CONCEPTUAL APPROACHES TO ORGANIZATION OF THE MODERN MODEL OF THE CONSULTATIVE-DIAGNOSTIC CENTER ON THE PRINCIPLES OF PUBLIC-PRIVATE PARTNERSHIPS 52 Kravchenko V. V. Conceptual approaches to the organization of a modern model of a consultative and diagnostic center on the principles of public-private partnership. Pedagogy and Psychology of Sport . 2018;4(1):52-62. eISSN 2450-6605. DOI http://dx.doi.org/10.5281/zenodo.1195711 http://apcz.umk.pl/czasopisma/index.php/PPS/article/view/16813 Original text Kravchenko V. V. Conceptual approaches to the organization of a modern model of a consultative and diagnostic center on the principles of public-private partnership. Journal of Education, Health and Sport. 2018;8(1):235-245. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1195711 http://ojs.ukw.edu.pl/index.php/johs/article/view/5357 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2018; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wie lki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which pe rm its any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Comme rcial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly c ited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is prope rly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 23.01.2018. Revised: 26.01.2018. Accepted: 31.01.2018. CONCEPTUAL APPROACHES TO THE ORGANIZATION OF A MODERN MODEL OF A CONSULTATIVE AND DIAGNOSTIC CENTER ON THE PRINCIPLES OF PUBLIC-PRIVATE PARTNERSHIP V. V. Kravchenko Shupyk National Medical Academy of Postgraduate Education Abstract Background The transition to progressive development models is an actual problem of the Ukrainian health care system. Objective: to substantiate conceptual approaches to the formation of a modern functional-organizational model of consultative-diagnostic centers (CDC) on the basis of public-private partnership (PPP). Materials and methods. General scientific methods of analysis, synthesis, generalization, interpretation of scientific data, as well as systemic and structural-functional approaches were used in the study. Results The article presents conceptual approaches to the organization of a consultative and diagnostic center on the principles of PPP, which include three components: the concept and methodological approaches to the restructuring of the CDC system, as well as the rationale for the organizational and economic formation of the CDC model on the principles of PPP. Conclusions Presented in the article the conceptual approaches to the organization of a modern model of a consultative and diagnostic center on the principles of PPPs are the way of adaptation of the communal CDC system to the conditions of a market economy. http://dx.doi.org/10.5281/zenodo.1195711 http://ojs.ukw.edu.pl/index.php/johs/article/view/5357 53 Key words: conceptual approaches, consultative and diagnostic center, public- private partnership. Introduction Current issue of the national health system is need to transition her to a progressive model of development, which provide the structural efficiency of industry [1, 2]. Relevance is also driven by the need to attract private investment in the sector of the health care community to improve the system of outpatient consultative-diagnostic assistance [3]. The aim of the study- to substantiate the conceptual approaches to formation of modern functional-organizational model of diagnostic centers (CDC) on the basis of public- private partnership (PPP). Materials and methods. To achieve this goal in the work of applied general scientific methods of analysis, synthesis and generalization, the interpretation of scientific data, as well as systemic and structural-functional approach. Results of the study To solve the problem of improvement of the CDC in modern economic conditions on the basis of a systematic approach and analysis developed conceptual approaches to the development of municipal CDC based on PPP. The concept of the development of any system is a set of the most essential elements of the theory of modern attitudes and views on the issues outlined in the acceptable to practice constructive form [4]. Conceptually, the PPP in the study regarded as institutional and organizational Alliance between Government and business to implement socially important project and the program of innovative development of OUR system. Conceptual approaches to organization of the consultative-Diagnostic Center on PPP we include three components (table 1). Methodological approaches to restructuring the system of municipal CDC based on PPP represent a set of approaches to the study and analysis of the practical activities of the system, identifying problem areas, determining the required the most significant changes to its economic, industrial and organizational components and prospects of development of the system of CDC on PPP. 54 Table 1 The conceptual components of development of CDC based on PPP 1. methodological approaches to restructuring the system of municipal CDC at based on PPP as set methodological recommendations obtained in the process of research Conceptual approaches to organization of consultative- Diagnostic Center on PPP 2. the concept of restructuring process determined the conceptual changes in the structure of the CDC based on PPP 3. the Study of organizational-economic formation model of CDC on the PPP as a program development implementation of CDC. The first phase of the study explored the basic processes of PPP development in the global economy and the health of developed countries of the West. Generalization of the successful experience of developed countries, including the UK, Germany, Canada on implementation of PPP in health as the main mechanism for the involvement of private capital in the public health sector, which contributes optimize infrastructure health care establishments (with) and improve the quality of medical aid to the population. On the next stage of the analysis of the State of health of the adult population of Kiev, studied according to population, doctors and experts on the Organization of work of CDC, conducted a comprehensive analysis of the resources and activities of the existing system of municipal CDC. Defined the presence of the legislative framework for the implementation of the principles of PPP in the CDC, which includes, in particular: the law of Ukraine on July 1, 2010, no. 2404-VI "on public-private partnership" is amended in accordance with the laws of 5007 N-VI (5007-17) from the 21.06.2012, the 16.10.2012 and the law of Ukraine of 24.11.2015 № 817-VIII "on amendments to certain laws of Ukraine regarding the removal of regulatory barriers to the development of public-private partnerships and stimulate investments in Ukraine» [5, 6], that define organizational and legal principles of interaction between Government partners with private partners and the basic principles of municipal and private partnerships on a contractual basis. 55 Was-SWOT analysis system of the CDC. Also investigated the legal, social, financial and economic, organizational and managerial prerequisites for the transition of the system of CDC on PPP guidelines and to identify risk factors. Next were allocated the basic premise of the restructuring, which are presented in table 2. Table 2 The basic premise to transfer municipal CDC guidelines on PPP • Lack of effective functional-organizational structure of CDC • The Community budget does not provide a decent content of CDC • Lack of technical, technological and financial position of the municipal CDC • Inefficient use of resources (financial, intellectual, etc.) • Weak preventive orientation in the activities of CDC • Absence of civilized market of services and programming to the consumer • The lack of competitiveness of services of municipal CDC • Low degree of investment attractiveness of CDC • Poor quality of medical services • Lack of economic motivation in personnel • Availability of legislative documents for legal regulation of PPP in health During the study there were examined the risks associated with putting the municipal CDC on the principles of public-private partnerships (table 3). Risk management is identifying events that may affect the project; definition according to the possible results of the project from the occurrence of the risk events; development strategy of risk management; planning, implementation and control measures associated with response to risks. On the basis of the analysis of activity of municipal CDC was derived a generalized organizational and management characteristic of OUR Kiev and made the following conclusion: the system of municipal CDC requires switching to PPP principles. 56 Table 3 The main groups of possible risks of transferring system of municipal CDC guidelines on PPP Financial risks -Insufficient volume of State/municipal funding. -The lack of money in the municipal budget to prepare for the implementation of the restructuring. -The presence of entrepreneurial and investment risks in private partners. Risks related to organization and management -The inadequacy of the legislative and regulatory framework for conducting reforms in the municipal sector, CDC -The inadequacy of the system of responsibility of the organs of municipal authorities for reforms in the system of outpatient medical care -Low level of priority for OUR system of local authorities -Lack of political will of the municipal authorities and the higher officer subject Administration on use of mechanisms of public-private partnership for the development of OUR Risks associated with neobìznanìstû and nepìdgotovlenìstû interest groups -Insufficient training of municipal CDC and lack of awareness of the population about the future of restructuring This transition will provide: • protection of the rights of participants in the process (the founders); • a clear delineation of responsibility administration districts of Kyiv and private legal entities in the activities with providing consultative-diagnostic assistance on the basis of PPP, • the Division of risks between the parties of the process on equal terms, one interest in long-term effective development institution; • the investment attractiveness of CDC; • create a system of contracting activity in the CDC and compliance with contractual obligations; • transparency of the financial and economic state of CDC for their participants (founders), investors, creditors; • establishment of an effective mechanism for the management of CDC; 57 • use in the work of OUR market mechanisms to attract financial resources; • improvement of professional skill of workers of CDC as one of the factors increasing the sustainability of development. Based on the analysis of the problems OUR system formulated recommendations that were practical material for the restructuring of CDC. A set of recommendations obtained in the process conducted by the research of the CDC, allowed to make the main conclusion that in modern economic conditions, there is a need to restructure municipal CDC and moving them to the principles of the PPP. The resulting material is allowed to formulate practical recommendations for carrying out restructuring of CDC and confirm that the main vector of development of the system of municipal CDC is the Organization of their work based on public/private sector partnership. Thus, the restructuring-management tool parameters of industrial and technological transformation in the activities of CDC, a tool of anti-crisis management and involves changing the structure of the CDC in order to its financial recovery. The changes that have come true in the process of restructuring, the table. 4. Table 4 Restructuring of CDC on PPP Changes Job restructuring 1 2 1. receipt of CDC status legally and economically independent of the Organization Internal changes: • organizational-legal structure • property and medico-technical complex • production complex • socio-organizational complex 2. development of the system of control of CDC with the PPP mechanism A new management organization • quality of production • business processes • information technology • financial flows 3 development of postačalnicko- sales policy Security: • the marketing strategy • possibility of influence on price segment of the market, compared with competitors • the impact of price as a criterion for purchase of services • monitoring of the operative information about the market 58 1 2 4. Justification of the industrial- technological and innovation policy Create a new business unit: • minimizing production costs • bringing quality products to the consumer requests • creation of an optimal system of support services • increase competitiveness on the basis of modern technologies of production • creation of a principally new departments and services 5. setting pricing and financial policy Strategy funding • setting prices for services within the policy of managing their sales with the aim of achieving the most profitable sales, average production costs for the maximum possible level of profit • analysis and planning of cash flows, the choice of strategy of attracting external resources-loans, a form of capital raising, development of accounting and tax policy, control and cost management. 6. determination of the investment policy Investment strategy -determination of the total investment of the enterprise, the ways of rational use of savings, the combination of various sources of financing, leveraged 7. The definition of personnel policy Human resources strategy -formation of the principles of personnel planning, attraction, selection and dismissal of workers, organization of work and management of personnel, training and preparation of employees of CDC, the introduction of a system to stimulate their activity, development social partnership 8. implementation of the resulting monitoring Continuous monitoring activity results The Organization of the modern model of CDC on the principles of public-private partnerships going Union potential partnership of State and private businesses in the equitable distribution of risks between the partners. Management of a conceptual model of the modern CDC on PPP moves from State to State and private legal form. Formed a new institutional structure of CDC, innovation-investment policy. Organizational-legal form of activity model of CDC on PPP acts as a public-private mechanism of interrelation between the economic interests of the State, private partners and OUR staff. Interests of the State are represented by a legal regulation of the production, the interests of private partners, the mechanisms of protection of property rights and improving the efficiency of management, the personnel in OUR organizational structure and methods 59 management, which provide sufficient guarantees of payment of labour and social protection of personnel. Model of CDC during the transition to the principles of PPP acquires the status of a legally and economically independent of the Organization, the Organization issued in integral commercial organism that has: organizational and legal structure (legal status, a certain organizational form, functional and hierarchical communication units); property – medico-technical complex (certain material unit and the relationship of ownership); production complex (certain activities, relationships, partners, customers, competitors, etc.); structured finance facility (capital investment and investors, lenders and borrowers, and etc.); staff-organizational complex (human resources structure, human resources management, training and retraining of personnel). Conceptually, the functionally-organizational structure model of CDC based on public-private partnerships must be submitted two sectors-municipal and commercial. Social services are provided within the public sector, and paid services, respectively, of the commercial. In correlation with factors of production developed their standards, "mixed economy of institution", which reflects the trend of combining the efforts of the public and commercial sectors, to ensure the needs of different segments of the population in one public- private of CDC. Each of the sectors is characterized by the synthetic and analytical indicators in the form of natural, cost and labour standards, which provide communication between sectors in the economic analysis. Simulation of cost-effective models of CDC stipulates economic components of its formation. Note the need for the implementation in practice of the model of separate rates for diagnostic services which can be outside of the finished case treatment, namely, laboratory, ultrasound, endoscopic, x-ray and other types of surveys that are carried out at the CDC. This will have a serious impact on OUR economy and the future integration of this sector into ISOS. Implementation of the proposals for changes in approaches to the formation of tariffs will increase competition, that will enhance the quality of medical services provided to the population. Conceptual model of CDC should have a multi-channel financing. Financing is carried out at the expense of the budget of municipal funds (agreements) for free guaranteed services 60 to the population, as well as the payment by the population of services at market prices and the funds from the voluntary medical insurance. The specifics of the model lies in the fact that: - communal and commercial form of the provision of medical services, even if identical characteristics, require modifications of the guidelines for each sector, and have their specific features, which depend on contingents; - model in General reflects the market demand on medical services in the commercial sector, and provides in the municipal sector, the volume of services in accordance with the concluded with the local administration of the agreement. Medical services in the new models have a public, social effect, and on the other hand, a certain contingent of the population in its desire to have the opportunity to get paid medical services. Model of CDC on PPP should be optimized. Methodological provision of optimization of management should be based on the general scientific methods, which include: - systematic approach-comprehensive study of the activities of the CDC for indicators work organization and preparedness to serve patients from the standpoint of system analysis; - method of analysis of causal connections using the data of the past and the detection of underlying patterns of development of the system, including the use of economic- mathematical calculations; - method of analysis of targeted actions and objective quantitative comparative evaluation of these actions to search for alternatives who aimed at rational modeling management. The CDC at the change of legal form on the basis of the implementation of the PPP you need to realize the value of human potential. Will be necessary to optimize the salaries of health workers, setting it below than in the leading sectors of the economy IE lay the coefficient of its increase in 2,5-3 times in comparison with the current level. Introduce the system of remuneration of medical personnel taking into account the volume and quality of care by introducing incentive allowances for qualitative performance of the work and the achievement of the established indicators of quality. To actualize the system of certification of medical personnel and harmonize this process with their certification. View labour standards of medical workers and their pay. 61 Expand the rights of the leaders of the CDC with personnel management, including its staff strength. Significantly improve the awareness of medical personnel about modern methods of diagnosis and treatment of diseases, including access to medical workers to electronic medical information resources. To optimize the activities of the diagnostic services by establishing modern diagnostic centres, on the basis of CDC and the creation of common laboratory centers. Laboratory centers at CDC need to equip automated diagnostic systems. Prices for medical care must also be attached to the above capabilities of CDC. Conceptual approaches to organization of consultative-diagnostic centers on PPP there are explanations for functionally-organizational model of CDC on PPP and obtained objective information has acted as a scientific basis for the development of measures to increase the efficiency of management. The CONCLUSIONS of the The concept of the development of consultative-diagnostic centers on the principles of PPP in the the article is presented in the form of three components: - methodology of restructuring as the totality of the methodological approaches to the comprehensive analysis of the current system of CDC; - the concept of restructuring of CDC-systems approach to the development of the object, its functions, structure, organization, and management on the principles of public- private partnerships; - study of organizational-economic formation model of CDC on PPP-like program development implementation of CDC. In the article conceptual approaches to organization of the modern model of the consultative-Diagnostic Center on the principles of public-private partnership is a way to adapt the system of municipal CDC to conditions of a market economy. Referances 1. Lekhan M. et al. ' in the strategy of development of the health care system: the Ukrainian dimension /M. Lekhan, G. A. Weak, M. V. Shevchenko//Ukraine. Health-2010.-n 1.-s. 5-23. 2. Orlova N. M. Regional health system: conceptual approaches to formation of its modern policy/ N. M. Orlova – К., 2010. – 184 s. 62 3. Kurdil N. Gosudarstvenno-častnoe partnership in pervičnoj medical sanitarnoj pomoŝi: predostavlenie services on based kontraktirovaniâ / N. Kurdil, A. G. Lutsenko//family medicine – 2014 – No. 3 p. 15 -18. 4. C ovremennaâ encyclopedy . Mode of access: https://dic.academic . ru/dic.nsf/enc1p/2390 5. Law Of Ukraine here is July 1, 2010, no. 2404-VI of the public-private partnership, as amended in accordance with the laws of the VVR 5007 N-VI (5007-17) from 21.06.2012, 16.10.2012. 6. Law of Ukraine of 24.11.2015 № 817-VIII "on amendments to certain laws of Ukraine regarding the removal of regulatory barriers to the development of public-private partnerships and stimulate investments in Ukraine" (Supreme Council (BD), 2016, # 10, Article 97) access mode: http://zakon2.rada.gov.ua/laws/show/817-19 https://www.microsofttranslator.com/bv.aspx?from=uk&to=en&a=http%3A%2F%2Fzakon0.rada.gov.ua%2Flaws%2Fshow%2F5007-17 https://www.microsofttranslator.com/bv.aspx?from=uk&to=en&a=http%3A%2F%2Fzakon2.rada.gov.ua%2Flaws%2Fshow%2F817-19