The purpose of this work is a scientific substantiation of the need to use reliable medical and statistical information for making managerial decisions. An example of making a rational management decision in the healthcare system is considered. The results of the analysis of problems and advantages of using such a system are presented. The main ways of reliability of medical and statistical information are determined. The possibilities of using various methods of statistical analysis are considered. The developed algorithm of medical-statistical research is presented. It has been established that the adequacy of the choice of statistical methods for processing and analyzing the indicators obtained in the course of clinical trials is decisive and the correct interpretation of the data obtained.
Management decision making plays an important role in the activities of every organization. Management is a directed influence on processes to change their passage in order to achieve a desired result or avoid an undesirable one. When making a decision, a certain amount of processed information is required. Lack of information does not allow management personnel to make conscious and reasoned decisions. An effective management decision that implies risk minimization, rationality and minimal costs. To address these issues, Roszdravnadzor has developed a regulation. This document establishes the timing and sequence of procedures and actions aimed at performing control actions over the level of reliability of primary statistical data provided by medical organizations. For the optimal solution, medical and statistical information is collected.
Materials and methods
A managerial decision is a directive act of purposeful influence on the control object, based on the analysis of reliable data and containing an algorithm for achieving the goal.
The main functions of management activities are:
forecasting (reasonable judgment about the possible state of the object in the future);
organization (optimization and streamlining of processes);
control (a set of measures aimed at maintaining the efficiency of activities);
motivation (motivating employees to work more efficiently);
coordination (ensuring the coordination of actions of all parts of the company);
Also, the adopted management decision must meet the following requirements:
- target orientation (full compliance with the set goals and objectives);
- justification (the need to make this decision and not another);
- targeting (by performers);
The stages of management decision are:
- Preparation — identification of deviations, analysis of the causes;
- Development — assessment of the situation, development of options, selection of the best option;
- Evaluation — economic effect, social effect, timeliness, risk;
- Acceptance — development of an order, instructions, appointment of responsible persons, bringing the decision to the executors, setting a deadline;
- Execution — development of an action program, development of tasks, motivation for implementation, clarification of tasks;
- Performance control — prevention of errors and deviations, compliance with deadlines, analysis of consequences, identification of reserves;
Any management represents the impact on certain objects, is carried out on the basis of certain actions that are the result of the analysis of information flows. Decision-making technology includes diagnosing a problem, identifying possible ways to solve it, evaluating various options and choosing an option that will allow the economic system to solve problems in a way that is beneficial for the economic system.
Decision support information system (IDSS) — intelligent decision support systems, which are an automated computer network that provides objective data analytics with the construction of a mathematical model of the expected development of events. The purpose of such products is to help people making complex management decisions in difficult conditions.
The main elements of such a system are:
Information — information obtained through monitoring, sampling from documents, polling, questioning, analysis, testing.
Information flow — a flow of messages in speech, documentary and other forms circulating between the organization and the external environment, as well as within the organization
Statistical information is the primary statistical material that is formed in the process of statistical observation, which is then subjected to systematization, summary, processing, analysis and generalization.
Characteristics of this information system:
- support decisions
- oriented for reporting and control.
- rely on existing shared data and data flows;
- have limited analytical capabilities;
- assist in decision making using past and present data;
- relatively inflexible.
- information requirements are stable;
- often require lengthy analysis and process design;
At the first stage of statistical research, the method of mass statistical observation is used, which ensures the generality, completeness and representativeness of obtaining primary data. The reliability of primary data depends on many factors: the professional training of the statistician himself, the observation program, the content of statistical tools (questionnaires, reporting forms, etc.), the quality of preparation of instructions for filling them out, etc. The reliability of the data is also affected by the social function of the indicator (there may be a deliberate distortion of data on the number of medical errors, the quality of medical care, infant mortality, the number of occupational diseases and industrial accidents, etc.).
At the second stage, the information collected in the course of mass observation is processed by the method of statistical groupings. Grouping methods differ depending on the tasks and the qualitative state of the primary material.
At the third stage, statistical information is analyzed based on the use of generalizing statistical indicators: absolute, relative and average values, variations, closeness of connection and the rate of change of the studied phenomena and processes, indices, etc. Carrying out a system analysis allows you to determine the cause-and-effect relationships, the influence and interaction of various factors, evaluate the effectiveness of healthcare management, calculate the possible consequences of decisions made, etc. At present, modern information technologies are used in the analysis of statistical information.
When processing and presenting statistical information, as a rule, tabular and graphical methods are used. Medico-statistical research is an integral function of the decision-making information system, as well as a scientific and organizational process in which, according to a single program, certain phenomena are observed, primary data are collected and recorded, processed and analyzed. In terms of data analysis capabilities, all systems can be quite comparable with each other.
The main methods used in statistical research include:
- organization of statistical observation;
- collection and processing of primary information;
- determining the level of information reliability;
- statistical analysis of the obtained indicators;
- assessment of the closeness of the links between the indicators and the performance indicator.
The most important functions of the medical-statistical information system in making managerial decisions in the healthcare system are:
Accounting for the qualifications of medical workers, holding events, accounting for medicines and medical devices, accounting for medical expertise;
Organization of activities of subjects;
Coordination of scientific research;
Development — of a unified accounting system, standards, healthcare programs;
Control — sanitary-epidemiological service, emergency measures;
The algorithm for conducting a medical-static study consists of five stages:
- Determining the goal, setting the task, developing a program and research plan;
- Performing work on collecting information and preparing it for processing;
- Grouping of data and generalization of observation materials;
- Special processing of the received observation materials;
- Analytical and design work;
The use of reliable statistical information, which is formed and worked out using statistical methods, in the management of healthcare organizations provides:
- performing studies of cause-and-effect relationships;
- determination of the interaction of various components and their impact on the efficiency of the medical organization;
- establishing the level of functioning of the management system;
- obtaining an assessment of the validity of decisions made at various levels of management.
In the process of this work, management issues are resolved:
- increase (decrease) the volume of medical services?
- increase (decrease) the supply of medicines and equipment?
- increase (decrease) the unit price of paid services?
Important features of an information system are the reliability and relevance of its indicators; the validity of the attractiveness of its use depends on them. Based on the results of the analysis of statistical information, management personnel have grounds for making both current and strategic decisions.
An exemplary calculation has been constructed on the use of technologies for various medical purposes. As of 2022, 775 software products for medicine have been developed in the Russian Federation. decision support information systems are spread by 13%;
Pic.1. Using of the Informational Systems
Thus, this direction is relevant and effective at the current time. The topic of using the processing of data analysis obtained in the course of research has been studied. The possibilities of considering the construction of various variations, solving management problems that are carried out in a certain algorithm are considered. The use of a reliable medical-statistical information system, which is formed and developed using statistical methods, in order to perform research, comparison, analysis, and assessment. As well as the rational use of all available resources and opportunities for the optimal solution.