[The advanced training of the therapists in a local medical association without interrupting their performance of service obligations as a variant in the postgraduate raising of qualifications on a permanent basis]. / Usovershenstvovanie terapevtov v territorial'nom meditsinskom ob''edinenii bez otryva ot vypolneniia sluzhebnykh obiazannostei kak variant poslediplomnogo povysheniia kvalifikatsii na postoiannoi osnove.

A new approach to continuous medical education of district physicians implies 4-5 annual (100-120 teaching periods) which are delivered to groups of 10 medical professionals for 4 days a week. The education is intended annually for 50 district therapists and other specialists and is especially helpful if outpatient service is organized according to the team principle (obstetrician, pediatrician, therapist). The lectures cover present-day advances in medical practice and research with special emphasis to borderline conditions.

[Fund for social development of regional health care coalitions in the conditions of collective bargaining]. / Fond sotsial'nogo razvitiia territorial'nogo meditsinskogo ob''edineniia v usloviiakh kollektivnogo podriada.

The introduction of economic incentives, the utilization of a fund for social development of institutions considerably increased the intensification of labour, improved health care indicators and the accessibility of health care for the population. The expedient form of work appeared to be collective bargaining which considerably expanded the rights of the leader and collective. ++ Interdepartmental cost-accountable relations with the future introduction of ++intra-structural cost-accountable relations is a prospective form of health services administration and management.

[Economic attitudes in the activities of therapeutic-prophylactic facilities under the conditions of new economic mechanisms]. / Ekonomicheskie otnosheniia v deiatel'nosti lechebno-profilakticheskikh uchrezhdenii v usloviiakh novogo khoziaistvennogo mekhanizma.

For two years an experiment on restructuring of health services system is being conducted in Leningrad. The economic mechanisms are being introduced into the health services system which allow health authorities, using internal resources, to considerably improve the delivery of medical care for the population. The introduction of economic incentives into the system of payment for labour, the use of some economic mechanisms into the co-operation between medical institutions led to considerable intensification of labour, improved the discipline and performance indices of medical institutions. The most expedient form of work proved to be collective contract which allowed to considerably broaden the rights of doctors and staff. Institutions working on the basis of collective contract achieved much better results. Unnecessary hospitalization of patients has decreased and planned hospitalization increased, intensification of labour is going on which permits to significantly increase wages. Intra-sectorial cost accounting relationships is a progressive form of public health organization and management.