Functional Simulation of Medical Organization Management System

Authors: Kostyrin E.V., Goryunova I.S. Published: 30.03.2021
Published in issue: #1(134)/2021  
DOI: 10.18698/0236-3933-2021-1-148-162

Category: Informatics, Computer Engineering and Control | Chapter: Management in Social and Economic Systems  
Keywords: functional simulation, SADT, IDEF0, AllFusion, medical saving accounts, electronic medical treatment card, medical organizations management system, structured approach, design

Key stages in the process of providing medical services to population were considered. Treatment and prophylactic institution financial, economic and accounting services (departments) operation were studied. Functional model of medical organization management system was formalized and developed, which appeared as a set of diagrams describing all aspects of the system under study. When creating the functional model, structural approach to design, IDEF0 methodology (Structured Analysis & Design Technique subset) and AllFusion toolkit were used. Functional cost analysis role was noted in the process of reliable determination of costs in providing medical services and improving financial performance of the medical institutions. Medical institution management system role in organizational and functional structure of a medical institution was revealed. Composition and sequence of procedures were determined for application of economic and mathematical models in managing the tariffs optimal distribution and the financial result of a medical organization operation. Separately, recommendations are provided on implementation of medical savings accounts in the activities of treatment and prophylactic institution and integration thereof with the patient medical treatment record. Analysis of the designed system was carried out as a toolkit in improving quality of the patient medical care and increasing the treatment and prophylactic institution income. Developed integrated medical organization management system is relevant for the medical institution financial and economic units and is aimed at improving their operation effectiveness


[1] Kovylkin D.Yu., Novikova V.N., Rataf’yev S.V. Capabilities of modern business process modeling tools. Kreativnaya ekonomika [Creative Economy], 2019, vol. 13, no. 7, pp. 1457--1474 (in Russ.). DOI: https://doi.org/10.18334/ce.13.7.40847

[2] Kostyrin E.V. Modeli upravleniya lechebno-profilakticheskimi uchrezhdeniyami [Management models of medical and preventive institutions]. Moscow, Nauchnaya biblioteka Publ., 2018.

[3] Latukha O.A. Training leaders of organizations in sustainable development management. Vestnik Novosibirskogo gosudarstvennogo pedagogicheskogo universiteta [Novosibirsk State Pedagogical University Bulletin], 2018, vol. 8, no. 3, pp. 225--236 (in Russ.). DOI: https://doi.org/10.15293/2226-3365.1803.16

[4] Latukha O.A. Application of international experience in lean production within the concept of sustainable development of healthcare settings. Vestnik Novosibirskogo gosudarstvennogo pedagogicheskogo universiteta [Novosibirsk State Pedagogical University Bulletin], vol. 8, no. 1, pp. 239--254 (in Russ.). DOI: https://doi.org/10.15293/2226-3365.1801.15

[5] Latukha O.A. Improving internal quality control system within a healthcare setting on the basis of project management. Vestnik Novosibirskogo gosudarstvennogo pedagogicheskogo universiteta [Novosibirsk State Pedagogical University Bulletin], vol. 7, no. 5, pp. 225--240 (in Russ.).

[6] Karas’ D.V., Danil’chenko Ya.V., Kryuchkov D.V., et al. Demands of scientific medical institution management personnel as a way to improve activity management. Vestnik KemGU. Ser. Politicheskie, sotsiologicheskie i ekonomicheskie nauki [Bulletin of Kemerovo State University. Ser. Political, Sociological and Economic Sciences], 2018, no. 4, pp. 26--32 (in Russ.). DOI: https://doi.org/10.21603/2078-8975-2018-1-26-32

[7] Karas’ D.V., Danil’chenko Ya.V., Kryuchkov D.V., et al. Quality management system and staff motivation. Meditsinskiy al’manakh [Medical Almanac], 2018, no. 5 (56), pp. 17--20 (in Russ.).

[8] Karpov O.E., Subbotin S.A., Zamyatin M.N., et al. Imitation modeling of the activity of the present-day multi-profile medical institution. Vestnik Rossiyskogo ekonomicheskogo universiteta im. G.V. Plekhanova [Vestnik of the Plekhanov Russian University of Economics], 2018, no. 6 (102), pp. 57--66 (in Russ.). DOI: https://doi.org/10.21686/2413-2829-2018-6-57-66

[9] Karpov O.E., Klimenko G.S., Lebedev G.S. The development of e-health system of the Russian Federation. Federalizm [Federalism], 2016, no. 2 (82), pp. 7--22 (in Russ.).

[10] Kaspruk L.I., Satmukhanbetova G.K., Maksimova N.E., et al. The first aid for children --- features and tendencies and on the example of the Orenburg region. Sovremennye problemy nauki i obrazovaniya [Modern Problems of Science and Education], 2017, no. 2 (in Russ.). Available at: https://science-education.ru/ru/article/view?id=26308

[11] Kaspruk L.I., Snasapova D.M., Zhakupova G.T. To the question of the professional orientation of medical and sister medical staff (on the example of Orenburg region). Sovremennye problemy nauki i obrazovaniya [Modern Problems of Science and Education], 2017, no. 6 (in Russ.). Available at: https://science-education.ru/ru/article/view?id=27345

[12] Kvachakhiya L.L. The effectiveness model of the national health system in comparison with developed countries. Innov: Scientific Journal, 2018, no. 3 (36) (in Russ.). Available at: https://www.innov.ru/science/economy/obeffektivnosti-modeli-otechestven

[13] Kiku P.F., Alekseeva G.N., Izmaylova O.A., et al. The model of organization of oncologic care of population of region. Zdravookhranenie Rossiyskoy Federatsii [Health Care of the Russian Federation], 2017, vol. 61, no. 6, pp. 284--291 (in Russ.).

[14] Kichatova E.Yu., Kuznetsov A.I., Arkhipova S.V. Special aspects of managing personnel in a private medical organization. Formula menedzhmenta, 2018, no. 1 (3), pp. 5--9 (in Russ.).

[15] Kiyanitsyna L.N., Orlov V.B. The opportunistic behavior of agents and principals of medical institutions and its localization by using effective contract. Business. Education. Law, 2018, no. 3 (44), pp. 59--66 (in Russ.). DOI: https://doi.org/10.25683/VOLBI.2018.44.303

[16] Igolkina V.V., Golub’ M.E., Kachan N.A. Budgeting as a subsystem of medical institution management accounting. Vestnik Belgorodskogo universiteta kooperatsii, ekonomiki i prava [Herald of the Belgorod University of Cooperation, Economics and Law], 2017, no. 2 (63), pp. 240--251 (in Russ.).

[17] Il’in I.V., Il’yashenko V.M. Formation of requirements for a reference architectural model for the digital transformation of a medical organization. Nauchnyy vestnik Yuzhnogo instituta menedzhmenta [Scientific Bulletin of the Southern Institute of Management], 2018, no. 4, pp. 82--88 (in Russ.).

[18] Il’in I.V., Il’yashenko O.Yu., Pavlov N.I. Development of a business model of multi-functional medical centers using telemedicine technologies. Nauka i biznes: puti razvitiya [Science and Business: Development Ways], 2017, no. 11 (77), pp. 116--121 (in Russ.).

[19] Il’in I.V., Il’yashenko O.Yu., Shchepinin V.E. Formation of a competence-based model of personnel management for a medical organization implementing the smart hospital concept. Global’nyy nauchnyy potentsial [Global Scientific Potential], 2018, no. 2 (83), pp. 44--46 (in Russ.).

[20] Choi J.H., Park I., Jung I., et al. Complementary effect of patient volume and quality of care on hospital cost efficiency. Health Care Manag. Sci., 2017, vol. 20, no. 2, pp. 221--231. DOI: https://doi.org/10.1007/s10729-015-9348-9

[21] Kesavayuth D., Poyago-Theotoky J., Tran D.B., et al. Locus of control, health and healthcare utilization. Econ. Model., 2020, vol. 86, pp. 227--238. DOI: https://doi.org/10.1016/j.econmod.2019.06.014

[22] Hao Y., Liu J., Lu Z.N., et al. Impact of income inequality and fiscal decentralization on public health: Evidence from China. Econ. Model., 2021, vol. 94, pp. 934--944. DOI: https://doi.org/10.1016/j.econmod.2020.02.034

[23] Zou B., Lu C., Li Y. Simulation of a hospital evacuation including wheelchairs based on modified cellular automata. Simul. Model. Pract. Theory, 2020, vol. 99, art. 102018. DOI: https://doi.org/10.1016/j.simpat.2019.102018

[24] Ajmi F., Zgaya H., Othman S.B., et al. Agent-based dynamic optimization for managing the workflow of the patient’s pathway. Simul. Model. Pract. Theory, 2019, vol. 96, art. 101935. DOI: https://doi.org/10.1016/j.simpat.2019.101935

[25] Mandalapu V., Ghaemmaghami B., Mitchell R., et al. Understanding the relationship between healthcare processes and in-hospital weekend mortality using MIMIC III. Smart Health, 2019, vol. 14, art. 100084. DOI: https://doi.org/10.1016/j.smhl.2019.100084

[26] Dubeykovskiy V.I. Effektivnoe modelirovanie s CA ERwin Process Modeler (BPwin; AllFusion Process Modeler) [Effective modeling with CA ERwin Process Modeler (BPwin; AllFusion Process Modeler)]. Moscow, Dialog-MIFI Publ., 2009.

[27] Zingerman B.V., Shklovskiy-Kordi N.E., Karp V.P., et al. Electronic health record: purpose and problems. Vrach i informatsionnye tekhnologii [Information Technologies for the Physician], 2015, no. 1, pp. 24--34 (in Russ.).

[28] Sokolov E.V., Kostyrin E.V. Proryvnye tekhnologii finansirovaniya zdravookhraneniya, pensionnogo obespecheniya i ekonomiki Rossii [Breakthrough technologies for financing healthcare, pension provision and Russian economy]. Moscow, Nauchnaya biblioteka Publ., 2018.