is presented, it is accepted to divide services into material (material-material), non-material (spiritual-information) and mixed, combining signs of that and other kind.
Material services are associated with the provision of benefits or obtaining the effect in a tangible form. In medicine, these are, first of all, pharmaceutical services, orthopedic services, certain types of dental services, as well as other services, the provision of which requires the use of materialized, tangible means of treatment as the main, structuring.
Intangible services are more common in health care and are inherent to it, implemented in the form of diagnostic and treatment processes, in which the main role belongs to the content and methods of medical care, while the material elements of activity have an auxiliary value.
It should be noted that due to the essence, nature and purpose of health care services, they organically combine tangible and intangible services, which in most cases are difficult to separate, because they form a single alloy. So it is legitimate to assert the prevalence of mixed health care services.
However, again, due to the nature of medical activity, personal services of an individual-oriented character prevail. Mass services in the form of sanitation aimed at preventing widespread diseases, quarantine measures constitute a relatively small share of total medical activity. Family, group, and collective services are at their core a set of somewhat organized personal, individual services.
So if in the economy of the sphere of material production individual production is only a tiny part of serial, mass production, then in the economy of health care individual services occupy a leading, defining place.
But it is necessary to bear in mind, that individual orientation of health care services is combined with mass application of universal means and methods of treatment of the majority of diseases, as well as health-improving measures. At the same time, the collective, group nature of health services is manifested in the fact that the same health care worker usually serves many patients.
The division of the health care industry into sub-branches according to the organizational and institutional trait characterizing the type of medical organization, as well as the types and ways of its activities, is more productive and defined.
In this approach, outpatient polyclinic, inpatient care of patients, pharmaceutical services, sanitary-epidemiological services, scientific and educational organizations, health care management bodies, organizations engaged in the resource support of health care are distinguished.
Such structuring of the health care sector to the greatest extent corresponds to the principles of formation of the sector structure accepted in the economy and management organization.
Depending on the nature of contacts between doctors and patients, direct treatment based on direct contacts, personal communication of patients with doctors, and remote services provided at a distance in the form of advice, instructions, surveys are distinguished. There is also a combination of direct and remote form of medical services.
In the structure of organizations of the Russian public health services the division of medical institutions depending on patterns of ownership and ways of payment for rendered services, which has received distribution in all countries with market economy, is strengthened.
State and municipal medical establishments, the fixed assets of which are owned by the federal, regional, and local medical establishments, are financed mainly from the corresponding budgets and extra-budgetary medical insurance funds. The services rendered by them are mainly free of charge for the patients served by these organizations.
At the same time, these services are mainly free of charge for patients served by these organizations. With a certain degree of conditionality, the number of commercial clinics, outpatient clinics and hospitals providing paid medical services is increasing. The lease of fixed assets of State medical and health-improving organizations by commercial medical institutions is spreading.
With a certain degree of conditionality in health care, sub-branches characterized by the professional orientation of types of medical activity and services provided are allocated.These are characterized by the professional orientation of the types of medical activity and services provided.
These sub-branches are widely known for therapy, surgery, paediatrics and sanitation, and specialized sub-branches include microbiology, neurophysiology, oncology, psychiatry, dentistry, cardiology, gastrology and cytology.