INSTITUTIONAL ASPECT OF SOCIO-ECONOMIC DESIGN OF MEDICAL SPHERE DEVELOPMENT

The author substantiates the key areas and details the tools for institutional design of the development of the medical sphere. It has been established that the modernization features of modern medicine are integration into the professional global space; spread of various forms of international cooperation, medical tourism; formation of international treatment protocols, and dissemination of electronic medical records, which together improve the quality of medical services and allow attracting new sources of funding. The process of institutionalization of the healthcare sector is ensured by formal regulations that combine direct and indirect regulatory instruments. Direct instruments are implemented within the framework of state targeted development programs, administrative regulation, and contractual resource financing. Indirect instruments are implemented through fiscal and monetary incentives. The author substantiates the key institutions that will contribute to the development of the private healthcare sector: licensing and certification; standard setting; financial support; investment incentives and the formation of a favorable investment climate; cooperation with the private sector in the format of public-private partnership projects; exchange of information on industry development trends, adaptation of best practices and best medical practices; determination of price limits and price control; quality monitoring and audit; and legislative regulation. It is emphasized that in the healthcare sector, the modernization of most institutional formats was implemented through “shock therapy”. This strategy did not ensure the spread of organizational innovations and positive changes due to the inability to minimize the risks of transplantation. It is determined that the most promising strategy of institutional design for implementation in the medical sphere is the strategy of forming intermediate forms of institutions. Such a transformation involves modifying existing institutions into intermediate forms and their further changes within the existing institutional and evolutionary constraints. It is proved that institutional support for the development of private medicine requires concentration of incentives on the effectiveness of regulation of private medical services, their accessibility and quality; financial support, financing models, and communication, information and infrastructure support.