METHODOLOGICAL APPROACHES TO FORMING THE STRUCTURE OF THE CENTRAL HEALTH EXECUTIVE AUTHORITY OF THE CONSTITUENT ENTITY OF THE RUSSIAN FEDERATION
Authors:   Russian Research Institute of Health of the Ministry of Health of the Russian Federation, Moscow, Russia, Rugol L.V. , Khodakova O.V. ,   Russian Research Institute of Health of the Ministry of Health of the Russian Federation, Moscow, Russia, Galeeva M.V. ,   Russian Research Institute of Health of the Ministry of Health of the Russian Federation, Moscow, Russia, Deev I.A. ,   Russian Research Institute of Health of the Ministry of Health of the Russian Federation, Moscow, Russia, Kungurtsev O.V., ,   Russian Research Institute of Health of the Ministry of Health of the Russian Federation, Moscow, Russia, Shakhova T.G. ,   Russian Research Institute of Health of the Ministry of Health of the Russian Federation, Moscow, Russia, Kobyakova O.S. ,   Russian Research Institute of Health of the Ministry of Health of the Russian Federation, Moscow, Russia, Chukhrienko I.Yu. ,   Russian Research Institute of Health of the Ministry of Health of the Russian Federation, Moscow, Russia
Published: March 2023

Intensification of the rule-making process in healthcare, active position of citizens and their increased demands for conditions of receiving medical services and quality of health care have resulted in increased burden on health authorities. To ensure efficiency in achieving targets in healthcare reforming and modernization, the requirements for quality managerial personnel are being increased. A wide variety of organizational and legal forms of the central health executive authorities of the constituent entities of the Russian Federation, their often insufficient staff size and imbalance in the staffing of structural units necessitate development of unified methodological approaches to the formation of the structure of the central health authorities of the constituent entities of the Russian Federation and substantiate methodology for calculating the staff size. The purpose of the study: to develop a methodology for creating the optimal structure of the health executive authority of a constituent entity of the Russian Federation and methodological recommendations for calculating their staffing. Results. Analysis of the organizational and legal structure and functional responsibilities of the state authorities in healthcare in 13 constituent entities of the Russian Federation has identified significant differences and different competencies, although each constituent entity of the Russian Federation solves general health issues within the competences, therefore, the scope of activities of all levels of government should be coordinated. Staffing of the regional executive authority (REA) should primarily depend on the population size of the constituent entity of the Russian Federation, its density, number of medical organizations, their total bed capacity, planned capacity of units providing outpatient care, and the number of medical personnel. A coefficient has been derived for calculating the staffing level of the state health authority in the constituent entities of the Russian Federation. In accordance with the general calculation criteria, several models of the REA structure were proposed, depending on the population size of the constituent entity of the Russian Federation. For REA with the number of deputies four and over, two versions of the model with different hierarchical subordination were proposed. Conclusion. Active processes of the industry reforming against the background of objective factors that determine new approaches to the healthcare system impose new, increased requirements to the executive bodies of state authority of the constituent entities of the Russian Federation, necessitate optimization of the structure, management and functional load of regional health executive authorities.