Prospects of a unified methodology for calculating medical care costs covered from public sources

The authors analyze the prospects of a unified methodology for calculating care cost funded by public sources. This issue is important due to growing demand for care, more complex treatment technologies, limited budgetary resources and the need to improve validity and transparency of care cost calculations. The Russian healthcare system has many disparate methods for calculating the cost of care differing in objectives, funding sources and details. This leads to incomparable results and insufficient transparency, as well as complicates financial management. A unified methodology as a basic concept for all participants in healthcare system is proposed. The key principles of this methodology are uniform units of calculation (medical service and case of care), separation of costs into direct and indirect ones, as well as combination of normative and actual approaches to their determination. Flow charts allowing for detailed cost structure and ensuring comparability of calculations are an important tool. This methodology is highly flexible and adaptable to various types of care. Its application to funding through the Circle of Kindness foundation, clinical trials, high-tech personalized interventions (including mRNA vaccines) and calculation of reimbursement for procurement and storage of blood plasma is discussed. In each case, basic principles are preserved, while specific features are taken into account by detailing the cost structure and introducing additional calculation elements. Particular attention is paid to prospects of this methodology. Key areas include further unification of approaches for various financing channels, digitalization of calculations and integration with medical information systems. This will automate processes, improve calculation accuracy, and ensure monitoring of resource efficiency. Thus, a unified methodology is seen as foundation for improving efficiency, transparency, and sustainability of healthcare system.