STRATEGIC ANALYSIS OF THE STATE-PRIVATE PARTNERSHIP INSTITUTE IN THE HEALTHCARE

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STRATEGIC ANALYSIS OF THE STATE-PRIVATE PARTNERSHIPINSTITUTE IN THE HEALTHCARE. Pharmacy & Pharmacology.Pharmacy & Pharmacology V. 5 N 4, 2017STRATEGIC ANALYSIS OF THE STATEPRIVATE PARTNERSHIP INSTITUTE IN THE HEALTHCARE V.L. AdzhienkoPyatigorsk Medical and Pharmaceutical Institute ? branch of Volgograd StateMedical University, 11, Kalinin ave., Pyatigorsk, Russia, 357532Volgograd State Medical University, 1, Pavshikh Bortsov Sq.,Volgograd, Russia, 400066carrying out a strategic analysis, which is regarded as the performance of a corresponding management function that is perspective-oriented and has a high level of uncertainty. Strategic analysis involves researching the system of factors that determine the future state of the public-private partnership (PPP) in the development of health care. The strategic analysis of PPP in the healthcare sector as a complex study of positive and negative factors that may affect ciency of the development of the PPP institution in the development of the healthcare is under consideration in the article. A number of new components complementing the system of strategic analysis of PPPs in the healthcare were proposed, and generalizations and conclusions were made. of the research is to study the impact of the strategic analysis of PPPs in the sphere of healthcare on the formation of strategic directions for increasing the ciency of using the PPP institution in healthcare. In the process of achieving the research goal, methods of strategic and integrated economic analysis were used. In our strategic analysis of PPP in the healthcare, it was revealed that under the conditions of underfunding national economy, medical institutions based on PPPs are being established in order to modernize and improve the quality of public services. PPP is an effective mechanism for attracting long-term investments aimed at the development of the health sector. The results of our analysis of PPP in the sphere of Russian healthcare made it possible to reveal that at present there are more than 70 projects in the process of implementation, 61 projects are already under construction and operation. Within the framework of the PPP-implemented healthcare projects, it is planned to attract investments of 61 billion rubles, while the total amount of private investments in PPP projects reaches 57 billion rubles. This is the basis for the systematic use of PPP tools for modernizing the healthcare sector and improving the accessibility and The advantages of the application of the PPP strategic analysis in the sphere of healthcare is theincreased effectiveness of interaction between the state and private business as a special type of cooperation with a view to implementing long-term investment projects in the sphere of healthcare. One of the main functions of the PPP strategic analysis in the sphere of healthcare is working out measures to create conditions for the implementation of PPPs in the sphere of healthcare both at the federal and regional levels. strategic analysis, public-private partnership, concessions, healthcare outsourcing, investment projects, infrastructure facilitiesȼɜɟɞɟниɟЭкономикɚкɚкɫɮɟɪɚɜключɚɞɟяɬɟльноɫɬьчɟлоɜɟкɚпоɫɬоянноɪɚзɜиɜɚɟɬɫяэɜолюциониɪɭɟɬпɪоцɟɫɫɟɜозникɚюɬɮоɪмыɪɟɚлизɚцииинɜɟɫɬиционныɯпɪоɟкɬоɜОɫоɛɟнноɬɟɯкоɬоɪыɟимɟюɬɝоɫɭɞɚɪɫɬɜɚɬолькоэкономичɟɫкоɟɫоциɚльноɟзнɚчɟниɟЭкономикɚɊоɫɫииэɬомиɫключɟниɟȼнɟɞɪɟниɟɮоɪмɮинɚнɫиɪоɜɚнияɫоциɚльноэкономичɟɫкиɯпɪоɟкɬоɜɚкɬɭɚэкономикиɫɬɪɚныɬɚккɚкоɬɪɚɫлиɬɪɚɞиционнонɚɯоɞящиɟɫяɝоɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬиɬɪɟɛɭюɬзнɚчиɬɟльныɯзɚɬɪɚɬчɬоɜɫɟɝɞɚɫооɬɜɟɬɫɬɜɭɟɬɫоɫɬояɝоɫɭɞɚɪɫɬɜɟнноɝоɛюɞжɟɬɚɬɚкимоɬɪɚɫлямоɬноɫяɬɫяоɛɪɚзоɜɚниɟзɞɪɚɜооɯɪɚнɟниɟкоммɭнɚльноɟɯозяйɫɬɜоɬɪɚнɫпоɪɬɞоɪожноɟɯозяйɫɬɜоОɛъɟкɬыоɬноɫящиɟɫяɫɮɟɪɚмɯозяйɫɬɜɟннойɞɟяɬɟльноɫɬипɪиɜɚɬизиɪоɜɚныɜɫлɟɞɫɬɜиɟциɚльнойэкономичɟɫкойɫɬɪɚɬɟɝичɟɫкойзнɚчимоɫооɬɜɟɬɫɬɜɟннопɪиноɫиɬьЧɬоɛыɜопɪоɫнɟɞоɮинɚнɫиɪоɜɚнииɫɬɪɚɬɟɝичɟɫкиɜɚжныɯоɛъɟкɬоɜнɚɪоɞноɝоɯозяйɫɬɜɚмиɪоɜойэкономичɟɫкойпɪɚкɬикɟɫозɞɚюɬɫяɮоɪмыоɫноɜɟɝоɫɭɞɚɪɫɬɜɟнчɚɫɬноɝопɚɪɬнɟɪɫɬɜɚиɫɫлɟɞоɜɚнияяɜляɟɬɫяизɭчɟниɟɜлиянияɫɬɪɚɬɟɝичɟɫкоɝоɚнɚлизɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟɮоɪмиɪоɜɚниɟɫɬɪɚɬɟɝичɟɫкиɯнɚпɪɚɜлɟнийэɮɮɟкɬиɜноɫɬииɫпользоɜɚнияинɫɬиɬɭɬɚɫɮɟɪызɞɪɚɜооɯɪɚнɟнияɞоɫɬижɟниянɟоɛɯоɞимоɫлɟɞɭзɚɞɚчиИзɭчиɬьɫɬɪɚɬɟɝичɟɫкоɝоɚнɚлизɚɬɭɬɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияОпɪɟɞɟлиɬьэɬɚпыɫоɫɬɚɜляющиɟэлɟмɟнɬыɫɬɪɚɬɟɝичɟɫкоɝоɚнɚлизɚинɫɬиɬɭɬɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияȾɚɬьоцɟнкɭɜлиянияɮɚкɬоɪоɜɬɪɟннɟйɫɪɟɞызɞɪɚɜооɯɪɚнɟɊɚзɪɚɛоɬɚɬьɫɬɪɚɬɟɝичɟɫкиɟнɚпɪɚɜлɟнияɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныэɮɮɟкɬиɜноɫɬииɫпользоɜɚнияинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟнииМɚɬɟɪиɚлымɟɬоɞыПɪɟɞмɟɬиɫɫлɟɞоɜɚния ? ɮинɚнɫоɜоэкономичɟɫкиɟɜзɚимооɬношɟнияɝоɫɭɞɚɪɫɬɜɚчɚɫɬноɝоɛизнɟɫɚɪɟɚлизɚциипɪоɟкɬоɜɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияпɪоцɟɫɫɟпоɫɬɚɜзɚɞɚчиɫпользоɜɚнымɟɬоɞыɫɬɪɚɬɟɝичɟɫкоɝокомплɟкɫноɝоэкономичɟɫкоɝоɚнɚлизɚɪɚɫɫмоɬɪɟнииɜлиянияɮɚкɬоɪоɜɜнɭɬɪɟнɫɪɟɞыинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟниииɫпользоɜɚнпоɞɯоɞɚнɚлизɟноɪмɚɬиɜнопɪɚɜоɜыɯɚкɬоɜзɞɪɚɜооɯɪɚнɟнииɮоɪммоɞɟлɟйоɬɞɟльныɯинɫɬɪɭмɟнɬоɜзɚɪɭɛɟжныɯɫɬɪɚнɚɯɪоɫɫийɫкойпɪɚкɬикɟɊɟзɭльɬɚɬыоɛɫɭжɞɟниɟɫоɜɪɟмɟнномэɬɚпɟɫиɫɬɟмноɟɪɟɮоɪмиɪоɜɚниɟɪоɫɫийɫкоɝозɞɪɚɜооɯɪɚнɚпɪɚɜлɟнокɚчɟɫɬɜɚпɪɟɞоɫɬɚɜмɟɞицинɫкиɯоɫноɜɟɫɬɪɚɬɟɝичɟɫкоɝоɭпɪɚɜлɟнияоɬɪɚɫльюНɟɫмоɬɪяпɪоɜɟɞɟниɟмоɞɟɪзɞɪɚɜооɯɪɚнɟниякоɬоɪоɟпоɫлɟɞнɟɟоɫɭщɟɫɬɜлялоɫьɜɜɟɞɟнияɞополниɬɟльныɯиɫɬочникоɜɮинɚнɫиɪоɜɚнияɫоциɚльноɝоɫɬɪɚɯоɜɚнияпɪиɜлɟчɟнияɫɪɟɞɫɬɜпоɬɪɟɛиɬɟлɟймɟɞицинɫкиɯпɪоɛлɟмынизкойэкономичɟɫкойэɮɮɟкɬиɜноɫɬиɛюɞжɟɬнойɫɮɟɪызɞɪɚɜооɯɪɚнɟнияоɝɪɚничɟнноɫɬиоɛщɟɫɬɜɟнɪɟɫɭɪɫоɜпɪоɛлɟмɜойпɪɚкɬикɟиɫпользɭɟɬɫяинɫɬиɬɭɬɫооɬɜɟɬɫɬɜииположɟниямиɝоɫɭɞɚɪɫɬɜɟнɊоɫɫийɫкойɎɟɞɟɪɚциизɞɪɚɜооɯɪɚнɟния 2020 ɝоɞɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияяɜляɟɬɫяɜзɚимоɞɟйɫɬɜияɝоɫɭɞɚɪɫɬɜɟннойзɞɪɚɜооɯɪɚнɟнияНɟоɛɯоɞимоɪɚзɜиɜɚɬьɜɯожɞɟниɟоɛязɚɬɟльноɝомɟɞицинɫкоɝоɫɬɪɚɯоɜɚниямɟɞицинɫкиɯиɫпользоɜɚниɟконцɟɫɫионныɯɫоɝлɚшɟнийɬɚкжɟпɪиɜлɟɭпɪɚɜляющиɯкомпɚнийɭпɪɚɜлɟнияоɬɞɟльнымимɟɞицинɫкиɯɚнɚлиɬичɟɫкимпɪизнɚкɚм 2020 ɋɬɪɚɬɟɝичɟɫкийɚнɚлизпозɜоляɟɬɮɚкɬоокɚзыɜɚющиɟкɚкпозиɬиɜноɟɬɚкнɟɝɚɬиɜноɟɜлияниɟинɫɬиɬɭɬɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияОɫоɛɟнноɫɬипɪоцɟɫɫɚпɪоɜɟɞɟнияɬɚкоɝоɚнɚлизɚпɪɟɞɫɬɚɜлɟныɪиɫɭнкɟɫоɜɪɟмɟнномпонимɚнии ? эɬооɫоɛыйɫоɬɪɭɞничɟɫɬɜɚɝоɫɭɞɚɪɫɬɜɟнноɝочɚɫɬноɝоɫɟкɬоɪɟɚлизɚцииɞолɝоɫɪочноɝоинɜɟɫɬиционноɝопɪоɟкɬɚлокɚльномɪɟɝионɚльномнɚционɚльноммɟжɞɭнɚɪоɞноммɚɫшɬɚɛɚɯȻɭɪноɟмноɝооɛɪɚзныɯɮоɪмэкономикɟɫɬɪɚнпоɫлɟɞнɟɟɜиɜɚющиɯɫяɫɬɪɚншиɪокоɟɪɚɫпɪоɫɬɪɚнɟниɟɮоɪмɫɚмыɯоɬɪɚɫляɯэкономикипозɜоляюɬпɪɚкɬикоɜɚɬьɮоɪмɭɜзɚимоɞɟйɫɬɜияɝоɫɭɞɚɪɫɬɜɚɛизнɟɫɚкɚкɯɚɪɚкɬɟɪнɭючɟɪɬɭɪыночэкономикиɊиɫɭнокпɪоɜɟɞɟнияɫɬɪɚɬɟɝичɟɫкоɝоɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияPharmacy & Pharmacology V. 5 N 4, 2017ȽоɫɭɞɚɪɫɬɜонɟɫɟɬоɬɜɟɬɫɬɜɟнноɫɬьпɟɪɟɞɫɬɜомɛɟɫпɟɪɟɛойноɟоɛɟɫпɟчɟниɟпɭɛличнымиɛлɚоɛъяɫняɟɬɫяɫоɯɪɚнɟниюоɬɪɚɫлɟйпɪоизɜоɞɫɬɜɝоɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬичɚɫɬномɭпɪɟɞпɪинимɚɬɟльɫɬɜɭпɪиɫɭщимоɛильноɫɬьɜыɫокɚяэɮɮɟкɬиɜноɫɬьпользоɜɚнияɪɟɫɭɪɫоɜɫклонноɫɬьинноɜɚциямНɚкоплɟнныйнɚɫɬоящɟмɭɚɪɫɟнɚлɮоɪммɟɬоɞоɜпозɜоляɟɬɫоɯɪɚнɟнииɜɚжнɚционɚльныɯоɛъɟкɬоɜɝоɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬипɟɪɟɞɚɜɚɬьполномочийномɭɫɟкɬоɪɭИмɟюɬɫяɬɚкиɟɮɭнкциикɚкɫооɪɭжɟниɟэкɫплɭɚɬɚцияɫоɞɟɪжɚниɟоɛъɟкɬоɜпɪоизɜоɞɫɬɜɟннойɫоциɚльнойинɮɪɚɫɬɪɭкɬɭɪыɬɚкжɟɭпɪɚɜлɟниɟɌɚкимоɛɪɚзомɬɪɚɞиционноɝоɫɭɞɚɪɫɬɜɟннɭюɫɮɟɪɭэкономикипɪиɜноɫяɬɫяɫɜоɟɝоɪоɞɚɬоɜɚɪычɬоɫозɞɚɟɬэɮɮɟкɬиɜноɝоɮɭнкциониɪоɜɚнияɭкɚзɚнныɯоɛъɟкɬоɜопɬимɚльноɝоɭпɪɚɜлɟнияɪɚционɚльноɝоиɫпользоɜɚнияɪɟɫɭɪɫоɜȽоɫɭɞɚɪɫɬɜополɭчɚɟɬɜыɝоɞɭɭɜɟличɟнияɫɜязɚнныɯпɪоɟкɬомɛюɞжɟɬныɯɯоɞоɜɬɚкжɟкоɫɜɟнныɯэɮɮɟкɬоɜожиɜлɟнияконъюнкɬɭɪыɪоɫɬɚинɜɟɫɬиционнойпɪиɜлɟкɚɬɟльноɫɬиɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияэɬоɜзɚимоɜыɝоɞноɟɫоɬɪɭɞничɟɫɬɜоɝоɫɭɞɚɪɫɬɜɟннойɜлɚɫɬимɟɫɬноɝоɫɚмоɭпɪɚɜлɟниянɟкоммɟɪчɟɫкиɯпозɜоляющɟɟоɛɟɫпɟчиɬьэɮɮɟкɬиɜноɟɜыполнɟниɟзɚɞɚчпɭɛличпɪɚɜоɜыɯоɛɪɚзоɜɚнийɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияпɪиɜлɟчɟнияɪɟɫɭɪɫоɜɫозɞɚнияконɫɬɪɭкцииɭпɪɚɜлɟнияɫоɞɟɪжɚнияинɮɪɚɫɬɪɭкɬɭɪызɞɪɚɜооɯɪɚнɟнияпɪɟɞоɫɬɚɜлɟния [2]. Пɟɪɟɞɝоɫɭɞɚɪɫɬɜɟннопɚɪɬнɟɪɫɬɜомзɞɪɚɜооɯɪɚнɟнииɫɬоиɬзɚɞɚчɚ ? ɫɞɟлɚɬьмɟɞицинɫкɭюпомощьɛолɟɟɞоɫɬɭпнойиɫпользоɜɚниɟɫɭɪɫоɜзɞɪɚɜооɯɪɚнɟнияɛолɟɟэɮɮɟкɬиɜнымконцɟпциизɞɪɚɜооɯɪɚнɟнияɊоɫɫийɫкойɎɟɞɟɪɚции 2020 ɝоɞɚмоɞɟɪнизɚциязɞɪɚɜооɯɪɚнɟнɚзɜɚнɚоɞнойзɚɞɚчɝоɫɭɞɚɪɫɬɜɚзнɚчиɬɟльнɚялɟчɟɛнопɪоɮилɚкɬичɟɫкиɯпоɫɬɪоɟнɚМинзɞɪɚɜɚɊоɫɫии 32% ɛольниц 30% поликлиникɬɪɟɛɭюɬкɚпиɬɚльноɝоɪɟмонɬɚоɬɫɭɬɫɬɜɭюɬɝоɪячɟɟɜоɞоɫнɚɛжɟниɟɜоɞопɪоɜоɞɚɜɬономноɟэнɟɪɝооɛɟɫпɟчɟниɟ 57% оɛоɪɭɞоɜɚнияɮизичɟɫкимоɪɚльноɭɫɬɚɪɟломоɞɟɪнизɚцииɜɫɟɝоɛлижɚйшиɟɝоɞыɫɬɪɚнɟнɟоɛɯоɞимопоɫɬɪоиɬьоколоɛольниц [3]. ɫɬɪɚɬɟɝичɟɫкиɯзɚɞɚчнɭжныинɜɟɫɬицииɫɭммɭ 0,8?1,0 ɬɪлнɪɭɛлɟйзɞɪɚɜооɯɪɚнɟния 20% окɚзыɜɚюɬɫɮɟɪɚɯпоɬɟнциɚльноɜоɫɬɪɟɛоɜɚнныɯинɜɟɫɬоɪоɜɜозможнɚяɫɭммɚинɜɟɫɬицийɫоɫɬɚɜляɟɬмлɪɞɪɭɛлɟйПомимоэɬоɝоɫɭɛъɟкɬоɜинɜɟɫɬициипɪиɜлɟкɚюɬɫяɫɬɪоиɬɟльɫɬɜоэкɫплɭɚɬɚциюзɞɪɚɜооɯɪɚнɟнияколоɝичɟɫкиɯɞиɫпɚнɫɟɪоɜцɟнɬɪоɜɪɟɚɛилиɬɚцииɞиɚлизныɯпɟɪинɚɬɚльныɯцɟнɬɪоɜоɛъɟкинɮɪɚɫɬɪɭкɬɭɪыɫɭщɟɫɬɜɭɟɬплɚɬɟжɟɫпоɫоɛныйɫпɪоɫɫɬоɪоныпоɬɪɟɛиɬɟлɟйчɬоможɟɬɪоɜɚɬьɜозɜɪɚɬинɜɟɫɬицийПоɬɟнциɚлɞɚнноɝоɫɟɝмɟнɬɚинɜɟɫɬицийоцɟниɜɚɟɬɫяэкɫпɟɪɬɚми 50?70 млɪɞɪɭɛлɟйɮɟɞɟɪɚльныɯɝоɫɭɞɚɪɫɬɜɟнныɯзɞɪɚɜооɯɪɚнɟнияпɪɟɞɜɚɪиɬɟльнымоцɟнкɚмɬɟкɭщɚяпоɬɪɟɛноɫɬьинɜɟɫɬициɫоɫɬɚɜляɟɬɛолɟɟ 20 млɪɞɪɭɛлɟй 20 ɊɟшиɬьпɪоɛлɟмыможноиɫпользоɜɚниɟммɟɯɚнизмɚОɞнимɜɚжнɟйшиɯɮɚкɬоɪоɜɫɪɟɞыокɚзыɜɚющимɜлияниɟинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟниияɜляɟɬɫяноɪмɚɬиɜнопɪɚɜоɜоɟлиɪоɜɚниɟɌɚкɎɟɞɟɪɚльноɝозɚконɚ 13 июля 2015 ɝоɞɚ 224-ɝоɫɭɞɚɪɫɬɜɟнночɚɫɬномпɚɪɬнɟɪɫɬɜɟмɭниципɚльночɚɫɬномпɚɪɬнɟɪɫɬɜɟɊоɫɫийɫкойɎɟɞɟɪɚцииɜнɟɫɟнииизмɟнɟнийоɬɞɟльзɚконоɞɚɬɟльныɟɚкɬыɊоɫɫийɫкойɎɟɞɟɪɚции? [5] пɪɟɞɭɫмɚɬɪиɜɚɟɬɫозɞɚниɟмоɞɟɪнизɚциюоɛъɟкɬоɜмɟɞицинɫкойинɮɪɚɫɬɪɭкɬɭɪыинɜɟɫɬокɚчɟɫɬɜɚпɪɟɞоɫɬɚɜляɟмыɯнɚɫɟɞопɭɫкɚɟɬɫɬɚɬɭɫɫоɛɫɬɜɟнноɫɬиɫозɞɚɜɚɟмыɟɪɟконɫɬɪɭиɪɭɟмыɟоɛъɟкɬыɫɬɪɭкɬɭɪыинɜɟɫɬоɪоɛязɚноɛɟɫпɟчиɬьиɫпользоɜɚɫɬɪоɝоцɟлɟɜомɭнɚзнɚчɟниюзɚконɭпɭɛличнɚяɫɬоɪонɚможɟɬпɪинимɚɬьпɪоɟкɬɟчɟɪɟзпɪямоɟɫоɮинɚнɫиɪоɜɚпɪɟɞоɫɬɚɜляяɫɭɛɫиɞиюɪɟɚлизɚциюпɪоɟкɬɚɝоɫɭɞɚɪɫɬɜɟннɭюɬɚкжɟпɪинимɚɬьимɭщɟɫɬɜɟнноɟɬомпɪɟɞоɫɬɚɜляяɜоɞныɟлɟɫныɟɫозɞɚɜɚɟмооɛъɟкɬɚКɪомɟэɬоɝопɪɟɞɭɫмоɬɪɟнмɟɯɚнизмɫоɯɪɚнɟниязɚключɚɟмоɝоконɬɪɚкɬɚȼмɟɫɬɟпоɞɝоɬоɜкойзɚконɚпɪоɜоɞилɚɫьɛоɬкɚконцɟɫɫионноɝозɚконоɞɚɬɟльɫɬɜɚиюлɟ 2014 ɝоɞɚɎɟɞɟɪɚльныйзɚкон 265-ɜнɟɫɟизмɟнɟнийɎɟɞɟɪɚльныйзɚконконцɟɫɫионɫоɝлɚшɟнияɯоɬɞɟльныɟзɚконоɞɚɬɟльныɟɚкɬыɊоɫɫийɫкойɎɟɞɟɪɚции 265-ȼ ɪɟзɭльɬɚɬɟɜнɟɞɪɟнɯɚнизминициɚɬиɜыпозɜоляющийɫокɪɚɬиɬьзɚключɟнияконцɟɫɫионноɝоɫоɝлɚшɟния 12 мɟɫяцɟɜпɪоɜɟɞɟнияконкɭɪɫɚ 150 50 ɟɫликонкɭɪɫпɪоɜоɞиɬɫяЗɚконɝɚɪɚнɬиɪɭɟɬокɭпɚɟмоɫɬьинɜɟɫɬицийконцɟɫɫионɟɪɚполɭчɟниɟɜыɪɭчкипɪɟɞɭɫмоɬɪɟннойконцɟɫɫионнымɫоɝлɚшɟпɪɟɞоɫɬɚɜляɟɬпɪɟимɭщɟɫɬɜɟнноɟпɪɚɜоɜыкɭпɚконцɟɫɫионɟɪомоɛъɟкɬɚконцɟɫɫионноɝоɫоɝлɚшɟнияɎɚкɬоɪомɜнɭɬɪɟннɟйɫɪɟɞыокɚзыɜɚющимпоɫɪɟɞɫɬɜɟнноɟɜлияниɟинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟниияɜляɟɬɫяиɫпользоɜɚниɟɮоɪммоɞɟлɟйоɛщɟпɪиняɬойɜɫɟмиɪнойпɪɚкɬикɟɞɜɟɮоɪмыɫоɬɪɭɞничɟɫɬɜɚконɬɪɚкɬнɚяинɫɬиɬɭционɚльнɚяИнɫɬиɬɭционɚльнɚяɮоɪмɚпɪɟɞполɚɫозɞɚниɟɫоɜмɟɫɬныɯпɪɟɞпɪияɬийɝоɫɭɞɚɪɫɬɜɚɛизнɟɫɚКонɬɪɚкɬнɚяɮоɪмɚɫɬɪɚɬɟɝичɟɫкоɝопɚɪɬнɟɪɫɬɜɚ ? эɬозɚключɟниɟконɬɪɚкɬɚɜыполнɟниɟопɪɟɞɟлɟнныɯɮɭнкцийоɬноɫиɬɟльнооɛъɟкɬɚзɞɪɚɜооɯɪɚнɟнияɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныɌɚɛлицɚɎоɪмыɫоɬɪɭɞничɟɫɬɜɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияИнɫɬиɬɭционɚльнɚяКонɬɪɚкɬнɚяɋозɞɚниɟноɜоймɟɞицинɫкойɫоɜмɟɫɬнымɝоɫɭɞɚɪɫɬɜɚɛизнɟɫɚɝоɫɭɞɚɪɫɬɜɟнныɟкоɪпоɪɚцииКонцɟɫɫияконцɟɫɫийпɪɚɜомпɟɪɟɞɚчиɛɟзпɪɚɜɚпɟɪɟɞɚчимɟɞицинɫкойчɚɫɬномɭпɚɪɬнɟɪɭɋозɞɚниɟнɟкоммɟɪчɟɫкойɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɫоɜмɟɫɬныɟпɪɟɞпɪияɬияɯолɞинɬɪɚɫɬыɝоɫɭɞɚɪɫɬɜɟннойɞолɟйКонɬɪɚкɬныɟɮоɪмыɜключɚяимɭщɟɫɬɜɚɝоɫɭɞɚɪɫɬɜɟнныйзɚкɚззɚкɚзпоɫɬɚɜкɭпɪоɞɭкцииɝоɫɭɞɚɪɫɬɜɟнныɯнɭжɞɋозɞɚниɟɭпɪɚɜляющɟйкомпɚнииɪɟɚлизɚцииɭпɪɚɜлɟнияпɪоɟкɬɚмиɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияКонɬɪɚкɬыɝоɫɭɞɚɪɫɬɜɟннымɪɚɛоɬɚмɮинɚнɫиɪɭɟмыɟɫɟкɬоɪомПɟɪɟɞɚчɚкомпɚнииɞолиɝоɫɭɞɚɪɫɬɜɟнноймɟɞицинɫкойɬомпɪиɜɚɬизɚцияɚкциониɪоɜɚниɟКонɬɪɚкɬныɟɮоɪмыкɜɚзиɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɞоɝоɜоɪокɚзɚниɟмɟɞицинɫкиɯɞоɝоɜоɪɫоɬɪɭɞничɟɫɬɜɟɞоɝоɜоɪɜыполнɟниɟɜɫпомоɝɚɬɟльныɯɮɭнкциймɟɞицинɫкойɚɭɬɫоɪɫинɝɪɟзɭльɬɚɬɚмɚнɚлизɚмоɞɟлɟйɝоɫɭɞɚɪɫɬɜɟнчɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɫооɬɜɟɬɫɬɜиинɚɪоɞнойклɚɫɫиɮикɚциɟйɬɚɛлзɞɪɚɜооɯɊоɫɫийɫкойɎɟɞɟɪɚцииɪɟкомɟнɞɭɟɬɫяиɫпользоɜɚɬьпɪиɜɟɞɟнныɟмоɞɟликонɬɪɚкɬнойɮоɪмыɫɭщɟɫɬɜɭющиɯконɬɪɚкɬныɯɮоɪмɫоɬɪɭɞничɟɫɬɜɚнɚиɛольшɟɟɪɚɫпɪоɫɬɪɚнɟниɟинɮɪɚɫɬɪɭкɬɭɪныɯоɬɪɚɫляɯɫоциɚльнойɫɮɟɪɟɬомзɞɪɚɜооɯɪɚнɟнииɝɞɟнɟоɛɯоɞимыпɪиɬокинɜɟɫɬицийɜыɫококɜɚлиɮициɪоɜɚнноɟɭпɪɚɜлɟполɭчиликонцɟɫɫииКонцɟɫɫияконцɟɫɫионноɟɫоɝлɚшɟниɟиɮичɟɫкɚяɮоɪмɚоɬношɟнийɝоɫɭɞɚɪɫɬɜомпɚɪɬнɟɪомоɫоɛɟнноɫɬькоɬоɪойɫоɫɬоɬомчɬоɝоɫɭɞɚɪɫɬɜоɫɭɛъɟкɬпɚльноɟоɛɪɚзоɜɚниɟɪɚмкɚɯпɚɪɬнɟɪɫкиɯоɬнооɫɬɚɜɚяɫьполнопɪɚɜнымɫоɛɫɬɜɟнникомимɭщɟɫɬɜɚɫоɫɬɚɜляющɟɝопɪɟɞмɟɬɫоɝлɚшɟнияɭполномочиɜɚɟɬчɚɫɬноɝопɚɪɬнɟɪɚɜыполняɬьоɝоɜɚɪиɜɚɟмыɟɫоɝлɚшɟнииɮɭнкцииɟɝоɫооɬɜɟɬɫɬɜɭющимиполномочиямипользоɜɚниɟɝоɫɭɞɚɪɫɬɜɟнноймɭниципɚльнойɫоɛɫɬɜɟнноконцɟɫɫионɟɪɜноɫиɬплɚɬɭоɝоɜоɪɟнныɯконцɟɫɫионномɫоɝлɚшɟнииПɪɚɜоɫоɛɫɬɜɟнноɫɬиокɚзɚнныɟконцɟɫɫиипɟɪɟɞɚɟɬɫяконцɟɫɫионɟɪɭɪɚмкɚɯконцɟɫɫииɝоɫɭɞɚɪɫɬɜоɜɫɟɝояɜляɟɬɫяоɪɝɚномпɭɛличнойɜлɚɫɬиэɬомкɚчɟɫɬɜɟпɪоɫɬопɪɟɞоɫɬɚɜляɟɬпɚɪɬнɟɪɚмɫоɝлɚшɟɫɜоиɯполномочийкɚкɫоɛɫɬɜɟнникɚɞɟлɟɝиɪɭɟɬɫɜоиɯɜлɚɫɬныɯɮɭнкцийключиɬɟльныɯɫɭɜɟɪɟнныɯИɫключиɬɟльноɫɬьɫɭɜɟɪɟнноɫɬьɯɚɪɚкɬɟɪиɫɬикпɪɟɞоɫɬɚɜляɟɝоɫɭɞɚɪɫɬɜомконцɟɫɫионɟɪɭчɚɫɬномɭпɚɪɬнɟзɚключɚɟɬɫяɬомчɬоɪɚмкɚɯкоɬоɪыйполɭчɚɟɬиɫключиɬɟльноɟпɪɚɜоɞопɭɫкɚɟɬɫяɚнɚлоɝичнɚяɞɟяɬɟльноɫɬьɬɪɟɬьиɯɬɚкжɟɫɚмоɝоɝоɫɭɞɚɪɫɬɜɚИɫɬочникиɮинɚнɫиɪоɜɚнияконцɟɫɫииможноизоɛɪɚзиɬьɫлɟɞɭющɟйɫɯɟмыȺнɚлизноɪмɚɬиɜнопɪɚɜоɜыɯɚкɬоɜпозɜоɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɬɪиконцɟɫɫийɫɭщɟɫɬɜɭющиɟоɛъɟкɬызɞɪɚɜооɯɪɚнɟнияɫɬɪоиɬɟльɫɬɜомоɞɟɪнизɚциюоɛъɟкɬоɜзɞɪɚɜооɯɪɚнɟнияпɟɪɟɞɚчɭоɛъɟкɬоɜɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬиɭпɪɚɜлɟниɟɭпɪɚɜляющɟйкомпɚнииɌɚккɚкɊоɫɫииɞɟйɫɬɜɭɟɬзɚконконцɟɫɫионныɯɫоɝлɚшɟнияɯɬоɪоɝоɫɬɚлооɫноɜойиɫпользоɜɚниямɟɯɚнизмоɜцɟлɟɫооɛɪɚзноɫиɫɬɟмɚɬизиɪоɜɚɬьоɛязɚɬɟльɫɬɜɚкɚжɞойɫɬоɪон ? концɟɞɟнɬɚконцɟɫɫионɟɪɚȺнɚлиззɚɪɭɛɟжноɝоопыɬɚиɫпользоɜɚнияɯɚнизмɚяɜляɟɬɫянɟоɬъɟмлɟмойɫоɫɬɚɜляющɟйɜлиянияɮɚкɬоɪоɜзɞɪɚɜооɯɪɚнɟнииɫɬɪɚнɚɯпɪоиɫɯоɞиɬɟɫлиȼɟликоɛɪиɬɚнииȽɟɪмɚнииɞоɫɬɚɬочноɫɮоɪмиɪоɜɚнɞɪɭɝиɟɫɬɪɚныɬольконɚчɚлиɪɚзɜиɜɚɬьɬɚкоɝоɪоɞɚпɚɪɬнɟɪɫɬɜɚɚнɚлизмɟжɞɭнɚɪоɞныɯпɪɚкɬикɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɪɚɫɜиɞɟɬɟльɫɬɜɭɟɬɪоɫɬɟэɮɮɟкɬиɜноɫɬижɟнииɫɬоимоɫɬилɟчɟнияɭɜɟличɟнииоɛъɟмɚэкономииɝоɫɭɞɚɪɫɬɜɟнныɯɪɟɫɭɪɫоɜɫɪɟɞнɟмЛиɞɟɪоммɟɞицинɟɜыɫɬɭпɚɟɬȼɟликоɛɪиɬɚния 1992 ɝоɞɚ 2014 ɞоляȼɟликоɛɪиɬɚнииоɛщɟɟɜɪопɟйɫкомколичɟɫɬɜɟпɪоɟкɬоɜɫоɫɬɚɜилɚ 67%, ɫɬоимоɫɬи ? 53%. оɛъɟмɟзɞɪɚɜооɯɪɚнɟниизɚнимɚɟɬ20%. Ƚоɫɭɞɚɪɫɬɜɟнночɚɫɬноɟпɚɪɬнɟɪɫɬɜозɞɪɚɜооɯȼɟликоɛɪиɬɚнииɪɚзɜиɜɚɟɬɫяɞɜɭɯнɚпɪɚɜ ? ɫɬɪоиɬɟльɫɬɜоɪɟконɫɬɪɭкцияоɫноɜныɯоɬɪɚɫлипɪɟɞоɫɬɚɜлɟниɟмɟɞицинɫкиɯ 1992 ɝоɞɭПɪɚɜиɬɟльɫɬɜоȼɟликоɛɪиɬɚниипɪɟɞɫɬɚɜилоɮинɚнɫоɜɭюинициɚɬиɜɭкɚкнɚиɛолɟɟэɮɮɟкɬиɜнɭюɮоɪмɭпɚɪɬнɟɪɫɬɜɚпɭɛличныɯɋɭɬьɬɚкойɛɪиɬɚнɫкойɮоɪмыɫоɫɬоялɚпɪиɜлɟчɟнииинɜɟɫɬɪоиɬɟльɫɬɜɚкɪɭпныɯɝоɫɭɞɚɪɫɬɜɟнныɯоɛъɟкɬоɜзɞɪɚɜооɯɪɚнɟниикоɝɞɚɛизнɟɫоɫɭщɟɫɬɜляɟɬɫɬɪоиɬɟльɫɬɜоɝоɫɭɞɚɪɫɬɜɟнноɝооɛъɟкɬɚɫчɟɬɫоɛɫɬɜɟнныɯɫɪɟɞɫɬɜPharmacy & Pharmacology V. 5 N 4, 2017ИɋɌОЧНИКИɎИНȺНɋИɊОȼȺНИЯȼнɟɛюɞжɟɬныɟɮонɞыȻюɞжɟɬЗɚɟмныɟɫɪɟɞɫɬɜɚ-60%)Пɪиɛыльоɬэкɫплɭɚɬɚцииипɪочиɟɞоɯоɞыɋоɛɫɬɜɟнныɟɫɪɟɞɫɬɜɚɞоɋɪɟɞɫɬɜɚконцɟɞɟнɬɚ(0-30%)ɋɪɟɞɫɬɜɚконцɟɫɫионɟɪɚ(30-100%)КонцɟɫɫионноɟɫоɝлɚшɟниɟКонцɟɫɫионноɟɫоɝлɚшɟниɟɎинɚнɫоɜыɟоɛязɚɬɟльɫɬɜɚконцɟɫɫионɟɪɚȺɪɟнɞнɚяплɚɬɚИнɜɟɫɬицииɜɫɬɪоиɬɟльɫɬɜоПлɚɬɚзɚконцɟɫɫиюɎинɚнɫоɜыɟоɛязɚɬɟльɫɬɜɚконцɟɞɟнɬɚɎинɚнɫиɪоɜɚниɟɫɬɪоиɬɟльɫɬɜɚɎинɚнɫиɪоɜɚниɟэкɫплɭɚɬɚции ɊиɫɭнокɎинɚнɫиɪоɜɚнияконцɟɫɫионноɝоɫоɝлɚшɟнияɊиɫɭнокɎинɚнɫоɜыɟоɛязɚɬɟльɫɬɜɚɭчɚɫɬникоɜконцɟɫɫионноɝоɫоɝлɚшɟнияɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныȽоɫɭɞɚɪɫɬɜɟнночɚɫɬноɟпɚɪɬнɟɪɫɬɜозɞɪɚɜооɯȼɟликоɛɪиɬɚнииɪɚзɜиɜɚɟɬɫяɞɜɭɯнɚпɪɚɜ ? ɫɬɪоиɬɟльɫɬɜоɪɟконɫɬɪɭкцияоɫноɜныɯоɬɪɚɫлипɪɟɞоɫɬɚɜлɟниɟмɟɞицинɫкиɯ 1992 ɝоɞɭПɪɚɜиɬɟльɫɬɜоȼɟликоɛɪиɬɚниипɪɟɞɫɬɚɜилоɮинɚнɫоɜɭюинициɚɬиɜɭкɚкнɚиɛолɟɟэɮɮɟкɬиɜнɭюɮоɪмɭпɚɪɬнɟɪɫɬɜɚпɭɛличныɯɋɭɬьɬɚкойɛɪиɬɚнɫкойɮоɪмыɫоɫɬоялɚпɪиɜлɟчɟнииинɜɟɫɬɪоиɬɟльɫɬɜɚкɪɭпныɯɝоɫɭɞɚɪɫɬɜɟнныɯоɛъɟкɬоɜзɞɪɚɜооɯɪɚнɟниикоɝɞɚɛизнɟɫоɫɭщɟɫɬɜляɟɬɫɬɪоиɬɟльɫɬɜоɝоɫɭɞɚɪɫɬɜɟнноɝооɛъɟкɬɚɫчɟɬɫоɛɫɬɜɟнныɯɫɪɟɞɫɬɜКомпɟнɫɚцияɪɚɫɯоɞоɜчɚɫɬноɝоинɜɟɫɬоɪɚоɫɭщɟɫɬɜляɟɬɫяɜпоɫлɟɞɫɬɜииɫчɟɬɞоɯоɞоɜэкɫплɭɚɬɚцииɫчɟɬплɚɬɟжɟйɛюɞжɟɬɚɮинɚнɫоɜойинициɚɬиɜыинɜɟɫɬоɪпɪиɜлɟкɚɟɬɫяɞɚльнɟйшɟйэкɫплɭɚɬɚцииоɛъɟкɬɚɜплоɬьнɚймɚпɟɪɫонɚлɚȼɟликоɛɪиɬɚнииɫɬоимоɫɬьоɛъɟкɬоɜɮинɚнɫоɜойинициɚɬиɜыɬоɪɚяɬɚмяɜляɟɬɫяоɫноɜнойɮоɪмойзɞɪɚɜооɯɫоɫɬɚɜляɟɬɛолɟɟ 30 млɪɞɮɭнɬоɜɫɬɟɪлинɝоɜɛɪиɬɚнɫкоɝоПɪɚɜиɬɟльɫɬɜɚɬɚкиɟпɪоɟкɬыоɛɟɫпɟчиɜɚюɬэкономииɛюɞжɟɬɚɫɬɪɚныȽɟɪмɚнииɫɮɟɪɟɪɚɫпɪоɫɬɪɚнɟниɟпɪоɞɚжɚɝоɫɭɞɚɪɫɬɜɟнныɯинɜɟɫɬоɪɚмɜоличɟɫкɭюɫɭммɭоɛмɟноɛɟɫпɟчɟниɟɮикɫиɪоɜɚннойɫɭммыинɜɟɫɬицийоɛязɚɬɟльɫɬɜɚполнɟниюɝоɫɭɞɚɪɫɬɜɟнноɝозɚкɚзɚЭɬооɛɭɫлоɜилоɭɜɟличɟниɟɞолипоɫлɟɞниɟ 10 Шɜɟциизɚключɚюɬɫяɫоɝлɚшɟнияинɜɟɫɬоɪɚмиɭпɪɚɜлɟниɟɝоɫɭɞɚɪɫɬɜɟннымиɝоɫпиɬɚлямиоɫɭщɟɫɬɜлɟниɟɫкоɪоймɟɞицинɫкойпомощипɪɟɞоɫɬɚɜлɟниɟклиничɟɫкиɯɬоɪийпɪочиɯмɟɞɭɫлɭɝмомɟнɬɚɜнɟɞɪɟнияпɪоɞолжиɬɟльноɫɬьожиɞɚнияɞиɚɝноɫɬилɟчɟнияɫокɪɚɬилɚɫь 30%, ɫɬоимоɫɬьмɟɞɭɫлɭɝзнɚчиɬɟльноɪɟнɬɝɟнɫɬикɟ 50%, клиничɟɫкимлɚɛоɪɚɬоɪнымокɚзɚниюɫкоɪойпомощи 50%, ȼ Ⱥɜɫɬɪɚлииɝɞɟɫоɛɫɬɜɟнноɫɬьɪɟɞɚнооколо 50 ɝоɫпиɬɚлɟйɪɚɫпɪоɫɬɪɚнɟныɫоɝлɚинɜɟɫɬоɪɚмиокɚзɚниɟɫɬɪоиɬɟльɫɬɜɭɜлɚɞɟниюɭпɪɚɜлɟниюконɬɪɚкɬɚɫɪоком 15 ɜключɚюɬоɛязɚɬɟльɫɬɜɚоɛɫлɭжиɜɚɬьɜɫɟɯɮикɫиɪоɜɚннымɪɚɫцɟнкɚмоɫɭщɟɫɬɜляɬьконɬɪолькɚчɟɫɬɜомокɚзɚнияɞицинɫкойпомощиɪɟзɭльɬɚɬɟɜнɟɞɪɟнияинɫɬиɬɭзɚɬɪɚɬыɫɬɪоиɬɟльɫɬɜоɭпɚли 20%, количɟɫɬɜооɛɫлɭжиɜɚɟмыɯпɚциɟнɬоɜɪоɫло 30%, пɪоɞолжиɬɟльноɫɬьожиɞɚниялɟчɟнияɫокɪɚɬилɚɫь 30%, Эɬи пɪимɟɪы оɬɪɚжɚюɬ ? ɫɬɚноɜиɬɫяпɪиɜлɟкɚɬɟльнойɫɮɟɪойжɟниячɚɫɬноɝокɚпиɬɚлɚчɬооɛлɟɝчɚɟɬзɚɞɚчиɝоɫɭɞɚɪɫɬɜɚпользɭпоɬɪɟɛиɬɟляммɟɞицинɫкиɯɮоɪмиɪоɜɚнииоɬɟчɟɫɬɜɟннойɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɫлɟɞɭɟɬпɪинимɚɬьɜнимɚниɟɪɟɚлизɚциипɪоɟкɬоɜоɫноɜɟэɬомɫɬоиɬɜɚɬьчɬокɚжɞɚяɪɚɫɫмɚɬɪиɜɚɟмыɯɫɬɪɚноɛлɚɞɚɫоɛɫɬɜɟннойɫɬɪɭкɬɭɪойпɭɛличноɝоɭпɪɚɜлɟнияɬɚкжɟɫоɛɫɬɜɟннымопыɬомɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚпоэɬомɭкопиɪоɜɚниɟоɬɞɟльныɯэлɟмɟнɬоɜнɟɞооɬɟчɟɫɬɜɟннойɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚцɟломэлɟмɟнɬоɜчɚɫɬноɫɬинɟоɛɯоɞимоɬыɜɚɬьоɫоɛɟнноɫɬипɚɪɬнɟɪɫкиɯоɬношɟɮɟɞɟɪɚльномоɬɞɟльныɯɫɭɛъɟкɬоɜɊоɫɫийɫкойɎɟɞɟɪɚцииɪоɫɫийɫкойэкономикɟɟɫɬьɜозможноɫɬиключɚɬьконɬɪɚкɬыжизнɟнноɝоɫɬɪоиɬɟльɫɬɜɟɪɟконɫɬɪɭкцииоɛъɟкɬоɜзɞɪɚɜооɯɪɚнɟнияпɪиɜлɟкɚɬьɪоɫɫийɫкиɟзɚɪɭɛɟжныɟкомɭпɪɚɜлɟниюоɛъɟкɬɚмизɞɪɚɜооɯɪɚнɟнияɪɚмкɚɯконцɟɫɫииКɪомɟɬоɝоɟɫɬьинɜɟɫɬоɪыкоɬоɪыɟɝоɬоɜыɭчɚɫɬɜоɜɚɬьпɪоɟкɬɚɯɞоɯоɞноɫɬью 8-9%. ɛɟжомоɛъɟкɬызɞɪɚɜооɯɪɚнɟнияɫɬɪояɬɭпɪɚɜляюɬкɪɭпныɟмɟжɞɭнɚɪоɞныɟкомпɚэɬомоɫноɜныɟɫɪɟɞɫɬɜɚɜклɚɞыɜɚюɬпɪоɟкɬыинɜɟɫɬоɪыɝоɫɭɞɚɪɫɬɜоɜыɫɬɭпɚɟɬɝɚɪɚнɬомɫоɛлюɞɟнияɜɫɟɯɞоɝоɜоɪɟнноɫɬɟйɜозɜɪɚɬкɪɟɞиɬоɜɞоɯоɞноɫɬьпоɫɬɪоɟнныɯɜошɟɞшиɯэкɫплɭɚɬɚциюоɛъɟкɬоɜЭɬопозɜоляɟɬоɛɟɫпɟчиɬьнɚɫɟлɟниɟмɟɞицинɫкойпомощьюɬɚмɝɞɟɯɜɚɬɚɟɬɫɪɟɞɫɬɜɝоɫɭɞɚɪɫɬɜɚэкономичɟɫкойɬочкиɜыɝоɞɚнɟɫомнɟннɚɝоɫɭɞɚɪɫɬɜоɫɬɪоиɬɛолɟɟɞоɪожɟɫɟкɬоɪщɟɫɬɜɟннɚпоɬɪɟɛиɬɟлямɟɞицинɫкиɯ ? ɫможɟɬполɭчиɬьɛыɫɬɪɟɟɛолɟɟкɚчɟɫɬɜомконɟц 2016 ɝоɞɚзɞɪɚɜооɯɫɬɚɞияɯɮоɪмɚɬɟɝоɫɭɞɚɪɫɬɜɟнчɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɪɟɚлизоɜыɜɚлоɫьɛолɟɟпɪоɟкɬоɜɫɬɚɞииɫɬɪоиɬɟльɫɬɜɚэкɫплɭɚɬɚции ? 61 пɪоɟкɬɪɚмкɚɯɪɟɚлизɭɟмыɯпɪоɟкɬоɜзɞɪɚɜооɯɪɚнɟнииплɚниɪɭɟɬɫяɜлɟчьинɜɟɫɬицийɫɭммɭ 61 млɪɞɪɭɛлɟйоɛъɟминɜɟɫɬицийпɪоɟкɬɚɯɞоɫɬиɝɚ ? 57 млɪɞɪɭɛлɟйчɬоɫоɫɬɚɜляɟɬоколо 10% оɛщɟɝооɛъɟмɚинɜɟɫɬицийпɪоɟкɬɚɯɜɫɟɯоɬɪɚɫляɯ [4]. нɚɫɬоящɟɟпоɞɜɟɞомɫɬɜɟнныɯМинзɞɪɚɜɭɊоɫɫииɮɟɞɟɪɚльныɯɝоɫɭɞɚɪɫɬɜɟнныɯэɬɚпɚɯпоɞɝоɬоɜкинɚɯоɞяɬɫя 15 инɜɟɫɬиционныɯпɪоɟкɬоɜɬомɫозɞɚниɟмноɝопɪоɮильноɝоцɟнɬɪɚокɚзɚɚмɛɭлɚɬоɪнополиклиничɟɫкойпомощипользоɜɚниɟммɟɯɚнизмɚконцɟɫɫииМоɫкɜɟɫɬɪоиɬɟльɫɬɜоконɫɭльɬɚɬиɜноɞиɚɝноɫɬичɟɫкойполиклиникицɟнɬɪɚнɟɮɪолоɝииɞиɚлизɚзɚключɟнияинɜɟɫɬиционноɝоɞоɝоɜоɪɚ ? мɚɪɟоɮиɫноɝокомплɟкɫɚɪɚзмɟщɟклиничɟɫкиɯпоɞɪɚзɞɟлɟнийзɚключɟнияинɜɟɫɬиционноɝоɞоɝоɜоɪɚ ? ɫɬоɜɟɪɟконɫɬɪɭкцияɚɜɚɪийныɯзɞɚнийинɜɟɫɬиционноɝоɞоɝоɜоɪɚПɟɪмиɫозɞɚниɟмɟɞицинɫкоɝоцɟнɬɪɚɛɚзойиɫпользоɜɚниɟммɟɯɚнизмɚконцɟɫɫииПɟɪмиPharmacy & Pharmacology V. 5 N 4, 2017ɋɪɟɞиɫɭɛъɟкɬоɜкоɬоɪыɯэɮɮɟкɬиɜноиɫпользɭɟɬɫямɟɯɚнизмможноɊɟɫпɭɛликɭɌɚɬɚɪɫɬɚнНɚпɪимɟɪȺȼȺзɚключɟконцɟɫɫионноɟɫоɝлɚшɟниɟɪɟконɫɬɪɭкцииплɚниɪоɜɚнияɫɟмьиɪɟпɪоɞɭкцииɫɪоком 10 чɬопозɜолилоɪɟɫпɭɛликɟоɛɪɟɫɬиɫоɜɪɟмɟнноɟмɟɞицинɫкоɟкоɬоɪоɟɛɭɞɟɬзɚнимɚɬьɫяпɪоɛлɟмɚмиɫоɯɪɚнɟнияɜоɫɫɬɚноɜлɟнияɪɟпɪоɞɭкɬиɜноɝозɞоɪоɜьяКлиникɚмɟɞицины HD? зɚключɟно 5 концɟɫɫионныɯɫоɝлɚɫозɞɚнииэкɫплɭɚɬɚциицɟнɬɪоɜɚмɛɭлɚɬоɪноɝоɝɟмоɞиɚлизɚКɚзɚниНɚɛɟɪɟжныɯНижнɟкɚмɫкɟȻɭɝɭльмɟчɬопозɜолилооɛɟɫпɟчиɬьɞоɫɬɭпноɫɬьɞɚнноɝопомощинɚɫɟлɟнияɪɟɫпɭɛликиКɪомɟɬоɝоцɟнɬɪɚмɛɭлɚɬоɪноɝоɝɟмоɞиɚлизɚКɚзɚниɊоɫɫииɫɬɪɭкɬɭɪнымпɪоɟкɬомɫоциɚльнойɫɮɟɪɟкɚɯНɚционɚльнойɫɮɟɪɟинɮɪɚɫɬɪɭкɬɭɪыпоɫлɟɞниɟɝоɞымɟɞɭчɪɟжɞɟнияɫɬɪɚныполɭмноɝоɫоɜɪɟмɟнноɝооɛоɪɭɞоɜɚнияɬолькоэɬоɝооɛоɪɭɞоɜɚнияɪɚɛоɬɚюɬполнɭюɬомчɬоɯɜɚɬɚɟɬпоɞɝоɬоɜлɟнныɯкɚɞɪоɜчɟɝоцɟнɬɪыɭɫпɟɜɚюɬиɫпользоɜɚɬьɞɚжɟɝоɫɭɞɚɪɫɬɜомɫɪɟɞɫɬɜɚɜыɫокоɬɟɯнолоɝичнɭюмɟɞицинɫкɭюпомощьɌɚкпояɜилɫяпɪоɟкɬ ? оɛɪɚзоɜɚɬɟльныйцɟнɬɪмɟɞицинɬɟɯнолоɝийКɚзɚни 2008 ɝоɞɭЭɬооɛɪɚзоɜɚɬɟльныйцɟнɬɪɊɟɝионɚльныɟɜлɚɫɬипɪɟɞоɫɬɚɜилизɞɚниɟоɛɟɫпɟɟɝокɚпиɬɚльныйɚɞминиɫɬɪɚɬиɜнɭюпоɞɞɟɪжкɭȻизнɟɫɜложилɫɜойɬомпɪоɟкɬноɝоɭпɪɚɜлɟнияɫɟɛяɪɚɫɯоɞыȻюɞжɟɬцɟнɬɪɚ 15 ɞоллɪɚɫɫчиɬɚнЗɞɟɫьпɪоɯоɞяɬоɛɭчɟниɟɜɪɚчимɟɞɫɟɫɬɪыɚɞминиɫɬɪɚɬоɪыɪɚɛоɬыЦɟнɬɪɚпоɞɝоɬоɜлɟноɛолɟɟ 4000 ɜɪɚчɟй 73 ɪоɞоɜɛольшинɫɬɜɚоɛɭчɟниɟ ? 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2016 ɝоɞɚПɚллɚɫоɜɫкоммɭниципɚльномɪɚмкɚɯɪɟɚлизɚцииɝоɫɭɞɚɪɫɬɜɟнчɚɫɬноɝопɚɪɬнɟɪɫɬɜɚпɟɪɟɞɚнконцɟɫɫиюнɚɬоɪийЭльɬонИнɜɟɫɬоɪконкɭɪɫпɪɚɜозɚключɟнияконцɟɫɫионноɝоɫоɝлɚшɟнияоɫɭщɟɫɬɜиɬɫɬɪоиɬɟльɫɬɜоɫпɚльноɝокоɪпɭɫɚмɟɫɬплɚɜɚɬɟльноɝоɛɚɫɫɟйнɚОɛъɟмɜɟɫɬицийпɪоɟкɬɫоɫɬɚɜиɬ 850 ɪɭɛлɟйОɛъɟкɬпозɜолиɬокɚзыɜɚɬькɚчɟɫɬɜɟнныɟɞоɫɬɭпныɟɜɫɟɝонɚɫɟлɟнияШиɪокоɟɪɚɫпɪоɫɬɪɚнɟниɟполɭчилɚпɪɚкɬикɚиɫпользоɜɚнияконɬɪɚкɬныɯɮоɪмкɜɚзиɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɚключɟнияɞоɝоɜоɪоɜɜыполнɟниɟɜɫпомоɝɚɬɟльныɯɮɭнкциймɟɞицинɫкойɛизнɟɫомɚɭɬȼолɝоɝɪɚɞɫкойоɛлɚɫɬиɞɜɟɬɪɟɬищиɯɫяɪɚɫпоɪяжɟниизɞɪɚɜооɯɪɚнɟнияɚɜɬоɬɪɚнɫпоɪɬныɯɫɪɟɞɫɬɜполноɫɬьюОɫноɜɭɚɜɬопɚɪкɚмɚшинɋкоɪойпомощиȼолɝоɝɪɚɞɫкойоɛлɚɫɬиɫоɫɬɚɜляюɬɚɜɬомоɛилиȽɚзɟлькоɬоɪыɟɪɚɛоɬɟɫложныɯɞоɪожныɯȼолɝоɝɪɚɞɚɜыɯоɞяɬɫɬɪояɞɜɚɝоɞɚПɪиоɛɪɟɫɬикɚɪɟɬыɋкоɪойпомощиɫчɟɬɫɪɟɞɫɬɜɛюɞжɟɬɚоɛязɚɬɟльноɝомɟɞицинɫкоɝоɫɬɪɚɯоɜɚнияɜозможноɫɬиПокɭпкɚɬɪɚнɫпоɪɬнойɫпɟциɚлизиɪоɜɚнныɯкомпɚнийпозɜолилɚɪɚмкɚɯзɚключɟнныɯɞоɝоɜоɪоɜɚɜɬопɚɪкмикɪоɚɜɬоɛɭɫыоɪиɟнɬиɪоɜɚныɜɪɚчɟɛоɛщɟɝооɫнɚɜɫɟмнɟоɛɯоɞимыммɟɞицинɫкимоɛоɪɭɞоɜɚниɟɝоɫɬоимоɫɬьɫоɫɬɚɜляɟɬоколоɫɬоимоɫɬиɚɜɬомоɛиляɋиɫɬɟмɚклимɚɬконɬɪоляɫозɞɚɟɬкомɮоɪɬныɟпɟɪɟɜозимыɯɜɪɚчɟйɬоɜлюɛоɟɝоɞɚИнɜɟɫɬоɪ 95 ɚлизиɪоɜɚнныɯмикɪоɚɜɬоɛɭɫоɜɫɬоимоɫɬьинɜɟɫɬпɪоɟкɬɚ ? 1,5 млɪɞɪɭɛлɟйɚɜɬомоɛилиɞоɝоɜоɪɭȼолɝоɝɪɚɞполɭчилɜɬоɪомкɜɚɪɬɚлɟɝоɞɚɪɚɫплɚчиɜɚɬьɫяокɚзыɜɚɟмɭюɝоɫɭɞɚɪɫɬɜоɛɭɞɟɬпоɫлɟɞɭющиɟмɟɞɭчɪɟжɞɟнияɯɚкɬиɜноɪɚзɜиɜɚɟɬɚɭɬɫоɪɫинɝпиɬɚнияклининɝоɜыɯлоɬнымпɪоɟкɬомɫɬɚлɚоɛлɚɫɬнɚяклиничɟɫкɚяɛольницɚȺɭɬɫоɪɫинɝпиɬɚниязɜолилоɛлɚɫɬнойɛольницɟɫɭщɟɫɬɜɟнноэкономиɬьɫɪɟɞɫɬɜɚкоɬоɪыɟɬɪɚɬилиɫьоɛɟɫпɟчɟниɟɪɚɛоɬыпищɟɛлокɚпɪɚчɟчнойэɬомкɚчɟɫɬɜопиɬɚнияɜыɪоɫлочɬоположиɬɟльно 2016 ɝоɞɭ 39 68 кɪɭɝлоɫɭɬочныɯлɟчɟɛныɯɫɬɚционɚɪоɜпиɬɚɚɭɬɫоɪɫинɝɭ [11]. ȼыɝоɞыпɟɪɟɞɚчизɚɞɚчмɟɞицинɫкоɝозɚключɚюɬɫяɫɭщɟɫɬɜɟнномɫнижɟниикɚкнɚɝɪɭзкипɟɪɫонɚлɬɚкɛолɟɟэɮɮɟкɬиɜномɭпɪɚɜлɟниизɚɬɪɚɬɚмикɭпкɭпоɞɞɟɪжкɭоɛɫлɭжиɜɚниɟɫоɛɫɬɜɟнноɝооɛоɪɭɞоɜɚнияпɪоɝɪɚммноɝооɛɟɫпɟчɟнияконɟчномиɬоɝɟзɚкɚзчикизɛɚɜляɟɬɫяцɟлоɝоɛюɞжɟɬныɯɛлɟмэɬомɫɚмойɜɚжнойɬɟкɭщɟмэɬɚпɟпɟɪɟɯоɞɚноɜойɫɯɟмɟоɬношɟнийзɚɞɚчɟйɫɬɚнɟɬɜыɫɬɪɚиɜɚниɟɞоɜɟɪиɬɟльныɯоɬɜɟɬɫɬɜɟнныɯпоɞɪяɞчикомокɚзыɜɚющимɚɭɬɫоɪɫинɝɭКонцɟнɬɪиɪɭяɫьокɚзɚниинɟпоɫɪɟɞɫɬɜɟнномɟɞицинɫкиɯзɞɪɚɜооɯɪɚнɟниɟиɫпользɭɟɬɫɯɟɚɭɬɫоɪɫинɝɚɜɫɟɯпɪоцɟɫɫɚɯнɚпɪимɟɪɬɟɯничɟɫкоɟоɛɫлɭжиɜɚниɟмɟɞицинɫкоɝооɛоɪɭɞоɜɚнияпɪоɜɟɞɟниɟлɚɛоɪɚɬоɪныɯиɫɫлɟɞоɜɚɜыɜозɚнɚɬомичɟɫкиɯоɬɯоɞоɜпɪопɭɫкноɝоɪɟжимɚоɯɪɚнɚоɛɟɫпɟчɟниɟоɛщɟɫɬɜɟнноɝопоɪяɞкɚɬɟɪɪиɬоɪииɛольницɬɟɯничɟɫкоɟоɛɫлɭжиɜɚниɟɬɟɯнолоɝичɟɫкоɝооɛоɪɭɞоɜɚнияпищɟɛлокɚлиɮɬоɜɜоɞоɫнɚɛжɟниякɚнɚлизɚɫɬиɪкɚɛɟльяоɛɟɫпɟчɟниɟɝоɬоɜымпиɬɚниɟмȼмɟɫɬɟнɟоɛɯоɞимооɬмɟɬиɬьчɬоɬɪɚɞиционныɟшɚɛлонныɟнɚпɪɚɜɞɟяɬɟльноɫɬиɫɮɟɪɟзɞɪɚɜооɯɪɚнɟниякоɬозɚɞɟйɫɬɜоɜɚнпоɬɟнциɚлНɚпɪимɟɪмɚлоɜнимɚнияɭɞɟляɟɬɫяпɪоɛлɟмɟоɛɭчɟниякɚɞɪоɜɪɚɛоɬыноɜойɬɟɯникойɫɬɚнɞɚɪɬоɜпоɪяɞкоɜɬɟɯничɟɫкомɭɫопɪоɜожɞɟниюɮɭнкциониɪоɜɚниюмɟɞицинɫкойɬɟɯникиинɮоɪмɚционныɯɮоɪмɜозможноɫɬɟйɜзɚимоɞɟйɜлɚɫɬиɛизнɟɫɚпɪоɞолжɚɟɬɫяɋозɞɚюɬɫяпɪɚɜоɜыɟзɚключɟнияконɬɪɚкɬɚноɝоɜыполнɟниɟɪɚɛоɬпɪоɟкɬиɪоɜɚниюɫɬɪоиɬɟльɫɬɜɭоɛъɟкɬоɜɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɬɚкжɟинɜɟɫɬиционныɯɞоɝоɜоɪоɜоɬношɟнииɞɟɪɚльнойинɮɪɚɫɬɪɭкɬɭɪызɞɪɚɜооɯɪɚнɟнияОɞнɚкоɊоɫɫииɪɚзɜиɜɚɟɬɫяɬɚкимиɛыɫɬɪымикɚкзɚɪɭɛɟжныɯɫɬɪɚнɚɯэɬоможнооɛъяɫниɬьɫɭɛъɟкɬиɜнымиɮɚкɬоɪɚмипɪɚɜоɜойɯозяйɫɬɜɟннойкомпɟɬɟнɬноɫɬиɜлɚɫɬилоɛɛизмомоɬɞɟльныɯɝɪɭппинɫɬиɬɭɬоɜɝɪɚжɞɚнɫкоɝооɛщɟɫɬɜɚɟɫɬьоɛъɟкɬиɜныɟɬɚкиɟкɚкоɬɫɭɬɫɬɜиɟɊоɫɫиимоɞɟлиɭпɪɚɜлɟнияɝоɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬьюȽоɫɭɞɚɪɫɬɜоɞолжнокɚкэɬоɞɪɭɝиɯɫɬɪɚнɚɯпоɫɪɟɞɫɬɜомзɚконоɞɚɬɟльɫɬɜɚɜоɜыɯноɪмчɟɬкоɫɜоɟйоɬɜɟɬɫɬɜɟнноɫɬипɟɪɟɞоɛщɟɫɬɜомнɟɝоɫоɛɫɬɜɟнноɫɬьопɪɟɞɟлиɬьɮɟɞɟɪɚльноɝозɚконɚкɪɭɝоɛъɟкɬоɜпоɞлɟжɚщиɯпɪиɜɚɬизɚцииПɪɚɜоɜɚянɟяɫноɫɬьэɬомɜопɪоɫɟɫпоɫоɛɫɬɜɭɟɬкоɪɪɭпциипɪиɜоɞиɬпояɜлɟниюмонополиимɟɫɬɟɝоɫɭɞɚɪɫɬɜɟнноймонополииɜɫɟмипоɫлɟɞɫɬɜиямиɝоɫɭɞɚɪɫɬɜɚоɛщɟɫɬɜɚоɞнимɫɞɟɪжиɜɚющимɮɚкɬоɪомяɜляɟɬɫянɚличиɟɪиɫкоɜɪɟɚлизɚциипɪоɟкɬоɜɊɚзɞɟлɟниɟɪиɫкоɜɝоɫɭɞɚɪɫɬɜоминɜɟɫɬоɪомɞолжноɜключɚɬьɫяконцɟɫɫионноɝоконɬɪɚкɬɚɫоɫɬɚɜляɬьɟɝоэкономичɟɫкɭюоɫноɜɭɊɚɫпɪɟɞɟлɟниɟɪиɫкоɜɞолжнопɪоɜоɞиɬьɫяпɟɪɟɞɚчиɭмɟɟɬнɚиɛолɟɟэɮɮɟкɬиɜноɭпɪɚɜляɬьɪиɫкɚмиоɫноɜномзɚключɚɟɬɫяɞоɫɬижɟнииɫинɟɪɝɟɬичɟɫкоɝоэɮɮɟкɬɚпɚɪɬнɟɪɫɬɜɚпɪɚкɬикɟпоɬɟнциɚлɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟиɫпользɭɟɬɫяполнойОɞнойɝлɚɜныɯэɬоɝояɜляɟɬɫяоɬɫɭɬɫɬɜиɟɫɮоɪмиɪоɜɚннойɭпɪɚɜлɟнияɞɚнноɝоинɫɬиɬɭɬɚPharmacy & Pharmacology V. 5 N 4, 2017кɚкɮɟɞɟɪɚльномɬɚкɪɟɝионɚльномɋɬɪɚɬɟɝиюɫɭɛъɟкɬоɜмɭниципɚльныɯзоɜɚнийнɚɫɬоящɟɟɜключɟнпɪɚкɬичɟɫкийɮɭнкциониɪɭющиɯпɪоɟкɬоɜоɫноɜɟɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚмɟɯɚнизмыɜзɚимоɞɟйɫɬɜияɜлɚɫɬиɛизнɟɫɚцɟлɟɜоɝоɭпɪɚɜлɟнияɪоɜɚнияɭпɪɚɜлɟнияɪɟɚлизɚциɟйпɪоɟкɬоɜɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚЗɚɪɭɛɟжныйɬɚкжɟɞɪɭɝиɯнɟоɛɯоɞимоɮоɪмɚлизоɜɚɬьɫɬɪɚɬɟɝичɟɫкиɯɞокɭмɟнɬоɜкоɬоɪыɟɞолжɜключɚɬьɫоɜокɭпноɫɬьɮоɪммɟɬоɞоɜинɫɬɪɭмɟнɬоɜɭпɪɚɜлɟнияпɪоɟкɬɚмипɚɪɬнɟɪɫɬɜɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɊɚзɪɚɛоɬкɚɪɟɚлизɚцияɬɚкоɝомɟɯɚнизмɚɫозɞɚɫɬоɛъɟкɬиɜныɟпɪɟɞпоɫылкиɪиɫкоɜɛɭɞɟɬɫпоɫоɛɫɬɜоɜɚɬьпɪиɬокɭоɬɪɚɫльинɜɟɫɬиционныɯɪɟɫɭɪɫоɜɋлɟɞɭɟɬоɬмɟɬиɬьчɬоɛизнɟɫɜɫɬɭпɚяпɪоɟкɬыпɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɪɚнɟниизɚинɬɟɪɟɫоɜɚнɞолɝоɫɪочномɫɬɚɛильномɫоɬɪɭɞничɟɫɬɜɟкоɝɞɚизɜɟɫɬныɬиɪɭющиɟɜозɜɪɚɬɜложɟнныɯɫɪɟɞɫɬɜнɟоɛɯоɞимыйɭɪоɜɟньɞоɯоɞноɫɬиɜлɚɫɬинɟоɛɯоɞимоɭлɭчшɚɬьоɬкɪыɬыйɞиɚлоɝɛизнɟɫомнɚɯоɞиɬьмɟɯɚнизмыɫɬимɭлиɪоɜɚнияɫоциɚльнойоɬɜɟɬɫɬɜɟнноɫɬичɟɬкоопɪɟɞɟлиɬьполномочияɜлɚɫɬикоɬоɪыɟнɟɫɭɬоɬɜɟɬɫɬɜɟнноɫɬьɜɫɟɯэɬɚпɚɯпоɞɝоɬоɜкиɪɟɚлизɚцииɫоɜмɟɫɬныɯпɪоɟкɬоɜɪɟɝионɚльноммɟɫɬномɫɮоɪмиɪоɜɚɬьпɪоɟкɬоɜкоɬоɪыɟɪɟɚлизоɜɚныоɫноɜɟпɪоɜоɞиɬьмониɬоɪинɝэɮɮɟкɬиɜноɫɬиɪɟɚлизɚɫоɜмɟɫɬныɯпɪоɟкɬоɜоɛɟɫпɟчиɬьоɫɜɟщɟниɟɫɪɟɞɫɬɜɚɯмɚɫɫоɜойɮоɪмɚциипозиɬиɜноɝоопыɬɚэɬоɫɜоюочɟɪɟɞьможɟɬзɚинɬɟɪɟɫоɜɚɬьинɜɟɫɬоɪоɜоɪɝɚнизоɜɚɬьпоɞɯоɞоɛɭчɟниюɫпɟциɚлиɫɬоɜɮоɪмиɪоɜɚниякомɚнɞыэɮɮɟкɬиɜнойɪɟɚлизɚциипɪоɟкɬоɜКɪомɟɬоɝоɫɜязиоɫɬɪойɫоциɚльнойнɚпɪɚɜлɟнноɫɬьюɫɮɟɪыэкономикинɟɪɚзɜиɬоɫɬьюɪыночныɯмɟɯɚнизмоɜɯозяйɫɬɜоɜɚнияоɝɪомныммɚɫшɬɚɛомнɚкопиɜшиɯɫяоɬɪɚɫлипɪоɛлɟмɬɚкнɟɞоɫɬɚɬкомɛюɞжɟɬныɯɫɪɟɞɫɬɜɫоɛɫɬɜɟнныɯɪɟɫɭɪɫоɜɯозяйɫɬɜɭющиɯɫɭɛъɟкɬоɜɜозникɚɟɬнɟоɛɯоɞимоɫɬьɚкɬиɜнойɝоɫɭɞɚɪɫɬɜɟннойпоɞɞɟɪжкипɚɪɬнɟɪɫкиɯоɬношɟнийɜлɚɫɬиɛизнɟɫɚоɬɪɚɫлиɊɟɚлизɚцияɫоɝлɚшɟнийɝоɫɭɞɚɪɫɬɜɟннопɚɪɬнɟɪɫɬɜɚоɫложнɟннɚяɞлиɬɟльноɫɬьюɫоɝлɚɫоɜɚнияɞолɝоɫɪочнымɯɚɪɚкɬɟɪомɬɚкиɯпɪоɟкɬоɜɪиɫкоɜнɟɪɟɞконɟпɪɟɞɜиɞɟннымɯɚɪɚкɬɟɪомɬɪɟɛɭɟɬопɪɟɞɟлɟннопɪоɮɟɫɫионɚльноɝонɚɜыкоɜпɪоɟкɬноɝоɮинɚнɫиɪоɜɚниякоɬоɪымиɛольшинɫɬɜоɪɚɛоɬникоɜɜлɚɫɬиоɛлɚɞɚюɬɫɜязиɚкɬɭɚзɚɞɚчɚкɜɚлиɮициɪоɜɚнноɝоɫопɪоɜожɞɟнияпɪоɟкɬоɜɜɫɟɯɫɬɚɞияɯжизнɟнноɝоэɬомɮɭнкцииинɮоɪмɚционномɭконɫɭльɬɚционномɭмɟɬоɞичɟɫкомɭɫопɪоɜожɞɟниюпɪоɟкɬоɜпɚɪɬнɟɪɫɬɜɚцɟлɟɫооɛɪɚзноɜозложиɬьɫозɞɚнныɟɫɭɛъɟкɬɚɊоɫɫийɫкойɎɟɞɟɪɚКоɪпоɪɚцииɞɟйɫɬɜɭющиɟкɚчɟɫɬɜɟнɟкоммɟɪчɟɫкой 5 N 4, 2017Оɫноɜными цɟлями КоɪпоɪɚциияɜляюɬɫяпоɫɬоянноɝоɜзɚимоɞɟйɫɬɜиякɪɭпнɟйшимиинɫɬиɬɭɬɚмиполɭчɟниɟмɟɬоɞичɟɫкойпоɞɞɟɪжкиинɫɬиɬɭɬоɜɮɟɞɟɪɚльноɝооɫɭщɟɫɬɜлɟниɟɜзɚимоɞɟйɫɬɜияɯозяйɫɬɜɭюɫɭɛъɟкɬɚмииɫполниɬɟльнойɜлɚɫɬипɪоцɟɫɫɟɫɛоɪɚинɮоɪмɚциипоɞɝоɬоɜɫопɪоɜожɞɟнияпɪоɟкɬоɜокɚзɚниɟмɟɬоɞичɟɫкойпоɞɯозяйɫɬɜɭющимɫɭɛъɟкɬɚмпɪоцɟɫɫɟɪɟɚлизɚциипɪоɟкɬоɜɮинɚнɫиɪоɜɚнияинɮɪɚɫɬɪɭкɬɭɪпɪоɟкɬоɜоɛɪɚзоɜɚниɟɝɪɭппинɜɟɫɬоɪоɜɫоɝлɚɫоɜɚниɟинɬɟɪɟɫоɜɫозɞɚниɟɛлɚɝопɪиɫɪɟɞыколлɟкɬиɜныɯинɜɟɫɬицийɮɟɞɟɪɚльныɯɪɟɝионɚльныɯципɚльныɯинɫɬɪɭмɟнɬоɜпɪоцɟɫɫɟɪɟɚликɪɭпныɯинɜɟɫɬиционныɯпɪоɟкɬоɜɌɚкимоɛɪɚзомɜɚжнɟйшимɫɬɪɚɬɟɝичɟɫкимпɪɚɜлɟниɟминɫɬиɬɭɬɚзɞɪɚɜооɯɪɚяɜляɟɬɫяɚɞɚпɬɚцияɭɫпɟшноɝозɚɪɭɛɟжноɝооɬɟчɟɫɬɜɟнноɝоопыɬɚɪоɫɫийɫкойɬɟльноɫɬичɬопɪɟɞполɚɝɚɟɬнɟоɛɯоɞимоɫɬьɫозɞɚэɬоɝоɛлɚɝопɪияɬныɯпɪɚɜоɜыɯинɫɬиɬɭционɚльныɯэɬоɝоɬɪɟɛɭɟɬɫяноɪмɚɬиɜнопɪɚɜоɜойцɟлоɝопоɞзɚконныɯɚкɬоɜɪɟɝлɚмɟнɬиɪɭпɚɪɬнɟɪɫкиɟоɬношɟнияɜлɚɫɬиɛизнɟɫɚɫозɞɚниɟинɫɬиɬɭɬɚпɚɪɬнɟɪɫɬɜɚкомплɟкɫныɯинɫɬɪɭмɟнɬоɜпоɞɞɟɪжкиноɝоинɜɟɫɬоɪɚпɪиɜлɟчɟнияɪɟɫɭɪɫоɜɪɟɚлизɚцииɫоɜмɟɫɬныɯпɪоɟкɬоɜɪɚзɪɚɛоɬкɚпɪɚкɬичɟɫкиɯɞокɭмɟнɬоɜоɬкɪыɬыɯпɪоɟкɬоɜчɬопозɜолиɬɬиɪɚжиɪоɜɚɬьɫозɞɚниɟɫɬɪɭкɬɭɪинɫɬиɬɭɬоɜоɫноɜзɚɞɚчɟйкоɬоɪыɯяɜляɟɬɫяɜɫɟɫɬоɪонняяпоɞɞɟɪжкɚпɪоɟкɬоɜпɚɪɬнɟɪɫɬɜɚɪолиинɫɬиɬɭɬоɜɝɪɚжɞɚнɫкоɝощɟɫɬɜɚпɪоɟкɬɚɯпɚɪɬнɟɪɫɬɜɚпɪиɜлɟчɟниɟɪɟɚлизɚцииɜɫɟɯзɚинɬɟɪɟɫоɜɚнныɯɫɬоɪонɌолькоэɬомɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɟпɚɪɬнɟɪɫɬɜоɫɬɚнɟɬэɮɮɟкɬиɜныминɫɬɪɭмɟнɬомзɞɪɚɜооɯɪɚнɟнияɊɟɚлизɚциякомплɟкɫɚɜышɟпɟɪɟчиɫлɟнныɯпозɜолиɬэɮɮɟкɬиɜноɫɬьɫɮɟɪойзɞɪɚɜооɯɪɚнɟнияɭɫɬɪɚниɬьинɜɟɫɬиɝолоɞнɚкопиɜшиɟɫяпɪоɛлɟмымɟɯɚнизмоɜпɚɪɬнɟɪɫɬɜɚɜлɚɫɬиɛизнɟɫɚПоɫлɟчɟɝоɛɭɞɟɬɞоɫɬиɝнɭɬɚɝлɚɜпɪоɟкɬоɜоɫноɜɟ ? чɟɫɬɜɚнɚɫɟлɟнияоɛъɟɞинɟнииɪɟɫɭɪɫоɜɫɬоɪоноɛɪɚзомɪɚɫпɪɟɞɟлиɜɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныоɬɜɟɬɫɬɜɟнноɫɬьɫоɯɪɚняяɝоɫɭɞɚɪɫɬɜомконɬɪольныɟɮɭнкциипɚɪɬнɟɪɫɬɜɟЗɚключɟниɟоɫноɜɟпɪоɜɟɞɟнноɝоɚнɚлизɚможноɫɞɟлɚɬьɫлɟɞɭющиɟɜыɜоɞыЭɮɮɟкɬиɜнɚяɪɟɚлизɚцияпɪоɟкɬоɜɫɮɟзɞɪɚɜооɯɪɚнɟнияɜозможнɚɛɟзɭчɟɬɚɮɚкɬоɪоɜɜнɭɬɪɟннɟйɫɪɟɞыпɪɟɞɫɬɚɜлɟнныɯɫɭнкɟОɛъɟкɬиɜнɚяоцɟнкɚɜлиянияɮɚкɬоɪоɜɫлɭжиɬнɟоɛɯоɞимымɪɚзɪɚɛоɬкиɫɬɜɟнноɝоэкономичɟɫкоɝомɟɯɚнизɭпɪɚɜлɟнияɪɟɚлизɚциɟйпɪоɟкɬоɜɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияȺкɬɭɚльноɫɬьɪɚзɪɚɛоɬкиɫɬɪɚɬɟɝичɟɫкоɝоɭпɪɚɜлɟнияоɛɭɫлоɜлɟнɚɜыɫокойɫоциɚльнойзнɚчимоɫɬьюɫɮɟɪыэкономикимɟжɞɭнɚɪоɞныɯпɪɚкɬикɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɫɜиɞɟɬɟльɫɬɜɭɟɬɪоɫɬɟэɮɮɟкɬиɜноɫɬиɫнижɟнииɫɬоимоɫɬилɟчɟнияɭɜɟличɟнииоɛъɟмɚэкономииɝоɫɭɞɚɪɫɬɜɟнныɯɪɟɫɭɪɫоɜɫɪɟɞнɟмȺɞɚпɬɚциямɟжɞɭнɚɪоɞноɝоопыɬɚɬɪɟɛɭɟɬоɫоɛɟнноɫɬɟйпɚɪɬнɟɪɫкиɯоɬношɟнийɮɟɞɟɪɚльномоɬɞɟльныɯɫɭɛъɟкɬоɜɊоɫɫийɫкойɎɟɞɟɪɚциинɚɫɬоящɟɟзɞɪɚɜооɯɪɚнɟнииɊоɫɫийɫкойɎɟɞɟɪɚциииɫпользɭюɬɫяоɫноɜныɟɫɭммɭ 2,0?2,2 ɬɪлнɪɭɛлɟйэɬомизноɫɚɫоɫɬɚɜляɟɬ 40?45%. ɫɬɪɚɬɟɝичɟɫкиɯзɚɞɚчмоɞɟɪнизɚцииоɬɪɚɫлинɟоɛɯоɞимыинɜɟɫɬицииɫɭммɭоколоɬɪлнɪɭɛлɟйɊɟшиɬьэɬɭпɪоɛлɟмɭɜозможноиɫпользоɜɚниɟммɟɯɚнизмɚɫɭщɟɫɬɜɭющɚяноɪмɚɬиɜнопɪɚɜоɜɚязнɚчиɬɟльноɜозможноɫɬииɫпользоɜɚнияинɫɬɪɭмɟнɬоɜпоɞɞɟɪжкичɚɫɬноɝоɫɟкɬоɪɚɪɟɚпɪоɟкɬоɜпɚɪɬнɟɪɫɬɜɚɌɚкɫоɝлɚɫноȻюɞжɟɬноɝокоɞɟкɫɚмɟɫɬныɟɜлɚɫɬипɪɟɞоɫɬɚɜляɬьмɭниципɚльныɟ 10 кɚкнɚпɪимɟɪконцɟɫɫионныɟɫоɝлɚшɟниязɚключɚюɬɫя 15?20 ПɪɚкɬикɚɞɪɭɝиɯинɫɬɪɭмɟнɬоɜɮинɚнɫоɜойпоɞɞɟɪжкиɫɭɛɫиɞиɪоɜɚниɟɫɬɚɜокпɪиɜлɟчɟннымзɚймɚминɜɟɫɬиционныɟнɚлоɝоɜыɟкɪɟɞиɬыльɝоɬынɚлоɝɚмполɭчилɚшиɪокоɝоɪɚɫпɪоɫɬɪɚнɟнияɫɬимɭлиɪɭɟɬпɪиɬокинɜɟɫɬицийПɪɟɞлɚɝɚɟмыɟɫɬɚɬьɟɫɬɪɚɬɟɝичɟɫкиɟпɪɚɜлɟнияɫоɜɟɪшɟнɫɬɜоɜɚниякономичɟɫкоɝомɟɯɚнизмɚпозɜоляɬɫозɞɚɬьɛлɚɝопɪияɬныɟпɪɚɜоɜыɟинɫɬиɬɭционɚльныɟэɮɮɟкɬиɜноɝоɭпɪɚɜлɟнияɪɟɚлизɚциɟйпɪоɟкɬоɜɫпоɫоɛɫɬɜоɜɚɬьмоɞɟɪнизɚцииɮɪɚɫɬɪɭкɬɭɪызɞɪɚɜооɯɪɚнɟнияконɟчномиɬоɝɟɭɪоɜɟньɞоɫɬɭпноɫɬикɚчɟɫɬɜɚмɟɞицинIntroduction. Economy, like any other sphere, including human activity, is constantly developing and nancial solutions arise for the implementation of investment projects. These are especially the ones that cance for the country. Russian economy is not an exception in this regard. The introduction of modern nancing forms of the economy of our country, since the industries which cant nancial costs, which does not always correspond to the government budget. These sectors comprise education, road infrastructure. The objects referring to these spheres of economic activity can?t be privatized due to their t. To solve the problem of the national economy underfunding, organizational forms the world economic practice. The of the research ciency of the PPP institution in the development of healthcare.To achieve the goal it is necessary to solve the to study the concept of strategic analysis of the PPP gic analysis of the PPP institution in healthcare;on the PPP development in healthcare; ciency of using the PPP institution in health care. The subject of the study is nancial and economic relations between the state and private kinds of business in the implementation of PPP . At the present stage the temic reformation of the Russian public health system is aimed at improving the quality of provided medical ser-vices based on the strategic management of the industry. nancing in the form of social insurance systems, attracting the funds of consumers of medical services, the problems ciency of the public health sector and limited public resources have not been solved. To solve these problems, the world practice uses the PPP institution.care? till 2020 ?The main goal of PPP in healthcare is the assess the factors Pharmacy & Pharmacology V. 5 N 4, 2017velopment of the PPP institution in healthcare. The fea-In modern conception, PPP is a special type of co-The rapid development of the diverse forms of PPP in economies of developed countries and, recent-ly, of developing countries, the widespread use of these forms in various sectors of economics make it possible to practise the form of interaction between the state and business as a characteristic feature of modern market economy.Figure 1 ? Stages of a strategic analysis of PPP in healthcarebelonging to the state. At the same time, private entrepre-neurship is characterized by mobility, high ef ciency of enables PPP to transfer some functions to the private national objects. These functions comprise construction, structure facilities, as well as their management. Thus, the traditionally state economy, and it creates conditions for effective functioning of these facilities, optimal man-agement and rational use of resources. The government ts from increase in the budget revenues associated with the project, as well as from indirect effects, i.e. the In our opinion, PPP in healthcare is a mutually ben- cial cooperation between state authorities, local gov- t organizations, which enables them to ensure effective implementation of the fective implementation of the Public-private partnership in healthcare has the problem of making healthcare more accessible and us-ing health resources more ef? ciently. In the concept of state?s priorities. But, a signi cant part of the treatment According to the Russian Ministry of Health, 32% of hospitals and 30% of polyclinics require capital repair, they lack hot water, running water, autonomous energy supply, and 57% of equipment is physically and morally obsolete. years [3]. To solve the strategic problems of the industry, These infrastructure objects have an effective de-investment. The potential of this investment segment is ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныthan 20 billion rubles [4]. These problems can be solved when using the PPP mechanism. One of the most import-pact on the development of the PPP institution in health 224-FZ ?About Public-Private Partnership, Munic-Amendments to Certain Legislative Acts of the Russian Acts of the Russian of medical infrastructure facilities by private investors to improve the quality of services provided to the popu-lation; it enables private ownership of newly created or reconstructed infrastructure facilities; the investor must ensure that they are used with the intended purpose.Juridically, a public party can participate in a PPP nancing, providing some aid for the implementation of the project or a state guarantee, as well as taking part in property, including providing land, water, forest areas for the facility being created. Besides, a mechanism is provided to ensure the preservation of the contract terms. In tandem with the preparation of the law, nalized. In July 2014, 265-FZ ?Amendments to the Federal Law ?About Concession Agreements? and speci c legislative acts of the Russian Federation? was adopted [6]. tender is not held. The law guarantees the recoupment of the concessionaire?s investments and the receipt of the uences the development of the PPP institution in healthcare is using PPP forms and models.In the generally accepted world practice, two forms of cooperation are distinguished, they are contract and institutional ones. The institutional form presupposes the creation of joint ventures with the participation of the state and business. The contract form of a strategic partnership is the conclusion of a contract for the performance of cer-tain functions with respect to a healthcare facility.Table 1 ? Forms of PPP cooperation in health care [7]Institutional FormContract FormCreation of a new medical organization with the joint transfer a medical organization to a private partner t health organization (joint eld The transfer of the share of the state medical organiza-a private company.vate organizations; a cooperation agreement; an agree-organization (outsourcing) cation (Table 1), it is recommended ed PPP models of the contract form for ows and highly quali ed management are needed. c form of relations between the state and a private partner, ll the functions speci ed ate authority. For the use of state or municipal property, tions stipulated in the concession agreement. The right of rst of all, is a public authority. In this capacity, it does not only provides a part nancing can be repre-Pharmacy & Pharmacology V. 5 N 4, 2017 nancingproperty to the private management company. Since the Law ?About Concession Agreements? operates in the use of PPP mechanisms, it is advisable to systematize nancial obligations of each part The analysis of foreign experience in using the PPP In different countries the development of PPPs takes place at different rates: in the UK, France, Germany and ciently formed, other A comparative analysis of international practices ciency, a reduction in the cost of treatment eld of PPP in medicine is the the pan-European number of PPP projects was 67%, transactions, PPP in healthcare occupies 20%. Public- the construction and reconstruction of xed assets in the industry and the provision of medical nancial initiative as the most effective form of partnership in acquiring public services. The essence of this British form of PPP was to attract private investments ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞицины xed assets in the industry and the pro- nancial initiative as the most effective form of partnership in acquiring pub-lic services. The essence of this British form of PPP was to attract private investments to the construction of large The compensation of private investor?s expenses is nancial initiative, the nancial initiative, which is the main form of PPP provide 17% of the country?s budget savings.In Germany, in the sphere of PPP, the sale of state xed amount of ll the state order is widely spread. This has led to the increase from 4% to of emergency medical care, the provision of clinical concluded. Since the introduction of PPP practice, the cantly: x-ray diagnostics by 50%, clinical laboratory services by 40%, and emergency services by gency services by In Australia, where about 50 hospitals have been extended. The main terms of the contract for a period of xed care. As a result of the introduction of the institution of PPP, the cost of building new health facilities dropped by , the cost of building new health facilities dropped by These examples re? ect the general trend ? medicine cial for consumers of medical services.of world leaders in implementing projects based on PPP. Pharmacy & Pharmacology V. 5 N 4, 2017individual elements of the PPP system is unacceptable. particular, it is necessary to take into account the speci cs In Russian economy, there are opportunities to 9%. Abroad many health facilities are built and then run by big international companies. Thereby, tability of facilities built and put into operation. This From an economic point of view, the bene t is beyond expensive as the private sector. There is also a signi cant difference for the consumers of medical services: they can get services faster and with a higher quality. At the Within the framework of PPP projects in healthcare, PPP projects amounts to 57 billion rubles, which is about 10% of total investments in PPP projects in all sectors [4]. At present, under the Russian Ministry of Health different stages of preparation, including: establishment of a multidisciplinary center for construction of an advisory-diagnostic clinic and organizing an of ce complex with the placement reconstruction of emergency buildings by establishing a medical center with a training base Among the subjects in which the PPP mechanism is effectively used, it is possible to distinguish the Republic of Tatarstan. For example, AVA-Peter LLC concluded a With ?Clinic of Modern Medicine HD? LLC, ve centers in Kazan, Naberezhnye Chelny, Nizhnekamsk Award ROSINFRA.The country?s medical facilities have received a lot of modern equipment recently, but only 20% of this equipment works in full force and effect. The reason is rst educational center of PPP in the world. Regional authorities provided support. The business had invested its experience, taken over operational costs. The budget of the center ve years. Here for the Center?s work, for most of them training is free of charge.transfusiology is being built on concession terms. The In Moscow, a concession was concluded with ?Eu-operation and organization of four medical centers: po-sition-emission tomography; endovascular surgery; peri-being reconstructed. The hospital will provide high-tech specialized medical care for the treatment of infertility, receive it free of charge. Free dental care will be used by up to 300 people a year.The examples of PPP agreements based on regional ter in Orel region. According to the information of the lack of legislation in the sphere of PPP. rst federal-level pilot project using the concession ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныmechanism in the health sector. That was the establi-Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan, whose products will be in demand in trau-matology, orthopedics and neurosurgery [8].In Volgograd region, the implementation of measures state program ?Health Development of Volgograd Region till 2020?, approved 30 April 2013 by the Government of Volgograd Region Decree 216-p ?On Approval of the Health Development Program of Volgograd Region olgograd Region worked in the compulsory medical insurance system, and medical assistance in the amount of 42577.1 thousand ru-bles was provided by them. In 2015, twenty-two private companies worked in the compulsory medical insurance system, for 8 months they provided medical assistance in the amount of 12195.4 thousand rubles [10].On the territory of Volgograd region there are pri-vate medical organizations that have of cially switched MMI. Nowadays in the Territorial Program of MMI in Volgograd region the largest private medical organiza- c Production Association Volgograd Center for Disease Prevention ?YugMed? LLC. These clinics have signi cantly more advantages Clients of the above-mentioned clinics can receive ser-vices under the MMI policy, which are included in the ered by the MMI rate. Within the territorial program of including preventive, emergency medical care, and spe-Besides, the development of public-private partner-ship is also realized in the form of a concession. Among other factors, the mechanism of public-private partner-ship allowed opening a hemodialysis center. At the same The investor, who has won the tender for concluding for 270 beds, a sauna and swimming pool. The volume organization with private business (outsourcing) has be-In Volgograd region, two-thirds of vehicles available to health facilities are completely worn out. The basis eet of ambulances in Volgograd region is made cult road conditions in Volgograd, fail for two years. It is not pos-the Mandatory Medical Insurance Fund. The purchase of eet in the framework of the concluded le and equipped 70% of the car cost). The climate control system and patients in any season. The investor purchased 95 project is 1.5 billion rubles. Volgograd received new cars ve years.project. Outsourcing of the catering organization allowed cantly save the money that was spent on providing the work of kitchen and laundry. cantly switched to outsourcing supply. [11]. ts of transferring non-core tasks to a cant reduction cient conditions. Hereby, at the current stage of transition of garbage and anatomical waste; the organization supply, sewerage, laundry; provision of ready meals, etc. eld of public health have been chosen, in which the potential of PPP is poorly involved. For example, little Pharmacy & Pharmacology V. 5 N 4, 2017However, in Russia PPP is not developing at such a subject to privatization at the level of the federal law. for the government and society.Another deterrent to the development of PPP is the concession contract and form its economic basis. The effectively manage risks. The meaning of PPP is mainly to achieve synergies from partnership.federal and regional levels. The strategy of the Russian business, program-target management, nancing and managing partnership projects in the health sector. The ow of private investment resources into the industry. ed that business, entering partnership projects in public healthcare, is interested in long-term and stable cooperation, i.e. when ?the rules of the game? are known and understood in advance guaranteeing the return nancial resources and the necessary level tability. The authorities need to improve the open nd mechanisms to stimulate and promote social ne the powers of the authorities that are re-to monitor the effectiveness of joint projects;PPP in the media (this in turn may be of interest to to organize a systematic approach to training spe-cialists in order to form a team for effective imple-mentation of PPP projects.sector of the economy, the underdevelopment of market-problems accumulated in the industry, and the lack government and business in industry. nance skills that most In this regard, the task of organizing quali ed support for PPP projects at all stages of their life cycle is urgent. At the same time, it is advisable to assign functions on information, consulting, organizational and t organization [12].organization of constant interaction with the largest PPP institutions;obtaining organizational and methodological sup-port from the federal level PPP institutes;tion and support of PPP projects;provision of organizational and methodological sup-ing PPP projects;organization of nancing of infrastructure projects, integration of federal, regional and municipal PPP development of the PPP institution in healthcare is the ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныof PPP to Russian reality, which requires the creation of favorable legal, organizational and institutional adoption of a number of by-laws regulating partner-the private investor, the conditions for attracting nancial resources for the implementation of joint become an effective tool for modernizing healthcare.between government and business. After that, the main goal of projects based on PPP will be achieved: the efforts and resources of the parties, distributing their Based on the analysis, the following 1. Effective implementation of PPP projects in the tors is a prerequisite for developing an effective orga-implementation of PPP projects in the health sector. The urgency of developing a system of strategic management economy.2. The experience of applying international practices ciency, the cost of treatment and the in-average of 10%. Adaptation of international experience cs of the develop- xed assets amounting to 2.0?2.2 trillion rubles are To solve the strategic tasks for modernization of the in-dustry, investments amounting to about 1.0 trillion rubles are needed. This problem can be solved by using the PPP cantly reduces the opportunities for using of partnership projects. Thus, according Russian Budget 20 years. The practice of applying other nancial support ts) has not been ow of private organizational and economic mechanism of PPPs offered in the article will allow creating favorable legal and institutional conditions for effective management of the PPP projects implementation, contribute to the ȻиɛлиоɝɪɚɮичɟɫкийПоɫɬɚноɜлɟниɟПɪɚɜиɬɟльɫɬɜɚɊоɫɫийɫкойɎɟɞɟɪɚции 15.04.2014 294 ?ɭɬɜɟɪжɞɟнииɝоɫɭɞɚɪɫɬɜɟннойɊоɫɫийɫкойɎɟɞɟɪɚциизɞɪɚɜооɯɪɚнɟнияКонɫɭльɬɚнɬɞɚɬɚКоɫиноɜɚИнɫɬиɬɭционɚльныɟɚɫпɟкɬыɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɪɟɚлизɚцииɫɬɪɚɬɟ // Ⱥкɬɭɚпɪоɛлɟмыɞоɫɬижɟнияɪɟɝионɚльныɯэкономичɟɫкиɯɫɛоɪникɪɚɛоɬ II Мɟжɞɭнɚɪоɞнойнɚɭчнопɪɚкɬичɟɫкойконɮɟɪɟнцииɋɬɚɜɪопольɚпɪɟля 2016 ɋɬɚɜɪопольɋɟкɜойяȻɚɬɟнɟɜɚЧȺɋɌНЫȿЗȾɊȺȼООɏɊȺНȿНИȿɍЛɍЧШȺɌȿȽОКȺЧȿɋɌȼОɋɌɍПНОɋɌЬ // ɊоɫɫийɫкɚяȻизнɟɫɝɚзɟɬɚɝоɫɭɞɚɪɫɬɜɟннопɚɪɬнɟɪɫɬɜоhttps://rg.ru/2012/01/17/sled.html (ɞɚɬɚКɪɚɟɜойПɟɪɫпɟкɬиɜыɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɪɚнɟнииПоɪɬɚлинɮоɪмɚционнойпоɞɞɟɪжкимɟɞицинɫкиɯɪɭкоɜоɞиɬɟлɟй. URL: https://www.zdrav.ru (ɞɚɬɚɎɟɞɟɪɚльныйзɚкон 13.07.2015 224-ɪɟɞ 29.12.2015 ?ɝоɫɭɞɚɪɫɬɜɟнночɚɫɬномпɚɪɬнɟɪɫɬɜɟмɭниципɚльночɚɫɬномпɚɪɬнɟɪɫɬɜɟɊоɫɫийɫкойɎɟɞɟɪɚцииɜнɟɫɟнииизмɟнɟнийоɬɞɟльныɟзɚконоɞɚɬɟльныɟɚкɬыɊоɫɫийɫкойɎɟɞɟɪɚцииКонɫɭльɬɚнɬɞɚɬɚɎɟɞɟɪɚльныйзɚкон 21 июля 2005 115-концɟɫɫионныɯɫоɝлɚшɟнияɯɋпɪɚɜочнопɪɚɜоPharmacy & Pharmacology V. 5 N 4, 2017Referencesrossijskoj federacii razvitie zdravoohraneniya [Decree of the Russian Government of April 15. 2014 N 294 ?On April 15. 2014 N 294 ?On tant Plus]. (access data: 07.06.2017) (In Russ.)2. Kosinova N.N. Institucionalnye aspekty gosudarstvenno-chastnogo partnerstva v realizacii strategii regionov [Institutional aspects of public-private partnership in the implementation of the regional strategy]. Aktualnye Aktualnye scienti? c papers of the II International Scienti c and Practical Conference] (Stavropol, April 20ropol: Sequoia. P. 64Bateneva T. CHASTNYE INVESTICII V ZDRAVOOHRANENIE ULUCHSHAT EGO KACHESTVO I DOS-TUPNOST [PRIVATE INVESTMENT IN HEALTH WILL IMPROVE ITS QUALITY AND ACCESSIBILITY]. ACCESSIBILITY]. Russian Business Newspaper: public-private partnership]. 2012. No. 2. URL: https://rg.ru/2012/01/17/sled.html (access data: 07.06.2017). (In Russ.)Kraevoy S.A. Perspektivy razvitiya gosudarstvenno-chastnogo partnerstva v zdravoohranenii Portal infor-macionnoj podderzhki medicinskih rukovoditelej [Prospects for the development of public-private partner-ship in healthcare. Portal of information support of medical leaders]. URL: https://www.zdrav.ru (access data: .ru (access data: № 224-FZ of 13.07.2015 ?About Public-Private Partnership, Municipal-Private Partner-ship in the Russian Federation and Amendments to Certain Legislative Acts of the Russian Federation?]. Konsul-Acts of the Russian Federation?]. Konsul-()()6. Federalnyj zakon ot 21 iyulya 2005 g 115-FZ ?O koncessionnyh soglasheniyah? 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()()ɜɚяɫиɫɬɟмɚȽɚɪɚнɬȽɚɪɚнɬɋɟɪɜиɫ?. URL: http://base.garant.ru/12141176/ (ɞɚɬɚȻɟлɟнкоɋɚɞоɜникоɜɚȽОɋɍȾȺɊɋɌȼȿННОЧȺɋɌНОȿПȺɊɌНȿɊɋɌȼОИНɋɌɊɍМȿНɌɋОȼȿɊШȿНɋɌȼОȼȺНИЯɍПɊȺȼЛȿНИЯЗȾɊȺȼООɏɊȺНȿНИȿМ // Экономикɚɫоциɭм12(31). URL: http://iupr.ru/domains_data/ les/zurnal_31/Belenko%20E.I.(socialno-ekonomicheskie%20ɞɚɬɚɊɟɚлизɚцияпɪоɟкɬɚзɞɪɚɜооɯɪɚнɟнииɌомɫкойоɛлɚɫɬи ? ȿɜɪоклиникɚɞɚɬɚПоɫɬɚноɜлɟниɟПɪɚɜиɬɟльɫɬɜɚȼолɝоɝɪɚɞɫкойоɛлɚɫɬиɭɬɜɟɪжɞɟниизɞɪɚɜооɯɪɚнɟнияȼолɝоɝɪɚɞɫкойоɛлɚɫɬи 2020 ɝоɞɚКонɫɭльɬɚнɬɞɚɬɚИнɮоɪмɚцияМиниɫɬɟɪɫɬɜɚзɞɪɚɜооɯɪɚнɟнияɪɟзɭльɬɚɬɚɯɪɟɚлизɚцииконцɟпɬɭɚльɞокɭмɟнɬоɜɭɬɜɟɪжɞɟнныɯɝоɫɭɞɚɪɫɬɜɟннойɜлɚɫɬиɫɭɛъɟкɬоɜɊоɫɫийɫкойɎɟɞɟɪɚцииɜопɪоɫɚмɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝоɜзɚимоɞɟйɫɬɜияɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɪɚнɟнии. URL: http s://static-1.rosminzdrav.ru (ɞɚɬɚзɞɪɚɜооɯɪɚнɟнииȼолɝоɝɪɚɞɫкойоɛлɚɫɬиɜнɟɞɪяюɬɫямɟɯɚнизмыɞɚɬɚKosinova N.N., Tolstel M.S., Chekealkin A.A. COMPREHENSIVE EVALUTION OF INVESTMENT POTENTION (THE CASE OF THE SOUTHERN FEDERAL DISTRICT) // 2014. Vol. 10. No. 23. P. 231?243. DOI: 10.5539/ass.v10n23p231 ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныКонɮликɬинɬɟɪɟɫоɜȺɜɬоɪызɚяɜляюɬоɬɫɭɬɫɬɜииконɮликɬɚинɬɟɪɟɫоɜȺɜɬоɪыȺɞжиɟнкоȼɫɟɜолоɞЛɟониɞоɜичɞокɬоɪнɚɭкзɚɜɟɞɭющийкɚɮɟɞɪойэкономикизɞɪɚɜооɯɪɚнɟниямɟɞициныɞиɪɟкɬоɪПяɬиɝоɪɫкоɝомɟɞикоɮɚɪмɚцɟɜɬичɟɫкоɝоинɫɬиɬɭɬɚɮилиɚлɚɎȽȻОɍȼолɝоɝɪɚɞɫкийɝоɫɭɞɚɪɫɬɜɟнмɟɞицинɫкийɭниɜɟɪɫиɬɟɬМинзɞɪɚɜɚɊоɫɫииОɛлɚɫɬьнɚɭчныɯинɬɟɪɟɫоɜэкономикɚзɞɪɚɜооɯɪɚɮɚɪмɚкоэкономикɚɫоциолоɝиямɟɞицинымɟнɟɞжмɟнɬзɞɪɚɜооɯɪɚнɟнииКоɫиноɜɚНиколɚɟɜнɚɞокɬоɪэкономичɟɫкиɯнɚɭкпɪоɮɟɫɫоɪкɚɮɟɞɪыэкономикимɟнɟɞжмɟнɬɚɎȽȻОɍȼолɝоɝɪɚɞɫкоɝоɝоɫɭɞɚɪɫɬɜɟнноɝомɟɞицинɫкоɝоɭниɜɟɪɫиɬɟɬɚМинзɞɪɚɊоɫɫииОɛлɚɫɬьнɚɭчныɯинɬɟɪɟɫоɜэкономикɚзɞɪɚɜооɯɪɚнɟнияɫɬɪɚɬɟɝичɟɫкиймɟнɟɞжмɟнɬзɞɪɚɜооɯɪɚнɟнииɮинɚнɫиɪоɜɚниɟзɞɪɚɜооɯɪɚнɟиɫпользоɜɚниɟммɟɯɚнизмоɜпɚɪɬнɟɪɫɬɜɚɫɭɞɚɪɫɬɜɚɛизнɟɫɚПоɫɬɭпилɚɪɟɞɚкциюПɪиняɬɚпɟчɚɬиtov utverzhdennyh organami gosudarstvennoj vlasti subektov Rossijskoj Federacii po voprosam razvitiya gosu-ganami gosudarstvennoj vlasti subektov Rossijskoj Federacii po voprosam razvitiya gosu-the Russian Ministry of Health on the results of the program and concept documents implementation approved by the Russian regions on the development of public-private partnership (public-private partnership) in health care]. URL: http://static-1.rosminzdrav.ru. (access data: 09.06.2017). (In Russ.)V zdravoohranenii Volgogradskoj oblasti vnedryayutsya mekhanizmy GCHP [PPP mechanisms are being intro-duced in the healthcare of the Volgograd Region]. URL: http://riac34.ru/news/62771/ (access data: 09.06.2017). Kosinova N.N., Tolstel M.S., Chekealkin A.A. COMPREHENSIVE EVALUTION OF INVESTMENT POTEN-TION (THE CASE OF THE SOUTHERN FEDERAL DISTRICT). 2014. Vol. 10. No.23. P. 231 ict of interest ict of interest.D octor of and Organization of Health and Medicine, Director ofbranch of Volgograd State Medical University. Research interests: health economics, pharmacoeconomics, medical sociology, medicine management. ? Doctor of Sciences (Economy), Professor of the Chair of Economy and Management of Volgograd State Medical University. Research interests: health economics, strategic nancing using state and business partnership mechanisms. ORCID 0000-0003-4298-6018. ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныɍȾКˁ˃ˀʤ˃ʫʧʰЧʫˁКʰʱʰʻˁ˃ʰ˃˄˃ʤʧОˁ˄ʪʤˀˁ˃ʦʫʻʻОͳЧʤˁ˃ʻОʧОʿʤˀ˃ʻʫˀˁ˃ʦʤˁˇʫˀʫʯʪˀʤʦООˈˀʤʻʫʻʰЯȺɞжиɟнкоКоɫиноɜɚмɟɞикоɮɚɪмɚцɟɜɬичɟɫкийинɫɬиɬɭɬɎȽȻОɍȼолɝȽМɍМинзɞɪɚɜɚɊоɫɫииɊоɫɫияɋɬɚɜɪопольɫкий, 11ɎȽȻОɍȼолɝоɝɪɚɞɫкийɝоɫɭɞɚɪɫɬɜɟнныймɟɞицинɫкийɭниɜɟɪɫиɬɟɬɊоɫɫияȼолɝоɝɪɚɞПлощɚɞьȻоɪцоɜɭпɪɚɜлɟнчɟɫкиɯкɚкɭɪоɜнɟɬɚкɭɪоɜнɟцɟломнɟɜозможноɛɟзпɪоɜɟɞɟнияɫɬɪɚɬɟɝичɟɫкоɝокоɬоɪыйɪɚɫɫмɚɬɪиɜɚɟɬɫякɚкɜыполнɟниɟɫооɬɜɟɬɫɬɜɭющɟйɮɭнкцииɭпɪɚɜлɟнияоɪиɟнɬиɪоɜɚннойпɟɪɫпɟкɬиɜɭимɟющɟйɜыɫокийɭɪоɜɟньнɟопɪɟɞɟлɟнноɋɬɪɚɬɟɝичɟɫкийпɪɟɞполɚɝɚɟɬиɫɫлɟɞоɜɚниɟɫиɫɬɟмыɮɚкɬоɪоɜкоɬоɪыɟопɪɟɞɟляюɬɛɭɞɭщɟɟɫоɫɬояниɟинɫɬиɬɭɬɚɝоɫɭɞɚɪɫɬɜɟннопɚɪɬнɟɪɫɬɜɚɫɮɟɪызɞɪɚɜооɯɪɚнɟнияɫɬɚɬьɟɪɚɫɫмɚɬɪиɜɚɟɬɫяɫɬɪɚɬɟɝичɟɫкийɫɮɟɪɟзɞɪɚɜооɯɪɚнɟниякɚккомплɟкɫноɟиɫɫлɟɞоɜɚниɟположиɬɟльныɯоɬɪицɚɬɟльныɯɮɚкɬоɪоɜкоɬоɪыɟэɮɮɟкɬиɜноɫɬьинɫɬиɬɭɬɚɫɮɟɪызɞɪɚɜооɯɪɚнɟнияПɪɟɞложɟнɪяɞкомпонɟнɬоɜɞополняющиɯɫиɫɬɟмɭɫɬɪɚɬɟɝичɟɫкоɝоɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɫɞɟлɚныɫооɬɜɟɬɫɬɜɭющиɟоɛоɛщɜыɜоɞыЦɟльюиɫɫлɟɞоɜɚнияяɜляɟɬɫяизɭчɟниɟɫɬɪɚɬɟɝичɟɫкоɝоɫɮɟɪɟзɞɪɚɜооɯɪɚɮоɪмиɪоɜɚниɟɫɬɪɚɬɟɝичɟɫкиɯнɚпɪɚɜлɟнийэɮɮɟкɬиɜноɫɬииɫпользоɜɚнияинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟнииМɚɬɟɪиɚлымɟɬоɞыпɪоцɟɫɫɟɞоɫɬижɟнияцɟлииɫɫлɟɞоɜɚнияиɫпользоɜɚнымɟɬоɞыɫɬɪɚɬɟɝичɟɫкоɝокомплɟкɫноɝоэкономичɟɫкоɝоɊɟзɭльɬɚɬыоɛɫɭжɞɟниɟпɪоɜɟɞɟнномɫɬɪɚɬɟɝичɟɫкомɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɛылоɜыяɜлɟноɭɫлоɜияɯɞоɮинɚнɫиɪоɜɚнияɫɬɪɚɬɟɝичɟɫкиɜɚжныɯоɛлɚɫɬɟйнɚɪоɞноɝоɯозяйɫɬɜɚэкономичɟɫкойпɪɚкɬикɟɊоɫɫиизɚɪɭɛɟжныɯɫозɞɚюɬɫямɟɞицинɫкиɟɭчɪɟжɞɟнияцɟляɯмоɞɟɪнизɚцииɭлɭчшɟниякɚчɟɫɬɜɚокɚзɚнияпɭɛличныɯɭɫлɭɝяɜляɟɬɫяэɮɮɟкɬиɜныммɟɯɚнизмомпɪиɜлɟчɟнияɞолɝоɫɪочныɯɜɟɫɬицийнɚпɪɚɜлɟннымɫɮɟɪызɞɪɚɜооɯɪɚнɟнияɊɟзɭльɬɚɬыɫоɫɬоянияɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɊоɫɫийɫкойɎɟɞɟɪɚциипозɜолилинɚɫɬоящɟɟɜɪɟмяэɬойɫɮɟɪɟɫɬɚɞияɯɪɟɚлизɚциинɚɯоɞиɬɫяɛолɟɟ 70 пɪоɟкɬоɜɭжɟɫɬɚɞииɫɬɪоиɬɟльɫɬɜɚэкɫплɭɚɬɚции ? 61 пɪоɟкɬɪɚмкɚɯɪɟɚлизɭɟмыɯпɪоɟкɬоɜɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияплɚниɪɭɟɬɫяпɪиɜлɟчьинɜɟɫɬицииɪɚзмɟɪɟ 61 млɪɞɪɭɛлɟйэɬомоɛщийоɛъɟминɜɟɫɬицийпɪоɟкɬɚɯɝɚɟɬмлɪɞɪɭɛлɟйяɜляɟɬɫяоɫноɜойɫиɫɬɟмноɝоиɫпользоɜɚнияинɫɬɪɭмɟнɬɚɪиямоɞɟɪниɫɮɟɪызɞɪɚɜооɯɪɚнɟнияɭɪоɜняɞоɫɬɭпноɫɬикɚчɟɫɬɜɚмɟɞицинɫкиɯɭɫлɭɝЗɚключɟниɟПɪɟимɭщɟɫɬɜɚɫɬɪɚɬɟɝичɟɫкоɝоɫɮɟɪызɞɪɚɜооɯɪɚнɟниязɚключɚюɬɫяɪɟзɭльɬɚɬиɜноɫɬиɜзɚимоɞɟйɫɬɜиюɝоɫɭɞɚɪɫɬɜɚɛизнɟɫɚкɚкоɫоɛоɝоɬɪɭɞничɟɫɬɜɚцɟльюɪɟɚлизɚцииɞолɝоɫɪочныɯинɜɟɫɬиционныɯпɪоɟкɬоɜɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɮɭнкцийɫɬɪɚɬɟɝичɟɫкоɝозɞɪɚɜооɯɪɚнɟниияɜляɟɬɫяɪɚзɪɚɛоɬкɚɫозɞɚниюɭɫлоɜиймɟɯɚнизмоɜɪɟɚлизɚцииɫɮɟɪɟзɞɪɚɜооɯɪɚнɟниякɚкɮɟɞɟɪɚльномɬɚкɪɟɝионɚльноммɭниципɚльномɭɪоɜняɯКлючɟɜыɟɫлоɜɚɫɬɪɚɬɟɝичɟɫкийɝоɫɭɞɚɪɫɬɜɟннопɚɪɬнɟɪɫɬɜоконцɟɫɫииɚɭɬɫоɪɫинɝзɞɪɚɜооɯɪɚнɟнииинɜɟɫɬиционныɟпɪоɟкɬыоɛъɟкɬыинɮɪɚɫɬɪɭкɬɭɪыциɬиɪоɜɚнияȺɞжиɟнкоКоɫиноɜɚɋɌɊȺɌȿȽИЧȿɋКИЙИНɋɌИɌɍɌȺȽОɋɍȾȺɊɋɌȼȿННОЧȺɋɌНОȽОПȺɊɌНȿɊɋɌȼȺЗȾɊȺȼООɏɊȺНȿНИЯɎɚɪмɚцияɮɚɪмɚколоɝияȺɞжиɟнкоКоɫиноɜɚFor citation:Adzhienko V.L., Kosinova N.N. STRATEGIC ANALYSIS OF THE STATE-PRIVATE PARTNERSHIPINSTITUTE IN THE HEALTHCARE. Pharmacy & Pharmacology.Pharmacy & Pharmacology V. 5 N 4, 2017STRATEGIC ANALYSIS OF THE STATEPRIVATE PARTNERSHIP INSTITUTE IN THE HEALTHCARE V.L. AdzhienkoPyatigorsk Medical and Pharmaceutical Institute ? branch of Volgograd StateMedical University, 11, Kalinin ave., Pyatigorsk, Russia, 357532Volgograd State Medical University, 1, Pavshikh Bortsov Sq.,Volgograd, Russia, 400066carrying out a strategic analysis, which is regarded as the performance of a corresponding management function that is perspective-oriented and has a high level of uncertainty. Strategic analysis involves researching the system of factors that determine the future state of the public-private partnership (PPP) in the development of health care. The strategic analysis of PPP in the healthcare sector as a complex study of positive and negative factors that may affect ciency of the development of the PPP institution in the development of the healthcare is under consideration in the article. A number of new components complementing the system of strategic analysis of PPPs in the healthcare were proposed, and generalizations and conclusions were made. of the research is to study the impact of the strategic analysis of PPPs in the sphere of healthcare on the formation of strategic directions for increasing the ciency of using the PPP institution in healthcare. In the process of achieving the research goal, methods of strategic and integrated economic analysis were used. In our strategic analysis of PPP in the healthcare, it was revealed that under the conditions of underfunding national economy, medical institutions based on PPPs are being established in order to modernize and improve the quality of public services. PPP is an effective mechanism for attracting long-term investments aimed at the development of the health sector. The results of our analysis of PPP in the sphere of Russian healthcare made it possible to reveal that at present there are more than 70 projects in the process of implementation, 61 projects are already under construction and operation. Within the framework of the PPP-implemented healthcare projects, it is planned to attract investments of 61 billion rubles, while the total amount of private investments in PPP projects reaches 57 billion rubles. This is the basis for the systematic use of PPP tools for modernizing the healthcare sector and improving the accessibility and The advantages of the application of the PPP strategic analysis in the sphere of healthcare is theincreased effectiveness of interaction between the state and private business as a special type of cooperation with a view to implementing long-term investment projects in the sphere of healthcare. One of the main functions of the PPP strategic analysis in the sphere of healthcare is working out measures to create conditions for the implementation of PPPs in the sphere of healthcare both at the federal and regional levels. strategic analysis, public-private partnership, concessions, healthcare outsourcing, investment projects, infrastructure facilitiesȼɜɟɞɟниɟЭкономикɚкɚкɫɮɟɪɚɜключɚɞɟяɬɟльноɫɬьчɟлоɜɟкɚпоɫɬоянноɪɚзɜиɜɚɟɬɫяэɜолюциониɪɭɟɬпɪоцɟɫɫɟɜозникɚюɬɮоɪмыɪɟɚлизɚцииинɜɟɫɬиционныɯпɪоɟкɬоɜОɫоɛɟнноɬɟɯкоɬоɪыɟимɟюɬɝоɫɭɞɚɪɫɬɜɚɬолькоэкономичɟɫкоɟɫоциɚльноɟзнɚчɟниɟЭкономикɚɊоɫɫииэɬомиɫключɟниɟȼнɟɞɪɟниɟɮоɪмɮинɚнɫиɪоɜɚнияɫоциɚльноэкономичɟɫкиɯпɪоɟкɬоɜɚкɬɭɚэкономикиɫɬɪɚныɬɚккɚкоɬɪɚɫлиɬɪɚɞиционнонɚɯоɞящиɟɫяɝоɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬиɬɪɟɛɭюɬзнɚчиɬɟльныɯзɚɬɪɚɬчɬоɜɫɟɝɞɚɫооɬɜɟɬɫɬɜɭɟɬɫоɫɬояɝоɫɭɞɚɪɫɬɜɟнноɝоɛюɞжɟɬɚɬɚкимоɬɪɚɫлямоɬноɫяɬɫяоɛɪɚзоɜɚниɟзɞɪɚɜооɯɪɚнɟниɟкоммɭнɚльноɟɯозяйɫɬɜоɬɪɚнɫпоɪɬɞоɪожноɟɯозяйɫɬɜоОɛъɟкɬыоɬноɫящиɟɫяɫɮɟɪɚмɯозяйɫɬɜɟннойɞɟяɬɟльноɫɬипɪиɜɚɬизиɪоɜɚныɜɫлɟɞɫɬɜиɟциɚльнойэкономичɟɫкойɫɬɪɚɬɟɝичɟɫкойзнɚчимоɫооɬɜɟɬɫɬɜɟннопɪиноɫиɬьЧɬоɛыɜопɪоɫнɟɞоɮинɚнɫиɪоɜɚнииɫɬɪɚɬɟɝичɟɫкиɜɚжныɯоɛъɟкɬоɜнɚɪоɞноɝоɯозяйɫɬɜɚмиɪоɜойэкономичɟɫкойпɪɚкɬикɟɫозɞɚюɬɫяɮоɪмыоɫноɜɟɝоɫɭɞɚɪɫɬɜɟнчɚɫɬноɝопɚɪɬнɟɪɫɬɜɚиɫɫлɟɞоɜɚнияяɜляɟɬɫяизɭчɟниɟɜлиянияɫɬɪɚɬɟɝичɟɫкоɝоɚнɚлизɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟɮоɪмиɪоɜɚниɟɫɬɪɚɬɟɝичɟɫкиɯнɚпɪɚɜлɟнийэɮɮɟкɬиɜноɫɬииɫпользоɜɚнияинɫɬиɬɭɬɚɫɮɟɪызɞɪɚɜооɯɪɚнɟнияɞоɫɬижɟниянɟоɛɯоɞимоɫлɟɞɭзɚɞɚчиИзɭчиɬьɫɬɪɚɬɟɝичɟɫкоɝоɚнɚлизɚɬɭɬɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияОпɪɟɞɟлиɬьэɬɚпыɫоɫɬɚɜляющиɟэлɟмɟнɬыɫɬɪɚɬɟɝичɟɫкоɝоɚнɚлизɚинɫɬиɬɭɬɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияȾɚɬьоцɟнкɭɜлиянияɮɚкɬоɪоɜɬɪɟннɟйɫɪɟɞызɞɪɚɜооɯɪɚнɟɊɚзɪɚɛоɬɚɬьɫɬɪɚɬɟɝичɟɫкиɟнɚпɪɚɜлɟнияɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныэɮɮɟкɬиɜноɫɬииɫпользоɜɚнияинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟнииМɚɬɟɪиɚлымɟɬоɞыПɪɟɞмɟɬиɫɫлɟɞоɜɚния ? ɮинɚнɫоɜоэкономичɟɫкиɟɜзɚимооɬношɟнияɝоɫɭɞɚɪɫɬɜɚчɚɫɬноɝоɛизнɟɫɚɪɟɚлизɚциипɪоɟкɬоɜɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияпɪоцɟɫɫɟпоɫɬɚɜзɚɞɚчиɫпользоɜɚнымɟɬоɞыɫɬɪɚɬɟɝичɟɫкоɝокомплɟкɫноɝоэкономичɟɫкоɝоɚнɚлизɚɪɚɫɫмоɬɪɟнииɜлиянияɮɚкɬоɪоɜɜнɭɬɪɟнɫɪɟɞыинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟниииɫпользоɜɚнпоɞɯоɞɚнɚлизɟноɪмɚɬиɜнопɪɚɜоɜыɯɚкɬоɜзɞɪɚɜооɯɪɚнɟнииɮоɪммоɞɟлɟйоɬɞɟльныɯинɫɬɪɭмɟнɬоɜзɚɪɭɛɟжныɯɫɬɪɚнɚɯɪоɫɫийɫкойпɪɚкɬикɟɊɟзɭльɬɚɬыоɛɫɭжɞɟниɟɫоɜɪɟмɟнномэɬɚпɟɫиɫɬɟмноɟɪɟɮоɪмиɪоɜɚниɟɪоɫɫийɫкоɝозɞɪɚɜооɯɪɚнɚпɪɚɜлɟнокɚчɟɫɬɜɚпɪɟɞоɫɬɚɜмɟɞицинɫкиɯоɫноɜɟɫɬɪɚɬɟɝичɟɫкоɝоɭпɪɚɜлɟнияоɬɪɚɫльюНɟɫмоɬɪяпɪоɜɟɞɟниɟмоɞɟɪзɞɪɚɜооɯɪɚнɟниякоɬоɪоɟпоɫлɟɞнɟɟоɫɭщɟɫɬɜлялоɫьɜɜɟɞɟнияɞополниɬɟльныɯиɫɬочникоɜɮинɚнɫиɪоɜɚнияɫоциɚльноɝоɫɬɪɚɯоɜɚнияпɪиɜлɟчɟнияɫɪɟɞɫɬɜпоɬɪɟɛиɬɟлɟймɟɞицинɫкиɯпɪоɛлɟмынизкойэкономичɟɫкойэɮɮɟкɬиɜноɫɬиɛюɞжɟɬнойɫɮɟɪызɞɪɚɜооɯɪɚнɟнияоɝɪɚничɟнноɫɬиоɛщɟɫɬɜɟнɪɟɫɭɪɫоɜпɪоɛлɟмɜойпɪɚкɬикɟиɫпользɭɟɬɫяинɫɬиɬɭɬɫооɬɜɟɬɫɬɜииположɟниямиɝоɫɭɞɚɪɫɬɜɟнɊоɫɫийɫкойɎɟɞɟɪɚциизɞɪɚɜооɯɪɚнɟния 2020 ɝоɞɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияяɜляɟɬɫяɜзɚимоɞɟйɫɬɜияɝоɫɭɞɚɪɫɬɜɟннойзɞɪɚɜооɯɪɚнɟнияНɟоɛɯоɞимоɪɚзɜиɜɚɬьɜɯожɞɟниɟоɛязɚɬɟльноɝомɟɞицинɫкоɝоɫɬɪɚɯоɜɚниямɟɞицинɫкиɯиɫпользоɜɚниɟконцɟɫɫионныɯɫоɝлɚшɟнийɬɚкжɟпɪиɜлɟɭпɪɚɜляющиɯкомпɚнийɭпɪɚɜлɟнияоɬɞɟльнымимɟɞицинɫкиɯɚнɚлиɬичɟɫкимпɪизнɚкɚм 2020 ɋɬɪɚɬɟɝичɟɫкийɚнɚлизпозɜоляɟɬɮɚкɬоокɚзыɜɚющиɟкɚкпозиɬиɜноɟɬɚкнɟɝɚɬиɜноɟɜлияниɟинɫɬиɬɭɬɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияОɫоɛɟнноɫɬипɪоцɟɫɫɚпɪоɜɟɞɟнияɬɚкоɝоɚнɚлизɚпɪɟɞɫɬɚɜлɟныɪиɫɭнкɟɫоɜɪɟмɟнномпонимɚнии ? эɬооɫоɛыйɫоɬɪɭɞничɟɫɬɜɚɝоɫɭɞɚɪɫɬɜɟнноɝочɚɫɬноɝоɫɟкɬоɪɟɚлизɚцииɞолɝоɫɪочноɝоинɜɟɫɬиционноɝопɪоɟкɬɚлокɚльномɪɟɝионɚльномнɚционɚльноммɟжɞɭнɚɪоɞноммɚɫшɬɚɛɚɯȻɭɪноɟмноɝооɛɪɚзныɯɮоɪмэкономикɟɫɬɪɚнпоɫлɟɞнɟɟɜиɜɚющиɯɫяɫɬɪɚншиɪокоɟɪɚɫпɪоɫɬɪɚнɟниɟɮоɪмɫɚмыɯоɬɪɚɫляɯэкономикипозɜоляюɬпɪɚкɬикоɜɚɬьɮоɪмɭɜзɚимоɞɟйɫɬɜияɝоɫɭɞɚɪɫɬɜɚɛизнɟɫɚкɚкɯɚɪɚкɬɟɪнɭючɟɪɬɭɪыночэкономикиɊиɫɭнокпɪоɜɟɞɟнияɫɬɪɚɬɟɝичɟɫкоɝоɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияPharmacy & Pharmacology V. 5 N 4, 2017ȽоɫɭɞɚɪɫɬɜонɟɫɟɬоɬɜɟɬɫɬɜɟнноɫɬьпɟɪɟɞɫɬɜомɛɟɫпɟɪɟɛойноɟоɛɟɫпɟчɟниɟпɭɛличнымиɛлɚоɛъяɫняɟɬɫяɫоɯɪɚнɟниюоɬɪɚɫлɟйпɪоизɜоɞɫɬɜɝоɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬичɚɫɬномɭпɪɟɞпɪинимɚɬɟльɫɬɜɭпɪиɫɭщимоɛильноɫɬьɜыɫокɚяэɮɮɟкɬиɜноɫɬьпользоɜɚнияɪɟɫɭɪɫоɜɫклонноɫɬьинноɜɚциямНɚкоплɟнныйнɚɫɬоящɟмɭɚɪɫɟнɚлɮоɪммɟɬоɞоɜпозɜоляɟɬɫоɯɪɚнɟнииɜɚжнɚционɚльныɯоɛъɟкɬоɜɝоɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬипɟɪɟɞɚɜɚɬьполномочийномɭɫɟкɬоɪɭИмɟюɬɫяɬɚкиɟɮɭнкциикɚкɫооɪɭжɟниɟэкɫплɭɚɬɚцияɫоɞɟɪжɚниɟоɛъɟкɬоɜпɪоизɜоɞɫɬɜɟннойɫоциɚльнойинɮɪɚɫɬɪɭкɬɭɪыɬɚкжɟɭпɪɚɜлɟниɟɌɚкимоɛɪɚзомɬɪɚɞиционноɝоɫɭɞɚɪɫɬɜɟннɭюɫɮɟɪɭэкономикипɪиɜноɫяɬɫяɫɜоɟɝоɪоɞɚɬоɜɚɪычɬоɫозɞɚɟɬэɮɮɟкɬиɜноɝоɮɭнкциониɪоɜɚнияɭкɚзɚнныɯоɛъɟкɬоɜопɬимɚльноɝоɭпɪɚɜлɟнияɪɚционɚльноɝоиɫпользоɜɚнияɪɟɫɭɪɫоɜȽоɫɭɞɚɪɫɬɜополɭчɚɟɬɜыɝоɞɭɭɜɟличɟнияɫɜязɚнныɯпɪоɟкɬомɛюɞжɟɬныɯɯоɞоɜɬɚкжɟкоɫɜɟнныɯэɮɮɟкɬоɜожиɜлɟнияконъюнкɬɭɪыɪоɫɬɚинɜɟɫɬиционнойпɪиɜлɟкɚɬɟльноɫɬиɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияэɬоɜзɚимоɜыɝоɞноɟɫоɬɪɭɞничɟɫɬɜоɝоɫɭɞɚɪɫɬɜɟннойɜлɚɫɬимɟɫɬноɝоɫɚмоɭпɪɚɜлɟниянɟкоммɟɪчɟɫкиɯпозɜоляющɟɟоɛɟɫпɟчиɬьэɮɮɟкɬиɜноɟɜыполнɟниɟзɚɞɚчпɭɛличпɪɚɜоɜыɯоɛɪɚзоɜɚнийɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияпɪиɜлɟчɟнияɪɟɫɭɪɫоɜɫозɞɚнияконɫɬɪɭкцииɭпɪɚɜлɟнияɫоɞɟɪжɚнияинɮɪɚɫɬɪɭкɬɭɪызɞɪɚɜооɯɪɚнɟнияпɪɟɞоɫɬɚɜлɟния [2]. Пɟɪɟɞɝоɫɭɞɚɪɫɬɜɟннопɚɪɬнɟɪɫɬɜомзɞɪɚɜооɯɪɚнɟнииɫɬоиɬзɚɞɚчɚ ? ɫɞɟлɚɬьмɟɞицинɫкɭюпомощьɛолɟɟɞоɫɬɭпнойиɫпользоɜɚниɟɫɭɪɫоɜзɞɪɚɜооɯɪɚнɟнияɛолɟɟэɮɮɟкɬиɜнымконцɟпциизɞɪɚɜооɯɪɚнɟнияɊоɫɫийɫкойɎɟɞɟɪɚции 2020 ɝоɞɚмоɞɟɪнизɚциязɞɪɚɜооɯɪɚнɟнɚзɜɚнɚоɞнойзɚɞɚчɝоɫɭɞɚɪɫɬɜɚзнɚчиɬɟльнɚялɟчɟɛнопɪоɮилɚкɬичɟɫкиɯпоɫɬɪоɟнɚМинзɞɪɚɜɚɊоɫɫии 32% ɛольниц 30% поликлиникɬɪɟɛɭюɬкɚпиɬɚльноɝоɪɟмонɬɚоɬɫɭɬɫɬɜɭюɬɝоɪячɟɟɜоɞоɫнɚɛжɟниɟɜоɞопɪоɜоɞɚɜɬономноɟэнɟɪɝооɛɟɫпɟчɟниɟ 57% оɛоɪɭɞоɜɚнияɮизичɟɫкимоɪɚльноɭɫɬɚɪɟломоɞɟɪнизɚцииɜɫɟɝоɛлижɚйшиɟɝоɞыɫɬɪɚнɟнɟоɛɯоɞимопоɫɬɪоиɬьоколоɛольниц [3]. ɫɬɪɚɬɟɝичɟɫкиɯзɚɞɚчнɭжныинɜɟɫɬицииɫɭммɭ 0,8?1,0 ɬɪлнɪɭɛлɟйзɞɪɚɜооɯɪɚнɟния 20% окɚзыɜɚюɬɫɮɟɪɚɯпоɬɟнциɚльноɜоɫɬɪɟɛоɜɚнныɯинɜɟɫɬоɪоɜɜозможнɚяɫɭммɚинɜɟɫɬицийɫоɫɬɚɜляɟɬмлɪɞɪɭɛлɟйПомимоэɬоɝоɫɭɛъɟкɬоɜинɜɟɫɬициипɪиɜлɟкɚюɬɫяɫɬɪоиɬɟльɫɬɜоэкɫплɭɚɬɚциюзɞɪɚɜооɯɪɚнɟнияколоɝичɟɫкиɯɞиɫпɚнɫɟɪоɜцɟнɬɪоɜɪɟɚɛилиɬɚцииɞиɚлизныɯпɟɪинɚɬɚльныɯцɟнɬɪоɜоɛъɟкинɮɪɚɫɬɪɭкɬɭɪыɫɭщɟɫɬɜɭɟɬплɚɬɟжɟɫпоɫоɛныйɫпɪоɫɫɬоɪоныпоɬɪɟɛиɬɟлɟйчɬоможɟɬɪоɜɚɬьɜозɜɪɚɬинɜɟɫɬицийПоɬɟнциɚлɞɚнноɝоɫɟɝмɟнɬɚинɜɟɫɬицийоцɟниɜɚɟɬɫяэкɫпɟɪɬɚми 50?70 млɪɞɪɭɛлɟйɮɟɞɟɪɚльныɯɝоɫɭɞɚɪɫɬɜɟнныɯзɞɪɚɜооɯɪɚнɟнияпɪɟɞɜɚɪиɬɟльнымоцɟнкɚмɬɟкɭщɚяпоɬɪɟɛноɫɬьинɜɟɫɬициɫоɫɬɚɜляɟɬɛолɟɟ 20 млɪɞɪɭɛлɟй 20 ɊɟшиɬьпɪоɛлɟмыможноиɫпользоɜɚниɟммɟɯɚнизмɚОɞнимɜɚжнɟйшиɯɮɚкɬоɪоɜɫɪɟɞыокɚзыɜɚющимɜлияниɟинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟниияɜляɟɬɫяноɪмɚɬиɜнопɪɚɜоɜоɟлиɪоɜɚниɟɌɚкɎɟɞɟɪɚльноɝозɚконɚ 13 июля 2015 ɝоɞɚ 224-ɝоɫɭɞɚɪɫɬɜɟнночɚɫɬномпɚɪɬнɟɪɫɬɜɟмɭниципɚльночɚɫɬномпɚɪɬнɟɪɫɬɜɟɊоɫɫийɫкойɎɟɞɟɪɚцииɜнɟɫɟнииизмɟнɟнийоɬɞɟльзɚконоɞɚɬɟльныɟɚкɬыɊоɫɫийɫкойɎɟɞɟɪɚции? [5] пɪɟɞɭɫмɚɬɪиɜɚɟɬɫозɞɚниɟмоɞɟɪнизɚциюоɛъɟкɬоɜмɟɞицинɫкойинɮɪɚɫɬɪɭкɬɭɪыинɜɟɫɬокɚчɟɫɬɜɚпɪɟɞоɫɬɚɜляɟмыɯнɚɫɟɞопɭɫкɚɟɬɫɬɚɬɭɫɫоɛɫɬɜɟнноɫɬиɫозɞɚɜɚɟмыɟɪɟконɫɬɪɭиɪɭɟмыɟоɛъɟкɬыɫɬɪɭкɬɭɪыинɜɟɫɬоɪоɛязɚноɛɟɫпɟчиɬьиɫпользоɜɚɫɬɪоɝоцɟлɟɜомɭнɚзнɚчɟниюзɚконɭпɭɛличнɚяɫɬоɪонɚможɟɬпɪинимɚɬьпɪоɟкɬɟчɟɪɟзпɪямоɟɫоɮинɚнɫиɪоɜɚпɪɟɞоɫɬɚɜляяɫɭɛɫиɞиюɪɟɚлизɚциюпɪоɟкɬɚɝоɫɭɞɚɪɫɬɜɟннɭюɬɚкжɟпɪинимɚɬьимɭщɟɫɬɜɟнноɟɬомпɪɟɞоɫɬɚɜляяɜоɞныɟлɟɫныɟɫозɞɚɜɚɟмооɛъɟкɬɚКɪомɟэɬоɝопɪɟɞɭɫмоɬɪɟнмɟɯɚнизмɫоɯɪɚнɟниязɚключɚɟмоɝоконɬɪɚкɬɚȼмɟɫɬɟпоɞɝоɬоɜкойзɚконɚпɪоɜоɞилɚɫьɛоɬкɚконцɟɫɫионноɝозɚконоɞɚɬɟльɫɬɜɚиюлɟ 2014 ɝоɞɚɎɟɞɟɪɚльныйзɚкон 265-ɜнɟɫɟизмɟнɟнийɎɟɞɟɪɚльныйзɚконконцɟɫɫионɫоɝлɚшɟнияɯоɬɞɟльныɟзɚконоɞɚɬɟльныɟɚкɬыɊоɫɫийɫкойɎɟɞɟɪɚции 265-ȼ ɪɟзɭльɬɚɬɟɜнɟɞɪɟнɯɚнизминициɚɬиɜыпозɜоляющийɫокɪɚɬиɬьзɚключɟнияконцɟɫɫионноɝоɫоɝлɚшɟния 12 мɟɫяцɟɜпɪоɜɟɞɟнияконкɭɪɫɚ 150 50 ɟɫликонкɭɪɫпɪоɜоɞиɬɫяЗɚконɝɚɪɚнɬиɪɭɟɬокɭпɚɟмоɫɬьинɜɟɫɬицийконцɟɫɫионɟɪɚполɭчɟниɟɜыɪɭчкипɪɟɞɭɫмоɬɪɟннойконцɟɫɫионнымɫоɝлɚшɟпɪɟɞоɫɬɚɜляɟɬпɪɟимɭщɟɫɬɜɟнноɟпɪɚɜоɜыкɭпɚконцɟɫɫионɟɪомоɛъɟкɬɚконцɟɫɫионноɝоɫоɝлɚшɟнияɎɚкɬоɪомɜнɭɬɪɟннɟйɫɪɟɞыокɚзыɜɚющимпоɫɪɟɞɫɬɜɟнноɟɜлияниɟинɫɬиɬɭɬɚзɞɪɚɜооɯɪɚнɟниияɜляɟɬɫяиɫпользоɜɚниɟɮоɪммоɞɟлɟйоɛщɟпɪиняɬойɜɫɟмиɪнойпɪɚкɬикɟɞɜɟɮоɪмыɫоɬɪɭɞничɟɫɬɜɚконɬɪɚкɬнɚяинɫɬиɬɭционɚльнɚяИнɫɬиɬɭционɚльнɚяɮоɪмɚпɪɟɞполɚɫозɞɚниɟɫоɜмɟɫɬныɯпɪɟɞпɪияɬийɝоɫɭɞɚɪɫɬɜɚɛизнɟɫɚКонɬɪɚкɬнɚяɮоɪмɚɫɬɪɚɬɟɝичɟɫкоɝопɚɪɬнɟɪɫɬɜɚ ? эɬозɚключɟниɟконɬɪɚкɬɚɜыполнɟниɟопɪɟɞɟлɟнныɯɮɭнкцийоɬноɫиɬɟльнооɛъɟкɬɚзɞɪɚɜооɯɪɚнɟнияɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныɌɚɛлицɚɎоɪмыɫоɬɪɭɞничɟɫɬɜɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияИнɫɬиɬɭционɚльнɚяКонɬɪɚкɬнɚяɋозɞɚниɟноɜоймɟɞицинɫкойɫоɜмɟɫɬнымɝоɫɭɞɚɪɫɬɜɚɛизнɟɫɚɝоɫɭɞɚɪɫɬɜɟнныɟкоɪпоɪɚцииКонцɟɫɫияконцɟɫɫийпɪɚɜомпɟɪɟɞɚчиɛɟзпɪɚɜɚпɟɪɟɞɚчимɟɞицинɫкойчɚɫɬномɭпɚɪɬнɟɪɭɋозɞɚниɟнɟкоммɟɪчɟɫкойɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɫоɜмɟɫɬныɟпɪɟɞпɪияɬияɯолɞинɬɪɚɫɬыɝоɫɭɞɚɪɫɬɜɟннойɞолɟйКонɬɪɚкɬныɟɮоɪмыɜключɚяимɭщɟɫɬɜɚɝоɫɭɞɚɪɫɬɜɟнныйзɚкɚззɚкɚзпоɫɬɚɜкɭпɪоɞɭкцииɝоɫɭɞɚɪɫɬɜɟнныɯнɭжɞɋозɞɚниɟɭпɪɚɜляющɟйкомпɚнииɪɟɚлизɚцииɭпɪɚɜлɟнияпɪоɟкɬɚмиɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияКонɬɪɚкɬыɝоɫɭɞɚɪɫɬɜɟннымɪɚɛоɬɚмɮинɚнɫиɪɭɟмыɟɫɟкɬоɪомПɟɪɟɞɚчɚкомпɚнииɞолиɝоɫɭɞɚɪɫɬɜɟнноймɟɞицинɫкойɬомпɪиɜɚɬизɚцияɚкциониɪоɜɚниɟКонɬɪɚкɬныɟɮоɪмыкɜɚзиɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɞоɝоɜоɪокɚзɚниɟмɟɞицинɫкиɯɞоɝоɜоɪɫоɬɪɭɞничɟɫɬɜɟɞоɝоɜоɪɜыполнɟниɟɜɫпомоɝɚɬɟльныɯɮɭнкциймɟɞицинɫкойɚɭɬɫоɪɫинɝɪɟзɭльɬɚɬɚмɚнɚлизɚмоɞɟлɟйɝоɫɭɞɚɪɫɬɜɟнчɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɫооɬɜɟɬɫɬɜиинɚɪоɞнойклɚɫɫиɮикɚциɟйɬɚɛлзɞɪɚɜооɯɊоɫɫийɫкойɎɟɞɟɪɚцииɪɟкомɟнɞɭɟɬɫяиɫпользоɜɚɬьпɪиɜɟɞɟнныɟмоɞɟликонɬɪɚкɬнойɮоɪмыɫɭщɟɫɬɜɭющиɯконɬɪɚкɬныɯɮоɪмɫоɬɪɭɞничɟɫɬɜɚнɚиɛольшɟɟɪɚɫпɪоɫɬɪɚнɟниɟинɮɪɚɫɬɪɭкɬɭɪныɯоɬɪɚɫляɯɫоциɚльнойɫɮɟɪɟɬомзɞɪɚɜооɯɪɚнɟнииɝɞɟнɟоɛɯоɞимыпɪиɬокинɜɟɫɬицийɜыɫококɜɚлиɮициɪоɜɚнноɟɭпɪɚɜлɟполɭчиликонцɟɫɫииКонцɟɫɫияконцɟɫɫионноɟɫоɝлɚшɟниɟиɮичɟɫкɚяɮоɪмɚоɬношɟнийɝоɫɭɞɚɪɫɬɜомпɚɪɬнɟɪомоɫоɛɟнноɫɬькоɬоɪойɫоɫɬоɬомчɬоɝоɫɭɞɚɪɫɬɜоɫɭɛъɟкɬпɚльноɟоɛɪɚзоɜɚниɟɪɚмкɚɯпɚɪɬнɟɪɫкиɯоɬнооɫɬɚɜɚяɫьполнопɪɚɜнымɫоɛɫɬɜɟнникомимɭщɟɫɬɜɚɫоɫɬɚɜляющɟɝопɪɟɞмɟɬɫоɝлɚшɟнияɭполномочиɜɚɟɬчɚɫɬноɝопɚɪɬнɟɪɚɜыполняɬьоɝоɜɚɪиɜɚɟмыɟɫоɝлɚшɟнииɮɭнкцииɟɝоɫооɬɜɟɬɫɬɜɭющимиполномочиямипользоɜɚниɟɝоɫɭɞɚɪɫɬɜɟнноймɭниципɚльнойɫоɛɫɬɜɟнноконцɟɫɫионɟɪɜноɫиɬплɚɬɭоɝоɜоɪɟнныɯконцɟɫɫионномɫоɝлɚшɟнииПɪɚɜоɫоɛɫɬɜɟнноɫɬиокɚзɚнныɟконцɟɫɫиипɟɪɟɞɚɟɬɫяконцɟɫɫионɟɪɭɪɚмкɚɯконцɟɫɫииɝоɫɭɞɚɪɫɬɜоɜɫɟɝояɜляɟɬɫяоɪɝɚномпɭɛличнойɜлɚɫɬиэɬомкɚчɟɫɬɜɟпɪоɫɬопɪɟɞоɫɬɚɜляɟɬпɚɪɬнɟɪɚмɫоɝлɚшɟɫɜоиɯполномочийкɚкɫоɛɫɬɜɟнникɚɞɟлɟɝиɪɭɟɬɫɜоиɯɜлɚɫɬныɯɮɭнкцийключиɬɟльныɯɫɭɜɟɪɟнныɯИɫключиɬɟльноɫɬьɫɭɜɟɪɟнноɫɬьɯɚɪɚкɬɟɪиɫɬикпɪɟɞоɫɬɚɜляɟɝоɫɭɞɚɪɫɬɜомконцɟɫɫионɟɪɭчɚɫɬномɭпɚɪɬнɟзɚключɚɟɬɫяɬомчɬоɪɚмкɚɯкоɬоɪыйполɭчɚɟɬиɫключиɬɟльноɟпɪɚɜоɞопɭɫкɚɟɬɫяɚнɚлоɝичнɚяɞɟяɬɟльноɫɬьɬɪɟɬьиɯɬɚкжɟɫɚмоɝоɝоɫɭɞɚɪɫɬɜɚИɫɬочникиɮинɚнɫиɪоɜɚнияконцɟɫɫииможноизоɛɪɚзиɬьɫлɟɞɭющɟйɫɯɟмыȺнɚлизноɪмɚɬиɜнопɪɚɜоɜыɯɚкɬоɜпозɜоɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɬɪиконцɟɫɫийɫɭщɟɫɬɜɭющиɟоɛъɟкɬызɞɪɚɜооɯɪɚнɟнияɫɬɪоиɬɟльɫɬɜомоɞɟɪнизɚциюоɛъɟкɬоɜзɞɪɚɜооɯɪɚнɟнияпɟɪɟɞɚчɭоɛъɟкɬоɜɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬиɭпɪɚɜлɟниɟɭпɪɚɜляющɟйкомпɚнииɌɚккɚкɊоɫɫииɞɟйɫɬɜɭɟɬзɚконконцɟɫɫионныɯɫоɝлɚшɟнияɯɬоɪоɝоɫɬɚлооɫноɜойиɫпользоɜɚниямɟɯɚнизмоɜцɟлɟɫооɛɪɚзноɫиɫɬɟмɚɬизиɪоɜɚɬьоɛязɚɬɟльɫɬɜɚкɚжɞойɫɬоɪон ? концɟɞɟнɬɚконцɟɫɫионɟɪɚȺнɚлиззɚɪɭɛɟжноɝоопыɬɚиɫпользоɜɚнияɯɚнизмɚяɜляɟɬɫянɟоɬъɟмлɟмойɫоɫɬɚɜляющɟйɜлиянияɮɚкɬоɪоɜзɞɪɚɜооɯɪɚнɟнииɫɬɪɚнɚɯпɪоиɫɯоɞиɬɟɫлиȼɟликоɛɪиɬɚнииȽɟɪмɚнииɞоɫɬɚɬочноɫɮоɪмиɪоɜɚнɞɪɭɝиɟɫɬɪɚныɬольконɚчɚлиɪɚзɜиɜɚɬьɬɚкоɝоɪоɞɚпɚɪɬнɟɪɫɬɜɚɚнɚлизмɟжɞɭнɚɪоɞныɯпɪɚкɬикɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɪɚɫɜиɞɟɬɟльɫɬɜɭɟɬɪоɫɬɟэɮɮɟкɬиɜноɫɬижɟнииɫɬоимоɫɬилɟчɟнияɭɜɟличɟнииоɛъɟмɚэкономииɝоɫɭɞɚɪɫɬɜɟнныɯɪɟɫɭɪɫоɜɫɪɟɞнɟмЛиɞɟɪоммɟɞицинɟɜыɫɬɭпɚɟɬȼɟликоɛɪиɬɚния 1992 ɝоɞɚ 2014 ɞоляȼɟликоɛɪиɬɚнииоɛщɟɟɜɪопɟйɫкомколичɟɫɬɜɟпɪоɟкɬоɜɫоɫɬɚɜилɚ 67%, ɫɬоимоɫɬи ? 53%. оɛъɟмɟзɞɪɚɜооɯɪɚнɟниизɚнимɚɟɬ20%. Ƚоɫɭɞɚɪɫɬɜɟнночɚɫɬноɟпɚɪɬнɟɪɫɬɜозɞɪɚɜооɯȼɟликоɛɪиɬɚнииɪɚзɜиɜɚɟɬɫяɞɜɭɯнɚпɪɚɜ ? ɫɬɪоиɬɟльɫɬɜоɪɟконɫɬɪɭкцияоɫноɜныɯоɬɪɚɫлипɪɟɞоɫɬɚɜлɟниɟмɟɞицинɫкиɯ 1992 ɝоɞɭПɪɚɜиɬɟльɫɬɜоȼɟликоɛɪиɬɚниипɪɟɞɫɬɚɜилоɮинɚнɫоɜɭюинициɚɬиɜɭкɚкнɚиɛолɟɟэɮɮɟкɬиɜнɭюɮоɪмɭпɚɪɬнɟɪɫɬɜɚпɭɛличныɯɋɭɬьɬɚкойɛɪиɬɚнɫкойɮоɪмыɫоɫɬоялɚпɪиɜлɟчɟнииинɜɟɫɬɪоиɬɟльɫɬɜɚкɪɭпныɯɝоɫɭɞɚɪɫɬɜɟнныɯоɛъɟкɬоɜзɞɪɚɜооɯɪɚнɟниикоɝɞɚɛизнɟɫоɫɭщɟɫɬɜляɟɬɫɬɪоиɬɟльɫɬɜоɝоɫɭɞɚɪɫɬɜɟнноɝооɛъɟкɬɚɫчɟɬɫоɛɫɬɜɟнныɯɫɪɟɞɫɬɜPharmacy & Pharmacology V. 5 N 4, 2017ИɋɌОЧНИКИɎИНȺНɋИɊОȼȺНИЯȼнɟɛюɞжɟɬныɟɮонɞыȻюɞжɟɬЗɚɟмныɟɫɪɟɞɫɬɜɚ-60%)Пɪиɛыльоɬэкɫплɭɚɬɚцииипɪочиɟɞоɯоɞыɋоɛɫɬɜɟнныɟɫɪɟɞɫɬɜɚɞоɋɪɟɞɫɬɜɚконцɟɞɟнɬɚ(0-30%)ɋɪɟɞɫɬɜɚконцɟɫɫионɟɪɚ(30-100%)КонцɟɫɫионноɟɫоɝлɚшɟниɟКонцɟɫɫионноɟɫоɝлɚшɟниɟɎинɚнɫоɜыɟоɛязɚɬɟльɫɬɜɚконцɟɫɫионɟɪɚȺɪɟнɞнɚяплɚɬɚИнɜɟɫɬицииɜɫɬɪоиɬɟльɫɬɜоПлɚɬɚзɚконцɟɫɫиюɎинɚнɫоɜыɟоɛязɚɬɟльɫɬɜɚконцɟɞɟнɬɚɎинɚнɫиɪоɜɚниɟɫɬɪоиɬɟльɫɬɜɚɎинɚнɫиɪоɜɚниɟэкɫплɭɚɬɚции ɊиɫɭнокɎинɚнɫиɪоɜɚнияконцɟɫɫионноɝоɫоɝлɚшɟнияɊиɫɭнокɎинɚнɫоɜыɟоɛязɚɬɟльɫɬɜɚɭчɚɫɬникоɜконцɟɫɫионноɝоɫоɝлɚшɟнияɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныȽоɫɭɞɚɪɫɬɜɟнночɚɫɬноɟпɚɪɬнɟɪɫɬɜозɞɪɚɜооɯȼɟликоɛɪиɬɚнииɪɚзɜиɜɚɟɬɫяɞɜɭɯнɚпɪɚɜ ? ɫɬɪоиɬɟльɫɬɜоɪɟконɫɬɪɭкцияоɫноɜныɯоɬɪɚɫлипɪɟɞоɫɬɚɜлɟниɟмɟɞицинɫкиɯ 1992 ɝоɞɭПɪɚɜиɬɟльɫɬɜоȼɟликоɛɪиɬɚниипɪɟɞɫɬɚɜилоɮинɚнɫоɜɭюинициɚɬиɜɭкɚкнɚиɛолɟɟэɮɮɟкɬиɜнɭюɮоɪмɭпɚɪɬнɟɪɫɬɜɚпɭɛличныɯɋɭɬьɬɚкойɛɪиɬɚнɫкойɮоɪмыɫоɫɬоялɚпɪиɜлɟчɟнииинɜɟɫɬɪоиɬɟльɫɬɜɚкɪɭпныɯɝоɫɭɞɚɪɫɬɜɟнныɯоɛъɟкɬоɜзɞɪɚɜооɯɪɚнɟниикоɝɞɚɛизнɟɫоɫɭщɟɫɬɜляɟɬɫɬɪоиɬɟльɫɬɜоɝоɫɭɞɚɪɫɬɜɟнноɝооɛъɟкɬɚɫчɟɬɫоɛɫɬɜɟнныɯɫɪɟɞɫɬɜКомпɟнɫɚцияɪɚɫɯоɞоɜчɚɫɬноɝоинɜɟɫɬоɪɚоɫɭщɟɫɬɜляɟɬɫяɜпоɫлɟɞɫɬɜииɫчɟɬɞоɯоɞоɜэкɫплɭɚɬɚцииɫчɟɬплɚɬɟжɟйɛюɞжɟɬɚɮинɚнɫоɜойинициɚɬиɜыинɜɟɫɬоɪпɪиɜлɟкɚɟɬɫяɞɚльнɟйшɟйэкɫплɭɚɬɚцииоɛъɟкɬɚɜплоɬьнɚймɚпɟɪɫонɚлɚȼɟликоɛɪиɬɚнииɫɬоимоɫɬьоɛъɟкɬоɜɮинɚнɫоɜойинициɚɬиɜыɬоɪɚяɬɚмяɜляɟɬɫяоɫноɜнойɮоɪмойзɞɪɚɜооɯɫоɫɬɚɜляɟɬɛолɟɟ 30 млɪɞɮɭнɬоɜɫɬɟɪлинɝоɜɛɪиɬɚнɫкоɝоПɪɚɜиɬɟльɫɬɜɚɬɚкиɟпɪоɟкɬыоɛɟɫпɟчиɜɚюɬэкономииɛюɞжɟɬɚɫɬɪɚныȽɟɪмɚнииɫɮɟɪɟɪɚɫпɪоɫɬɪɚнɟниɟпɪоɞɚжɚɝоɫɭɞɚɪɫɬɜɟнныɯинɜɟɫɬоɪɚмɜоличɟɫкɭюɫɭммɭоɛмɟноɛɟɫпɟчɟниɟɮикɫиɪоɜɚннойɫɭммыинɜɟɫɬицийоɛязɚɬɟльɫɬɜɚполнɟниюɝоɫɭɞɚɪɫɬɜɟнноɝозɚкɚзɚЭɬооɛɭɫлоɜилоɭɜɟличɟниɟɞолипоɫлɟɞниɟ 10 Шɜɟциизɚключɚюɬɫяɫоɝлɚшɟнияинɜɟɫɬоɪɚмиɭпɪɚɜлɟниɟɝоɫɭɞɚɪɫɬɜɟннымиɝоɫпиɬɚлямиоɫɭщɟɫɬɜлɟниɟɫкоɪоймɟɞицинɫкойпомощипɪɟɞоɫɬɚɜлɟниɟклиничɟɫкиɯɬоɪийпɪочиɯмɟɞɭɫлɭɝмомɟнɬɚɜнɟɞɪɟнияпɪоɞолжиɬɟльноɫɬьожиɞɚнияɞиɚɝноɫɬилɟчɟнияɫокɪɚɬилɚɫь 30%, ɫɬоимоɫɬьмɟɞɭɫлɭɝзнɚчиɬɟльноɪɟнɬɝɟнɫɬикɟ 50%, клиничɟɫкимлɚɛоɪɚɬоɪнымокɚзɚниюɫкоɪойпомощи 50%, ȼ Ⱥɜɫɬɪɚлииɝɞɟɫоɛɫɬɜɟнноɫɬьɪɟɞɚнооколо 50 ɝоɫпиɬɚлɟйɪɚɫпɪоɫɬɪɚнɟныɫоɝлɚинɜɟɫɬоɪɚмиокɚзɚниɟɫɬɪоиɬɟльɫɬɜɭɜлɚɞɟниюɭпɪɚɜлɟниюконɬɪɚкɬɚɫɪоком 15 ɜключɚюɬоɛязɚɬɟльɫɬɜɚоɛɫлɭжиɜɚɬьɜɫɟɯɮикɫиɪоɜɚннымɪɚɫцɟнкɚмоɫɭщɟɫɬɜляɬьконɬɪолькɚчɟɫɬɜомокɚзɚнияɞицинɫкойпомощиɪɟзɭльɬɚɬɟɜнɟɞɪɟнияинɫɬиɬɭзɚɬɪɚɬыɫɬɪоиɬɟльɫɬɜоɭпɚли 20%, количɟɫɬɜооɛɫлɭжиɜɚɟмыɯпɚциɟнɬоɜɪоɫло 30%, пɪоɞолжиɬɟльноɫɬьожиɞɚниялɟчɟнияɫокɪɚɬилɚɫь 30%, Эɬи пɪимɟɪы оɬɪɚжɚюɬ ? ɫɬɚноɜиɬɫяпɪиɜлɟкɚɬɟльнойɫɮɟɪойжɟниячɚɫɬноɝокɚпиɬɚлɚчɬооɛлɟɝчɚɟɬзɚɞɚчиɝоɫɭɞɚɪɫɬɜɚпользɭпоɬɪɟɛиɬɟляммɟɞицинɫкиɯɮоɪмиɪоɜɚнииоɬɟчɟɫɬɜɟннойɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɫлɟɞɭɟɬпɪинимɚɬьɜнимɚниɟɪɟɚлизɚциипɪоɟкɬоɜоɫноɜɟэɬомɫɬоиɬɜɚɬьчɬокɚжɞɚяɪɚɫɫмɚɬɪиɜɚɟмыɯɫɬɪɚноɛлɚɞɚɫоɛɫɬɜɟннойɫɬɪɭкɬɭɪойпɭɛличноɝоɭпɪɚɜлɟнияɬɚкжɟɫоɛɫɬɜɟннымопыɬомɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚпоэɬомɭкопиɪоɜɚниɟоɬɞɟльныɯэлɟмɟнɬоɜнɟɞооɬɟчɟɫɬɜɟннойɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚцɟломэлɟмɟнɬоɜчɚɫɬноɫɬинɟоɛɯоɞимоɬыɜɚɬьоɫоɛɟнноɫɬипɚɪɬнɟɪɫкиɯоɬношɟɮɟɞɟɪɚльномоɬɞɟльныɯɫɭɛъɟкɬоɜɊоɫɫийɫкойɎɟɞɟɪɚцииɪоɫɫийɫкойэкономикɟɟɫɬьɜозможноɫɬиключɚɬьконɬɪɚкɬыжизнɟнноɝоɫɬɪоиɬɟльɫɬɜɟɪɟконɫɬɪɭкцииоɛъɟкɬоɜзɞɪɚɜооɯɪɚнɟнияпɪиɜлɟкɚɬьɪоɫɫийɫкиɟзɚɪɭɛɟжныɟкомɭпɪɚɜлɟниюоɛъɟкɬɚмизɞɪɚɜооɯɪɚнɟнияɪɚмкɚɯконцɟɫɫииКɪомɟɬоɝоɟɫɬьинɜɟɫɬоɪыкоɬоɪыɟɝоɬоɜыɭчɚɫɬɜоɜɚɬьпɪоɟкɬɚɯɞоɯоɞноɫɬью 8-9%. ɛɟжомоɛъɟкɬызɞɪɚɜооɯɪɚнɟнияɫɬɪояɬɭпɪɚɜляюɬкɪɭпныɟмɟжɞɭнɚɪоɞныɟкомпɚэɬомоɫноɜныɟɫɪɟɞɫɬɜɚɜклɚɞыɜɚюɬпɪоɟкɬыинɜɟɫɬоɪыɝоɫɭɞɚɪɫɬɜоɜыɫɬɭпɚɟɬɝɚɪɚнɬомɫоɛлюɞɟнияɜɫɟɯɞоɝоɜоɪɟнноɫɬɟйɜозɜɪɚɬкɪɟɞиɬоɜɞоɯоɞноɫɬьпоɫɬɪоɟнныɯɜошɟɞшиɯэкɫплɭɚɬɚциюоɛъɟкɬоɜЭɬопозɜоляɟɬоɛɟɫпɟчиɬьнɚɫɟлɟниɟмɟɞицинɫкойпомощьюɬɚмɝɞɟɯɜɚɬɚɟɬɫɪɟɞɫɬɜɝоɫɭɞɚɪɫɬɜɚэкономичɟɫкойɬочкиɜыɝоɞɚнɟɫомнɟннɚɝоɫɭɞɚɪɫɬɜоɫɬɪоиɬɛолɟɟɞоɪожɟɫɟкɬоɪщɟɫɬɜɟннɚпоɬɪɟɛиɬɟлямɟɞицинɫкиɯ ? ɫможɟɬполɭчиɬьɛыɫɬɪɟɟɛолɟɟкɚчɟɫɬɜомконɟц 2016 ɝоɞɚзɞɪɚɜооɯɫɬɚɞияɯɮоɪмɚɬɟɝоɫɭɞɚɪɫɬɜɟнчɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɪɟɚлизоɜыɜɚлоɫьɛолɟɟпɪоɟкɬоɜɫɬɚɞииɫɬɪоиɬɟльɫɬɜɚэкɫплɭɚɬɚции ? 61 пɪоɟкɬɪɚмкɚɯɪɟɚлизɭɟмыɯпɪоɟкɬоɜзɞɪɚɜооɯɪɚнɟнииплɚниɪɭɟɬɫяɜлɟчьинɜɟɫɬицийɫɭммɭ 61 млɪɞɪɭɛлɟйоɛъɟминɜɟɫɬицийпɪоɟкɬɚɯɞоɫɬиɝɚ ? 57 млɪɞɪɭɛлɟйчɬоɫоɫɬɚɜляɟɬоколо 10% оɛщɟɝооɛъɟмɚинɜɟɫɬицийпɪоɟкɬɚɯɜɫɟɯоɬɪɚɫляɯ [4]. нɚɫɬоящɟɟпоɞɜɟɞомɫɬɜɟнныɯМинзɞɪɚɜɭɊоɫɫииɮɟɞɟɪɚльныɯɝоɫɭɞɚɪɫɬɜɟнныɯэɬɚпɚɯпоɞɝоɬоɜкинɚɯоɞяɬɫя 15 инɜɟɫɬиционныɯпɪоɟкɬоɜɬомɫозɞɚниɟмноɝопɪоɮильноɝоцɟнɬɪɚокɚзɚɚмɛɭлɚɬоɪнополиклиничɟɫкойпомощипользоɜɚниɟммɟɯɚнизмɚконцɟɫɫииМоɫкɜɟɫɬɪоиɬɟльɫɬɜоконɫɭльɬɚɬиɜноɞиɚɝноɫɬичɟɫкойполиклиникицɟнɬɪɚнɟɮɪолоɝииɞиɚлизɚзɚключɟнияинɜɟɫɬиционноɝоɞоɝоɜоɪɚ ? мɚɪɟоɮиɫноɝокомплɟкɫɚɪɚзмɟщɟклиничɟɫкиɯпоɞɪɚзɞɟлɟнийзɚключɟнияинɜɟɫɬиционноɝоɞоɝоɜоɪɚ ? ɫɬоɜɟɪɟконɫɬɪɭкцияɚɜɚɪийныɯзɞɚнийинɜɟɫɬиционноɝоɞоɝоɜоɪɚПɟɪмиɫозɞɚниɟмɟɞицинɫкоɝоцɟнɬɪɚɛɚзойиɫпользоɜɚниɟммɟɯɚнизмɚконцɟɫɫииПɟɪмиPharmacy & Pharmacology V. 5 N 4, 2017ɋɪɟɞиɫɭɛъɟкɬоɜкоɬоɪыɯэɮɮɟкɬиɜноиɫпользɭɟɬɫямɟɯɚнизмможноɊɟɫпɭɛликɭɌɚɬɚɪɫɬɚнНɚпɪимɟɪȺȼȺзɚключɟконцɟɫɫионноɟɫоɝлɚшɟниɟɪɟконɫɬɪɭкцииплɚниɪоɜɚнияɫɟмьиɪɟпɪоɞɭкцииɫɪоком 10 чɬопозɜолилоɪɟɫпɭɛликɟоɛɪɟɫɬиɫоɜɪɟмɟнноɟмɟɞицинɫкоɟкоɬоɪоɟɛɭɞɟɬзɚнимɚɬьɫяпɪоɛлɟмɚмиɫоɯɪɚнɟнияɜоɫɫɬɚноɜлɟнияɪɟпɪоɞɭкɬиɜноɝозɞоɪоɜьяКлиникɚмɟɞицины HD? зɚключɟно 5 концɟɫɫионныɯɫоɝлɚɫозɞɚнииэкɫплɭɚɬɚциицɟнɬɪоɜɚмɛɭлɚɬоɪноɝоɝɟмоɞиɚлизɚКɚзɚниНɚɛɟɪɟжныɯНижнɟкɚмɫкɟȻɭɝɭльмɟчɬопозɜолилооɛɟɫпɟчиɬьɞоɫɬɭпноɫɬьɞɚнноɝопомощинɚɫɟлɟнияɪɟɫпɭɛликиКɪомɟɬоɝоцɟнɬɪɚмɛɭлɚɬоɪноɝоɝɟмоɞиɚлизɚКɚзɚниɊоɫɫииɫɬɪɭкɬɭɪнымпɪоɟкɬомɫоциɚльнойɫɮɟɪɟкɚɯНɚционɚльнойɫɮɟɪɟинɮɪɚɫɬɪɭкɬɭɪыпоɫлɟɞниɟɝоɞымɟɞɭчɪɟжɞɟнияɫɬɪɚныполɭмноɝоɫоɜɪɟмɟнноɝооɛоɪɭɞоɜɚнияɬолькоэɬоɝооɛоɪɭɞоɜɚнияɪɚɛоɬɚюɬполнɭюɬомчɬоɯɜɚɬɚɟɬпоɞɝоɬоɜлɟнныɯкɚɞɪоɜчɟɝоцɟнɬɪыɭɫпɟɜɚюɬиɫпользоɜɚɬьɞɚжɟɝоɫɭɞɚɪɫɬɜомɫɪɟɞɫɬɜɚɜыɫокоɬɟɯнолоɝичнɭюмɟɞицинɫкɭюпомощьɌɚкпояɜилɫяпɪоɟкɬ ? оɛɪɚзоɜɚɬɟльныйцɟнɬɪмɟɞицинɬɟɯнолоɝийКɚзɚни 2008 ɝоɞɭЭɬооɛɪɚзоɜɚɬɟльныйцɟнɬɪɊɟɝионɚльныɟɜлɚɫɬипɪɟɞоɫɬɚɜилизɞɚниɟоɛɟɫпɟɟɝокɚпиɬɚльныйɚɞминиɫɬɪɚɬиɜнɭюпоɞɞɟɪжкɭȻизнɟɫɜложилɫɜойɬомпɪоɟкɬноɝоɭпɪɚɜлɟнияɫɟɛяɪɚɫɯоɞыȻюɞжɟɬцɟнɬɪɚ 15 ɞоллɪɚɫɫчиɬɚнЗɞɟɫьпɪоɯоɞяɬоɛɭчɟниɟɜɪɚчимɟɞɫɟɫɬɪыɚɞминиɫɬɪɚɬоɪыɪɚɛоɬыЦɟнɬɪɚпоɞɝоɬоɜлɟноɛолɟɟ 4000 ɜɪɚчɟй 73 ɪоɞоɜɛольшинɫɬɜɚоɛɭчɟниɟ ? 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2016 ɝоɞɚПɚллɚɫоɜɫкоммɭниципɚльномɪɚмкɚɯɪɟɚлизɚцииɝоɫɭɞɚɪɫɬɜɟнчɚɫɬноɝопɚɪɬнɟɪɫɬɜɚпɟɪɟɞɚнконцɟɫɫиюнɚɬоɪийЭльɬонИнɜɟɫɬоɪконкɭɪɫпɪɚɜозɚключɟнияконцɟɫɫионноɝоɫоɝлɚшɟнияоɫɭщɟɫɬɜиɬɫɬɪоиɬɟльɫɬɜоɫпɚльноɝокоɪпɭɫɚмɟɫɬплɚɜɚɬɟльноɝоɛɚɫɫɟйнɚОɛъɟмɜɟɫɬицийпɪоɟкɬɫоɫɬɚɜиɬ 850 ɪɭɛлɟйОɛъɟкɬпозɜолиɬокɚзыɜɚɬькɚчɟɫɬɜɟнныɟɞоɫɬɭпныɟɜɫɟɝонɚɫɟлɟнияШиɪокоɟɪɚɫпɪоɫɬɪɚнɟниɟполɭчилɚпɪɚкɬикɚиɫпользоɜɚнияконɬɪɚкɬныɯɮоɪмкɜɚзиɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɚключɟнияɞоɝоɜоɪоɜɜыполнɟниɟɜɫпомоɝɚɬɟльныɯɮɭнкциймɟɞицинɫкойɛизнɟɫомɚɭɬȼолɝоɝɪɚɞɫкойоɛлɚɫɬиɞɜɟɬɪɟɬищиɯɫяɪɚɫпоɪяжɟниизɞɪɚɜооɯɪɚнɟнияɚɜɬоɬɪɚнɫпоɪɬныɯɫɪɟɞɫɬɜполноɫɬьюОɫноɜɭɚɜɬопɚɪкɚмɚшинɋкоɪойпомощиȼолɝоɝɪɚɞɫкойоɛлɚɫɬиɫоɫɬɚɜляюɬɚɜɬомоɛилиȽɚзɟлькоɬоɪыɟɪɚɛоɬɟɫложныɯɞоɪожныɯȼолɝоɝɪɚɞɚɜыɯоɞяɬɫɬɪояɞɜɚɝоɞɚПɪиоɛɪɟɫɬикɚɪɟɬыɋкоɪойпомощиɫчɟɬɫɪɟɞɫɬɜɛюɞжɟɬɚоɛязɚɬɟльноɝомɟɞицинɫкоɝоɫɬɪɚɯоɜɚнияɜозможноɫɬиПокɭпкɚɬɪɚнɫпоɪɬнойɫпɟциɚлизиɪоɜɚнныɯкомпɚнийпозɜолилɚɪɚмкɚɯзɚключɟнныɯɞоɝоɜоɪоɜɚɜɬопɚɪкмикɪоɚɜɬоɛɭɫыоɪиɟнɬиɪоɜɚныɜɪɚчɟɛоɛщɟɝооɫнɚɜɫɟмнɟоɛɯоɞимыммɟɞицинɫкимоɛоɪɭɞоɜɚниɟɝоɫɬоимоɫɬьɫоɫɬɚɜляɟɬоколоɫɬоимоɫɬиɚɜɬомоɛиляɋиɫɬɟмɚклимɚɬконɬɪоляɫозɞɚɟɬкомɮоɪɬныɟпɟɪɟɜозимыɯɜɪɚчɟйɬоɜлюɛоɟɝоɞɚИнɜɟɫɬоɪ 95 ɚлизиɪоɜɚнныɯмикɪоɚɜɬоɛɭɫоɜɫɬоимоɫɬьинɜɟɫɬпɪоɟкɬɚ ? 1,5 млɪɞɪɭɛлɟйɚɜɬомоɛилиɞоɝоɜоɪɭȼолɝоɝɪɚɞполɭчилɜɬоɪомкɜɚɪɬɚлɟɝоɞɚɪɚɫплɚчиɜɚɬьɫяокɚзыɜɚɟмɭюɝоɫɭɞɚɪɫɬɜоɛɭɞɟɬпоɫлɟɞɭющиɟмɟɞɭчɪɟжɞɟнияɯɚкɬиɜноɪɚзɜиɜɚɟɬɚɭɬɫоɪɫинɝпиɬɚнияклининɝоɜыɯлоɬнымпɪоɟкɬомɫɬɚлɚоɛлɚɫɬнɚяклиничɟɫкɚяɛольницɚȺɭɬɫоɪɫинɝпиɬɚниязɜолилоɛлɚɫɬнойɛольницɟɫɭщɟɫɬɜɟнноэкономиɬьɫɪɟɞɫɬɜɚкоɬоɪыɟɬɪɚɬилиɫьоɛɟɫпɟчɟниɟɪɚɛоɬыпищɟɛлокɚпɪɚчɟчнойэɬомкɚчɟɫɬɜопиɬɚнияɜыɪоɫлочɬоположиɬɟльно 2016 ɝоɞɭ 39 68 кɪɭɝлоɫɭɬочныɯлɟчɟɛныɯɫɬɚционɚɪоɜпиɬɚɚɭɬɫоɪɫинɝɭ [11]. ȼыɝоɞыпɟɪɟɞɚчизɚɞɚчмɟɞицинɫкоɝозɚключɚюɬɫяɫɭщɟɫɬɜɟнномɫнижɟниикɚкнɚɝɪɭзкипɟɪɫонɚлɬɚкɛолɟɟэɮɮɟкɬиɜномɭпɪɚɜлɟниизɚɬɪɚɬɚмикɭпкɭпоɞɞɟɪжкɭоɛɫлɭжиɜɚниɟɫоɛɫɬɜɟнноɝооɛоɪɭɞоɜɚнияпɪоɝɪɚммноɝооɛɟɫпɟчɟнияконɟчномиɬоɝɟзɚкɚзчикизɛɚɜляɟɬɫяцɟлоɝоɛюɞжɟɬныɯɛлɟмэɬомɫɚмойɜɚжнойɬɟкɭщɟмэɬɚпɟпɟɪɟɯоɞɚноɜойɫɯɟмɟоɬношɟнийзɚɞɚчɟйɫɬɚнɟɬɜыɫɬɪɚиɜɚниɟɞоɜɟɪиɬɟльныɯоɬɜɟɬɫɬɜɟнныɯпоɞɪяɞчикомокɚзыɜɚющимɚɭɬɫоɪɫинɝɭКонцɟнɬɪиɪɭяɫьокɚзɚниинɟпоɫɪɟɞɫɬɜɟнномɟɞицинɫкиɯзɞɪɚɜооɯɪɚнɟниɟиɫпользɭɟɬɫɯɟɚɭɬɫоɪɫинɝɚɜɫɟɯпɪоцɟɫɫɚɯнɚпɪимɟɪɬɟɯничɟɫкоɟоɛɫлɭжиɜɚниɟмɟɞицинɫкоɝооɛоɪɭɞоɜɚнияпɪоɜɟɞɟниɟлɚɛоɪɚɬоɪныɯиɫɫлɟɞоɜɚɜыɜозɚнɚɬомичɟɫкиɯоɬɯоɞоɜпɪопɭɫкноɝоɪɟжимɚоɯɪɚнɚоɛɟɫпɟчɟниɟоɛщɟɫɬɜɟнноɝопоɪяɞкɚɬɟɪɪиɬоɪииɛольницɬɟɯничɟɫкоɟоɛɫлɭжиɜɚниɟɬɟɯнолоɝичɟɫкоɝооɛоɪɭɞоɜɚнияпищɟɛлокɚлиɮɬоɜɜоɞоɫнɚɛжɟниякɚнɚлизɚɫɬиɪкɚɛɟльяоɛɟɫпɟчɟниɟɝоɬоɜымпиɬɚниɟмȼмɟɫɬɟнɟоɛɯоɞимооɬмɟɬиɬьчɬоɬɪɚɞиционныɟшɚɛлонныɟнɚпɪɚɜɞɟяɬɟльноɫɬиɫɮɟɪɟзɞɪɚɜооɯɪɚнɟниякоɬозɚɞɟйɫɬɜоɜɚнпоɬɟнциɚлНɚпɪимɟɪмɚлоɜнимɚнияɭɞɟляɟɬɫяпɪоɛлɟмɟоɛɭчɟниякɚɞɪоɜɪɚɛоɬыноɜойɬɟɯникойɫɬɚнɞɚɪɬоɜпоɪяɞкоɜɬɟɯничɟɫкомɭɫопɪоɜожɞɟниюɮɭнкциониɪоɜɚниюмɟɞицинɫкойɬɟɯникиинɮоɪмɚционныɯɮоɪмɜозможноɫɬɟйɜзɚимоɞɟйɜлɚɫɬиɛизнɟɫɚпɪоɞолжɚɟɬɫяɋозɞɚюɬɫяпɪɚɜоɜыɟзɚключɟнияконɬɪɚкɬɚноɝоɜыполнɟниɟɪɚɛоɬпɪоɟкɬиɪоɜɚниюɫɬɪоиɬɟльɫɬɜɭоɛъɟкɬоɜɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɬɚкжɟинɜɟɫɬиционныɯɞоɝоɜоɪоɜоɬношɟнииɞɟɪɚльнойинɮɪɚɫɬɪɭкɬɭɪызɞɪɚɜооɯɪɚнɟнияОɞнɚкоɊоɫɫииɪɚзɜиɜɚɟɬɫяɬɚкимиɛыɫɬɪымикɚкзɚɪɭɛɟжныɯɫɬɪɚнɚɯэɬоможнооɛъяɫниɬьɫɭɛъɟкɬиɜнымиɮɚкɬоɪɚмипɪɚɜоɜойɯозяйɫɬɜɟннойкомпɟɬɟнɬноɫɬиɜлɚɫɬилоɛɛизмомоɬɞɟльныɯɝɪɭппинɫɬиɬɭɬоɜɝɪɚжɞɚнɫкоɝооɛщɟɫɬɜɚɟɫɬьоɛъɟкɬиɜныɟɬɚкиɟкɚкоɬɫɭɬɫɬɜиɟɊоɫɫиимоɞɟлиɭпɪɚɜлɟнияɝоɫɭɞɚɪɫɬɜɟннойɫоɛɫɬɜɟнноɫɬьюȽоɫɭɞɚɪɫɬɜоɞолжнокɚкэɬоɞɪɭɝиɯɫɬɪɚнɚɯпоɫɪɟɞɫɬɜомзɚконоɞɚɬɟльɫɬɜɚɜоɜыɯноɪмчɟɬкоɫɜоɟйоɬɜɟɬɫɬɜɟнноɫɬипɟɪɟɞоɛщɟɫɬɜомнɟɝоɫоɛɫɬɜɟнноɫɬьопɪɟɞɟлиɬьɮɟɞɟɪɚльноɝозɚконɚкɪɭɝоɛъɟкɬоɜпоɞлɟжɚщиɯпɪиɜɚɬизɚцииПɪɚɜоɜɚянɟяɫноɫɬьэɬомɜопɪоɫɟɫпоɫоɛɫɬɜɭɟɬкоɪɪɭпциипɪиɜоɞиɬпояɜлɟниюмонополиимɟɫɬɟɝоɫɭɞɚɪɫɬɜɟнноймонополииɜɫɟмипоɫлɟɞɫɬɜиямиɝоɫɭɞɚɪɫɬɜɚоɛщɟɫɬɜɚоɞнимɫɞɟɪжиɜɚющимɮɚкɬоɪомяɜляɟɬɫянɚличиɟɪиɫкоɜɪɟɚлизɚциипɪоɟкɬоɜɊɚзɞɟлɟниɟɪиɫкоɜɝоɫɭɞɚɪɫɬɜоминɜɟɫɬоɪомɞолжноɜключɚɬьɫяконцɟɫɫионноɝоконɬɪɚкɬɚɫоɫɬɚɜляɬьɟɝоэкономичɟɫкɭюоɫноɜɭɊɚɫпɪɟɞɟлɟниɟɪиɫкоɜɞолжнопɪоɜоɞиɬьɫяпɟɪɟɞɚчиɭмɟɟɬнɚиɛолɟɟэɮɮɟкɬиɜноɭпɪɚɜляɬьɪиɫкɚмиоɫноɜномзɚключɚɟɬɫяɞоɫɬижɟнииɫинɟɪɝɟɬичɟɫкоɝоэɮɮɟкɬɚпɚɪɬнɟɪɫɬɜɚпɪɚкɬикɟпоɬɟнциɚлɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟиɫпользɭɟɬɫяполнойОɞнойɝлɚɜныɯэɬоɝояɜляɟɬɫяоɬɫɭɬɫɬɜиɟɫɮоɪмиɪоɜɚннойɭпɪɚɜлɟнияɞɚнноɝоинɫɬиɬɭɬɚPharmacy & Pharmacology V. 5 N 4, 2017кɚкɮɟɞɟɪɚльномɬɚкɪɟɝионɚльномɋɬɪɚɬɟɝиюɫɭɛъɟкɬоɜмɭниципɚльныɯзоɜɚнийнɚɫɬоящɟɟɜключɟнпɪɚкɬичɟɫкийɮɭнкциониɪɭющиɯпɪоɟкɬоɜоɫноɜɟɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚмɟɯɚнизмыɜзɚимоɞɟйɫɬɜияɜлɚɫɬиɛизнɟɫɚцɟлɟɜоɝоɭпɪɚɜлɟнияɪоɜɚнияɭпɪɚɜлɟнияɪɟɚлизɚциɟйпɪоɟкɬоɜɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚЗɚɪɭɛɟжныйɬɚкжɟɞɪɭɝиɯнɟоɛɯоɞимоɮоɪмɚлизоɜɚɬьɫɬɪɚɬɟɝичɟɫкиɯɞокɭмɟнɬоɜкоɬоɪыɟɞолжɜключɚɬьɫоɜокɭпноɫɬьɮоɪммɟɬоɞоɜинɫɬɪɭмɟнɬоɜɭпɪɚɜлɟнияпɪоɟкɬɚмипɚɪɬнɟɪɫɬɜɚɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияɊɚзɪɚɛоɬкɚɪɟɚлизɚцияɬɚкоɝомɟɯɚнизмɚɫозɞɚɫɬоɛъɟкɬиɜныɟпɪɟɞпоɫылкиɪиɫкоɜɛɭɞɟɬɫпоɫоɛɫɬɜоɜɚɬьпɪиɬокɭоɬɪɚɫльинɜɟɫɬиционныɯɪɟɫɭɪɫоɜɋлɟɞɭɟɬоɬмɟɬиɬьчɬоɛизнɟɫɜɫɬɭпɚяпɪоɟкɬыпɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɪɚнɟниизɚинɬɟɪɟɫоɜɚнɞолɝоɫɪочномɫɬɚɛильномɫоɬɪɭɞничɟɫɬɜɟкоɝɞɚизɜɟɫɬныɬиɪɭющиɟɜозɜɪɚɬɜложɟнныɯɫɪɟɞɫɬɜнɟоɛɯоɞимыйɭɪоɜɟньɞоɯоɞноɫɬиɜлɚɫɬинɟоɛɯоɞимоɭлɭчшɚɬьоɬкɪыɬыйɞиɚлоɝɛизнɟɫомнɚɯоɞиɬьмɟɯɚнизмыɫɬимɭлиɪоɜɚнияɫоциɚльнойоɬɜɟɬɫɬɜɟнноɫɬичɟɬкоопɪɟɞɟлиɬьполномочияɜлɚɫɬикоɬоɪыɟнɟɫɭɬоɬɜɟɬɫɬɜɟнноɫɬьɜɫɟɯэɬɚпɚɯпоɞɝоɬоɜкиɪɟɚлизɚцииɫоɜмɟɫɬныɯпɪоɟкɬоɜɪɟɝионɚльноммɟɫɬномɫɮоɪмиɪоɜɚɬьпɪоɟкɬоɜкоɬоɪыɟɪɟɚлизоɜɚныоɫноɜɟпɪоɜоɞиɬьмониɬоɪинɝэɮɮɟкɬиɜноɫɬиɪɟɚлизɚɫоɜмɟɫɬныɯпɪоɟкɬоɜоɛɟɫпɟчиɬьоɫɜɟщɟниɟɫɪɟɞɫɬɜɚɯмɚɫɫоɜойɮоɪмɚциипозиɬиɜноɝоопыɬɚэɬоɫɜоюочɟɪɟɞьможɟɬзɚинɬɟɪɟɫоɜɚɬьинɜɟɫɬоɪоɜоɪɝɚнизоɜɚɬьпоɞɯоɞоɛɭчɟниюɫпɟциɚлиɫɬоɜɮоɪмиɪоɜɚниякомɚнɞыэɮɮɟкɬиɜнойɪɟɚлизɚциипɪоɟкɬоɜКɪомɟɬоɝоɫɜязиоɫɬɪойɫоциɚльнойнɚпɪɚɜлɟнноɫɬьюɫɮɟɪыэкономикинɟɪɚзɜиɬоɫɬьюɪыночныɯмɟɯɚнизмоɜɯозяйɫɬɜоɜɚнияоɝɪомныммɚɫшɬɚɛомнɚкопиɜшиɯɫяоɬɪɚɫлипɪоɛлɟмɬɚкнɟɞоɫɬɚɬкомɛюɞжɟɬныɯɫɪɟɞɫɬɜɫоɛɫɬɜɟнныɯɪɟɫɭɪɫоɜɯозяйɫɬɜɭющиɯɫɭɛъɟкɬоɜɜозникɚɟɬнɟоɛɯоɞимоɫɬьɚкɬиɜнойɝоɫɭɞɚɪɫɬɜɟннойпоɞɞɟɪжкипɚɪɬнɟɪɫкиɯоɬношɟнийɜлɚɫɬиɛизнɟɫɚоɬɪɚɫлиɊɟɚлизɚцияɫоɝлɚшɟнийɝоɫɭɞɚɪɫɬɜɟннопɚɪɬнɟɪɫɬɜɚоɫложнɟннɚяɞлиɬɟльноɫɬьюɫоɝлɚɫоɜɚнияɞолɝоɫɪочнымɯɚɪɚкɬɟɪомɬɚкиɯпɪоɟкɬоɜɪиɫкоɜнɟɪɟɞконɟпɪɟɞɜиɞɟннымɯɚɪɚкɬɟɪомɬɪɟɛɭɟɬопɪɟɞɟлɟннопɪоɮɟɫɫионɚльноɝонɚɜыкоɜпɪоɟкɬноɝоɮинɚнɫиɪоɜɚниякоɬоɪымиɛольшинɫɬɜоɪɚɛоɬникоɜɜлɚɫɬиоɛлɚɞɚюɬɫɜязиɚкɬɭɚзɚɞɚчɚкɜɚлиɮициɪоɜɚнноɝоɫопɪоɜожɞɟнияпɪоɟкɬоɜɜɫɟɯɫɬɚɞияɯжизнɟнноɝоэɬомɮɭнкцииинɮоɪмɚционномɭконɫɭльɬɚционномɭмɟɬоɞичɟɫкомɭɫопɪоɜожɞɟниюпɪоɟкɬоɜпɚɪɬнɟɪɫɬɜɚцɟлɟɫооɛɪɚзноɜозложиɬьɫозɞɚнныɟɫɭɛъɟкɬɚɊоɫɫийɫкойɎɟɞɟɪɚКоɪпоɪɚцииɞɟйɫɬɜɭющиɟкɚчɟɫɬɜɟнɟкоммɟɪчɟɫкой 5 N 4, 2017Оɫноɜными цɟлями КоɪпоɪɚциияɜляюɬɫяпоɫɬоянноɝоɜзɚимоɞɟйɫɬɜиякɪɭпнɟйшимиинɫɬиɬɭɬɚмиполɭчɟниɟмɟɬоɞичɟɫкойпоɞɞɟɪжкиинɫɬиɬɭɬоɜɮɟɞɟɪɚльноɝооɫɭщɟɫɬɜлɟниɟɜзɚимоɞɟйɫɬɜияɯозяйɫɬɜɭюɫɭɛъɟкɬɚмииɫполниɬɟльнойɜлɚɫɬипɪоцɟɫɫɟɫɛоɪɚинɮоɪмɚциипоɞɝоɬоɜɫопɪоɜожɞɟнияпɪоɟкɬоɜокɚзɚниɟмɟɬоɞичɟɫкойпоɞɯозяйɫɬɜɭющимɫɭɛъɟкɬɚмпɪоцɟɫɫɟɪɟɚлизɚциипɪоɟкɬоɜɮинɚнɫиɪоɜɚнияинɮɪɚɫɬɪɭкɬɭɪпɪоɟкɬоɜоɛɪɚзоɜɚниɟɝɪɭппинɜɟɫɬоɪоɜɫоɝлɚɫоɜɚниɟинɬɟɪɟɫоɜɫозɞɚниɟɛлɚɝопɪиɫɪɟɞыколлɟкɬиɜныɯинɜɟɫɬицийɮɟɞɟɪɚльныɯɪɟɝионɚльныɯципɚльныɯинɫɬɪɭмɟнɬоɜпɪоцɟɫɫɟɪɟɚликɪɭпныɯинɜɟɫɬиционныɯпɪоɟкɬоɜɌɚкимоɛɪɚзомɜɚжнɟйшимɫɬɪɚɬɟɝичɟɫкимпɪɚɜлɟниɟминɫɬиɬɭɬɚзɞɪɚɜооɯɪɚяɜляɟɬɫяɚɞɚпɬɚцияɭɫпɟшноɝозɚɪɭɛɟжноɝооɬɟчɟɫɬɜɟнноɝоопыɬɚɪоɫɫийɫкойɬɟльноɫɬичɬопɪɟɞполɚɝɚɟɬнɟоɛɯоɞимоɫɬьɫозɞɚэɬоɝоɛлɚɝопɪияɬныɯпɪɚɜоɜыɯинɫɬиɬɭционɚльныɯэɬоɝоɬɪɟɛɭɟɬɫяноɪмɚɬиɜнопɪɚɜоɜойцɟлоɝопоɞзɚконныɯɚкɬоɜɪɟɝлɚмɟнɬиɪɭпɚɪɬнɟɪɫкиɟоɬношɟнияɜлɚɫɬиɛизнɟɫɚɫозɞɚниɟинɫɬиɬɭɬɚпɚɪɬнɟɪɫɬɜɚкомплɟкɫныɯинɫɬɪɭмɟнɬоɜпоɞɞɟɪжкиноɝоинɜɟɫɬоɪɚпɪиɜлɟчɟнияɪɟɫɭɪɫоɜɪɟɚлизɚцииɫоɜмɟɫɬныɯпɪоɟкɬоɜɪɚзɪɚɛоɬкɚпɪɚкɬичɟɫкиɯɞокɭмɟнɬоɜоɬкɪыɬыɯпɪоɟкɬоɜчɬопозɜолиɬɬиɪɚжиɪоɜɚɬьɫозɞɚниɟɫɬɪɭкɬɭɪинɫɬиɬɭɬоɜоɫноɜзɚɞɚчɟйкоɬоɪыɯяɜляɟɬɫяɜɫɟɫɬоɪонняяпоɞɞɟɪжкɚпɪоɟкɬоɜпɚɪɬнɟɪɫɬɜɚɪолиинɫɬиɬɭɬоɜɝɪɚжɞɚнɫкоɝощɟɫɬɜɚпɪоɟкɬɚɯпɚɪɬнɟɪɫɬɜɚпɪиɜлɟчɟниɟɪɟɚлизɚцииɜɫɟɯзɚинɬɟɪɟɫоɜɚнныɯɫɬоɪонɌолькоэɬомɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɟпɚɪɬнɟɪɫɬɜоɫɬɚнɟɬэɮɮɟкɬиɜныминɫɬɪɭмɟнɬомзɞɪɚɜооɯɪɚнɟнияɊɟɚлизɚциякомплɟкɫɚɜышɟпɟɪɟчиɫлɟнныɯпозɜолиɬэɮɮɟкɬиɜноɫɬьɫɮɟɪойзɞɪɚɜооɯɪɚнɟнияɭɫɬɪɚниɬьинɜɟɫɬиɝолоɞнɚкопиɜшиɟɫяпɪоɛлɟмымɟɯɚнизмоɜпɚɪɬнɟɪɫɬɜɚɜлɚɫɬиɛизнɟɫɚПоɫлɟчɟɝоɛɭɞɟɬɞоɫɬиɝнɭɬɚɝлɚɜпɪоɟкɬоɜоɫноɜɟ ? чɟɫɬɜɚнɚɫɟлɟнияоɛъɟɞинɟнииɪɟɫɭɪɫоɜɫɬоɪоноɛɪɚзомɪɚɫпɪɟɞɟлиɜɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныоɬɜɟɬɫɬɜɟнноɫɬьɫоɯɪɚняяɝоɫɭɞɚɪɫɬɜомконɬɪольныɟɮɭнкциипɚɪɬнɟɪɫɬɜɟЗɚключɟниɟоɫноɜɟпɪоɜɟɞɟнноɝоɚнɚлизɚможноɫɞɟлɚɬьɫлɟɞɭющиɟɜыɜоɞыЭɮɮɟкɬиɜнɚяɪɟɚлизɚцияпɪоɟкɬоɜɫɮɟзɞɪɚɜооɯɪɚнɟнияɜозможнɚɛɟзɭчɟɬɚɮɚкɬоɪоɜɜнɭɬɪɟннɟйɫɪɟɞыпɪɟɞɫɬɚɜлɟнныɯɫɭнкɟОɛъɟкɬиɜнɚяоцɟнкɚɜлиянияɮɚкɬоɪоɜɫлɭжиɬнɟоɛɯоɞимымɪɚзɪɚɛоɬкиɫɬɜɟнноɝоэкономичɟɫкоɝомɟɯɚнизɭпɪɚɜлɟнияɪɟɚлизɚциɟйпɪоɟкɬоɜɫɮɟɪɟзɞɪɚɜооɯɪɚнɟнияȺкɬɭɚльноɫɬьɪɚзɪɚɛоɬкиɫɬɪɚɬɟɝичɟɫкоɝоɭпɪɚɜлɟнияоɛɭɫлоɜлɟнɚɜыɫокойɫоциɚльнойзнɚчимоɫɬьюɫɮɟɪыэкономикимɟжɞɭнɚɪоɞныɯпɪɚкɬикɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɫɜиɞɟɬɟльɫɬɜɭɟɬɪоɫɬɟэɮɮɟкɬиɜноɫɬиɫнижɟнииɫɬоимоɫɬилɟчɟнияɭɜɟличɟнииоɛъɟмɚэкономииɝоɫɭɞɚɪɫɬɜɟнныɯɪɟɫɭɪɫоɜɫɪɟɞнɟмȺɞɚпɬɚциямɟжɞɭнɚɪоɞноɝоопыɬɚɬɪɟɛɭɟɬоɫоɛɟнноɫɬɟйпɚɪɬнɟɪɫкиɯоɬношɟнийɮɟɞɟɪɚльномоɬɞɟльныɯɫɭɛъɟкɬоɜɊоɫɫийɫкойɎɟɞɟɪɚциинɚɫɬоящɟɟзɞɪɚɜооɯɪɚнɟнииɊоɫɫийɫкойɎɟɞɟɪɚциииɫпользɭюɬɫяоɫноɜныɟɫɭммɭ 2,0?2,2 ɬɪлнɪɭɛлɟйэɬомизноɫɚɫоɫɬɚɜляɟɬ 40?45%. ɫɬɪɚɬɟɝичɟɫкиɯзɚɞɚчмоɞɟɪнизɚцииоɬɪɚɫлинɟоɛɯоɞимыинɜɟɫɬицииɫɭммɭоколоɬɪлнɪɭɛлɟйɊɟшиɬьэɬɭпɪоɛлɟмɭɜозможноиɫпользоɜɚниɟммɟɯɚнизмɚɫɭщɟɫɬɜɭющɚяноɪмɚɬиɜнопɪɚɜоɜɚязнɚчиɬɟльноɜозможноɫɬииɫпользоɜɚнияинɫɬɪɭмɟнɬоɜпоɞɞɟɪжкичɚɫɬноɝоɫɟкɬоɪɚɪɟɚпɪоɟкɬоɜпɚɪɬнɟɪɫɬɜɚɌɚкɫоɝлɚɫноȻюɞжɟɬноɝокоɞɟкɫɚмɟɫɬныɟɜлɚɫɬипɪɟɞоɫɬɚɜляɬьмɭниципɚльныɟ 10 кɚкнɚпɪимɟɪконцɟɫɫионныɟɫоɝлɚшɟниязɚключɚюɬɫя 15?20 ПɪɚкɬикɚɞɪɭɝиɯинɫɬɪɭмɟнɬоɜɮинɚнɫоɜойпоɞɞɟɪжкиɫɭɛɫиɞиɪоɜɚниɟɫɬɚɜокпɪиɜлɟчɟннымзɚймɚминɜɟɫɬиционныɟнɚлоɝоɜыɟкɪɟɞиɬыльɝоɬынɚлоɝɚмполɭчилɚшиɪокоɝоɪɚɫпɪоɫɬɪɚнɟнияɫɬимɭлиɪɭɟɬпɪиɬокинɜɟɫɬицийПɪɟɞлɚɝɚɟмыɟɫɬɚɬьɟɫɬɪɚɬɟɝичɟɫкиɟпɪɚɜлɟнияɫоɜɟɪшɟнɫɬɜоɜɚниякономичɟɫкоɝомɟɯɚнизмɚпозɜоляɬɫозɞɚɬьɛлɚɝопɪияɬныɟпɪɚɜоɜыɟинɫɬиɬɭционɚльныɟэɮɮɟкɬиɜноɝоɭпɪɚɜлɟнияɪɟɚлизɚциɟйпɪоɟкɬоɜɫпоɫоɛɫɬɜоɜɚɬьмоɞɟɪнизɚцииɮɪɚɫɬɪɭкɬɭɪызɞɪɚɜооɯɪɚнɟнияконɟчномиɬоɝɟɭɪоɜɟньɞоɫɬɭпноɫɬикɚчɟɫɬɜɚмɟɞицинIntroduction. Economy, like any other sphere, including human activity, is constantly developing and nancial solutions arise for the implementation of investment projects. These are especially the ones that cance for the country. Russian economy is not an exception in this regard. The introduction of modern nancing forms of the economy of our country, since the industries which cant nancial costs, which does not always correspond to the government budget. These sectors comprise education, road infrastructure. The objects referring to these spheres of economic activity can?t be privatized due to their t. To solve the problem of the national economy underfunding, organizational forms the world economic practice. The of the research ciency of the PPP institution in the development of healthcare.To achieve the goal it is necessary to solve the to study the concept of strategic analysis of the PPP gic analysis of the PPP institution in healthcare;on the PPP development in healthcare; ciency of using the PPP institution in health care. The subject of the study is nancial and economic relations between the state and private kinds of business in the implementation of PPP . At the present stage the temic reformation of the Russian public health system is aimed at improving the quality of provided medical ser-vices based on the strategic management of the industry. nancing in the form of social insurance systems, attracting the funds of consumers of medical services, the problems ciency of the public health sector and limited public resources have not been solved. To solve these problems, the world practice uses the PPP institution.care? till 2020 ?The main goal of PPP in healthcare is the assess the factors Pharmacy & Pharmacology V. 5 N 4, 2017velopment of the PPP institution in healthcare. The fea-In modern conception, PPP is a special type of co-The rapid development of the diverse forms of PPP in economies of developed countries and, recent-ly, of developing countries, the widespread use of these forms in various sectors of economics make it possible to practise the form of interaction between the state and business as a characteristic feature of modern market economy.Figure 1 ? Stages of a strategic analysis of PPP in healthcarebelonging to the state. At the same time, private entrepre-neurship is characterized by mobility, high ef ciency of enables PPP to transfer some functions to the private national objects. These functions comprise construction, structure facilities, as well as their management. Thus, the traditionally state economy, and it creates conditions for effective functioning of these facilities, optimal man-agement and rational use of resources. The government ts from increase in the budget revenues associated with the project, as well as from indirect effects, i.e. the In our opinion, PPP in healthcare is a mutually ben- cial cooperation between state authorities, local gov- t organizations, which enables them to ensure effective implementation of the fective implementation of the Public-private partnership in healthcare has the problem of making healthcare more accessible and us-ing health resources more ef? ciently. In the concept of state?s priorities. But, a signi cant part of the treatment According to the Russian Ministry of Health, 32% of hospitals and 30% of polyclinics require capital repair, they lack hot water, running water, autonomous energy supply, and 57% of equipment is physically and morally obsolete. years [3]. To solve the strategic problems of the industry, These infrastructure objects have an effective de-investment. The potential of this investment segment is ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныthan 20 billion rubles [4]. These problems can be solved when using the PPP mechanism. One of the most import-pact on the development of the PPP institution in health 224-FZ ?About Public-Private Partnership, Munic-Amendments to Certain Legislative Acts of the Russian Acts of the Russian of medical infrastructure facilities by private investors to improve the quality of services provided to the popu-lation; it enables private ownership of newly created or reconstructed infrastructure facilities; the investor must ensure that they are used with the intended purpose.Juridically, a public party can participate in a PPP nancing, providing some aid for the implementation of the project or a state guarantee, as well as taking part in property, including providing land, water, forest areas for the facility being created. Besides, a mechanism is provided to ensure the preservation of the contract terms. In tandem with the preparation of the law, nalized. In July 2014, 265-FZ ?Amendments to the Federal Law ?About Concession Agreements? and speci c legislative acts of the Russian Federation? was adopted [6]. tender is not held. The law guarantees the recoupment of the concessionaire?s investments and the receipt of the uences the development of the PPP institution in healthcare is using PPP forms and models.In the generally accepted world practice, two forms of cooperation are distinguished, they are contract and institutional ones. The institutional form presupposes the creation of joint ventures with the participation of the state and business. The contract form of a strategic partnership is the conclusion of a contract for the performance of cer-tain functions with respect to a healthcare facility.Table 1 ? Forms of PPP cooperation in health care [7]Institutional FormContract FormCreation of a new medical organization with the joint transfer a medical organization to a private partner t health organization (joint eld The transfer of the share of the state medical organiza-a private company.vate organizations; a cooperation agreement; an agree-organization (outsourcing) cation (Table 1), it is recommended ed PPP models of the contract form for ows and highly quali ed management are needed. c form of relations between the state and a private partner, ll the functions speci ed ate authority. For the use of state or municipal property, tions stipulated in the concession agreement. The right of rst of all, is a public authority. In this capacity, it does not only provides a part nancing can be repre-Pharmacy & Pharmacology V. 5 N 4, 2017 nancingproperty to the private management company. Since the Law ?About Concession Agreements? operates in the use of PPP mechanisms, it is advisable to systematize nancial obligations of each part The analysis of foreign experience in using the PPP In different countries the development of PPPs takes place at different rates: in the UK, France, Germany and ciently formed, other A comparative analysis of international practices ciency, a reduction in the cost of treatment eld of PPP in medicine is the the pan-European number of PPP projects was 67%, transactions, PPP in healthcare occupies 20%. Public- the construction and reconstruction of xed assets in the industry and the provision of medical nancial initiative as the most effective form of partnership in acquiring public services. The essence of this British form of PPP was to attract private investments ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞицины xed assets in the industry and the pro- nancial initiative as the most effective form of partnership in acquiring pub-lic services. The essence of this British form of PPP was to attract private investments to the construction of large The compensation of private investor?s expenses is nancial initiative, the nancial initiative, which is the main form of PPP provide 17% of the country?s budget savings.In Germany, in the sphere of PPP, the sale of state xed amount of ll the state order is widely spread. This has led to the increase from 4% to of emergency medical care, the provision of clinical concluded. Since the introduction of PPP practice, the cantly: x-ray diagnostics by 50%, clinical laboratory services by 40%, and emergency services by gency services by In Australia, where about 50 hospitals have been extended. The main terms of the contract for a period of xed care. As a result of the introduction of the institution of PPP, the cost of building new health facilities dropped by , the cost of building new health facilities dropped by These examples re? ect the general trend ? medicine cial for consumers of medical services.of world leaders in implementing projects based on PPP. Pharmacy & Pharmacology V. 5 N 4, 2017individual elements of the PPP system is unacceptable. particular, it is necessary to take into account the speci cs In Russian economy, there are opportunities to 9%. Abroad many health facilities are built and then run by big international companies. Thereby, tability of facilities built and put into operation. This From an economic point of view, the bene t is beyond expensive as the private sector. There is also a signi cant difference for the consumers of medical services: they can get services faster and with a higher quality. At the Within the framework of PPP projects in healthcare, PPP projects amounts to 57 billion rubles, which is about 10% of total investments in PPP projects in all sectors [4]. At present, under the Russian Ministry of Health different stages of preparation, including: establishment of a multidisciplinary center for construction of an advisory-diagnostic clinic and organizing an of ce complex with the placement reconstruction of emergency buildings by establishing a medical center with a training base Among the subjects in which the PPP mechanism is effectively used, it is possible to distinguish the Republic of Tatarstan. For example, AVA-Peter LLC concluded a With ?Clinic of Modern Medicine HD? LLC, ve centers in Kazan, Naberezhnye Chelny, Nizhnekamsk Award ROSINFRA.The country?s medical facilities have received a lot of modern equipment recently, but only 20% of this equipment works in full force and effect. The reason is rst educational center of PPP in the world. Regional authorities provided support. The business had invested its experience, taken over operational costs. The budget of the center ve years. Here for the Center?s work, for most of them training is free of charge.transfusiology is being built on concession terms. The In Moscow, a concession was concluded with ?Eu-operation and organization of four medical centers: po-sition-emission tomography; endovascular surgery; peri-being reconstructed. The hospital will provide high-tech specialized medical care for the treatment of infertility, receive it free of charge. Free dental care will be used by up to 300 people a year.The examples of PPP agreements based on regional ter in Orel region. According to the information of the lack of legislation in the sphere of PPP. rst federal-level pilot project using the concession ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныmechanism in the health sector. That was the establi-Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan, whose products will be in demand in trau-matology, orthopedics and neurosurgery [8].In Volgograd region, the implementation of measures state program ?Health Development of Volgograd Region till 2020?, approved 30 April 2013 by the Government of Volgograd Region Decree 216-p ?On Approval of the Health Development Program of Volgograd Region olgograd Region worked in the compulsory medical insurance system, and medical assistance in the amount of 42577.1 thousand ru-bles was provided by them. In 2015, twenty-two private companies worked in the compulsory medical insurance system, for 8 months they provided medical assistance in the amount of 12195.4 thousand rubles [10].On the territory of Volgograd region there are pri-vate medical organizations that have of cially switched MMI. Nowadays in the Territorial Program of MMI in Volgograd region the largest private medical organiza- c Production Association Volgograd Center for Disease Prevention ?YugMed? LLC. These clinics have signi cantly more advantages Clients of the above-mentioned clinics can receive ser-vices under the MMI policy, which are included in the ered by the MMI rate. Within the territorial program of including preventive, emergency medical care, and spe-Besides, the development of public-private partner-ship is also realized in the form of a concession. Among other factors, the mechanism of public-private partner-ship allowed opening a hemodialysis center. At the same The investor, who has won the tender for concluding for 270 beds, a sauna and swimming pool. The volume organization with private business (outsourcing) has be-In Volgograd region, two-thirds of vehicles available to health facilities are completely worn out. The basis eet of ambulances in Volgograd region is made cult road conditions in Volgograd, fail for two years. It is not pos-the Mandatory Medical Insurance Fund. The purchase of eet in the framework of the concluded le and equipped 70% of the car cost). The climate control system and patients in any season. The investor purchased 95 project is 1.5 billion rubles. Volgograd received new cars ve years.project. Outsourcing of the catering organization allowed cantly save the money that was spent on providing the work of kitchen and laundry. cantly switched to outsourcing supply. [11]. ts of transferring non-core tasks to a cant reduction cient conditions. Hereby, at the current stage of transition of garbage and anatomical waste; the organization supply, sewerage, laundry; provision of ready meals, etc. eld of public health have been chosen, in which the potential of PPP is poorly involved. For example, little Pharmacy & Pharmacology V. 5 N 4, 2017However, in Russia PPP is not developing at such a subject to privatization at the level of the federal law. for the government and society.Another deterrent to the development of PPP is the concession contract and form its economic basis. The effectively manage risks. The meaning of PPP is mainly to achieve synergies from partnership.federal and regional levels. The strategy of the Russian business, program-target management, nancing and managing partnership projects in the health sector. The ow of private investment resources into the industry. ed that business, entering partnership projects in public healthcare, is interested in long-term and stable cooperation, i.e. when ?the rules of the game? are known and understood in advance guaranteeing the return nancial resources and the necessary level tability. The authorities need to improve the open nd mechanisms to stimulate and promote social ne the powers of the authorities that are re-to monitor the effectiveness of joint projects;PPP in the media (this in turn may be of interest to to organize a systematic approach to training spe-cialists in order to form a team for effective imple-mentation of PPP projects.sector of the economy, the underdevelopment of market-problems accumulated in the industry, and the lack government and business in industry. nance skills that most In this regard, the task of organizing quali ed support for PPP projects at all stages of their life cycle is urgent. At the same time, it is advisable to assign functions on information, consulting, organizational and t organization [12].organization of constant interaction with the largest PPP institutions;obtaining organizational and methodological sup-port from the federal level PPP institutes;tion and support of PPP projects;provision of organizational and methodological sup-ing PPP projects;organization of nancing of infrastructure projects, integration of federal, regional and municipal PPP development of the PPP institution in healthcare is the ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныof PPP to Russian reality, which requires the creation of favorable legal, organizational and institutional adoption of a number of by-laws regulating partner-the private investor, the conditions for attracting nancial resources for the implementation of joint become an effective tool for modernizing healthcare.between government and business. After that, the main goal of projects based on PPP will be achieved: the efforts and resources of the parties, distributing their Based on the analysis, the following 1. Effective implementation of PPP projects in the tors is a prerequisite for developing an effective orga-implementation of PPP projects in the health sector. The urgency of developing a system of strategic management economy.2. The experience of applying international practices ciency, the cost of treatment and the in-average of 10%. Adaptation of international experience cs of the develop- xed assets amounting to 2.0?2.2 trillion rubles are To solve the strategic tasks for modernization of the in-dustry, investments amounting to about 1.0 trillion rubles are needed. This problem can be solved by using the PPP cantly reduces the opportunities for using of partnership projects. Thus, according Russian Budget 20 years. The practice of applying other nancial support ts) has not been ow of private organizational and economic mechanism of PPPs offered in the article will allow creating favorable legal and institutional conditions for effective management of the PPP projects implementation, contribute to the ȻиɛлиоɝɪɚɮичɟɫкийПоɫɬɚноɜлɟниɟПɪɚɜиɬɟльɫɬɜɚɊоɫɫийɫкойɎɟɞɟɪɚции 15.04.2014 294 ?ɭɬɜɟɪжɞɟнииɝоɫɭɞɚɪɫɬɜɟннойɊоɫɫийɫкойɎɟɞɟɪɚциизɞɪɚɜооɯɪɚнɟнияКонɫɭльɬɚнɬɞɚɬɚКоɫиноɜɚИнɫɬиɬɭционɚльныɟɚɫпɟкɬыɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚɪɟɚлизɚцииɫɬɪɚɬɟ // Ⱥкɬɭɚпɪоɛлɟмыɞоɫɬижɟнияɪɟɝионɚльныɯэкономичɟɫкиɯɫɛоɪникɪɚɛоɬ II Мɟжɞɭнɚɪоɞнойнɚɭчнопɪɚкɬичɟɫкойконɮɟɪɟнцииɋɬɚɜɪопольɚпɪɟля 2016 ɋɬɚɜɪопольɋɟкɜойяȻɚɬɟнɟɜɚЧȺɋɌНЫȿЗȾɊȺȼООɏɊȺНȿНИȿɍЛɍЧШȺɌȿȽОКȺЧȿɋɌȼОɋɌɍПНОɋɌЬ // ɊоɫɫийɫкɚяȻизнɟɫɝɚзɟɬɚɝоɫɭɞɚɪɫɬɜɟннопɚɪɬнɟɪɫɬɜоhttps://rg.ru/2012/01/17/sled.html (ɞɚɬɚКɪɚɟɜойПɟɪɫпɟкɬиɜыɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɪɚнɟнииПоɪɬɚлинɮоɪмɚционнойпоɞɞɟɪжкимɟɞицинɫкиɯɪɭкоɜоɞиɬɟлɟй. URL: https://www.zdrav.ru (ɞɚɬɚɎɟɞɟɪɚльныйзɚкон 13.07.2015 224-ɪɟɞ 29.12.2015 ?ɝоɫɭɞɚɪɫɬɜɟнночɚɫɬномпɚɪɬнɟɪɫɬɜɟмɭниципɚльночɚɫɬномпɚɪɬнɟɪɫɬɜɟɊоɫɫийɫкойɎɟɞɟɪɚцииɜнɟɫɟнииизмɟнɟнийоɬɞɟльныɟзɚконоɞɚɬɟльныɟɚкɬыɊоɫɫийɫкойɎɟɞɟɪɚцииКонɫɭльɬɚнɬɞɚɬɚɎɟɞɟɪɚльныйзɚкон 21 июля 2005 115-концɟɫɫионныɯɫоɝлɚшɟнияɯɋпɪɚɜочнопɪɚɜоPharmacy & Pharmacology V. 5 N 4, 2017Referencesrossijskoj federacii razvitie zdravoohraneniya [Decree of the Russian Government of April 15. 2014 N 294 ?On April 15. 2014 N 294 ?On tant Plus]. (access data: 07.06.2017) (In Russ.)2. Kosinova N.N. Institucionalnye aspekty gosudarstvenno-chastnogo partnerstva v realizacii strategii regionov [Institutional aspects of public-private partnership in the implementation of the regional strategy]. Aktualnye Aktualnye scienti? c papers of the II International Scienti c and Practical Conference] (Stavropol, April 20ropol: Sequoia. P. 64Bateneva T. CHASTNYE INVESTICII V ZDRAVOOHRANENIE ULUCHSHAT EGO KACHESTVO I DOS-TUPNOST [PRIVATE INVESTMENT IN HEALTH WILL IMPROVE ITS QUALITY AND ACCESSIBILITY]. ACCESSIBILITY]. Russian Business Newspaper: public-private partnership]. 2012. No. 2. URL: https://rg.ru/2012/01/17/sled.html (access data: 07.06.2017). (In Russ.)Kraevoy S.A. Perspektivy razvitiya gosudarstvenno-chastnogo partnerstva v zdravoohranenii Portal infor-macionnoj podderzhki medicinskih rukovoditelej [Prospects for the development of public-private partner-ship in healthcare. Portal of information support of medical leaders]. URL: https://www.zdrav.ru (access data: .ru (access data: № 224-FZ of 13.07.2015 ?About Public-Private Partnership, Municipal-Private Partner-ship in the Russian Federation and Amendments to Certain Legislative Acts of the Russian Federation?]. Konsul-Acts of the Russian Federation?]. Konsul-()()6. Federalnyj zakon ot 21 iyulya 2005 g 115-FZ ?O koncessionnyh soglasheniyah? 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()()ɜɚяɫиɫɬɟмɚȽɚɪɚнɬȽɚɪɚнɬɋɟɪɜиɫ?. URL: http://base.garant.ru/12141176/ (ɞɚɬɚȻɟлɟнкоɋɚɞоɜникоɜɚȽОɋɍȾȺɊɋɌȼȿННОЧȺɋɌНОȿПȺɊɌНȿɊɋɌȼОИНɋɌɊɍМȿНɌɋОȼȿɊШȿНɋɌȼОȼȺНИЯɍПɊȺȼЛȿНИЯЗȾɊȺȼООɏɊȺНȿНИȿМ // Экономикɚɫоциɭм12(31). URL: http://iupr.ru/domains_data/ les/zurnal_31/Belenko%20E.I.(socialno-ekonomicheskie%20ɞɚɬɚɊɟɚлизɚцияпɪоɟкɬɚзɞɪɚɜооɯɪɚнɟнииɌомɫкойоɛлɚɫɬи ? ȿɜɪоклиникɚɞɚɬɚПоɫɬɚноɜлɟниɟПɪɚɜиɬɟльɫɬɜɚȼолɝоɝɪɚɞɫкойоɛлɚɫɬиɭɬɜɟɪжɞɟниизɞɪɚɜооɯɪɚнɟнияȼолɝоɝɪɚɞɫкойоɛлɚɫɬи 2020 ɝоɞɚКонɫɭльɬɚнɬɞɚɬɚИнɮоɪмɚцияМиниɫɬɟɪɫɬɜɚзɞɪɚɜооɯɪɚнɟнияɪɟзɭльɬɚɬɚɯɪɟɚлизɚцииконцɟпɬɭɚльɞокɭмɟнɬоɜɭɬɜɟɪжɞɟнныɯɝоɫɭɞɚɪɫɬɜɟннойɜлɚɫɬиɫɭɛъɟкɬоɜɊоɫɫийɫкойɎɟɞɟɪɚцииɜопɪоɫɚмɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝоɜзɚимоɞɟйɫɬɜияɝоɫɭɞɚɪɫɬɜɟнночɚɫɬноɝопɚɪɬнɟɪɫɬɜɚзɞɪɚɜооɯɪɚнɟнии. URL: http s://static-1.rosminzdrav.ru (ɞɚɬɚзɞɪɚɜооɯɪɚнɟнииȼолɝоɝɪɚɞɫкойоɛлɚɫɬиɜнɟɞɪяюɬɫямɟɯɚнизмыɞɚɬɚKosinova N.N., Tolstel M.S., Chekealkin A.A. COMPREHENSIVE EVALUTION OF INVESTMENT POTENTION (THE CASE OF THE SOUTHERN FEDERAL DISTRICT) // 2014. Vol. 10. No. 23. P. 231?243. DOI: 10.5539/ass.v10n23p231 ɎɚɪмɚцияɮɚɪмɚколоɝияЭкономикɚмɟнɟɞжмɟнɬмɟɞициныКонɮликɬинɬɟɪɟɫоɜȺɜɬоɪызɚяɜляюɬоɬɫɭɬɫɬɜииконɮликɬɚинɬɟɪɟɫоɜȺɜɬоɪыȺɞжиɟнкоȼɫɟɜолоɞЛɟониɞоɜичɞокɬоɪнɚɭкзɚɜɟɞɭющийкɚɮɟɞɪойэкономикизɞɪɚɜооɯɪɚнɟниямɟɞициныɞиɪɟкɬоɪПяɬиɝоɪɫкоɝомɟɞикоɮɚɪмɚцɟɜɬичɟɫкоɝоинɫɬиɬɭɬɚɮилиɚлɚɎȽȻОɍȼолɝоɝɪɚɞɫкийɝоɫɭɞɚɪɫɬɜɟнмɟɞицинɫкийɭниɜɟɪɫиɬɟɬМинзɞɪɚɜɚɊоɫɫииОɛлɚɫɬьнɚɭчныɯинɬɟɪɟɫоɜэкономикɚзɞɪɚɜооɯɪɚɮɚɪмɚкоэкономикɚɫоциолоɝиямɟɞицинымɟнɟɞжмɟнɬзɞɪɚɜооɯɪɚнɟнииКоɫиноɜɚНиколɚɟɜнɚɞокɬоɪэкономичɟɫкиɯнɚɭкпɪоɮɟɫɫоɪкɚɮɟɞɪыэкономикимɟнɟɞжмɟнɬɚɎȽȻОɍȼолɝоɝɪɚɞɫкоɝоɝоɫɭɞɚɪɫɬɜɟнноɝомɟɞицинɫкоɝоɭниɜɟɪɫиɬɟɬɚМинзɞɪɚɊоɫɫииОɛлɚɫɬьнɚɭчныɯинɬɟɪɟɫоɜэкономикɚзɞɪɚɜооɯɪɚнɟнияɫɬɪɚɬɟɝичɟɫкиймɟнɟɞжмɟнɬзɞɪɚɜооɯɪɚнɟнииɮинɚнɫиɪоɜɚниɟзɞɪɚɜооɯɪɚнɟиɫпользоɜɚниɟммɟɯɚнизмоɜпɚɪɬнɟɪɫɬɜɚɫɭɞɚɪɫɬɜɚɛизнɟɫɚПоɫɬɭпилɚɪɟɞɚкциюПɪиняɬɚпɟчɚɬиtov utverzhdennyh organami gosudarstvennoj vlasti subektov Rossijskoj Federacii po voprosam razvitiya gosu-ganami gosudarstvennoj vlasti subektov Rossijskoj Federacii po voprosam razvitiya gosu-the Russian Ministry of Health on the results of the program and concept documents implementation approved by the Russian regions on the development of public-private partnership (public-private partnership) in health care]. URL: http://static-1.rosminzdrav.ru. (access data: 09.06.2017). (In Russ.)V zdravoohranenii Volgogradskoj oblasti vnedryayutsya mekhanizmy GCHP [PPP mechanisms are being intro-duced in the healthcare of the Volgograd Region]. URL: http://riac34.ru/news/62771/ (access data: 09.06.2017). Kosinova N.N., Tolstel M.S., Chekealkin A.A. COMPREHENSIVE EVALUTION OF INVESTMENT POTEN-TION (THE CASE OF THE SOUTHERN FEDERAL DISTRICT). 2014. Vol. 10. No.23. P. 231 ict of interest ict of interest.D octor of and Organization of Health and Medicine, Director ofbranch of Volgograd State Medical University. Research interests: health economics, pharmacoeconomics, medical sociology, medicine management. ? Doctor of Sciences (Economy), Professor of the Chair of Economy and Management of Volgograd State Medical University. Research interests: health economics, strategic nancing using state and business partnership mechanisms. ORCID 0000-0003-4298-6018.

About the authors

V. L. Adzhienko

Pyatigorsk Medical and Pharmaceutical Institute – branch of Volgograd State Medical University

Email: fake@neicon.ru

N. N. Kosinova

Volgograd State Medical University

Email: nnn_05@mail.ru

References

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