Имитационные модели процессов управления здравоохранением: отчет о совещании рабочей группы ВОЗ, Лиссабон, 26–29 сентября 1978 года

3R,6: oTcETY i lssuE Dovftuis Q " CEvRo pErsHoE RF€,ioxft/NoE BJoRo,rroz) EPB: Orrreru r Ilcc.re.qonanua No 6- C.L lril[rA[]r0lllrbrr moflr,rl [P0[rccm v[PAulHl]rfl SllPA[00IPAlltll]ltM Olqer o coBeqanrz Pa6o.refi rpyuuu BO3 mpqtrficxoB PEnronAJIbHoE BDPo Bceupuaa oprautraaqEt 3rqpaaooxpaueuf,g KONEITATEII I 2 MAI 1s81 Et{ oU6 RBL u) (@ ,.1 a EPE: Ortreru u llcc.re4oDalrr 20 [MrrrA[[01lllblt M0lltffi MOIIGCOB YIIPABIII]IIIfl 3llPAB00[PAllHl]ltM Ortrer o coBeqatruu Pa6o.refi rpyuuu BO3 JIscca6oH 26-29 cenrr6pa 1978 BPONEfiCICOE PETITOHA'IbHOE BDPO Bceupnaa opr arrggarTri.tr S.4paEooxpaxerur.E KOIIE{TATETI 1 980 @ z?s96 Bceupnar oprarrroar1Ff s.qpaBooxpanexra, 1980 Ha uy6.rrrarP, Bc'errpxofi oprauua^qm 3ApaBooxpasemfi pa- ctrpocrpasrrcTc.fi trororeHr.E upororo.ra lle 2 Bceuproi rorrBeqEu o6 oxpaxe aBropcEEx qpaB. 3ara.renga Ha trepeuetrarry E.,!r tre- peaog uy6nlratrBfi Eapoueficroro pertrouzL[brroro 6npo BO3 rracrsrr- Eo rrs in toto cae.qyetr EaEllaBrfillb a o.ry opranuoaqtrn no aApe- cy: Scherfigsvej 8, DK-2IOO, Copenhagen f, Denmark. 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H3AAHO B ]IAHHH ISBN 978 92 890 7316 5 (печатная версия) ISSN 0250-8729 (печатная версия) CQNEPIAHIM 2 Bne.qerre Xo4e.m: Crp 7 3 3 5 6 I 10 10 11 13 Onpe.qe.reuus ro.[e.refi . Omcare.rnrrre ro.qerr . 06 racmte.rrglre rorqerf, lfunonaqrqnrrue roAerz 3. Coaperernaa cf,ryaq3a, upo6"ren E D( rrplqf,flLt Coapeuennar ctrryar{q.fi Teoperuuecrue upo6.uern Ilpamuvecrre [po6.,rem . 4. Heroropue ro.qe.)rr .qJra trraxrpoBarrf,a 2.1 2.2 2.3 2.4 3.1 3.2 3.3 otrpe.qereEf,r f, lIf,Utr Brrpa6oma trorur[trf, [ urauupoBaxne .Crcrersrd [o/p(o.4 r opraHx3ary.Ex . . ldogerupoaarrEe rat cpe.qctBo o6yvenra l(arporoge.rf,.... Cy6ro4e"u Oueparponxue roAe.rf, 5. llunanqosulre ro.qerr E yrrpaBrentre 4.1 4.2 4.3 18 18 2t 22 5.1 5.2 5.3 6.1 6.2 .lleficrss.E rra sa4xoaarbxor ypoBHe . lgficrnaa rra rerrqyrrapo.qxor ypoBue 23 23 24 25 26 26 27 2A 32 6. 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B iDegepalrnnofi Pecuy6.rure fepxanrz, Earrprluep, ecrr upoSeccop BaH 3firepex ns Ifuctntyra ue.qlqnncrofi rxrpopua- qnr n ltrroro<eue co6upaerca uctroJrbaoBarb ary roAeJrb A.rfi f,3yqe- rru.a pactrperqeileuzfl pecJpcoB c.lyr6 s,4paaooxparreHufl a Baaapuu. 18 4.1.2 Mo4e.nr .qJs Dacqeta noragarerefi qacrotLr Aererreparrlngtp( 3a6oreBaHufi. OTAHH JI urtrrcA (15) 3na uo4e;rr UItrICA orreprpyer .4auxlrxtr o cuepruocrrr or Ae- rexepartrBu[D( 6oJresuefi E EnQopraryefi o6 m< orgoJrorrrtr rqJrf, oqeIIIgE ypoBr{ei aa6otenaexocts. 3ra xoge,rr 6xla rpro6pene- Ea g Ectro.trboyeTca [ccJIeAoBaTe.rffrE Bo Oparulm z rlexoclonarsu. Ha[puep, .4x. 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Baegr B uoAeJrb unQopua4no, troqeptrsyrJr:m ua n,larosofi .qoryreuler{Er q)6 ypoBllax pecypcoB, qf,cre trorerflIraJrb- rrrD( tr,rueHroB, rro peoyitrTarau t[z:raryt c rrqroqbrc rarofi xoge.m xoruo cy.qgTb o Bepofillloo< r[opuax E ypoBrr.D( o6cirr5musarra u o rr[cJrexroclru o6cayrraaemor E.rtrerrtloB. a__ - H4r[qoga.nbnrfi rxcraryr arqpanooxparrenrfi E reArrlrrrcmx trcc.[eAoBaHr.rfi , Ilapux is 4.7.4 Llayqenre DacrDe.4eJeHrs sDererrf, spaqa, [pose.{egxoe uuficA (20) 3ra uo.qeas, paspa6orarnaa Pycco n llonpea-rrcror yEEBep- cETeTe, EcuoJBsOBaEa .4rA f,3] reEEA pac[pe.4ereEE BpeIeEE Epa-qa uerrqy paoJrrrqlrDrrtr Eareropf,.Eur rraqf,estroB. Ona loret uora- 3arb Eorenewe o6ecuerreEEocrf, rraceJregu.E Bpaqaxf,, rorer uo- n.lrr.arb rra pac[perqeJeutre I Ectro.rbaoBarue pa6ouero Epererru Bpaqefi. f,ero4o.rorrqecm ara roAerb Ereer rnoro o6qero c yrcaaarrrm Bhrrne roAeJrbn 6ananca, paspa6oranaofi n Aur"rru, z ro.qerbr pacEpeAeJrerilar pecy)coB, paepa6oraxnoi a III{IICA. B cBtr3[ C sTEr BCe Tpf, rpylmil f,ccreAoBaTerrefi arlrsHo coTpyArrE- rraDT Apyr c .qpyror. 4.1.5 to.qe.nr DacrrpeAe.renrn Decypcos, cos.qangarr flEHf,Dr n cC€P (21) 3ra no4ear [ocrpoeua Ha ocuoBe ypanxenufi, orparaeryx lepereqentre .rnq4efi as ogxofi rpyrm[r B .4)yr)Eo, Eptrqex pac[pe- AeJrerrEe [o rpylral .4era$T, f,cxo.4a E3 r4aHErD( O DO3paCTEO-trO- .roBou cocTaBe Hace.,reHrr.n tr uoragare,refi coctoflHu.E ero arqopoBbJr. lloge;rr trororaer pacEpeAe.,rarb [rer@ec.E pecypcn rerrqy ytrpaB- .rreBqecruxf, ypoBlrflru ctrctexil o6qecrnenxoro a.qpaBooxpaHeruJr. Pao.ruqnru BapxaHrar J[rpaBJeHqecrcu:< penexd f, pactrpe.qeJerrxto pecypcoB .4aeTca raqecTBeuHa.E OqeEra. 4.1.6 Mo.qeJrr. ouncusamqas orpyraroqyro cDe.qy, coa.qaum.f, ItruxcJreu s Uexoc.rrosamri (22) Ile.zrro etofi xo4e"u rBJraercf, otrperqenerrre ourma.lrnofi cTparerEr rarrura.roB"[orenrfi n o6lacrr rf,rrerru orp5rramqefi cpe- .6r. B uoge;u orpaxexlr B3atruocB.rtatr uexgy gartopaur orpyraxF qefi cpe.qu tr cocro.fiHtrer s.4opoBbf, HaceJreBE.E E B orouorrqecxux TepuxHzrx xapatTepr a Jrrdlc a o S.qopoBnTe JrbrrHe uepotrprr.ETra . 4.1.? lhomamonnoe xo.[e;urpoaanue r.r u;raruponanre a cucrexe s"qpasooxparersa Borrapzr (23) B Eo.rraprr cooAaerc.E ro.4e..[b, B aar4arrg roropofi Bxo.qnr: o6ecne.renue ar4erDarnofi znrpoprawa o Bcex qpoqecce rer4nro- carrrrapHoro o6c;yxraanz.fl, pemerrze rerJ@( 3a.qarr, cB.aaarrxLD( c qpoqeccou uJraHEpoBarrE.a, ycrolreHrre [poqecca trpf,HaTEfl peEe- IIEA tryTeX HaXOX..qeErrA OtrTtrIa.rIbHiD( BapraIIToB. 20 I(orerurxe Baprarrru, trorjrqeErrxe c uoroqbm roge.m, 6ygyr o6cyrgarrca rra Baqxoxa.rbEor lrpoBne. B upoqecce pa6oln 6y- .qyr yroqrrsraca o6rye Oyx-f.- ro.qerz. 4.2 Cy6xo.qe;rz 4.2.1 4sggparyqqp4q! Eqt4ryg4E4rr t oAeqt 6roArera rarc Bcrro- uorare.rrbrroe cpencrBo lr.raxapoBarrra, paapa6oranua.f, Jlareprpenor s IItBe[E (24) 3ca roge.rr paepa6oraxa rar qacrb rrpoerra uo paspa6orre cEcrern rrrtrtr.,retrxero trrarrpoBanxa s cQepe re,Ero-cauurapaofi rrorory. I{e.rr ro4e.iz - oEpe,qeaerre r[rnancoaror uoc;re4crarfi paS.rIqElD( a.rbrepEarEB tr.[allrpoBarrEa rrpu paSrnqHLD( oroHorrrqec- rE)( .qotryqeHuE(, Eallpurep B ofEomerrnE olcoHorrEtrecroro pocTa, yBeruqertrfi ro.rf,qecrBa Brrtro.lrraexlD( ouepaqof, tlextroB un(p.zrrrFz, yponrrs na.roroo6lanenn.f, u r.rq. 3agaua coc[orr a rou, uro6n yJryqET6 EaqecTBo rf,aEf,poBarrE.E tryller paccroTperrE.f aJrbTepHa- EtrB. 4.2.2 llccae.qosaHus crDyrnypu aarDar n 6oJrgrrqax, rpoaeAerr- 1rrreBqlr Aqplo! c corpy.qrmras a I{s,4epaan.qo! (25) B Ifugep"raxga:c 6nra qpe.Epunf,Ta rrorf,rrra rrpu troxotrpr sro- Houe.Bptrrrecro-crarucrrqecrtrx rero.4oB o6rscnzrr rrpEqnuy c Jrqe- crBJnoqp( pe3rm( paa.rzud B De.,[ErIEHe 3arpar xex,qy pa3rrbrxtr 6o;rnonan. 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Mo4e"rr 6u*a trocrpoeua ucxo.qfi Ea rercaroua.mnoi cxemr o6c.ly:runaeuor 6o;rr- rgqrrrlr pafiouon, rarJtrd Ea roropDD( o6cayrrsaercr 1 ilqeunpa.m- roitt, 3 ltperroHa.lrElMrt tr 12 tr6aoogr'wrt 6o.xrruqaw, pacuoJro- reHrllrrn B trop.E4re JrIeEblreHEf, oclla.qellrrocrlE E troxlr.relccrrocTu o6c.rytrsaura. 27 I.raasas Oysrys cocrroflJa B orrpe.4ereBur o6qefi rt6lg6qxrr r o6qtro< oarpar rrpf, rarcgxarbrrD( paSruqua)<. I{cno.maosanze rpErepxf, rrc[poc paBeH pecypcalrt 6xlo corpf,re[o c rlloroqf,cJeE- BHIU CJOTHOCTAyE B OtrHoltreHf,E raI,qOrO BEr4a pecypcoB. 4.3 Oneparyonnue xoAe.m 4.3.1 flrnralEonnas xo.4e.m .4esre.lrHoctz ua6oDaropul, pag- pa6oraHsas Baauagexou r .qpyrrs a iDrsrfiH.quu (27) Ocnosnoi ouepargosuofi eggr4ei trporpaxru srofi ro.qem .EBlf,ercg rpotoEo.r, rolopd uepe.qBEraercs tro aJerexrau rorqe- JrE f,3yqaerofi cucrenr, BITrEpy.t tryrb rrpoxorrqeElt uo la60pano- pf,u uccre.qyeroro o6paaqa. B ltar,\or trpotorore yraoaru oqpe- r4e.rerrrhre ceptru soxepoB, rreclruFx rx![opuarr,rrc o qpoBorqrxofi lex- Eo.rorEtlecrofi ouepatTro. Banrr.qnocrr xoAe.rf, 6urra nponepexa tryfer ErETaryf, cperqxe- ro pa6otrero .qHf, B Eoyqaeuoil .aa6oparopf,x f, cotrocraBrenEf, tro- JrytreHHbD( pesyJbraroB c pea.ftrofi cunyaqngfi. llcqo.moosaEre f,rxra4toHEoro rero.4a .qrfl E3yqegf,ff .4errerb- rrocrr rrErr.recrofi ra6oparoprtr rqaer Boarorxocrb paqzorraJru3f,- poBarb troBceAEeBELre rexrrolorlqecrf,e otreparyrr cipopxy.upoBarb rpe6ooanra r trepconary r o6opy4oBaxtrm aa6oparopzu E uJanupo- salr o6rer ee .4effrerbxocttr. 4.3.2 Oqenxa o0@rtuanocta uporpau cxprnznra. npoaeaesnas Kxorcou r Coe.qrnenxou KopoJrescnse (2Ar29) .ll,la oqexm aQQernnauocru rrporparr xaccoBoro o6c.re.qoaa- nzg 6ula pa3pa6orarra [rrrarlDorrsag roAeJlb. ona 6rura f,cuo.,rb- 3onarra .q.rfi BuficserrEa troc.reAcrBd a.mrepnarEanf,D( pemexrfi a paorrbD( ycJroBtrfl)< ctpurrtrra c qe.rBn DblfiB.rextrs para meiru rarrr. 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Heo6xo.qpane .qJrr ro.qeJru rqaHulretroryrulb Eecroruo, a Epoqecc u:r o6pa6onrtr roxuo trpoBo.4Erb BpyrmyD. 4.3.4 to.qe.rr craEIIu cropoi uoxory. pagpa6oraEuas Byrcoshu a IlzueDosofi n Bo.rraom (31 ) IIpr uoxory o6u.rsoi EnQoprar[Eornofi cscrenr 6rura nocrpoe- Ba ro.qe.rr6 or.qe.J[eEz.fi reor.lornofi UororTE. Kornrrorep Bocrrpor3_ Bor4ET crpyrrypy, Qynryr u Boatruo.qeficrsre xexrqy pa3"ErtrulruuqacrarE or.qereEf,r. IIpu uoroqg etofi xoge.ru uoruo rroyrrarb troTor tralEerrToB 3a IIpO[er@e uepEor+r, paSHoe Bpeutr roAa E cyror. 5. I4MIITAIII,IOHHLIE MOIE]II,I }I YIIPABJIUII,IE llrurerlnottrrre ro.4eJtu xoryr ycrrewo llcuo.lr3oBarbcfl rrp[ penrerrEf, trxorrr( rpo6.rex yrtpaB.lenrfi. B 4ouo;nrerue r orofi tro.)rbge, roropym oEf, trpf,soc.ET rrpr petueusr [po6Jrex pac[peAe.f,e_ HE.E tr trorpe6,l.er,u'g, pecJrpcoB, rorqeJff xoryr crroco6craonarr ryu- tlery rrouxrarrE$ JrrrpaB.,!.EqryB oco6engocrefi yupaa;aexoi nxn op_famgaqgu; oHtr Tarle oaperoxeu.qoaa.m ce6g tar trore3uoe cpeg_ crBo trorqrorDoBxE rar,gloB n o6lacrn ytrpaBJerrzr. 5.1 Bupa6orra uoJrsrrrrs u uJamrooaaxue C torrra apem.a JmpaBJ@ero-a,{Es[crparoparrc11o.trbgoBa-q-e uwTarfBOIlItOfO IOrqe..[f,pOBaII[A IOIeT paCCIaTpIrBaTIrC.f, B Iep- rrfuzu( ctrcoeurofi repap:uu. 3ro upe4uo;araer, qro xolej[xpo- BarrEe B trpoqecce yqpaB.reEEa .qoJrrro Ilpelr4e Bcero trptrxerraTBc.f, B cBsoE c aupa6orrofi uo.mrrrr zJrrr uJranrponaHna crpareruu o6nqxo rra Haqgorra.Jroxou JrpoBrre. IIa ypoaexr Hz:te B acofi uepa- px:aE croar upo6tem paof,eqextrfi r o6ecuerrenra pecypcon. IIo- cJteAHee neo6xongro trorory, trro rq.jlr cog.qanrfl xgorux Btr.qoB pe- cypcog B crc[ere re.4trro-carrf,rapnofi uoro,'(n rpe6yerca .4"[xreJrb- Hoe Bpeua, a AJI.E ocyqecra.renrr.fl Haq[oraJrrnofi uo.mrurq uoreT uorpe6onanrc.a cJroJruaa cucrexa Epof,BBorqcrBa pecypcoB, paBrro 23 rar r ro.qsQEtaq[a pa3reqes'fi cJrqectrB]mE( pecypcoB' IIpz- repor f,B.rtercfi uraEEpoBaHEe u crpotrTe.rbcrBo 6olluoi nogofi 6o.rrnrF c troc.re.4Jt@rr uotpe6uocr'm E ra.4pa:( Alra rree' IIa ypoBenb HEre Ea)(orqgrcf otreparyoHBoe ruaEEpoBarrge Et Ea- roueq, oQQerrrBnoe f,ctro.rbSoBanre pecypcoB rrpE trpattrtrecrofi .4eareJbrrocrr. Ilocre.qpee rorrro BLrIerBrb tat or4e'nxyn upo6- tery, trro B cJ4rocEr u .4e'aerca rllorErr' Cocras.rexue naroi Eepapxxqecroi cxeru coorBercrByer r.ar xaparrepy upo6;enrr Tatr E r'raccrr[rraqra uo aperear6ry roprooHEy. rla 6oree E[3tor JrpoBHe Ereror '4eJto c rracrot@r BpereEerr xBor.qa z c 6yay'\* - Ea o'qErr-'qBa ro'4a Dtrepe'q; Ea 6o.ree aucoror ypoBse trepcuetrEBa EctrrcJr'Eerct'qB5ilt-r4ecarBx' ro.4autr (rraqe 5 no4arz); a rra BlrcIler ypoBrre aperern6fi ropr- BoHlr xor,er cocraBrarb tO-5O ref' 5.2 Cucrexnrfi uolxo.q r oDranraarym Saaaut zccJre.4oBareJrfi Sarqnoqamtncfi B nou, uto6u cxogem- poBarb ocHoBrrble ocodennocru upo6;reuu, [ctro''tbSoBars rroJryqeE- HJEo Uo,4eJrb rqJr8 otrpeAeneHufl rlocIe.qcnrrfi rourpeTrrDD( rrpeA'roxe- nui u oqensrb BosuoxnLle llcxoALt' Pa6ona'a B Tecrrou rou[arlre c arraJrnrErou' a,4rElrtrcrparop-y[paDJr@fi c'ryx6ofi 3r@aBooxpa- rrerrufl uorer 6olee rly6oto tronarb lEpaBJrteuy& cf,crery' 3To ota3uBaer pf,n tro.,rorure'JrbHror aoa4efictssfi Ba rrpoqecc yrrpaBJreEE.fl, Tat' HatrpExep: - 6o.ree rotlEo otrpe.qerarorc'f, pearBHLIe SaAaqs; - yupaBreme crarroBrTcg 6olee eQ@rtrsnru E qe'eycrper- ,EEIIHI; - EoBoBBeAerrst roruo paccEtpsBam na 6o'ree peigrora.rb- xofi ocaore; - uoryr 6urr paccrorpeHu aDopraJbsrre u neQopxalrnue' paBrro rat [pfrf,re tr rocBegrrNe troAxoAlt r upo6leraxl - xoxrro ycraHoBrrrbr raraa znQopuqqrf, Hyrga 'qJf, ylrpaB- Jreurtt u n rarofi Qopue ora 6yAel nan6olee uo'leenofi' - crarroBf,rrcf, Bo3rotH[rr otrpe.qe.f,eEre rplrTlqecroro tryTtr tr y3rz)( xecT; 24 Orporgoe ro.trrqecrBo ![arropoa, n.f,trflnryx na g.qopoBbe s o64ecraeanoe o.4paBooxpanerrxe, rryEarx&a rxorEx trpoqeccoB, 6o;rruoil o6rerr r 6o.lrmoe paeroo6pasue pecypcoB, HaxoAsqzxcr B pac[opaJrerrEf, aIgraf,crparraruD( pa6ornrron o.qpaBooxpareHrrt - Bce oro B artaqrterbBofi creuertr troBlIlraer rrcrotrtocrb ouu6rrtt B peoyJrbrare rre[paatr,rEur,D( pemeu[fi. Y4avno paapa6oranuue roAers uoryr o6ecueqrrb .,If,q, upf,EurarpTrx pe[eure, raxofi rn- dopxaryefi, roropar Aeraer oqeBrr4rrbrx BoaxoxHue rrocreAcrBrr.E rcr pemexzfi, E xoryr rarrr o6pagor curanra rrcronuocrr onr6- trxrtB Bawogal6gor racmta6e. 5.3 UoAe.rrponanse rar cpeAcrno o6yqenra Moge"mposaatre xorer 6urr ucuo;rs3oBarro upr o6yuenrr u troAroroBre f,a.qpoB. Clqecrryer xuoro upErepoB Toro, rar Ha rpy[HrD( rrperqrrpEfiTtrD( paspa6arlnamr yrrpaBJrerrqecrtre rrpLr c qeJr6ro rrpEBHeceEEJr cBerEx rget a p.flArr ppoBo4arpo< pa6orrurcoB. Hecromro trpErepoB Taroro poAa EoBecrHLr rr B o6.racrr y[paaJe- Hrs crcTeraun sApaBooxpaHerrEJl. B Coe.ryuenHox Kopo.rencrBe KratAeE (32) paapa6ora.z no- .qeJrb trorqroroarr 6pzra,4 crreryaJlrxcroB, orBercrBeHubD( 3a Bce- o6teu.lcoqee tr.rautrpoBarrf,e gApaBooxpaxerrzlr AJrt rpyrru HaceJrerrrt qlrcrerrrrocrbp ororo 5OO OOO qeroBer. }Iwnaqnonxafi xoAerb trpEnarra perrenri uepBolraqaJbno 6u.ra paopa6oraua rqJra lrccJre.qo- Bareilbcnr:( qeJrefi, rro rrrrporo Ecrrorboyercfl s. Anr o6yveura. B nacroaqee Bpena ee Haqa.trE EctroilBooBarr (npanga ocroporHo) rr EaE cpe.4cTBo .q"[f, oqpeAe.treHxg troJrxrf,qectrrx aJbrDepHaTrrB. B ro.qe;rr BBo.qfiT pa3rroo6paarrNe .qarruLre o rraceresrrr f, xaparre- ptrcrurcax cryr6. ltroxer 6urr rrpurrflTo HecrcoJrbro pernenzfi (xa- trpErep, 06 u3ueIIeIItrE ro.nnqecrBa Eues[Excfl pecypcoB, uSuerre- nsn cuoco6a Irx Ectrorr63oBaHu.ff, EoxetterrEu crpyrrypH aa6o*esae- IOCTE Uyrex CrptrrrsHra E .qpyrD( trpoo[Jarruqecrurx uporpauu); c EoroqDro eroi uo.qe"u ee tro.rb3oBare.lb cxorer oqeHurb Boalror- BLre troc.re.qctBrf orf,x penerrufi B trJlane Ex B.rr,EHEr na aa6oreaae- uocrE, cxeprrrocrb B rctrorbaoBanue pecypcon. llsyuaa [ocJreA- crBns pag.ruqruD( BapEaHToB, orr rorer r.ty6re rrousrb xaparreptr- crztu trJraurpyeuoi clcrerf,r. Mefiep za yrruoepcrrera iDpr,4rma-AJercaEIpa (3p;anren- I{ropn6epr) paapa6orar Erpy rqrlfi 6o.mru.rnoro tr.tastrpoBarfirs, Haa- Baany$ ru Ifurxa-l (33). IIpf, EpoBe.qeruf, rrpu ee yqacrrrurz rpro6peraror orrlrr oqeErr c.rorrnD( uocreAcrBtrfi (ar"Eo.ra.E BrnffHtre rra Sarparbr paSJEqrI[D( pe[eHrfi, cBf,SaIrELrx c pa6olofi 6o.rrnzqu). 25 6. PECoI{Eq4ALU4I,I oopry.upya cBor DuBo.q!, Pa6ouaa rpyuua cocpe.qorotura Brrrrarrue na xeo6xo.@rocrE corpy,lgEtrecrBa Bryrpr crpalr E rerr4y crpasarE. B rraclnoctu, 6u.n BHBeceEH cJe.4lrnrye pe- roreH.qaqlxf,S 6.1 .Aeficrnzs na nagona.rrnox lrlronne a) Ibmraqnogrrble ro.qertr creAyer rrprlSrrarb Eaxrrbrr Errcrpy- rexTox yqpaBJrenE.a a.4llaBooxpaneEf,err cuoco6cro5noqrrr yJryqtrenrm upoqecca rrpunarzs peuerufi . 6 ) Boupoc o rrpzerrerocrr ro.qe.rf, c"neAyer penarnb Ee rorb- rco Ha ocHoBe yqeTa raTexlaTEqecrD( x lrexHo..[orEqecrtrx xa- parTepEcTEr ro.4er!, IIo f, D saBEcErocTE ol! oTpareEf,a B nefi pe;renanrnLD( orprrourqecrn( tr rro.JluTzqectu:( Oatropon' Cne4yer oupe.qeJErb ctreueub Heotrpe.qeJreHrocru r cBf,sanrror c trpoBe.4elrrer EccJerqoBaHrrfl IIpr yciloBtz Ecrro.'r53oBarrn8 uoAeJrr. s) lluraryoxrrue xoAeJrtr .qJr[ yupaB.rexrrs 3ApaBooxpanerrrer uoryl 6utt ycnernflo paapa6oranrl To.rbrco coBuecrxLrxE yca- ,ufrlf, ctrewa..,lf,crloB tro cEcTersory aBaJruSy E ar4arrncTpa- [rBrrLD( pa6ornuroa 3.qpaBooxpaflenlr, rprrqer raroe corpyA- rrErrecrBo lre aoJ[rHo orparrEqrrBarbca rreproAou ueparturofi paspa6orru roAer[r a Aorrno trpoAoJDtarbcfl E .qaJeer rrro- 6n o6ecue.mrr uoggQuraqEro xoAeJru, sorAa ero neo6xogtoro, f, trpaBE.trbtroe ee f,ctro.nb3oBarrue. r) Ars o6ecue.renra recHoro corpyAgraqecrBa ctreryal[crLl tro xoAerlpoBarrf,D .qorrxu 6ulr BoB.,reqeHLI B rrpoqecc yu- paBJreHtrf, S.qpaBooxpaHeHrex lra ypoBlre, rAe ocjEecrBrs- erct yupaB.rexEe ro.qerf,pyeuoi ctrcrerll. a) Bn6op rrpnoprretoB ,q.rfi xo.4e.ttrpoBarrtrfl a cQepe xe.Bro- caxurapnofi uorolg AorreH oupeAe.rf,lrbcf, [ptroprreraf,tr, yc TaHo B.reEELrrE Opr arrf, 3 aT oparr{ 3.4p aBooxpa Ee rrqfi r xBerrtr - eu paapa6orqrtoB rogeJrtr o ee rrparcrtrtrecrofi ocyqeclBruo- crE E Ha-rrttrer c[eqga.ttrcroB, cnoco6nroc Ectrorb3oBarb ro.4eJb. 26 6.2 e) O6yuexre ocuoDrr[x rrptrrqzuar xo.qeJrrrpoBaHzs u trplueue- rrE.E Erztlaryourf,D( xor4ere& 4o.rrno crarb rracrbro uporpauxlr IIOATOTOBTE E ycoBep[escTDoBarlf,.fi OprauuSaTopoB 3AI]aBO_ oxpauerrtrfi; trpEqer raroe o6yuexf,e Ao.rrso Becrscb c rru_porul IIpIrBJreqeHEeI UparcTEqecrEx rlp[IepoB, coBuecTHo oT- 6rpaerom paapa6oruuraw roAeaefi E z>( troJrt3oBareJr.Euu. .4eficrar.a na yer,qynapolrou llposge a) BO3 reo6xo4uo upffro EJE rocBeEuo croco6craoaarr o6xeny rn(popraryefi xergy rocy.qapctBarrr-rrJreEaxrr o HoBID( .qocrareHr.rx ro.qeJrEpoBanr.a n o6.lacr[ 3ApaBooxpaHerrrx B oTtrX Clpasax, Btc.rrcqar opraHr!3aqEro ceurHapoB r, .qpyrux coaeqgnaf. 6) BO3 cre.qyer oraolrBarb rroA,4eprxy uo.qroroBre ragpoB B .4arnofi o6nacrr, Earrpzrep cogeficraonarr paapa6orre [po- rpaur [o.4roroBrE f, troBtlurerrgJt rnalrerrarTnrr pyrcoBo.qaryx pa6oruErcoB orqpaBooxpauenrra tr o6aertrarr o6uex crauen4u- aTar4 XeX,4y CTpaHaur. a) BO3 E .qpyrru uerrqJrnapo.qxuu oprarrroary.Eu, oarrtrxabt\-u- c.E Boqpoczluf, roAerrpoBansa a o6.racra aApaBooxpanerrr.E, cJIeIyeT troOEpATb qpoBe.qellEe CpaBrrnTeJrbr$or rccrre4orannfi rrpaETuEE uo4errpoBaHus B gApaBooxpauenrrz, oco6enno s cTpaBa)< c paSlrLrux coqra"rlbllo-otroHoIuqecruurr cucTeuauu. 27 JIIdTEPA:[YPA 1 c6opnsr DesoJEqEi r pemexzi BCeEoHofi accau6Jer oapaso- oxDaHeHEt f, llctroJnrTerbHoro Eoxf,Terar ror II, 3 u3.q', 198O, crp. 11 (peoo.noqpg !YIIA31.43). Eaponeficroe perxoua,u,Hoe 6ropo BO3. Ilo.qroronra pyrosg- .Eie.refi c,ryr6 o.(pasooxDaneuss. olqer o coaeqau[f, Pa6o- ".fi .py"*,. Kouesrarex, 19?9 (goryrenr ICP'IHSD o43)' 3. IYHO Technicat Report Series' No 596 (Application o! systems anal vsis to health management: report of a 4 WHO Expert Committee). Eaponetcroe perrloHa-lbnog 6ropo BO3. Eapoueicras rosiDe- G,rer. Kouenraren, 7975 (.4orluenr EURO 4107)' 5 Enpoueilcroe pe-rroaa.rrbxoe,(ropo -!O3-., Ilpnxenenue rcc'ne'4o- aanus ouepaqEfi n enDoueicrrx c.lyt6ax aADasooxDanensg' Or"an " coBeqaurrE Pa6otrefi rpy[trll. I(ouenrarex, 1977 (.qoxyrexr ICP,/SHS O28). 6 ,qr. XoraPT. IJroccapufi neprznon uo ue.4qro-cagrrapgou rroxotrF. Kouegrareg, Espoueficroe per[oga'mnoe 6ropo BO3' 19?6. (O6qectaensoe 3ApaBooxpaneHf,e a Eapoue, N9 4)' 7. Roethlisberger, S. & Dixon, W. In Management and the worker. Carrbridge ' Mass. , Harvard University Press ' )'939 ' 8. International Institute for Apptied Systems Analysis' Hea I th svstem modellin q and the information system for the coordination of research in oncolo . Report of a I977 (documentconference. IIASA, Laxenburg' Aust ria, cP-77-4). 9. International Institute for Applied Systems Analysis Modelling health care systems. Report of a workshop 2a IIASA, Laxenburg, Austria, 197'7 (document CP-77-8). IO. International Institute for Apptied Systems Analysis ModeIIin health care s tems Proceedings of a con- ference held in November 1977. IIASA, Laxenburg, Austria (in preparation). I1. Gibbs, R. A disaesresated heal th care resource a1loca- tion modeI. Report. IIASA, Laxenburg, Austria, I978(docunent RM-78-I) 12. Gibbs, R. The IIASA health care resource aLlocation sub-nodeI mark I. Report. IIASA, Laxenburg, Austria, 1978 (document RR-78-8). 13. Camps, F.8., ed. Ofaarglll€_lgCCl medicine, 2nd ed. Bristol, Wright, 1968. role of validation in healthThe14. Bailey, N. tens. In: Coverdale, model I ing services. 29: 1043 I8 care sys- ProceedlngsModelling health care systelqs of a conference held in November 1977. IIASA, Laxen- burg, Austria (in preparation). 15. Klementiev, A. On the estimation of morbidity Report IIASA, Laxenburg, Austria, 1977 (document RM-77-43) 16. McDonald, A. et aI. Balance of care: models of the national health service bu11etin, 30: 262 (1974>. t7. I. & Negrine, S. The balance of care project some mathematical British medical socialthe allocation of health and personal Journal of the Operational Research 19 Society ( re78 ) Gibbs, R. The use of strategic planning model for health and personal social services. Journal of the Boldy, D. et al. Planning the balance of health and personal social services in the United Kingdom. Managenent science (in preparation). 29 Operational Research Society, 29: 875 (I978). 20 Rousseau, J. The need for an equili.brium model for health care system planning in modelling health care systems. In r Modellin€ health care sJE-]lsse . Report of a vorkshop. IIASA, Laxenburg, Austria, L977 (document CP-77-8). 21. Yashin, A. Methodological aspects of nod€Iling decision-making in the health care system. In: and Hea I th the co-system nodelling and the information system for ordination of research in oncolosy Proceedings of a conference. cP-77-4) . IIASA, Laxenburg, Austria, L97'7 (document 22. Miksl, R. Sy prostiedl /Sy environmerfl. t974. stemovd synt6za stems synthesis In: Sbornik a aoalyza iivotnitro and analysis of the referdt CSVIS , Ostrava ' 23 Zahariev, T. et aI. Conceptual basis of a model for the optimization of a regional public health service. In: Use of operational research in European health services Copenhagen, WHO Regional Office for Europe' 1976(document rc+HS o28). 24. Lagergren, M. (personal communication) 25. van Aert, J. et aI. in the Netherlands. Cost structure of sene raI hospita Is Report. Utrecht, National Zieken- huisinstitut, 1977. 26. Pischer, I In: Modelling health care systems. Report of a workshop. IIASA, Laxenburg, Austria, L977(docunent CP-77-8). 27 Vaananen, I. at al. Laboratoriosimulaattori: SairaaLa- Iaboratorion toiminnan tutkiminen simulointimenetel- mHlIe flaboratorypital Iaboratory Sairaalaliiton Tu simulation: investigation of a_hos- by ureans of simulation techniquy'. tkimusososaston JuIk. A.: No. 4 (I971-) 24. Knox, E. The evaluation of mass-screening programmes for cervical cancer. Tumori,62: 339 (f976). 30 29 Knox, E. Ages and frequencies for cervical cancer screening. British journal of cancer, 34: 444 (1926). 30 Davidov, B. A natrix nethod for easy determination of the parameters of queue in the polyclinic, based on the Monte Carlo method. In No. 3, Bulgarian State Medi ene and 11c health, caI Publishing Agency, L977 3I. Vukov, M. & Piperova, M. (personal sommunication) 32, Clayden, A. A decision simulation model for health services manageme 28: 5O5 (I977). nt. Operational rese arch qu arterly, 33 Meyer, R. KIima-I: Planspiel Klinikmanagement /fplanning g"r; t". crinic managerent, KTilry-- - Erlangen-Niirnberg, Institute of Business Management, Friedrich-Alexander University, I926. 3I IlpsJrorerue cm{coK vrIAcTH}IItots Boeleugue cogerguru flp@eccop I(. Arrrescrertep, u.rex Hayurroro o6qecrsa s a.qaDnrr -trpoQeccop- Xer.qyBaporqtror o Enc rf, T yt a yupaBte- naa, 3auagurd Eep"ms Ilpo@ccop A. Angepccox, atronorxqecmfi ([ary.nrer l€te- 6oprcroro yrrf,BepcuTera, IIIBeT4Irf, flporpeccop .(a.o. Byacnr€, Xnraepcsretcmfi 6o.rrnurrxsi qexrp llzrze-Ca.ruerprepa (Ilaprr VI), Qaxyarrer. 6rot@- a[rtr tr 6rouareuanrtrE, [Iapu, Oparrya IlpoQeccop JI. Kaio.r.ra ga Xonra, lgperrop Bmpo rccle.qo- naxnfi r u.raurpoBarrtra, llrnzcrepcTBo coryaJbrrlrx Ae.r, Jlucca6on, Ilopryra;ua (flpelce.qane.ar) Ilpo@ccop I(. .Isrq, Ifuclrryr xe.@Excrofi 6rorerprr, Ib- 6znrencrrfi yrrrBepcxrer, iDe4eparrrnaa Pecuy6.mra lep- IAHtrf, A-p C. 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