By its status and influence, Moscow is undoubtedly the leader of the country and is perceived as a world city with great potential in the global economic, political and cultural space. Since 1991, Moscow is constantly present in the list of world leading cities, which is confirmed by all authoritative ratings.
However, Moscow’s position in this list is weakening, first of all, in terms of the parameters that make up the core of the development and competition of the leaders of the global rankings: the quality of the environment and institutions, quality of life, security and ecology. The exclusive political position of Moscow as the capital of Russia has created conditions for the concentration in the city of 80% of the country’s financial turnover, the same share of investments in commercial real estate, 70% of the share of Moscow banks in the total assets of the Russian banking system and a significant part of export-import payments. This led to the formation of the phenomenon of “rental economy” in Moscow, created conditions of instability and critical dependence of the financial potential of the capital on the situation of world prices for Russian exports and the placement of the tax base. The city, as shown by the last financial crisis, is difficult to compensate for fluctuations in the external environment, since its own export potential is small, and the development of promising economic activities is limited by their scale and the weakness of basic infrastructure. In addition to the existing areas of growth (trade, construction), there are no new active drivers of economic and innovative development.
The key problem of the city is an acute imbalance between the level of business activity in Moscow (usually recorded in the top twenty world rankings) and the quality of the urban environment (according to this indicator, Moscow takes in different ratings from 50 to 70 places).
The main trends in the socio-economic development of the city of Moscow in 2017 – the 1st half of 2018 were characterized by a steady decline in inflation, growth of investments in fixed assets, increased business activity and an increase in production and exports of the main sectors of the real sector, expansion of consumer demand (volumes of retail trade, catering and paid services), a positive financial result of enterprises and organizations, an increase in real wages.
With significant health resources, Moscow has as low health indicators as the average for the Russian Federation. At the same time, the population of the city faces additional problems of access to medical care, the main of which are the low availability of specialist services and diagnostic studies in outpatient settings, the increasing cost of medical care.
The main structural imbalances are the insufficient level of PHC development, the dominance of inpatient care, the low level of intensity of inpatient care, the weak level of interaction between individual health services and, as a result, the lack of continuity of treatment.
A radical improvement in the quality of the network of medical institutions is impossible without a number of institutional changes associated with the creation of a competitive market of medical services and services for the formation of a healthy lifestyle in the city. Prospects for changing the situation in this area are associated with the optimization of the urban network of existing institutions, and with the development of the commercial segment of services in the field of health and healthy lifestyles
Implementation of the Strategic plan for the restructuring of the city’s health care until 2025 (Restructuring of the health care network) the Key mechanisms for this task are:
- the extension of the functions of local service,
- the development of General practice,
- increasing the availability of hospital resources for specialized outpatient care,
- restructuring of the network of hospitals, coordination of stages of medical care,
- improving the effectiveness of health Informatization
- increased investment in human capital in the health sector.
One of the mechanisms for a qualitative change in the situation in the health sector may be the transition to personal licensing of doctors, along with the licensing of medical institutions and centers. This measure is most effective in terms of the development of the private sector and the creation of a truly competitive situation in the urban health system.
Creating conditions for maintaining a healthy lifestyle in the city.
In addition to the traditionally used prohibitive measures (limiting the availability of tobacco and alcohol), it is necessary to implement measures to transform the urban environment so that it supports the desire for a healthy lifestyle of citizens. The number of people involved in various sports in the city is more effective in promoting a healthy lifestyle than any social advertising. Therefore, the construction of flat sports facilities, the creation of Bicycle paths and playgrounds for sports is the most effective mechanisms for solving this problem.
Increasing the export potential of medical institutions of the city
In order to develop the export potential of medical institutions located in Moscow, it is necessary to focus on certain areas of health care, which in terms of the quality of medical services, cost, and available conditions for servicing visiting patients may be attractive both for residents of Russian regions and for citizens of other countries, including the CIS and Eastern Europe.
One of the main priorities of the city development was the development of high-tech business and consumer services, which also includes medical services. The city is objectively interested in active international exchange of specialists and students, in international research programs, in the deployment of international Congress sites and infrastructure for the reception of foreign students. The availability of world-class educational and medical centers is a prerequisite for qualitative changes in the entire system of urban services. In addition, the export potential of education and health services is the fastest growing segment in the global economy – both in terms of attracting investment and in terms of direct and indirect income generated by the city.
According to the results of the first stage of the State program, the capacity and structure of medical organizations of the state health care system of the city of Moscow were brought into line with the needs of the population in medical care: the main measures for the reorganization of the network of inpatient institutions and restructuring of their bed Fund with the creation of multi-profile hospital complexes, consolidating medical diagnostic and human resources necessary for the effective provision of medical care and ensuring the continuity of treatment and rehabilitation stages were completed.
The formation of multidisciplinary medical institutions has improved the availability and quality of specialized medical care, to provide a full range of medical services therapeutic and surgical profiles — from narrowly focused manipulations to high-tech medical care in one institution, to involve for the diagnosis and treatment of medical specialists of various profiles, multidisciplinary diagnostic teams. Thus, the patient in one medical organization receives a full range of medical services — from diagnosis and treatment to medical rehabilitation at the present level.
Leading healthcare organizations
Due to the factors: economic development, the largest number of residents and visitors, the concentration of investment projects, the highest minimum and average wages in the country, Moscow has formed a strong competitive market of medical services.
In almost every area, you can select a medical institution where the quality and availability of services will be at the level of world health leaders. In this block, will be considered only a small part of the medical institutions of the capital, worthy of attention.