[The certain issues of supporting non-barrierness of objects and services for not mobile citizen].

The article presents analysis of establishing conditions to adapt the environment and to remove barriers for not mobile citizen (the disabled with disorders of musculoskeletal system). In the process of analysis of possibilities to organize non-barrier environment for not mobile citizen the national and foreign normative legal acts, international conventions, materials of national and foreign experts, Internet sources were used. The analysis of current international regulation of non-barrier urban environment for not mobile citizen demonstrates gradual transition from medical concept of disability to social one. The disabled society model surmises that people are disabled to the extent that the environment prevents them from fulfilling their needs and receiving necessary services. The importance of development of municipal and regional quality standards of accessibility of the environment and services for the disabled increases. It is necessary to eliminate informational, communicative and other barriers for this contingent of citizens. The consequences of impact of the COVID-19 pandemic on paradigm alteration in the field of strategy of adaptation of municipalities to needs of not mobile citizen are analyzed. The analysis of interaction between non-barrier environment and not mobile citizen permits to consider this process as an element of their post-medical rehabilitation. Only application of integrated intersectoral approach can positively effect on solution of problems in this area.

[Medical and economic analysis of the effectiveness of the structural units of a medical organization].

Medico-economic analysis in a medical organization is a set of techniques and methods for assessing the indicators of medical, industrial and financial activities, the purpose of which is to choose ways to rationally use internal resources. The main objectives of medical and economic analysis is to determine the reserves for the use of the organization's resources; introduction of effective technologies of the treatment process; assessment of the effectiveness of medical care, assessment of the effectiveness of management decisions. The combination of types of analysis, their subordination to management goals can improve the efficiency of the medical organization and its structural divisions. In the context of increasing competition in the medical services market, the importance of medical and economic analysis in medical organizations of various forms of ownership is growing. State medical institutions are no exception. Modern autonomous and budgetary healthcare institutions operate in the status of independent economic entities, while the role of the chief physician as the organizer of the medical and economic process, as well as the role of the head of the structural unit, who must analyze the results and costs, calculate the need for material and financial resources, determine efficiency of medical activity. The subject of the analysis of this article is to determine the optimal algorithm for conducting a medical and economic analysis in the context of the functioning of the structural units of a medical organization.

The organizational legal forms of noncommercial organizations in health care of The Russian Federation.

One of the goals of development of health care system is to increase availability and quality of medical care of population. To achieve this goal is possible by continuous improvement of health care system, search of new solutions to assigned tasks, development of medical care of population. Over the past 20 years, health care system of the Russian Federation underwent a number of significant changes. In the Strategy of Development of Health Care of the Russian Federation for the Long-Term Period 2015-2030 it is noted that to achieve highest possible level of development of health care with coordinated application of all national resources it is necessary to form health care system that integrates all medical services and organizations, regardless of their form of ownership and affiliation. This system is to function within single regulatory and legal framework (uniform requirements for quality and availability of medical care, qualifications of medical personnel, etc.), as well as uniform state, expert and public control. In this regard the study of prospects of using in health care of various organizational and legal forms of noncommercial organizations that contribute to formation of competitive environment in the industry, is of particular relevance, which should also affect quality of medical care provided. The article considers prospects for development of those organizational and legal forms of noncommercial organizations that are already functioning in health care system: state budgetary health care institutions, state autonomous health care institutions, autonomous noncommercial organizations, private institutions. According to the Federal Foundation of Mandatory Medical Insurance Register of medical organizations, on June 2021 about half of medical organizations in the Russian Federation are registered as budgetary organizations. Accordingly, predominant organizational and legal form is budgetary institution, which makes up to 55% of all medical organizations of various organizational and legal forms involved into mandatory medical insurance system. The percentage of state autonomous institutions comes to 8%, private healthcare institutions - 2%. The percentage of autonomous noncommercial organizations comes to 0.4%. The perspectives of development of each of these organizational and legal forms in health care system are analyzed in the article.

[The prospective directions of development of entrepreneurship in health care of the Russian Federation].

The analysis of international data established that the national indicator of population health quality in the Russian Federation is significantly lower than in the EU, the USA and Canada. In this regard, the urgency of enhancement of state policy concerning updating and promoting development of national health care system,involving available resources of the public and private health sectors is obvious. The development of entrepreneurship in health care should be considered as a mean of improving social and economic efficiency of health care system in Russia. The purpose of study was to analyze perspective directions of development of entrepreneurial initiatives in national health care. On the basis of analysis of corresponding normative legal acts and publications, it is demonstrated that in national health care system prerequisites are establishing to implement new opportunities for patient-oriented entrepreneurial activities associated with development of digital technologies, e-Health, new forms of public-private partnership focused primarily on prevention and rehabilitation of patients.