Quality Assessment in Medical Care Provided under the Russia's Obligatory Medical Insurance System in Medical Disputes (A Case Study of Oncological Care)

EXPERT OPINION

https://doi.org/10.37469/0507-3758-2024-70-4-765-774

Published 06.09.2024

Elena Viktorovna Tkachenko⁺⁻
Sergey Leonidovich Semenov⁺⁻
Dmitry Gennadievich Bartenev⁺⁻
Sergey Valerievich Kondratev⁺⁻
Oksana Dmitrievna Tipisova⁺⁻

Elena Viktorovna Tkachenko

FSBI «Petrov Research Institute of Oncology» of the Ministry of Healthcare of the Russian Federation

https://orcid.org/0000-0001-6375-8335

Sergey Leonidovich Semenov

S. M. Kirov Military Medical Academy

https://orcid.org/0000-0003-0938-8454

Dmitry Gennadievich Bartenev

Federal State Budgetary Educational Institution of Higher Professional Education "Saint-Petersburg State University", Attorney at law, ONEGIN Group Law Office

https://orcid.org/0000-0003-3872-6539

Sergey Valerievich Kondratev

FSBI «Petrov Research Institute of Oncology» of the Ministry of Healthcare of the Russian Federation

https://orcid.org/0000-0002-7266-1604

Oksana Dmitrievna Tipisova

North-Western State Medical University named after I.I. Mechnikov

https://orcid.org/0009-0006-6169-7106

pdf (Русский)

Keywords

экспертиза качества медицинской помощи; медицинские судебные споры; оспаривание экспертных заключений

How to Cite

Tkachenko, E. V., Semenov, S. L., Bartenev, D. G., Kondratev, S. V., & Tipisova, O. D. (2024). Quality Assessment in Medical Care Provided under the Russia’s Obligatory Medical Insurance System in Medical Disputes (A Case Study of Oncological Care). Voprosy Onkologii, 70(4), 765–774. https://doi.org/10.37469/0507-3758-2024-70-4-765-774

Abstract

The quality assessment of medical care within the framework of obligatory medical insurance serves not only as an important tool for identifying defects at various stages of medical care provision but also, in some cases, opens up potential opportunities for patients or their relatives to file legal claims against health care providers. Therefore, the quality assessment of medical care should not be viewed solely as an economic tool for influencing medical organizations. The expert evaluation of medical care quality within the obligatory medical insurance system can become evidence in medical disputes and, consequently, a basis for holding a medical organization or healthcare worker legally accountable. Understanding the procedure and legal consequences of medical care quality assessment enables medical organizations to evaluate potential legal expenses, timely contest the assessment results, engage in meaningful dialogue with the expert, and thereby avoid significant costs in disputes with patients.

https://doi.org/10.37469/0507-3758-2024-70-4-765-774

pdf (Русский)

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