Enhancement of market entity management: healthy approach using EU experience

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Sumy State University

ENHANCEMENT OF MARKET ENTITY MANAGEMENT: HEALTHY APPROACH USING EU EXPERIENCE

Letunovska N.Ye., Demikhov O.I., Kryvych Ya.M.,

Khomenko L.M., Shevchenko Ya.Yu.

Introduction

The analysis of developed countries comprising the European Union shows that the central resource of health entities in the market is their personnel. In this vein, prospects for the development of the healthcare sector mainly depend on the state of professional level and the quality of employees of medical institutions. Medical staff refers to expensive resources that require considerable expense for training qualified specialists; however, unlike most resources, whose value decreases over time, the value of human resources increases with the accumulation of professionalism and experience [1].

Main material

healthcare personnel policy medical

In the field of health care, personnel policy plays a vital role. The Ministry of Health of Ukraine has created a system of personnel policy regulation to enhance the human potential of the medical care sector. The main executors of the state personnel policy in the healthcare sector are regional bodies responsible for the formation and optimal use of labor resources and the professional involvement of human resources in health institutions. The purpose of personnel policy is to ensure an optimal balance of the renewal and preservation of the number and quality of staff according to the institution's needs, the requirements of current legislation, and the state of the labor market. The formation of personnel policy consists of identifying potential opportunities in human resources management and defining those areas of work with personnel that should be strengthened for successful marketing strategy implementation. The staff of a health institution is divided into professional and qualification groups. The following categories of positions are used in medical institutions [2]: managers, specialists, specialists with higher medical education, specialists with higher professional education, specialists with secondary medical education (secondary medical staff), and junior medical staff. other staff. The relationship of the personnel management function forms a system of interactions, as shown in Figure 1.

Personnel management at a health entity is a permanent process of systematically implementing measures to monitor and effectively organize personnel decisions. Directions and methods of working with personnel are determined following their goals and priorities. Methods of encouragement, such as changing the size of wages and surcharges, are established and regulated per the position in an institution, and the features of this position are defined and regulated by law.

Fig. 1.1 The relationship of the functions ofpersonnel management

Certain countries, such as Ireland, United Kingdom (EU country before Brexit), Finland, and the Netherlands have developed an expansion of authority of nursing practice in primary health care institutions. The author of [3] notes, that nurses with extended empowerment were authorized to work at higher levels of practice. Comparing this with Ukraine would mean that nurses in Ukraine would have the authority to prescribe medicines to patients. However, this practice is considered unacceptable for the Ukrainian healthcare system. This practice was first introduced in Ireland with amendments to the Irish Law on the Council on Medicines. Based on the updated law, new professional standards were developed and a six-month training program was introduced, according to the results of which certificates in nursing were issued. Based on independent assessments, one can state that this reform has led to decreased hospitalization and a reduced workload on doctors. However, it is worth noting that the research does not mention such a factor as a medical error. Therefore, it is not necessary to talk about the effectiveness of the reform.

The Finnish and Swedish health systems have their own features. For example, in Finland, the main load is usually received by the hospital's Department of Primary Health Care, which works in municipal clinics. This service is also included in the school healthcare system and is subordinated to the Ministry of Social Security and Health of Finland. In Spain, the primary healthcare system is multidisciplinary. It includes family doctors, pediatricians, dentists, primary care nurses, nurses, social workers and administrative staff who work as a team and serve a specific area [1]. The German healthcare system is characterized by strict adherence to the high standard of medical care and by the control carried out by the Federal Joint Committee and the Institute for Quality and Economic Efficiency of Healthcare. Furthermore, the state promotes implementing a system of complaints and arbitration advice for the extrajudicial settlement of claims for medical negligence. Among EU countries, Germany has the highest cost of medical services. In the staffing plan, the healthcare system in Germany is arranged similarly to the Spanish system.

The UK healthcare system combines state and commercial components. The responsibility to finance general practitioners rests mainly with the State in charge of the National Health Service [3]. At the implementation stage, the updated UK healthcare system provided free services, but over time, it has naturally changed to a system of private patient contributions. The salary of general practitioners depends on the number of patients permanently registered with them. Requirements for healthcare workers include possessing a license granted by the Central Medical Council and re-certification every five years.

The Danish health system is publicly available; services are provided at the expense of budget funds. The exception is dentistry and physiotherapy - these services patients receive at the expense of their funds. The healthcare system's governing body is the Denmark government, which forms a personnel policy [4]. The existing system of medical personnel is based on accreditation and is used for primary health care and municipalities.

Thus, the study of the EU's experience in implementing personnel policy in the healthcare system showed that all countries have their characteristics. Still, there are standard features such as responsible control and improved efficiency of primary care.

The Ukrainian non-profit enterprise "Lypovodolynska Hospital" of Lipopovolonska village council of Sumy region, then "KNP," by the current legislation of Ukraine, is a legal entity and is guided in its activities. This entity has an independent balance sheet, current currency, other bank accounts, and seals, stamps, and forms with its name, trademark, a sign for goods and services, and other details. Doctors of 26 specialties are working there. Overall, there are more than 100 qualified specialists. There are stationary departments, a clinic, and a round-the-clock ambulance.

Management of the hospital pays its efforts to upgrade working conditions and workplace equipment. Each department has nursing rooms for the rest of the staff and computer rooms. Planning, organization, and the analysis of wages in the Municipal Enterprise “Lypovodolynska Hospital” is engaged in the Planning and Economic department (Department of Labor Organization and Salaries).

The economic and marketing calculations provide general information about the institution necessary to determine the financial and other costs (the area of the building, information about water supply, heating system, etc.). To enhance budget planning efficiency, it's imperative to incorporate an evaluation of expenditure effectiveness and progressively shift towards planning focused on achieving tangible, measurable outcomes. For awareness of the institution's position, it is necessary to analyze the share of wages in the expenditure part of financing the health care unit. Thus, according to the institution expenditure table, the share of labor costs to the total budget expenditures was determined. The next group of indicators describes the financial condition of the institution. The coefficient of autonomy for the study period is 0.7 (Table 1), which indicates that the institution does not use its full potential. The normative value of this coefficient is 0.4-0.6. This indicator points to the possibility that it can be involved in development.

Table 1

Analysis of economic and market indicators of “Lypovodolynska hospital”