Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot30810.32687/0869-866X-2020-28-3-438-443Научная статьяThe hospital-substituting technologies: condition and strategic tasks of their developmentKalininskayaA. A.akalininskya@ya.ruKonovalovO. E.-MerekinaM. D.-ShlyaferS. I.-SulkinaF. A.-N. A. Semashko National Research Institute of Public HealthThe Federal State Budget Institution “The Central Research Institute for Health Organization and Informatics” of Minzdrav of RussiaThe Federal State Autonomous Educational Institution of Higher Education “The Peoples' Friendship University of Russia” (RUDN University)1512202028343844306042021Copyright © 2020,2020The program of state guarantees of free medical care of citizens for 2019 and up to 2020-2021 plans to reduce volume of inpatient medical care through development of hospital-replacing technologies. The economic feasibility of hospital-replacing technologies is in significantly lower cost of medical services in a day hospital as compared with twenty-four hours hospital (UPC). However, the existing legislative framework and the lack of proactive financial mechanisms do not stimulate development of hospital-replacing technologies.The purpose of study is to analyze reporting data and results of SWOT analysis of rating of factors affecting introduction of day hospitals, On the basis of analysis the strategic objectives of development of hospital-replacing technologies are formed.The study applied statistical analysis, direct observation, sociological survey, SWOT analysis. The analysis was applied to data from forms of Federal statistical observation No. 14 and industrial statistical monitoring No. 14 for 2009-2018. Based on results of SWOT analysis, experts were interviewed by the heads of health care authorities and medical organizations regarding development of strategy of medical care of children with disabilities. The expert survey was carried out with health care managers in Moscow, the Moscow oblast, Orenburg, Chelyabinsk, Samara, Ivanovo, Ryazan oblasts and the Republic of North Ossetia-Alania.The analysis established that in 2018 the number of medical care organizations increased up to 6495, including medical institutions providing outpatient medical care (41.4%) and in-patient medical care (58.6 %).The analysis demonstrated that percentage of treated patients in day hospitals out of the total number of hospitalized patients (in hospitals was 29,1% in 2018, while in 2009 this percentage was significantly lower - 15,6%, which indicates the intensification of the use of the bed fund of the UPC, which to some extent is associated with increased development of hospital-replacing technologies.The results of SWOT analysis demonstrated that the strategic objectives of development of hospital-replacing technologies should be targeted to develop financial stability of health care, active position of the heads managers of health care institutions and medical organizations and introduction of innovations if needed.It is necessary to develop modern management methods, rational application of health care resources, implementation of economic incentives in all components of health care system, ensure functioning of the system, including effective contract.day hospitaltwenty-four-hour hospitalhospital-replacing technologiesmedical organizationsoutpatient and inpatient caredevelopment strategyдневной стационарстационар круглосуточного пребываниястационарзамещающие технологиимедицинские организации, оказывающие медицинскую помощь в амбулаторных и в стационарных условияхстратегия развития1.Карпов О. Э., Никитенко Д. Н. Фатеев С. А., Дьяченко П. С. Проектирование структуры коечного фонда медицинского центра с использованием информационных технологий. В кн.: Автоматизация процессов, цифровые и информационные технологии в управлении и клинической практике лечебного учреждения. М.: Деловой экспресс; 2016. C. 111-22.2.Новик И. И., Русенчик А. И., Седых А. И., Ясюля Т. В. Коечный фонд: сокращение или перепрофилирование? Вопросы организации информатизации здравоохранения. 2014;(1):63-7.3.The World Health Report 2008. Primary Health Care. Now more, then ever. Geneva: WHO; 2008.4.Payne S. M. Identifying and managing inappropriate hospital utilization: a policy synthesis. Health Serv. Res. 1987;22(5):709-69.5.Солодухин Д. П., Толмачев Н. Е. Изучение рационального использования коечного фонда в отделениях терапевтического профиля городских больниц. Медицина. 2013;(1):23-8.6.Дзуганов М. Д., Шабунова А. А., Калашников К. Н. Опыт постиндустриальных стран в реструктуризации медицинской помощи и уроки для России. Проблемы развития территории. 2016;82(2):65-81.7.Федоткина С. А., Карайланов М. Г., Русев И. Т. Рациональное использование стационарозамещающих технологий и форм оказания медицинской помощи. Вестник Санкт-Петербургского университета. Медицина. 2017;12(2):179-89.8.Черниенко Е. И., Волнухин А. В., Дробязко Н. А. Анализ эффективности стационарозамещающих технологий на примере многопрофильной поликлиники с отделением общей врачебной практики. Экономика здравоохранения. 2008;(1):36-40.9.Буракова Т. С. Должное качество при сокращении расходов (опыт работы дневного стационара НОКДЦ). Новосибирск: Новосибирская областная ассоциация врачей; 2009.10.Лебедев Н. Н., Решетников С. В., Шихметов А. Н., Решетников В. Н. Стационарозамещающие технологии в многопрофильном клинико-диагностическом центре. Стационарозамещающие технологии: Амбулаторная хирургия. 2017;(1-2):9-14.11.Чубирко М. И., Антоненков Ю. Е., Чубирко Ю. М. Новые формы оказания медицинской помощи в России и Воронежской области. Вестник новых медицинских технологий. 2018;(2):122-6.