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ANALYSIS OF THE STATE OF THE COMPETITIVE ENVIRONMENT IN THE
MEDICAL SERVICES MARKET OF THE REPUBLIC OF KARAKALPAKSTAN
Khalmuratov K.P.
Associate Professor, Department of Economics,
Karakalpak State University
Annotation:
The article presents analyses of the state of the competitive environment in the
medical services market of the Republic of Karakalpakstan.
Keywords:
medical services market, medical organization, healthcare, health rehabilitation,
medical activities, medical care.
Annotatsiya:
Maqolada Qoraqalpog'iston Respublikasi tibbiy xizmatlar bozoridagi raqobat
muhiti holatining tahlillari keltirilgan.
Kalit so'zlar:
tibbiy xizmatlar bozori, tibbiy tashkilot, sog'liqni saqlash, sog'liqni tiklash, tibbiy
faoliyat, tibbiy xizmatlar.
Аннотация:
В статье представлены анaлизы сoстoяния кoнкурeнтнoй срeды нa рынкe
мeдицинских услуг Рeспублики Кaрaкaлпaкстaн.
Ключевые слова:
рынок медицинских услуг, медицинская организация, здравоохранение,
реабилитация здоровья, медицинская деятельность, медицинское обслуживание.
Improving the quality of medical services and reducing the cost of medical services, biologically
active additives and medicinal products, medical equipment is the most effective mechanism for
achieving such strategic goals as developing a competitive environment in the medical services
market.
As noted in the first chapter of the dissertation, medical services include prevention, diagnosis,
treatment, and rehabilitation of patients according to specific characteristics and value orientation
[1].
Before analyzing the competitive environment in the medical services market, we will note the
existing contradictions and features of their provision:
1. Medical services, unlike other types of services, have a priority task, since the cost of life and
health cannot be determined by possible costs.
2. In the oligopolistic market, medical services are always in demand, but the quality of medical
services is low, as consumers do not take any action.
3. Many entities providing medical services in the market do not have equilibrium and real prices
with suppliers.
4. Consumers do not have sufficient official information on the methods of indirect participation
in the provision of services, the cost of medical services from various medical organizations and
specialists, and the degree to which they are provided by various specialists.
5. There is a contradiction between the assessment of medical services for the prevention,
diagnosis, and treatment of diseases and the accessibility of medical services in the compulsory
or voluntary health insurance system.
6. The quality of medical services aimed at preventing, diagnosing, treating, and rehabilitating
patients, restoring them to their full potential, does not depend on the cost of the service and the
number of consumers.
7. As in our republic, in Karakalpakstan, the medical service system in the medical services
market does not stimulate the introduction of innovations, the development of new biomedical
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and medical ICT, and improving the quality of medical services without increasing the cost of
medical service methods [2].
The most complete list of medical services is presented in the nomenclature of medical services,
where all services are divided into classes A and B. Class A includes "simple and complex
medical services," which amount to more than 6000 thousand, and class B includes "complex
medical services" (about 500 types of services). Simple medical services include services
performed in accordance with the formula: Patient plus equal part of prevention, diagnosis,
treatment, or rehabilitation.
Complex medical services include several simple medical services, mainly diagnostic and other
medical services, which include several stages. Complex medical services also encompass a
number of simple and complex medical services that constitute the stages of medical care
complexes, diagnostics, treatment, or rehabilitation [3].
Patients can be provided with both free and paid medical services.
Patients can receive medical services free of charge (mandatory and voluntary medical insurance)
with:
- in state, local medical organizations;
- departmental industry organizations that have their own medical centers or clinics, on the basis
of specially concluded contracts;
- In non-state medical organizations included in the MTS and ITS system.
The following organizations may provide medical services to patients on a paid basis (at the
expense of their own funds):
- state, territorial, and local medical organizations;
- departmental industry organizations that have their own medical centers or clinics on the basis
of specially concluded contracts;
- non-state medical organizations or individual entrepreneurs.
Thus, the presented classification of medical services not only reflects the priority specialization
of the medical organization, but also combines all medical services into larger groups, which
significantly simplifies structural analysis when studying the medical services market.
In order to obtain reliable scientific results and conclusions based on the analysis of the
competitive environment in the medical services market in our research work, we used research
methods based on sociological statistics and questionnaires. Because the most inexpensive and
effective tool of social statistics in the analysis of the competitive environment in the medical
services market is the mass research method used by the author [4].
The development of a competitive environment in the medical services market in the Republic of
Karakalpakstan depends on the state of its main components: supply, demand and price, medical
services markets, the supply of medical services provided by medical organizations to the
population of the region during a certain period of time. In 2023, the number of hospital
institutions carrying out medical activities in the Republic of Karakalpakstan will be 66 units, the
number of outpatient clinics - 421 units, and the number of hospital beds - 8000 units (2.2.1-
table).
If in 2010 there were 50 medical institutions in the Republic of Karakalpakstan, by 2023 there
were 66. In turn, if 301 outpatient clinics operated in 2010, their number reached 421 by 2023.
The number of treatment beds in 2023 decreased by 600 compared to 2010. However, this can be
explained by the fact that the total number of private medical organizations in Karakalpakstan
increased from 46 in 2010 to 324 by 2023, and the number of treatment beds in them reached
almost 6 thousand.
Table 2.2.1.
Some indicators of the system of the Ministry of Healthcare of the Republic of
Karakalpakstan in 2010-2023
Indicators / years
2010-
year
2012-
year
2014-
year
2016-
year
2018-
year
2022-
year
2023-
year
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Number of medical institutions,
units.
50
51
41
42
43
51
66
Number of outpatient clinic
institutions, units
301 305
300
337
292
342
421
Number of places in medical
institutions, thousand places
8,6 8,4
7,5
7,3
7,3
7,5
8,0
Number of private clinics, units. 46
62
128
174
218
304
324
This ratio of the number of organizations and institutions providing medical services in the
Republic of Karakalpakstan positively assesses the state of competition in the medical services
market and reflects the current trends in consumer demand. Specifically:
- Non-state medical organizations occupy all new segments of the medical services market and
every year new specialized, multidisciplinary private clinics, various medical examination rooms
are being created;
- there is an increase in demand for comprehensive medical services in non-state medical
organizations. This is related to patients' desire to receive a full volume of medical services in
one place and at an acceptable price;
- the volume of very expensive medical services (orthopedics, implantology, etc.) provided in
premium-class clinics has a downward trend.
This will not only increase competition in the medical services market, but will also make it
possible for clinics that previously operated in more "comfortable" conditions to work effectively
and efficiently.
If we analyze the dynamics of changes in the volume of paid medical services in the territory of
the Republic of Karakalpakstan, then in 2010-2023 there is a stable trend towards an increase in
their volume.
Table 2.2.2.
Distribution of medical organizations by forms of ownership in the context of the
territories of the Republic of Karakalpakstan in 2023
Districts and cities
Composition of medical organizations by form of ownership
State
and
local
medical
organizations
Medical organizations in the
form of private property
Nukus
26 (25,7%)
75 (74,3%)
Takhiatash
4 (40,0%)
6 (60,0%)
Turtkul
16 (23,9%)
51 (76,1%)
Beruniy
12 (25,0%)
36 (75,0%)
Ellikkala
13 (26,0%)
37 (74,0%)
Amudarya
14 (29,1%)
34 (70,9%)
Xadjeli
8 (33,3%)
16 (66,7%)
Shumanay
9 (60,0%)
6 (40,0%)
Kanlikul
8 (57,1%)
6 (42,9%)
Kungrad
13(68,4%)
6 (31,6%)
Muynak
7 (58,3%)
5 (41,7%)
Nukus district
7 (46,7%)
8 (53,3%)
Kegeyli
11 (47,8%)
12 (52,2%)
Chimbay
11 (55,0%)
9 (45,0%)
Karauzyak
9 (52,9%)
8 (47,1%)
Takhtakupir
7 (53,8%)
6 (46,2%)
Bozataw
7 (63,6%)
4 (36,4%)
TOTAL
167
325
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If we analyze the dynamics of changes in the volume of paid medical services in the
Republic of Karakalpakstan, from 2010 to 2023, there is a steady trend towards their increase.
According to our online surveys conducted among 321 representatives of various forms of
ownership of medical institutions operating in the Republic of Karakalpakstan in 2022-2023, the
majority of respondents (59%) noted that the paid medical services market is experiencing
"high" growth rates, while almost 1/3 of respondents (29%) rated the market's growth rate as
"low," while the remaining 12% of respondents characterized the PMU as "frozen."
According to the data of surveys conducted by the author, respondents noted that during the
period from 2019 to 2022, most medical organizations (almost 40%) did not increase prices for
their services for individuals due to the pandemic, and 17% of subjects even reduced tariffs for
certain types of medical services to 10%. In 2010, the non-food services index in Karakalpakstan
was 10.6%, and the maximum value was recorded in 2018 - 1112.4%. In 2023, the index
increased by 107.7%, which is 3.0 points less than in 2022, and this can be assessed as a positive
result.
According to our analyses, the main problems and prospective trends in the development of a
competitive environment in the medical services market were identified:
- In the structure of demand for medical services by gender, women clearly dominate (in Muynak,
Karauzyak, Bozatau, Nukus, Takhiatash, and the city of Nukus, their share reaches 65%). This
peculiarity of the demand requires medical institutions to introduce new services and benefits,
primarily aimed at this category of patients;
- it is necessary to reduce the number of visits and treatment times. Since each patient or their
loved ones strive to solve problems related to diagnosis and treatment as quickly as possible,
seeking a better doctor with minimal number of repeated visits;
- As a result of insufficient work of the primary healthcare unit, many patients turn to paid
medical organizations and narrow specialists, as they do not require an initial appointment with a
general practitioner;
- Patients prefer medical organizations that utilize low-invasive, high-tech methods of prevention,
diagnosis, treatment, and rehabilitation of patients, including medical ICT methods. Because all
this increases the effectiveness of treatment and reduces treatment time and the cost of services;
- In recent years, there has been a growing trend of "positive" demand for the services of medical
organizations operating 24/7, both on weekdays and weekends. This is related to the desire of
able-bodied patients to visit a doctor during their free time and the unwillingness to receive
temporary disability certificates, as this affects their material well-being;
- In private clinics, there is a growing demand for services related to surgical intervention, such
as reducing excess areas in the stomach, div, and stomach surgical procedures, as well as
services in the fields of dentistry and necessary implantation, and other oncological diagnostic
services;
In the Republic of Karakalpakstan, there is an economic cyclical and seasonal demand for
medical services. According to the respondents, at the beginning of the week and in the first ten
days of the month, the number of appeals to medical institutions will increase, and by the end of
the week - decrease. Also, during the summer and winter holidays, the number of appeals to
medical organizations decreases.
Bibliography:
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trans. from English / M. Porter. M.: Alpina Business Books, 2005. 715 p.
2. Assessment of competitiveness of enterprises (organizations). Theory and methodology
[Text]: textbook / V.V. Tsarev, A.A. Kantarovich, V.V. Chernysh. - M .: UNITY-DANA,
2015. - 799 p.
3. Competitiveness of an organization [Text]: textbook / A.S. Golovachev. - Minsk: Higher.
school, 2012. - 319 p.
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4. Togunov, I.A. Is competition real in healthcare? [Text] / I.A. Togunov // TAP. - 2011. - No.
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konkurentsiya-v-zdravoohranenii (date of access 01.02.2018)
