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As a preliminary stage to solution of these problems, systems analysis of health service management
should be performed. The goal of systems analysis is
to determine the optimal ways of development of the
health service system providing maximal social and
medical efficiency and minimal expenditure of all types
of resources (physical, manpower, intellectual, innovational, financial, information, etc.).
Cognitive structuring (one of the methods of systems
analysis) is a useful method for imaging and analysis of
systems [1]. It is a modification of the graph theory method
for simulation of problematic situations in socioeconomic
systems. The goal of cognitive structuring is to generate
and refine hypotheses concerning functioning of the object
under consideration. The object is considered as a complicated system involving various elements, subsystems,
factors, variables, etc. A structural diagram of causeand-effect relations is constructed to analyze the functioning of the complicated socioeconomic system.
The diagram shown in Fig. 1 can be considered as
a cognitive map representing the cause-and-effect relations between various factors. If the contributions of
two factors are directly proportional to one another,
the link between them is labeled with +; if inversely
proportional, . The cognitive map includes several
loops: some of them (positive feedback loop) enhance
factor divergence, while other loops (negative feedback
loop) reduce it. The majority of feedback loops are
positive, which shows that the system under consideration is unstable and constantly developing.
Under conditions of centrally planned economy, state
budget was the main source providing funding of the
public health service. Crisis of national economy and
budget deficiency resulted in financial and economic
crisis of the public health service. This crisis can be
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0006-3398/02/3606-0344$27.00 2002 Plenum Publishing Corporation
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H erot
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Bukharbaeva
Fig. 2. Cognitive map illustrating the financial infrastructure of public health service management.
=1
ij
Q=
Wj
(1)
.
j
Q x
j
ij
gi +
y g
i
max .
g B W
i
+R.
(2)
It follows from Eq. (2) that the problem of optimization of the program of measures is a problem of
347
linear integer programming. The rights of the representatives in this problem are reduced to a minimal
level.
ij
, if B j
ij
>0
0, otherwise
Y g
i
i : Mi Md
ith program.
measure is included
which V i > 0.
be allocated as fol-
max .
g V R
i
i : Mi Md
(3)
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