Grischuk S. Optimization of health insurance

Object. The system of care members of health insurance. Aim. Develop and justify the optimal model of organization and functioning of the health insurance fund. Methods. Systems analysis, bibliosemantichny, historical analogy, statistical, sociological, descriptive modelling, natural experiment, an economic expert assessments. Theoretical and practical results. Research has proved the best functional and organizational model for health insurance fund regional level. Introduced in the hospitals improved control system of medical care quality with automatic monitoring of compliance with clinical protocols and drug formulary. Determined the need for funding of medical people in the hospital at different levels of care within the region. Novelty. For the first time in Ukraine was developed and tested model for optimal functioning of the health insurance fund, which is implemented through the involvement of public resources, focus on the general principles of organization of health care in the state and can be implemented in any region of Ukraine without considerable cost of adaptation. Designed and implemented automated monitoring system for the rational use of resources, health insurance companies, the use of which significantly reduces the problem of underfunding the health sector in terms of medical services. Studied and tested effective mechanisms of cooperation with the health insurance fund by family physicians. Improved system of medical treatment facilities at all levels of care through the implementation of drug formulary and treatment protocols. Established commitment to solidarity of the population to participate in the financing of health care through health insurance schemes. Sphere (branch) utilization: In health care.