The external environment of health care institutions. Internal and external environment of a healthcare organization External environment of a private medical organization

IMPACT OF THE EXTERNAL ENVIRONMENT ON THE MANAGEMENT OF MEDICAL ORGANIZATIONS

A.A. Gromov, Candidate of Economic Sciences, Associate Professor, Department of Social Sciences, Kharkiv National Medical University

The relevance of studying the influence of the external environment on the functioning of any organization is due to its ever-increasing role in effective management. In today's globalizing world, the external environment is dynamically changing, prompting organizations to form adaptive responses to uncontrollable factors of their development. In modern conditions, the improvement of management is associated not so much with the internal environment as it is due to the goals that are achieved just in the external environment. The management policy of medical institutions and firms is no exception. Its content is of particular interest, because social in essence and the services provided, organizations are forced to operate in an open market environment and in conditions of global competition.

It is known that the external environment of a medical organization is a set of factors and conditions that exist outside it, but influence the process of making managerial decisions. It seems that uncontrollable factors have the greatest impact on the activities of medical manufacturers (the outstripping growth of average costs of medicine compared to this growth in other sectors of the economy, the monopoly of clinics and pharmaceutical TNCs, the system of higher and secondary medical education).

The reason for the regular outstripping growth of the average costs of medical care lies in the institutional features of the medical services market, such as the asymmetry of information about their quality and the stimulation of demand for them by the supply itself. The growth of costs is influenced by the natural monopoly of hospitals, which practically do not compete with each other, as well as such a phenomenon of the medical services market as payment for treatment not by the patient himself, but by a third party (state, insurance company, firm, etc.).

The emergence of new medical discoveries also has an impact on the growth of medical care costs. Foreign practice shows that awareness of fundamentally new diagnostic and treatment methods and the desire to use them is a factor in the rapid growth of the expectations of many people. It should be noted that only a part of these expectations is due to real needs for improving health, the rest is a tribute to fashion.

One of the most important influencing factors is inflated requirements for additional medical services, which stimulate diversified and often aggressive marketing of pharmaceutical companies.

The outstripping growth of the average costs of medical care is also influenced by the change in the structure of diseases and the emergence of, for example, AIDS, SARS, bird flu. At the same time, the cost of creating an AIDS vaccine alone reaches more than $1 billion a year.

The main reason for the increase in demand for medical services is a significant increase in GDP, which serves as the basis for the growth of citizens' incomes. Constantly growing incomes switch the demand of the population to more expensive medicines and medical services, the “Giffen paradox” works: income growth leads not only to an increase in the level of demand, but also to a change in its structure - an increase in the share of consumption of those services that can be equated with luxury goods.

A significant factor influencing the external environment is the monopoly of producers. The monopoly position is usually occupied by large specialized clinics or large multidisciplinary hospital complexes. The economic advantages of large producers lie in the fact that a positive effect of scale is triggered, which makes it possible to increase production efficiency. Another variant of monopoly is a natural monopoly within a specific territory. From the point of view of the external market, medical organizations are greatly influenced by the monopoly of foreign pharmaceutical companies, which contribute to inflating the costs of medical care by supporting corruption schemes during tender transactions, high prices for medicines and equipment, subordinating doctors to themselves using network marketing tools.

It is known that monopoly is dangerous by stagnation and rising prices. However, it is opposed by competition in the manager market. More effective competition arises in the case of the formation of a quasi-market of medical services. Therefore, managers should be interested in its formation and pursue an active policy aimed at concluding contracts with local authorities and obtaining state orders. This means replacing the mechanism of budgetary distribution of medical services with an act of sale.

A significant impact on the effectiveness of the management of medical institutions is provided by the system of training medical personnel, which is in a state of reform, which has a significant impact on the quality of training. The content of education is changing - student practice is canceled, a number of theoretical disciplines are reduced, work with phantoms is increased, and not with patients, etc. These circumstances should be taken into account by modern management when concluding contracts with employees and graduates of medical universities.

Thus, effective management in a modern medical organization is possible only if it adapts to constant changes in the external environment. It is impossible to stop the growth of medical care costs, however, it is possible to find other reserves for the rational use of resources, new forms of organizational structures, a higher degree of autonomy of departments within a medical organization that encourages savings and efficiency, competent marketing of paid services, etc.

An important and modern factor in management is now becoming the initiation of change, which should turn into a decisive management strategy for a medical organization.

Management depends on an infinite number of factors. All factors influencing the management process are often divided into manageable and unmanageable. In a number of cases, it is not about the absolute, but about the relative controllability / uncontrollability of certain processes. More or less directly controllable variables are ranked among the factors of the internal environment of the organization. Those that are less subject to the leader are considered as environmental factors.

To the internal environment of the organization include factors such as purpose, objectives, personnel, structure, technology. In the previous topic, attention was paid to the analysis of the structure of the organization. In this section, we turn to the consideration of the essence and significance in the organization of its goals and objectives.

staging goals- the most important starting point of the management process. An organization is a complex multi-purpose system that is closely connected with the outside world and has a comprehensive impact on it. The management of such a system requires the definition of the entire set of goals and objectives that it must solve in its daily activities; the products it will produce and the markets it will serve; necessary resources for the implementation of the planned goals and ways to achieve them.

The main point of intra-organizational goal-setting is the formulation of the mission of this organization, which reflects its features, reasons for existence and its future role in society. Mission- this is a general (strategic) goal, which cannot be set by quantitative parameters, but characterizes purpose and philosophy followed by this organization. The mission implies the presence of certain values, rules and techniques that the company uses in its activities. This is the microculture of the company, its traditions, the approach of leaders to decision-making, that is, the uniqueness that makes the organization unique, different from others. The mission, on the one hand, provides information about the organization to its employees and potential applicants for work in this organization, on the other hand, it forms an appropriate opinion about itself in the eyes of the external environment. As a rule, the mission of the organization is formed over the years, honed and rarely changed.

The concept of "mission" is new for our economy. Under the conditions of the planned structure, it was automatically set through the structure of directive indicators from higher authorities. In a competitive environment, the mission becomes very important. The mission statement details the status of the organization and provides guidance for setting goals and strategy across the various organizational levels.

The formation of the mission is influenced by:

- the owners of the organization, developing the organization in order to solve their life problems at the expense of profit;

- employees of the organization who directly create the product, organize the receipt of the necessary resources, ensure (through marketing) the sale of products and thus solve their vital problems and interests;

- buyers of the company's products, at the expense of their financial resources, acquiring products to meet their needs and interests;

- business partners of the organization providing it with certain commercial services in their own interests.

When forming the mission of the organization, it is necessary to take into account the interests of all these subjects, each of which has a different influence in different decisions. A well-defined mission sets the organization apart from others like it. To do this, the following characteristics of the organization should be formulated:

- the philosophy of the organization, chosen by the administration of the company for the organization of work;

- the scope of the organization, the account of which is necessary for the selection of resources and product;

- a system of its goals, showing what the organization is striving for;

- technological capabilities of the organization.

Thus, a mission is not a specific indication of what to do and when. It forms only the general direction of movement of the organization, taking into account its external and internal conditions. This is a very important management statement that reflects the socially significant intentions of the organization, as well as giving an idea of ​​​​the scope, key goals and principles of work.

The mission of the organization to a certain extent influences the forecast of the firm's action, which is determined by market conditions and the chosen period of existence of the firm. It is here that the managerial content of the mission is revealed, since the mission is a set of strategies that the company's administration develops to achieve global goals.

When developing a mission, i.e. set of strategies, not only the external environment (geopolitical, economic and social conditions) is studied, but also the system characteristics of the organization, the totality of resources, production or organizational processes, products.

The mission must be clearly formulated, communicated to each employee so that they can understand it, since the goals and objectives of the organization will follow from the mission.

The science of management has not developed any universal rules applied in the formulation of the mission. There are only a few general guidelines that management should consider. Among them:

- the mission is formulated outside the time frame, which allows us to consider it "timeless";

- the mission should not depend on the current state of the organization, forms and methods of its work, as it is directed to the future and shows what efforts will be directed to and what values ​​will be most important for the organization;

- in the mission it is not customary to indicate profit as a goal, despite the fact that profitable work is the most important factor in the life of any commercial organization; but focusing on profit can significantly limit the range of development paths and directions considered by the organization, which ultimately will lead to negative consequences;

- the mission is formulated by top management, which is fully responsible for its implementation by setting and implementing the goals of the organization;

- there should be no contradictions between the mission of the organization and the more general system of which it is a part.

There are many approaches to defining the mission and its content, reflecting the assessment of the role and importance of the organization, primarily by decision makers. As already noted, the central point is the answer to the question: what is the main goal (purpose) of the organization? At the same time, it is preferable to put the interests, expectations and values ​​of consumers (current and future) in the first place.

An example is the wording of Ford's mission as "providing people with cheap transportation." It clearly defines the area of ​​activity - transport, consumers of the product - people, as well as orientation to a wide range of consumers. Such a mission can have a decisive impact on the strategy and tactics of the company, as well as public support for its activities. However, it lacks what companies began to pay attention to later - this is a focus on the fundamental differences of this company from others, as well as on its desire to reveal the talents of the people working in it.

Managers and leaders of many large companies believe that organizations should identify themselves in the mission not by a production product or service, but by a key purpose, that is, by definition: who we are and how we differ from others. In other words, what matters is not what the company produces, but what it fights for, what it will do in the future.

For example, Motorola defined its core mission as "using technology for the benefit of people," rather than making television networks or high-end TVs. This wording may seem rather broad and meaningless, but it provides a specific choice of what to produce and to whom to sell. And this allowed the company to develop in directions that its competitors could not imagine, and thereby develop market immunity.

Many companies introduce statements into the mission that emphasize value orientations, stimulate the work of staff and fill everyday activities with meaning and awareness of its noble goal for the benefit of people.

So, in the value system of the American company 3M there is an eleventh commandment, which says: "Do not kill the idea of ​​​​a new type of product." And in the mission statement of one of the companies in Japan, such universal principles are emphasized as “achieving excellence in all areas - in our goals, products, services, people and our lifestyle”; it emphasizes that “quality is an integral part of our products, our working environment and people”; such characteristics as "honesty and openness, work in a single team, free exchange of information" are revealed. It makes an important statement: "We want people to be able to say that our company is a great place to work and that it supports and recognizes individual achievement."

The mission forms the foundation for setting the goals of the organization as a whole, its divisions and functional subsystems, each of which sets and implements its own goals, logical, arising from the overall goal of the enterprise.

Goals organization - the direction in which its activities should be carried out. This is the state in which organizations want to be. The goals of the organization are called the purposes of functioning. The objectives of the management system are the starting point for planning. In essence, planning is the development of the goals and objectives of the company, which have found concrete expression in long-term and current plans. Goals are always formed by those who manage key resources in accordance with the value system of the owners of these resources. The top management of an organization is such a resource. The value structure of leaders always influences the structure of goals. The formulation of goals is always influenced by the interests of a number of subjects:

– owners and managers;

– employees;

– business partners represented by suppliers and consumers;

- local authorities, which the organization helps to solve certain problems;

- society as a whole (local population, which may have different attitudes towards different organizations).

If we consider the goal as a desired result, then we must recognize that there are many goals - different depending on the type of organization. Some organizations are engaged in business, service provision, etc. – they always operate within specific constraints. Their goal is to make a profit, reduce costs, i.e. indicators such as profitability, etc.

Other organizations (founders) - non-profit - operate in the service sector and do not receive profit as such, but they are concerned about costs, since they operate within budget constraints. The goal of the enterprise should take into account such areas of activity as market share, development of new types of products, quality of services, etc. Non-profit organizations also have different goals, but they pay more attention to responsibility. In other words, in various organizations, as a rule, you have to deal with a set of goals. The task of the head of an organization at any level is to be able to take into account all the variety of factors affecting the functioning of the organization, correctly assess the situation and choose the best solutions.

At each level of the organization, some private goals arise, and only their totality must be considered as a certain goal of a certain level of management. The goals of the organization form a hierarchy, i.e. they are in a hierarchical relationship. Higher level goals are always more important and broader in scope than lower level goals. This raises the need to build a tree of goals, which links the goals of various levels of management of the organization and in various areas of activity.

In the management structure of the organization, the goals perform a number of actions (functions):

1) reflecting the philosophy of the activity and development of the organization, the goals ultimately determine the nature and characteristics of this organization;

2) goals always reduce the uncertainty of current activities, since they are considered as guidelines, allow you to adapt to the environment, concentrate on achieving the desired results, and therefore, regulate the appropriate actions and behavior;

3) goals form the basis of criteria for highlighting decision-making problems and evaluating results;

4) goals always allow (regardless of their reality) to rally enthusiasts around themselves, take on additional responsibilities, and make efforts to fulfill them;

5) even the official proclamation of the goal is a confirmation of the need for the legitimacy of the existence of this organization in the eyes of the public, even if this organization by its activities causes adverse consequences.

Goals are important from the point of view of the existence of the organization, they must satisfy a number of requirements:

a) must be specific, formulated in quantitative terms (as a rule);

b) must be real (under given specific conditions, otherwise there will be no effort to achieve them);

c) must be flexible (capable of transformation and adjustment in accordance with changing conditions);

d) must be compatible in time and space, so as not to disorient the performers in their actions (incompatibility leads to conflicts);

e) must be consistent and consistent with other goals, as well as with the resources required to achieve them;

e) must be recognized.

Goals are usually achieved through a combination of the overall goals of the organization and the personal goals of leaders. A certain compromise must be found: leaders must recognize and recognize the goals of the organization as their personal goals. Only in this case they will be interested in achieving results.

The goals of the organization are structural character, that is, they imply a certain classification:

- the goals of the organization are strategic, tactical and operational. The first are key, they are focused on solving promising (5–10 years) problems; the latter are more specific and focused on a shorter period (from one to three to five years). Still others represent the concretization of strategic and tactical goals to the level of tasks that specific performers must solve in their daily work (within a year, half a year, quarter, month, working day);

- based on period time necessary for implementation, there are: long-term(over 15 years), medium-term(1–5 years), short-term(1 year) goals;

- grouping targets content built on the diversity of interests of the organization: allocate technological, economic, social, industrial, administrative, marketing etc. goals;

- in your own way level The goals of the organization are divided into general and specific. General reflect the concept of development of the organization as a whole in the most important areas. And specific ones are developed in separate divisions of the organization and determine the main direction of their activities in terms of the implementation of common goals. To specific goals include operational and operational. The first are the goals that are set for employees; the second are the goals that are set for a separate unit. The process of setting goals, depending on the characteristics of the organization, can take place centrally and decentralized. In the first case, they can be imposed, which can lead to resistance from lower levels; in the second case, they can be carried out from the bottom up;

- Goals can be qualitative and quantitative. If quantitative goals can be evaluated in a single equivalent, for example, in monetary terms, in years, in tons, etc., then the assessment of qualitative goals in quantitative terms is very difficult and requires the application of a method known as method of expert assessments, which allows you to select the purpose of the operation, determine the priority of the goals and their importance.

Expert judgment is defined as a “procedure” that takes into account subjective opinion in order to determine quantitative relationships between variables when these relationships cannot be established from theoretical considerations or based on accumulated statistical data. Therefore, the task of formulating the goals of the organization's functioning with the help of expert assessments is the task of obtaining an objective result based on the individual subjective opinions of a group of experts.

The value of the result obtained using the method of expert assessments largely depends on the competence of the specialists involved in the experiment. Creating conditions for the fruitful activity of experts who choose the goals of functioning means the need to organize the most effective system of contacts between them, which allows:

- create conditions under which a specialist can actively interact with other experts;

– have free access to relevant information;

– exclude the possibility of misinterpretation of the opinion.

This method is the simplest, but has a number of disadvantages caused by the excessive influence of psychological factors. Recently, methods have been developed with the help of which it is possible to overcome these difficulties by eliminating the direct communication of specialists with each other or by taking into account the qualifications of experts, weighing their opinions.

There are other classifications as well. For example, by importance goals are divided into high priority(key), the achievement of which is associated with obtaining the overall result of the development of the organization; priority, leadership necessary for success and demanding attention; rest, also important, but non-urgent goals that require constant monitoring.

The allocation of goals by priority I. Ansoff calls management based on the ranking of strategic goals and proposes a scheme for establishing ranks. To do this, all tasks are divided into four categories: a) the most urgent and important tasks that require immediate consideration; b) important tasks of medium urgency that can be solved within the next planning cycle; c) important, but non-urgent tasks that require constant monitoring; d) tasks that are false alarms and do not deserve further consideration.

Each organization is connected by many communications with other organizations that make up its business environment, which has a direct or indirect impact on it. According to this criterion, all goals are divided into internal goals the organization itself and for purposes related to its business environment (external).

Tasks of the organization. Based on the goals, the organization formulates tasks, which are part of the work that needs to be done in a certain way in a given time frame. Tasks are a certain set of issues to be resolved, as well as the conditions necessary for this solution. From a technical point of view, tasks are assigned not to the employee, but to his position. Based on the decision of management on the structure, each position has a certain range of tasks that are considered as a necessary contribution to the achievement of the goals of the organization. It is believed that if the tasks are performed in a given way and within a given timeframe, then the organization is operating successfully. Therefore, tasks are more specific than goals, because they have not only qualitative, but also quantitative temporal and spatial characteristics.

Tasks are more individual because they may include elements that are attractive to performers.

Two other important points in the work: the time required to complete it; frequency of repetition of this task. A machine operation, for example, may consist of performing the task of drilling holes a thousand times a day. It only takes a few seconds to complete each operation. The researcher performs varied and complex tasks, and they may not be repeated at all during the day, week or year. In order to complete some of the tasks, the researcher needs several hours or even days. In general, we can say that managerial work is less monotonous, repetitive, and the time to complete each type of work increases as managerial work moves from a lower level to a higher one. In a calm environment, tasks are repeated at regular intervals, solutions have been worked out and do not present big problems for management. The situation is much more complicated in a dynamic environment, when new tasks arise all the time, the solutions to which are not always obvious and the time for their implementation is unknown. These variables affect the quality of management primarily through the organizational structure, which must be rebuilt to meet a new range of tasks.

Tasks, like goals, are subject to the principles of building and functioning of large systems: they can be subjected to decomposition, they are characterized by the properties of synergy, non-additiveness, emergence, etc. The “task tree”, which characterizes the task as a large system facing the socio-economic system, is also an important element of program-target management.

The category of a task should be distinguished from the category of a problem, a problem situation. The problem can be considered as the main contradiction between the situation and the goal and as the main link in changing the situation in the direction of achieving the goal. The problem category is generally much broader than the problem category. The task is more related to the activities of leaders, needs and interests, and the problem is more related to the correspondence of the situation and the goal. The same problem can give rise to an abundance of problems. For example, the problem of getting out of the crisis state of the economy gives rise to tasks for each business entity, for each producer and consumer. Solving problems is associated with the need to perform a complex network of procedures, during which material, labor and financial resources are set in motion. This sequence is implemented in the process of making and implementing managerial decisions.

Approaches to task classification depend on the goals of the analysis and subsequent management decisions. Let's consider the two most promising approaches. At first of which tasks are classified according to features related to technological division of labor. These types of tasks include the following:

1) proper management tasks related to operational management and leadership, the implementation of management functions by managers, the distribution of rights and powers;

2) organizational and economic tasks related to ensuring the unity and organizational integrity of socio-economic systems, achieving the required technical and economic parameters of systems, observing financial discipline, etc.;

3) ideological and educational tasks those associated with the formation of moral and ideological criteria and ideals that correspond to public views and attitudes, the needs of socio-economic development;

4) socio-psychological tasks related to the improvement of diverse relationships between members of the team, the formation and development of the psychological climate in the team, management style, motivation of spiritual incentives, self-affirmation and self-expression;

5) scientific and technical, technological tasks, related to the provision of research, design, technological solutions.

To one degree or another, each leader must possess a wide range of knowledge in order to competently solve all these types of tasks (or organize their solution), as well as have appropriate legal levers and incentives. Naturally, there are no sharp, impenetrable boundaries between the content of tasks; on the contrary, these boundaries are quite mobile, conditional, and changeable. Usually, the tasks to be solved are determined by an expert.

The tasks facing leaders can be classified as tasks of functioning and development. The solution of the first is intended to ensure the cyclical nature of the activity of production systems, the fulfillment of planned targets, the functioning of the activities of the enterprise's services. The second tasks (development) are connected with the inclusion in the reproduction processes of new elements and factors of production, new factors of a scientific, technical and social nature, which requires constant updating and qualitative improvement of the entire management system.

Thus, the achievement of the set goal requires a preliminary solution of a set of specific tasks. Since the task is a unity of questions and conditions for their resolution, a logical chain is formed: goal - tasks - result, in which tasks can be presented for simplicity as a sequence of questions and conditions.

The achieved result is commensurate with the previously set goal and serves as the basis for setting a new, refined goal, solving problems and obtaining a new result, etc. This process continues uninterrupted: individually - as long as an individual exists, socially - as long as society exists.

It is very important that this process be accompanied by self-learning - the goals are formulated and set more clearly, definitely, specifically; tasks were identified in full; the most favorable conditions for their solution were created. In many cases, it is useful to decompose goals, objectives, and results. It is customary to consider the overall goal achieved if the main partial goals are achieved, the main tasks are solved, and the result deviates from the goal within acceptable limits.

The internal environment of the organization reflects the specifics of its activities, namely the features of technology, the promotion of goods to the buyer, the organizational structure, the climate in the team, approaches to staff training and labor stimulation.

Factors of the internal environment (internal variables) are situational factors within the organization that are the result of management decisions. Internal variables are controllable to varying degrees. Among them are the following, the most important:

The goals of the organization;

Structure;

Technology;

Organizational goals are specific end states or desired outcomes that the members of the organization would like to achieve by working together.

Without a clear formulation of the goals of its activities, the organization cannot establish itself in the market and survive in the competition. The point of setting a goal is to identify the most significant areas of activity and expected results in order to focus on achieving these results.

The formulation and communication of goals is an important means of coordinating the work divided among specialized groups, provided that the goals of the units are consistent with the goals of the organization as a whole.

For commercial organizations, the goals of profitability, profitability, etc. are set, for non-profit organizations - the goals of budget fulfillment, social responsibility to society, etc.

The most common areas of goal setting in a business organization are:

Profitability;

Market position;

Performance;

Financial resources;

The capacity of the organization;

Product development, product manufacturing and technology upgrade;

Changes in organization and management;

Human resources;

Work with buyers;

Providing assistance to society, etc.

The structure of an organization is a logical relationship between levels of management and functional areas, built in a form that allows you to most effectively achieve the goals of the organization.

A task is a prescribed work, a series of work functions that must be completed in some form and within a limited period of time. Tasks can be classified as work with objects, people, information.

From a technical point of view, tasks are assigned not to an employee, but to a position. Based on the decision on the structure, each position includes a number of tasks that are considered as a necessary contribution to the achievement of the goals of the organization.

Production technology in the field of business activity is understood as methods, methods, and techniques for combining factors of production in order to obtain a product ready for consumption.

Technology from a managerial point of view is not a way of processing raw materials, not a method of connecting machines and workers. The manager, first of all, is looking for the most effective way to achieve the goals.

The technology of production and its choice is an engineering and technical function, and the technology of organizing the production process is an economic and organizational function, fully assigned to the manager.

The main tasks that a manager has to solve in relation to technology:

Compliance of technology with the chosen (chosen) profile of the organization;

Technology performance evaluation;

Estimation of the cost of technology (payback period, efficiency, energy intensity);

Assessment of compliance of the level of actual qualification of personnel with the requirements of the chosen (used) technology;

Assessment of the compliance of the selected technology with competitive technological standards.

Tasks and technology are closely related. The performance of a particular task involves the use of a particular technology as a means of converting input material into an output form.

An organization, including leaders and subordinates, is nothing but a group of people. There are three main aspects of the human variable in the situational approach to management:

The behavior of individuals;

Behavior of people in groups;

The nature of the leader's behavior, the manager's functioning as a leader and its influence on the behavior of individuals or groups.

For the company "Meridian" due to the limited number of its staff, the most suitable is a linear-functional structure, in which two departments can be distinguished: Ivanovo and Rodnikovskoye.

In 2007, Meridian LLC was engaged in the sale of finished optics: a number of models of finished glasses with various lenses. In 2008, the company received a license for the production and sale of medical products (connection of frames with glasses).

According to existing regulations, in order to obtain and renew a license, it is mandatory that at least one specialist who has undergone special training and has at least 3 years of experience in licensed optics work in optics. Taking into account this condition, 3 masters were hired in the organization.

The organization does not have a formal division of masters and optical consultants into categories depending on qualifications. More experienced employees are admitted to more information and carry out more serious assignments, receiving appropriate compensation.

The work schedule of optical consultants is formed in advance for a month, taking into account the requirements of the Labor Code and the wishes of the employees themselves. There is a distribution of the mandatory number of workers per shift depending on the time of day. In the absence of any employee at the workplace, he must be replaced by another. From these conditions follows the need for hourly pay.

Members of the organization believe that the main direction of the development of the organization is due to the established goals of the organization: decent working conditions and pay for employees and profit for the founders.

Due to the limited financial resources of the founders, and the small amount of the authorized capital, a small amount was allocated for working capital, which determined the assortment of goods for a poor buyer at the beginning of the organization's activities. "Meridian" has carved its niche in the market for this product and has become known as optics with affordable prices.

At the desired level of development, Meridian LLC would like to have its own laboratory for the production of frames and a workshop for the production of lenses, as well as a network of opticians, consisting of one to two dozen points in the Ivanovo, Vladimir, Kostroma regions. At the moment, the organization is at the beginning of the path to its design capacity, an efficient management and labor collective are being formed, the foundations of a strategic vision of development prospects are being laid, fixed assets are being increased, a business idea is being polished, and a management system is being established. The life cycle stage of Meridian LLC should be defined as "Growth".

Ecological factors of the internal and environment are a combination of climatic and sanitary-hygienic components of the optics environment itself.

Moderate temperatures are maintained at both points of sale of Meridian LLC. In the summer, air conditioners work in the premises, not only refreshing, but also purifying the air. The stores provide moderately bright lighting of the trading floor. Maintaining the composition of the air at the required level LLC "Meridian" achieves the implementation of active air exchange, for which ventilation, air conditioning, ozonation, aromatization are used.

The sanitary and hygienic environment of Meridian LLC meets all the necessary norms and standards. Corporate clothing is intended for staff. There is no noise pollution in the trading floor. Through the windows made according to modern technologies, the noise of vehicles is not heard.

External environment of the organization

The external environment of the organization consists of groups of situational factors outside the organization. The significance of external factors varies from organization to organization and from unit to unit within the same organization. Factors that have an immediate impact on the organization refer to the environment of direct impact (factors of the microenvironment); all others - to the environment of indirect influence (macro-environment factors).

Characteristics of the external environment:

Interconnection of factors (all factors of the external environment are interdependent and interact with each other);

Complexity (the complexity of the external environment is understood as the number and variety of factors to which the organization is forced to respond);

Mobility (the mobility of the environment is characterized by the speed with which changes occur in the environment);

Uncertainty (the uncertainty of the environment is a function of the amount of information available for a particular factor and confidence in the reliability of this information).

The macro-environment includes the legal factor, political, social, economic, technological.

From a substantive point of view, the legal factor is the “rules of the game” that society establishes for the professional functioning of producers.

From a formalized point of view, the legal factor is the sum of laws and regulations that determine the direction and content of business activity and the content of relations with other subjects of economic relations and government agencies and public institutions. In other words, the legal factor is everything that determines the possible scope of the rights, duties and freedoms of a business person.

The characteristic of the legal factor also includes such a concept as legal culture, by which we mean law-abiding.

Specific forms of the legal factor:

Rights, obligations and liability of the manufacturer;

Possible forms of protecting one's own interests in case of their violation by other subjects of law;

Procedural mechanism for the protection of interests and its characteristics;

Possible forms of liability in case of violation of obligations assumed on the basis of contractual relations;

Stability of the legal system;

Opportunity to lobby your own interests in legislative bodies.

The political factor determines the attitude of the state to the processes taking place in society in the sphere of business relations and the direction of its influence (real and potential) on such processes.

The quality and nature of the stability of the political system are the main characteristics of the factor.

Components of the political factor:

The dominant political force in society and its positions;

Opposition and its position in society;

Threats to the organization if the opposition comes to power;

Government attitude towards entrepreneurship and the business community;

Forms of government contacts with representatives of the business community;

The amount and form of fees charged by the government or officials from commercial structures for lobbying interests;

The attitude of the government towards the industry in which the organization operates;

The attitude of the government to the region where the organization is located and the characteristics of the region.

The main components of the social factor:

National traditions and customs;

The educational level of the nation;

Features of national culture;

Level and quality of life;

national values;

The level of professional training of the workforce;

People's attitudes towards work, self-employment and business success;

Mobility of the labor force and the population as a whole;

The attitude of others to independent business activity and business success;

Availability of infrastructure and its quality (everything that contributes to doing business - transport communications, information centers, marketing, engineering consulting structures).

The main components of the economic factor:

The degree of availability of the use of the necessary resources;

GNP value and its structure;

inflation rate;

Unemployment rate;

labor productivity;

tax rates;

Average salary or average family income;

The stability of the economic policy of the federal government and regional authorities and its direction;

The level of market prices for consumed resources and their possible dynamics;

The level of development of national economic and management schools, etc.

The technological factor is something that appears outside the industry where the organization operates.

When studying and understanding the technological factor of the external environment, the following two options are possible.

1. Identification and fixation of the technological gap from competitors, if the manager in the process of competition adheres to the strategy of pursuing competitors.

2. Identification and fixation of the appearance on the market of a new (compared to currently used), more advanced and productive technology, if the manager adheres to a strategy to outperform competitors.

The external environment of LLC "Meridian" should be characterized as complex. The enterprise in question has about fifty different counterparties:

Competitors;

Suppliers;

Landlord;

OJSC "Medtekhnika", which performs verification and calibration of measuring instruments;

FGUZ "Center for Hygiene and Epidemiology in the Ivanovo Region", which measures lighting and microclimate, issues medical books, as well as sanitary and epidemiological expertise and microbiological studies;

Organizations; carrying out preventive examination of employees;

Organizations providing various communication services such as Internet, intra-zone, long-distance, international and mobile telephony;

Private security;

Organizations that carry out operational and technical maintenance of technical means of fire and security alarms and electrical installations of Meridian LLC;

Laundry;

JSC "JSC Lotos", which provides temporary storage and demercurization of mercury-containing waste;

Educational and technical center conducting pre-certification training for power personnel and others.

Optics interacts with the above counterparties on the basis of existing legislative acts, norms and rules. The management of Meridian is confident that the precise fulfillment of formalities protects the organization from being closed by regulatory authorities, while for many competing organizations such a possibility theoretically exists. At the same time, Meridian also tries to maintain informal relations with representatives of the listed counterparties, which helps the optician to maintain constant compliance with existing standards.

In the region where Meridian LLC is located, there are many competing dynamically developing organizations, many of which represent trade and industrial networks, for example, icraft, Ochkarik and others. In various malls and stores, small stalls are opening selling glasses made without a license.

Thus, the competitive environment of LLC "Meridian" should be recognized as mobile and uncertain.

Changes in the demographic situation taking place in Russia have both a positive and a negative impact on the company's activities. A change in the age structure of society, in which the largest share is occupied by the population of pre-retirement and retirement age, which has very low incomes, will lead to a reduction in the number of products sold and services provided. But an aging society, which contributes to an increase in the proportion of people with visual impairments, will increase the volume of orders and services rendered and, if the most optimal prices are established, will allow the organization to increase sales.

Social factors that may further affect Meridian's operations include the following:

The average level of wages in the industry: since the wages of the firm's employees are slightly higher than the average wages in the industry, the firm has the opportunity to increase the requirements for employees;

Movements to protect consumer rights and increase requirements for firms providing medical services and products;

Increasing attention of consumers of the middle and upper class to their health and preservation, which contributes to an increase in the company's sales;

The territorial environment (location) of optics has a significant impact on the perception and attitude of customers towards the store.

The Ivanovo branch of the organization is located in the central business zone of the city, the Rodnikovsky branch is located near a large store in the city center.

The formation of a favorable atmosphere is facilitated by the territorial and transport accessibility of both divisions of Meridian, which is determined by the state of transport communications, access roads, as well as accessibility for pedestrians.

The technological factor of optics has the following feature. New modern machines, designed according to new methods and technologies, make it possible to produce glasses not only of a higher class and attractive shape, but also to do it faster and better. Thus, the growth of fixed assets allows you to increase the number of products and expand its range. Currently, Meridian optics uses manual, semi-automatic and automatic machines, the latter of which fully meets modern requirements. In general, the company's management characterize their technological state as corresponding to the level of the main competitors.

The strengths and weaknesses of the organization, as well as the threats and opportunities of the external environment, are shown by the SWOT analysis presented in Table 2.1.

Table 2.1

Suentaeva G. R.

Master's student at Almaty Management University

INCOME GENERATION FACTORS OF A MEDICAL ORGANIZATION

annotation

The existing practice of planning the formation and distribution of income in healthcare organizations should be reformed in favor of focusing on the development trends of certain types of medical services. Health organizations should improve their capacity in the process of formation and distribution of expenses, planning of income and expenses of the organization, drawing up investment plans, introducing innovative medical products, etc.

Keywords: healthcare organization, income, factors of income formation

Suentaeva G.R.

undergraduate of Almaty Management University

FACTORS OF FORMATION OF INCOME HEALTH ORGANIZATIONS

Abstract

The current practice of planning the formation and distribution of income in health care organizations should be reformed to focus on trends in the development of certain types of medical services. Health organizations have the potential of improving the process of formation and distribution costs, planning revenues and expenses, preparation of investment plans, the introduction of innovative medical products.

keywords: health organization, revenues, income generation factors

It seems that the tasks of a comprehensive analysis of the income of a medical organization are satisfied by the classification of factors according to the following criteria:

1. By the influence of the external and internal environment of a medical organization.

The whole set of environmental factors of a medical organization can be differentiated into 2 groups: microenvironment factors and macroenvironment factors.

The microenvironment is represented by factors that are directly related to the medical organization and its capabilities. These include factors that directly and directly affect the income of a medical organization:

• the state acts as a regulating, protecting and leading link;
• suppliers;
• consumers: individuals and enterprises;
• competitors.

The macroenvironment is represented by broader factors that have an indirect impact on the microenvironment, such as political, economic, scientific, technical, social, demographic factors:

• economic factors include the financial condition of the country, the purchasing power of the population, the level of inflation, real incomes of the population;
• scientific and technological factors are crucial for the emergence of technological innovations in the field of medicine. The growth of income, development and efficiency of the functioning of any medical organization is possible only when it fully uses all the achievements of scientific and technological progress;
• the social factors of the external environment include the healthcare system and the consumer culture of the population, the moral norms of its behavior, the professional and personal qualities of medical workers, the level of healthcare;
• demographic factors, on the one hand, determine the real possibilities of providing a medical organization with labor resources, and on the other hand, they form the level and scale of market needs;
• political factors determine the degree of stability in society, which is important for attracting investments, including foreign ones, and the development of foreign economic activity of a medical organization;
• environmental factors are represented by restrictions on the volume of environmental pollution established by law and are expressed by the regulation of discharges into water bodies, emissions into the atmosphere, as well as the collection of fees for both standard and excess pollution of the environment.

The influence of the internal environment on the amount of income of a medical organization is characterized by the following main factors and their characteristics:

• production of medical services: volume, structure of services of a medical organization; availability of raw materials and supplies; medical equipment; the location of the organization and availability of infrastructure; quality control of services, costs; technology; innovations; information;
• medical personnel: labor potential, number of employees, staff structure, labor productivity, staff turnover, labor costs, interests and needs of employees;
• management organization: organizational structure, management system; level of management, etc.;
• marketing: market share; marketing budget and its execution; marketing plans and programs; image, reputation and quality of medical services; advertising, pricing;
• finance and accounting: own and borrowed funds and their ratio; an effective accounting system, including cost accounting, budgeting, profit planning.

1. According to the components of human activity.

In the classification of economic resources, in all types of human activity, 3 components can be distinguished:

1. Regulated labor performed according to a given technology, instructions, scheme, when the performer of the work does not introduce any elements of novelty into it, his own creativity. Such labor is called α-labor.

2. Creative work - the creation of new ideas, methods, products, technologies. This component is called β-labor.

1. Motivational and coordination work aimed at ensuring effective interaction between people and social groups. This activity is referred to as ɣ-labor.

All factors, based on the results of creative work, can be divided into areas of technical, organizational, economic and social nature, which together form the toolkit, with the help of which the income growth of a medical organization is achieved. These areas are very diverse, among the most important of them are:

• improving the organization of medical services and labor;
• scientific and technological progress and its implementation;
• improvement of forms and methods of management;
• improving the quality of medical services;
• development of concentration, specialization, cooperation, combination;
• improvement of the system of motivation of medical personnel;
• raising the cultural, professional and qualification level of medical workers and others.

One way or another, all of the listed areas of creative work contribute to the development and improvement of economic systems, that is, they contribute to the growth of income. Therefore, we can assume that creative work is a complex factor in income growth.

Regulated α-labor prevails in the activities of nursing staff, as well as in the activities of secretaries, ordinary accountants, economists, and lawyers of a medical organization. Creative work is typical for doctors, doctors, researchers. β-labor can also make up a significant proportion of the activities of rationalizing doctors, designers of labor organization systems, law and management.

Motivational-coordinating work is the main activity of managers; the share of ɣ-labor is especially important in the activities of those who belong to the highest hierarchy of the enterprise. Along with ɣ-labor, the activities of effective managers may contain a significant part of β-labor, the results of which are usually not formalized in the form of inventions and rationalization proposals.

As follows from the profitability theorem of labor components, the greatest contribution to the increase in the income of the enterprise is made by the results (β-labor in the form of inventions, new medical technologies, rationalization proposals, computer programs, etc.).

Accounting for these components of labor is especially important when analyzing ways to increase the volume of medical services. Due to α-labor, this is possible only as a result of an increase in the number of medical staff or the intensity of their work, that is, in this case, there is a linear relationship. Fundamentally different possibilities of β-labor. Here the decisive role is played by the creative abilities of a person and the conditions for their implementation. With the use of these resources (that is, thanks to new technical and organizational ideas), the volume of medical services can be increased with a constant or reduced number of staff. In other words, the influence of β-labor on output is characterized by non-linear effects. Similar effects are characteristic of α-labor, although to a lesser extent.

The third component (ɣ-labor) creates the conditions for the effective realization of a person's creative abilities thanks to the system of ethical and legal norms, traditions, social atmosphere in the country and in medical organizations, which significantly depends on the personal qualities of leaders at all levels.

III. institutional factors.

By analogy with productivity factors, income factors of a medical organization can be classified by types of institutional norms (rules).

Based on the definition of the category “institution”, two main types of institutional factors can be distinguished:

• informal factors, which include traditions, customs, culture, moral standards, social conventions, corporate culture and others;
• formal factors that exist in the form of official texts, fixed in legal documents. These include: the Constitution of the state, laws, regulations, contracts between market participants, etc.

All institutional factors influencing the performance of a particular medical organization can be divided into five levels: international, state, regional, sectoral, in-house.

The main institutional factors of the international level include: international division and cooperation of labor, monetary and credit relations, exchange rules in the field of science and technology, migration relations, international business etiquette, capital movement and foreign investment, etc.

At the regional level, institutional factors are implemented by the relevant authorities. Within their competence, the regions provide medical organizations with orders on a commercial basis, benefits on tariffs for the use of electrical and thermal energy, and on rent. The center of gravity of the implementation of social policy is transferred to the regional level, especially in terms of housing and communal services, consumer services, education, healthcare, social protection, employment, etc. Their possibilities are expanding in the regulation of wages on the basis of agreements between associations of trade unions, employers and local authorities.

Industry-specific institutional factors are implemented by state and regional governments and include industry-wide and cross-sectoral measures. These include measures for the development, concentration and specialization of the output of products of intersectoral and sectoral application, the regulation of research work of a sectoral nature, the development and implementation of sector-wide standards for the expenditure of resources, etc.

At the intra-organizational level, institutional factors cover a wide range of organizational, technical, economic and social measures designed to solve the problems of increasing efficiency on the scale of a medical organization. These factors include various regulation options based on formal and informal rules.

1. According to the degree of controllability of a medical organization, the factors can be divided into:

• adjustable;
• poorly regulated;
• unregulated.

Regulated factors include factors that characterize the quality of management, the level of organization of the provision of medical services and medical work, the degree of use of resources, etc.

Weakly regulated factors are most often understood as having great inertia, the change of which over a certain period of time depends little on managerial decisions. These factors include: the volume and structure of fixed assets, characteristics of the level of equipment with medical equipment, etc.

Unregulated factors include factors that characterize tax legislation, natural and climatic conditions, etc.

Thus, in this article we have developed a classification of income factors of a medical organization according to four criteria: by the influence of the external and internal environment of a medical organization; by components of human activity; by types of institutional norms (rules); by degree of control.

Literature

1. Vyvarets A.D. Enterprise Economics: Textbook for university students. – M.: UNITI-DANA, 2012. – 312 p.
2. Efremov B.C. Business systems of post-industrial society; On labor, capital and profit of a commercial enterprise // Management abroad. 2009. No. 5. - P. 164

References

1. Vyvarets A.D. Business Economics: A textbook for university students. - M .: UNITY-DANA, 2012. - 312 p.
2. Efremov B.C. Business of post-industrial society; On labor, capital and profits of business management // abroad. 2009. No. 5. - S. 164
3. Lopez-Navidad A, Domingo P, Viedma MA. Professional characteristic of the transplant coordinators. Transplant Proc 2014. - 333 p.