Modern challenges and a Conceptual Model of Georgias Health Development

Lali Chagelishvili-Agladze  Maya Gonashvili  Ketevan Archaia

Journal number 3 ∘ Lali Chagelishvili-Agladze ∘ Maya Gonashvili ∘ Ketevan Archaia ∘
Modern challenges and a Conceptual Model of Georgias Health Development

Summary

10.36172/EKONOMISTI.2023.XIX.03.Lali.Chagelishvili-Agladze/Maya.Gonashvili/Ketevan.Archaia

The agreement on the cooperation of the sustainable development of the United Nations in 2021 - 2025, is the first strategic priority for the well-being of a person who, along with material well-being, education and social protection, takes care of his health. The right of all people is health, and its provision is primarily the prerogative of the state.

The vectors of the Georgian health care system are considered in three main directions: ensuring universal health; implementation of alternative health financing models; Reproduction of sustainable development models of the health field.

In order to ensure the main right and health of a person, it is necessary to establish a system that will be equally accessible to all strata of society, and most importantly, quality health services will be provided for them for this purpose, in 2013, a reform in the field of health of Georgia began, the result of which was the implementation of the universal health program. The first stage of the reform provided for the universal availability of health services for the population, and the second stage was aimed at establishing a demand-oriented service buyers, introducing a service acquisition model. In this regard, a competitive environment was created.

Despite the active action of the state, the development of the sphere is carried out at a slow pace and has not been possible to receive services of European standards through universal health programs. This is acutely observed in terms of providing health services of the regions. Moreover, a large part of the investments are used to organize the health infrastructure and health services throughout the city, which cannot be said about the regions.

However, it should be noted that both in the city and in the regions there is a lack of medical personnel such as nurses, small service personnel, doctor laboratory assistants and others. outpatient institutions cannot withstand high loads, technical equipment of hospitals is at a very low level; The number of medicines and medical equipment in medical institutions/ clinics is insufficient.

To overcome the rapid development and difficulties of countries, the field of the region. In the modern world, the concept of development process is becoming more and more relevant.

In the work, along with health investment and financing problems, the concept of cluster development of the health field is brought to the fore.

As a result of the research, conclusions are drawn and recommendations for the sustainable development of the health field of Georgia are set.

key words: Sustainable development; Financing model; Strategic development model.

Introduction

Practice has show us that for the sustainable development of countries, it has become increasingly necessary for the state to develop a conceptual vision in conditions of entropic indeterminacy and to develop long-term strategies, which ensures the country's social - economic security and stability not only during the crisis period, but also in the conditions of stable social - economic development.

In order to overcome the rapid development and difficulties of countries, regions, fields, the concept of developmental development is becoming more and more relevant in the modern world. M. Porter's cluster strategies contain the very connections that determine the solidity, stability of the system under conditions of indeterminacy and contribute to its stability. This is very important in such a field as health care.

Analysis

What does sustainable development mean? How should the continuous development of the field of violence be carried out in any period and conditions? Which factors are determining the continuous functioning of the field of high-quality service? Does the modern health care system withstand the demands of time? Should he follow his earlier rhythm or should he be resuscitated? What paths should be set before the sphere so that it can continue to move steadily towards development and deal with any difficulties. These are the questions that were asked before us at the beginning of the research and which we tried to answer in the given work.

During the research, in order to analyze the current state of health, we selected the health structures of Tbilisi, Kutaisi, Zestafon, Oni - Ambrolauri, Zugdidi and Kakheti regions. Massive research has shown us the real picture of the health care field.

First of all, when certain long-term views are implemented in such priority fields, which may be related to radical changes, it is necessary to study the approaches of state policy and take appropriate steps.

That is why, at the beginning of the research, we studied the information base of the health field, the main directions of politics, on the basis of which the approaches of the state policy of forming a cluster in the field were developed, which envisages the existence of structural approaches to the creation of a cluster in the field.

The latter includes:

state policy of the health group;
Innovation approach in the development of the health industry;
the policy of vertical management of the health group;
model of clinical management of the health group;
A health funding model based on scientific research.

The purpose of the policy presented in the formation of health centers is to create sustainable development processes and to develop normative documents regulating their realization, which ensures the effective functioning of health centers at the country's level.

The policy of vertical management of clusters is significant in the structural approaches, which is due to the specifics of the field. The policy of vertical management should be aimed at promoting the sustainable marketing of the field by developing and implementing appropriate goal programs.

The effectiveness of the functioning of the health departments is related to the relations between such governmental bodies as:

For clinical development - Ministry of Health; Region municipalities; Where are the structures; clinic administration;
Support for innovative forms/ directions/ development - source of budget financing of the country and the region; Financial institutions;
To ensure favorable infrastructure (micro environment) - structures providing material - technical, information, human resources;
To ensure the field of cluster construction - state and private partnership business spheres; insurance institutions;
To advance the brand of clusters - to join international clusters.

The close interaction between the government and the health care unit management bodies leads to sustainable development of the health field across the country. With a balanced relationship between government and business representatives in the clusters, it will be possible to turn the country into an attractive determinism. In the field of health, the government should transfer part of the administrative authority to the management of the health groups, and concentrate the resources for supporting the target programs to the target audience. This ensures the formation of health and insurance (health insurance) culture in society (at the micro/ macro level), the development of medical structures and personnel [1]

The health care team should be focused not only on the Diagnostic, outpatient or hospital treatment of the society, but also on preventive medical-health services. It is in this way, as a result of actual implementation of such a structure, that we can achieve an increase in demand at medical resorts not only at the national, but also at the international level, which is an important step for obtaining competitive advantages and advancing health brands.

In order to ensure sustainable development of the field, it is also important to develop and operate a targeted model of financing and investment.

In this regard, it has been studied by us (to add here to the health care information about investments and financing model, which is in the dissertation)

Conclusion

The concept of sustainable development of health care developed by us, which is manifested in the development of networks and goal-funding model in the field, contributes to the flexible functioning of health and promotional structures in conditions of entropic indeterminacy (and not only), continuity of processes and stable development of the field as a whole.

The peculiarity and attractiveness of the cluster is also in the function of its positive orientation. Which means that it ensures that all branches, structures, institutions included in the cluster develop synchronously and demand them, which ultimately brings positive social and economic results.

Based on all of this, we can mention that for the sustainable development of the health field, it is necessary: close connection of the health care management bodies;

Close connection of health care management bodies;
State support in the development of a regional health care unit;
Creation of innovation and investment support centers; Implementation of the digital health program.
Modernization of the Health Information Base;
Implementation of purposefulness programs by financial institutions;
Medical prevention/ functioning of the recreational/ resort facilities/ sanatoriums/ rehabilitation centers;
Development of specialized dispensaries. expansion of SSR;
Modernization, development, continuous functioning of the health logistics network;
Expansion of the network of professional educational institutions and preparation of demanding medical personnel;
Bringing the universal health system closer to European standards;
Ensuring the quality of health care services of European and world standards.

The implementation of the mentioned reforms will contribute to the development of the health field of Georgia; It will allow the introduction of digital health strategies in the field of health care of Georgia as quickly and in a short time as possible at the stages of diagnosis, treatment, surgical operation. This ensures high-quality public service, correct and timely diagnosis and treatment, and finally the improvement of life expectancy aging, mortality rates, which is directly related to the growth of productivity and social - economic prosperity.

References:

Chagelishvili - Chagelishvili, Methodological issues of formation of groups in the field of health care of Georgia; International scientific-practical magazine "Moambe" by the Academy of Public Works of Georgia; .. " ; XLV 2022
Chagelishvili - Chagelishvili. Pandemic and conceptual issues of economic development of the region; P. Gugushvili economy infrastructure; Collection of works of the international scientific conference; 2020.
L. Chagelishvili, Entropic economy and conceptual issues of change management; Collection of works of the international scientific conference; from Gori; 2018;
Jonauskis, M. (2007), Technology platforms and cluster development in Lithuania, Paper presented at International Conference: “Clusters Connecting possibilities in South East Europe”, April 20-21, Opatija: Ministry Of Economy, Transport and Communications of the Republic of Croatia. Available at: www.migpv.rh
Ketels, C. H. M. (2003) The Development of the cluster concept – present experiences and further developments; Prepared for NRW conference on clusters, Duisburg, Germany, 5 Dec 2003.
https://www.who.int/activities/prioritizing-diseases-for- research-and-development-in-emergency-contexts;
EPI-WIN: WHO Information Network for Epidemics; WHO, 2022;
Ketels, Ch., (2004) European Clusters, Hagbarth Publications 2004.
O. Solvell, G. Lindqvist, C. Ketels, Cluster Initiatives in Developing and Transition Economies, ISBN 91-974783-2-6; Center for Strategy and Competitiveness, Stockholm, First edition, May 2006;
OECD (2001) World Congress on Local Clusters: Local Networks of Enterprises in the World Economy; Issues paper; 23-24 January, 2001
Prioritizing Diseases for research and development; WHO; 2022; https://www.who.int/teams/epi-win;
COVID-19 Vaccine Delivery Partnership; WHO; 2022
https://www.who.int/emergencies/ diseases/novel-coronavirus-2019/covid- 19-vaccines/covid- 19-vaccine-delivery-partnership;

EKONOMISTI The international scientific and analytical, reviewed, printing and electronic journal of Paata Gugushvili Institute of Economics of Ivane Javakhishvili Tbilisi State University

DOI: 10.36172/EKONOMISTI E ISSN 2346-8432 Print ISSN 1987-6890	Journal number 3 ∘ Lali Chagelishvili-Agladze ∘ Maya Gonashvili ∘ Ketevan Archaia ∘ Modern challenges and a Conceptual Model of Georgias Health Development *Summary* *10.36172/EKONOMISTI.2023.XIX.03.Lali.Chagelishvili-Agladze/Maya.Gonashvili/Ketevan.Archaia* The agreement on the cooperation of the sustainable development of the United Nations in 2021 - 2025, is the first strategic priority for the well-being of a person who, along with material well-being, education and social protection, takes care of his health. The right of all people is health, and its provision is primarily the prerogative of the state. The vectors of the Georgian health care system are considered in three main directions: ensuring universal health; implementation of alternative health financing models; Reproduction of sustainable development models of the health field. In order to ensure the main right and health of a person, it is necessary to establish a system that will be equally accessible to all strata of society, and most importantly, quality health services will be provided for them for this purpose, in 2013, a reform in the field of health of Georgia began, the result of which was the implementation of the universal health program. The first stage of the reform provided for the universal availability of health services for the population, and the second stage was aimed at establishing a demand-oriented service buyers, introducing a service acquisition model. In this regard, a competitive environment was created. Despite the active action of the state, the development of the sphere is carried out at a slow pace and has not been possible to receive services of European standards through universal health programs. This is acutely observed in terms of providing health services of the regions. Moreover, a large part of the investments are used to organize the health infrastructure and health services throughout the city, which cannot be said about the regions. However, it should be noted that both in the city and in the regions there is a lack of medical personnel such as nurses, small service personnel, doctor laboratory assistants and others. outpatient institutions cannot withstand high loads, technical equipment of hospitals is at a very low level; The number of medicines and medical equipment in medical institutions/ clinics is insufficient. To overcome the rapid development and difficulties of countries, the field of the region. In the modern world, the concept of development process is becoming more and more relevant. In the work, along with health investment and financing problems, the concept of cluster development of the health field is brought to the fore. As a result of the research, conclusions are drawn and recommendations for the sustainable development of the health field of Georgia are set. *key words:* Sustainable development; Financing model; Strategic development model. Introduction Practice has show us that for the sustainable development of countries, it has become increasingly necessary for the state to develop a conceptual vision in conditions of entropic indeterminacy and to develop long-term strategies, which ensures the country's social - economic security and stability not only during the crisis period, but also in the conditions of stable social - economic development. The agreement on the cooperation of the sustainable development of the United Nations in 2021 - 2025, is the first strategic priority for the well-being of a person who, along with material well-being, education and social protection, takes care of his health. The right of all people is health, and its provision is primarily the prerogative of the state. The vectors of the Georgian health care system are considered in three main directions: ensuring universal health; implementation of alternative health financing models; Reproduction of sustainable development models of the health field. In order to ensure the main right and health of a person, it is necessary to establish a system that will be equally accessible to all strata of society, and most importantly, quality health services will be provided for them for this purpose, in 2013, a reform in the field of health of Georgia began, the result of which was the implementation of the universal health program. The first stage of the reform provided for the universal availability of health services for the population, and the second stage was aimed at establishing a demand-oriented service buyers, introducing a service acquisition model. In this regard, a competitive environment was created. Despite the active action of the state, the development of the sphere is carried out at a slow pace and has not been possible to receive services of European standards through universal health programs. This is acutely observed in terms of providing health services of the regions. Moreover, a large part of the investments are used to organize the health infrastructure and health services throughout the city, which cannot be said about the regions. However, it should be noted that both in the city and in the regions there is a lack of medical personnel such as nurses, small service personnel, doctor laboratory assistants and others. outpatient institutions cannot withstand high loads, technical equipment of hospitals is at a very low level; The number of medicines and medical equipment in medical institutions/ clinics is insufficient. In order to overcome the rapid development and difficulties of countries, regions, fields, the concept of developmental development is becoming more and more relevant in the modern world. M. Porter's cluster strategies contain the very connections that determine the solidity, stability of the system under conditions of indeterminacy and contribute to its stability. This is very important in such a field as health care. Analysis What does sustainable development mean? How should the continuous development of the field of violence be carried out in any period and conditions? Which factors are determining the continuous functioning of the field of high-quality service? Does the modern health care system withstand the demands of time? Should he follow his earlier rhythm or should he be resuscitated? What paths should be set before the sphere so that it can continue to move steadily towards development and deal with any difficulties. These are the questions that were asked before us at the beginning of the research and which we tried to answer in the given work. During the research, in order to analyze the current state of health, we selected the health structures of Tbilisi, Kutaisi, Zestafon, Oni - Ambrolauri, Zugdidi and Kakheti regions. Massive research has shown us the real picture of the health care field. First of all, when certain long-term views are implemented in such priority fields, which may be related to radical changes, it is necessary to study the approaches of state policy and take appropriate steps. That is why, at the beginning of the research, we studied the information base of the health field, the main directions of politics, on the basis of which the approaches of the state policy of forming a cluster in the field were developed, which envisages the existence of structural approaches to the creation of a cluster in the field. The latter includes: state policy of the health group; Innovation approach in the development of the health industry; the policy of vertical management of the health group; model of clinical management of the health group; A health funding model based on scientific research. The purpose of the policy presented in the formation of health centers is to create sustainable development processes and to develop normative documents regulating their realization, which ensures the effective functioning of health centers at the country's level. The policy of vertical management of clusters is significant in the structural approaches, which is due to the specifics of the field. The policy of vertical management should be aimed at promoting the sustainable marketing of the field by developing and implementing appropriate goal programs. The effectiveness of the functioning of the health departments is related to the relations between such governmental bodies as: For clinical development - Ministry of Health; Region municipalities; Where are the structures; clinic administration; Support for innovative forms/ directions/ development - source of budget financing of the country and the region; Financial institutions; To ensure favorable infrastructure (micro environment) - structures providing material - technical, information, human resources; To ensure the field of cluster construction - state and private partnership business spheres; insurance institutions; To advance the brand of clusters - to join international clusters. The close interaction between the government and the health care unit management bodies leads to sustainable development of the health field across the country. With a balanced relationship between government and business representatives in the clusters, it will be possible to turn the country into an attractive determinism. In the field of health, the government should transfer part of the administrative authority to the management of the health groups, and concentrate the resources for supporting the target programs to the target audience. This ensures the formation of health and insurance (health insurance) culture in society (at the micro/ macro level), the development of medical structures and personnel [1] The health care team should be focused not only on the Diagnostic, outpatient or hospital treatment of the society, but also on preventive medical-health services. It is in this way, as a result of actual implementation of such a structure, that we can achieve an increase in demand at medical resorts not only at the national, but also at the international level, which is an important step for obtaining competitive advantages and advancing health brands. In order to ensure sustainable development of the field, it is also important to develop and operate a targeted model of financing and investment. In this regard, it has been studied by us (to add here to the health care information about investments and financing model, which is in the dissertation) Conclusion The concept of sustainable development of health care developed by us, which is manifested in the development of networks and goal-funding model in the field, contributes to the flexible functioning of health and promotional structures in conditions of entropic indeterminacy (and not only), continuity of processes and stable development of the field as a whole. The peculiarity and attractiveness of the cluster is also in the function of its positive orientation. Which means that it ensures that all branches, structures, institutions included in the cluster develop synchronously and demand them, which ultimately brings positive social and economic results. Based on all of this, we can mention that for the sustainable development of the health field, it is necessary: close connection of the health care management bodies; Close connection of health care management bodies; State support in the development of a regional health care unit; Creation of innovation and investment support centers; Implementation of the digital health program. Modernization of the Health Information Base; Implementation of purposefulness programs by financial institutions; Medical prevention/ functioning of the recreational/ resort facilities/ sanatoriums/ rehabilitation centers; Development of specialized dispensaries. expansion of SSR; Modernization, development, continuous functioning of the health logistics network; Expansion of the network of professional educational institutions and preparation of demanding medical personnel; Bringing the universal health system closer to European standards; Ensuring the quality of health care services of European and world standards. The implementation of the mentioned reforms will contribute to the development of the health field of Georgia; It will allow the introduction of digital health strategies in the field of health care of Georgia as quickly and in a short time as possible at the stages of diagnosis, treatment, surgical operation. This ensures high-quality public service, correct and timely diagnosis and treatment, and finally the improvement of life expectancy aging, mortality rates, which is directly related to the growth of productivity and social - economic prosperity. References: Chagelishvili - Chagelishvili, Methodological issues of formation of groups in the field of health care of Georgia; International scientific-practical magazine "Moambe" by the Academy of Public Works of Georgia; .. " ; XLV 2022 Chagelishvili - Chagelishvili. Pandemic and conceptual issues of economic development of the region; P. Gugushvili economy infrastructure; Collection of works of the international scientific conference; 2020. L. Chagelishvili, Entropic economy and conceptual issues of change management; Collection of works of the international scientific conference; from Gori; 2018; Jonauskis, M. (2007), Technology platforms and cluster development in Lithuania, Paper presented at International Conference: “Clusters Connecting possibilities in South East Europe”, April 20-21, Opatija: Ministry Of Economy, Transport and Communications of the Republic of Croatia. Available at: www.migpv.rh Ketels, C. H. M. (2003) The Development of the cluster concept – present experiences and further developments; Prepared for NRW conference on clusters, Duisburg, Germany, 5 Dec 2003. https://www.who.int/activities/prioritizing-diseases-for- research-and-development-in-emergency-contexts; EPI-WIN: WHO Information Network for Epidemics; WHO, 2022; Ketels, Ch., (2004) European Clusters, Hagbarth Publications 2004. O. Solvell, G. Lindqvist, C. Ketels, Cluster Initiatives in Developing and Transition Economies, ISBN 91-974783-2-6; Center for Strategy and Competitiveness, Stockholm, First edition, May 2006; OECD (2001) World Congress on Local Clusters: Local Networks of Enterprises in the World Economy; Issues paper; 23-24 January, 2001 Prioritizing Diseases for research and development; WHO; 2022; https://www.who.int/teams/epi-win; COVID-19 Vaccine Delivery Partnership; WHO; 2022 https://www.who.int/emergencies/ diseases/novel-coronavirus-2019/covid- 19-vaccines/covid- 19-vaccine-delivery-partnership;