ISSN 0798 1015

Vol. 39 (Number 12) Year 2018. Page 24

The study of the regional market as a management object

El estudio del mercado regional como un objeto de gestión

Olga V. GRIGORENKO 1; Tatiana Yu. GAVRILENKO 2; Irina V. BELOUSOVA 3; Artem E. TERPUGOV 4;Irina O. SADOVNICHAYA 5; Victoria A. TURUKINA 6

Received: 10/01/2018 • Approved:31/01/2018

Contents

1. Introduction

2. Methods of research

3. Results and discussion

4. Conclusions

Bibliographic references

1. Introduction

The transition to market forms of socioeconomic relations has become a period of intensive changes for the Russian healthcare sector, leading to the emergence of medical and preventive institutions with non-state forms of ownership, which, as the industry has grown, has led to considerable competition of services rendered by them. The share of medical institutions providing paid medical services is constantly increasing. There are a number of prerequisites for the dynamic development of paid medicine: a reduction in the share of state medical institutions; an increase in the incidence of the population; an increase in the incomes of the population, the absence of a specialized specialists in a budgetary institution, and others.

In order to understand the needs of patients, evaluate competitors, obtain objective information about the market, develop market forecasts and ultimately secure a competitive advantage, medical institutions of a commercial type are increasingly forced to resort to marketing research. This determines the relevance of our research.

In connection with the growing demand for paid medical services in the city of Khabarovsk, which are offered by commercial medical institutions of this city, it is necessary to conduct a demand survey, which will result in the formation of the optimal set of paid medical services in private hospitals of Khabarovsk (Far East of Russian Federation; according to the statistical information on January 1, 2016 population is 611,000 people).

The subject of this study was the consumers of paid medical services in the city of Khabarovsk. The subject of the study is the satisfaction of consumers with paid medical services of commercial type health facilities and the criteria that have the greatest impact on their choice.

The purpose of the study is to diagnose the market for paid medical services aimed at identifying the satisfaction of the residents of Khabarovsk with the quantity and quality of medical services offered by commercial medical institutions, as well as evaluating the most significant criteria in selecting this type of health facility.

In accordance with the goal of the research, the following tasks are put forward:

• Determine the socio-demographic profile of users of paid medical services of commercial health facilities in Khabarovsk.

• Identify the most important criteria when consumers choose medical facilities of this type.

• Draw up a list of the most popular paid medical services in Khabarovsk.

• To designate the average amount of consumers' expenses for servicing in paid medical centers in Khabarovsk.

• To determine the social and economic portrait of the consumer of paid medical services in the city of Khabarovsk.

Carrying out of marketing research of the market of paid medical services in Khabarovsk will allow to describe more clearly practical prospects of development of branch in region. Market research and market diagnostics, conducted on the basis of analysis of collected and processed data, today is one of the most frequently used business technologies that are available in the arsenal of modern theorists and practitioners of economics and sociology. Evaluation and identification of the prospects for the development of any regional market is impossible without prior and ongoing monitoring conducted using marketing procedures.

To determine specific approaches to the research of the market for paid medical services, it is first of all necessary to understand what medical marketing or marketing of medical services is. The main prerequisites for the emergence of marketing of medical services were:

• changing the methods and sources of financing for medical institutions that are independent of the state, in the form of insurance companies, consumers of health services themselves;

• development of commercial medical organizations, the functioning of which implies the receipt of profit from the sale of services;

• increase the costs of medical institutions to provide services in connection with the use of new treatment technologies, improved equipment, new medicines;

• increase of requirements to the quality of medical services in the conditions of increasing the volume of paid services and the establishment of a fundamentally new quality control system;

• significant deterioration in the health indicators of the population, which led to the growth and change in the structure of needs in various types of medical care (Preconditions for the emergence…).

Under medical marketing, it is necessary to understand the activities aimed at obtaining complete information about the needs of the population in various types of medical and social care that ensures the preservation of public health.

Marketing in medicine is a system for studying the market of medical services with the purpose of forming and satisfying the needs of consumers by controlling the consumer properties of medical services (Nagapetyan, 2015, p. 45).

According to the Civil Code of the Russian Federation, a medical service is an activity or a set of measures aimed at the prevention of diseases, their diagnosis, treatment, having an independent completed value and a certain cost (Kosolapova, 2014, p. 56-61). At the same time, it is stressed that any medical services are rendered on a compensated contract. Consumers of medical services are defined as patients receiving treatment under voluntary medical insurance policies, as well as paid and services in public and private medical institutions. To paid medical services should also include services that are not part of territorial

compulsory health insurance programs (for example, aesthetic medicine) or are conducted on the personal initiative of a citizen (Federal Service…).

From the point of view of a market economy, a medical service is a purely market-based category that is a complex product of the financial and economic and medical prophylactic activity of a healthcare enterprise that has its own price, formed by measuring the demand (on the part of patients, the state and insurance companies) and proposals in the health care market. In this case, the use-value of a medical service for a patient is the value of the acquired benefits necessary to maintain and minimize the risk of loss of health; and the cost of medical services for a health care enterprise is the cost of costs incurred during the provision of medical services, taking into account the average market rate of return.

In other words, a medical service is a professional activity aimed at maintaining or maintaining the optimal level of health of a particular individual or group of individuals. When conducting marketing research, it is necessary to take into account the characteristic features of medical services. We list some of them:

1) intangibility (impossibility to present in material form);

2) inseparability from the source (the service occurs during the contact of the patient with the doctor);

3) non-preservation (depending on the state of health, the patient has to resort to medical services repeatedly);

4) inconstancy of quality (the quality of the service depends on many factors - the qualifications of the doctor, his personal characteristics, the psychological characteristics of the patient, the degree of the patient's trust in the doctor, etc.) (Pozdnyakova).

In addition, medical services have a number of specific features, such as: individual character; uncertainty of the amount of required assistance at the initial stage; uncertainty of the time of the service occurrence; the presence of a possible risk; impossibility of preliminary estimation of the volume of financial resources; information asymmetry of the doctor and patient about the volume, quality and results of the required medical care, etc. (Aristova, 2012, p. 224-228).

Medical service as a market category is characterized by certain parameters of demand, which are:

- the trust that is necessary in order to attract and retain the client of the private medical services market. If a patient is provided with poor-quality medical services, this can have severe physical, moral and material consequences for his health. When receiving medical services, satisfaction with services, both the process (service level) and the result is very important;

- secondary role of private medical services in comparison to mandatory medical care. As a rule, obtaining private medical services is not something obligatory in the life of clients. In most cases, the list of services provided in commercial centers is either identical to that of state and municipal medical institutions, or they solve problems that are not vitally important to clients. In this connection, the demand for services can be formed by supplementing the aid with new qualitative characteristics (higher level of service, positive emotions, etc.);

- debugging of demand. Under the influence of psychological and external factors, consumers mostly try not to meet the need to solve their health problems right up to the situation of extreme necessity, while the solvency factor becomes less significant (Vyalkov, 2013, p. 48-54).

Carrying out specific marketing research in the field of health services needs to determine the sequence of stages:

1. Identify the problem and formulate research objectives.

2. Conduct the selection of information sources.

3. Collect and analyze secondary information.

4. Plan and organize collection of primary information;

5. Systematize and analyze collected information.

6. Process statistical results.

7. Draw conclusions from the study.

In accordance with this sequence, market research was conducted on the paid medical services market in Khabarovsk. Let us briefly discuss each of the stages of the work done.

To obtain secondary information, the following sources were considered: electronic resources, Khabarovsk map, official statistics. After the collection and analysis of secondary information, the marketing research program aimed at collecting primary information was specified. It was taken into account that this research is a field and the main method of its implementation is a quantitative survey. In turn, the main tool for conducting a quantitative survey is a questionnaire, which is most appropriate for the purposes of marketing research and allows you to obtain information about the beliefs and preferences of people, the degree of their satisfaction, etc. The developed questionnaire consisted of sixteen questions, containing both alternative and multi-alternative types of questions. When answering multiple-choice questions, respondents were given the opportunity to select no more than three variants of answers.

The questionnaire was designed in such a way that it was possible to identify the target audience, find out the goals and frequency of applications for the relevant medical service, determine the main motives and criteria for applying to private medical centers in the city, and provide an integral assessment of the quality and level of customer service. Also, the financial side of the issue was touched upon, namely, the average amount spent on medical services was revealed. Part of the questions of the questionnaire is the passport of the respondent. The answer gives an opportunity to get information about the demographic and socioeconomic situation of the respondent, which is necessary to provide a portrait of users of services.

As a general set of consumers of medical services the population of the city of Khabarovsk is accepted. Accordingly, all residents of the city were accepted as conditional units of the sample. Based on the requirements for reliability and reliability of the results, a statistical method was used to determine the sample size, which also helps to determine the minimum number of respondents participating in the survey. The calculated sample size was 20 people, however, for greater reliability of the results obtained during the survey, it was decided to interview at least 50 people.

The processing of secondary information allowed to create a detailed topographic map of the location of the main commercial organizations that provide medical services in different directions, their number at the beginning of 2017 in Khabarovsk were more than 40.

Analysis of the quantitative survey data showed that the majority of consumers of paid medical services in Khabarovsk are women (70% of the total number of respondents). The age of the majority of respondents-consumers of medical services is between 20 and 50 years (76% of respondents); 50-65 years - 22% and only 2% - people over the age of 65 years.

Almost half of respondents resort to paid medical services "as needed" (45%), a quarter of respondents visit medical centers "no more than once a year" and only 14% attend regularly ("more than 4 times a year"). When completing these data by analyzing the attitude of respondents in general to paid medicine, it can be concluded that residents of Khabarovsk do not consider paid medicine as a direct alternative to medicine that provides services for compulsory medical insurance policies. In the course of this study, the main reasons that prompt consumers to use the services of private medical centers were identified. First of all, this is the speed of service and the availability of modern high-tech equipment (25% and 21% respectively). Important reasons for the treatment are the availability in Khabarovsk paid medical centers of highly qualified personnel and a high level of patient care (15% and 17% of respondents). Attention is drawn to the fact that just a small amount of consumers (4%) are interested in the reputation of a particular medical institution, which can, nevertheless, talk about trust in paid medicine. The choice of a specific medical center in most cases is made on the advice of relatives and friends (31% of respondents).

Respondents associate high quality and service level with lack of waiting in queues, attentive attitude to each patient and, even, external design of medical center premises. All this indicates an increased demand for medical services from the city's population. And it is these services, in the respondents' opinion, they receive in private paid medical centers in Khabarovsk.

Further, an analysis was carried out of a specific set of the most popular medical services in paid centers. First of all, respondents addressed to the services of dentists (23%). Even more popular diagnostic services and laboratory and hardware medical research (in the amount of 37%). Further down the list: services of gynecologists (10%), ophthalmologists (7%), gastroenterologists (6%), cardiologists (4%). 8% of respondents used the services of medical massage. Indirectly, this indicates problems in insurance medicine, which are not the subject of this study, but the analysis allows to draw additional important conclusions and conclusions about the state of the provision of medical services in Khabarovsk.

In detail within the framework of this study, financial aspects of the consumption of paid medical services in Khabarovsk, namely the determination of the costs of the population for this type of services, were considered. More than half of the respondents during the study spent less than 3 thousand rubles on paid medical services in 2016, 22% - no more than 5 thousand rubles, 12% - no more than 15 thousand rubles. The average amount spent by residents of Khabarovsk for service in paid medical centers is approximately 4.5 to 6 thousand rubles a year. It should be noted that the average figure for the country is 7-10 thousand rubles. The data presented should be compared with the average monthly salary in the whole of the Russian Federation and in Khabarovsk in 2016 - 36, 7 thousand rubles and 44.5 thousand. Respectively (Federal State Statistics…). This suggests that with an average wage higher than the national average, for paid medical services residents of Khabarovsk spend less money. The cost per capita for paid medical services averages 1.5% of Khabarovsk's annual income. It is worth mentioning that only 14% of respondents in this study consider themselves regular visitors to private paid medical centers. Recall that this is mainly young women with a relatively high income, who consider these institutions a complement to medical care. Patients of paid medical centers rarely consider them as a disease prevention institution (16% of those surveyed).

A study of the market for paid medical services provided by private medical centers in Khabarovsk showed that the paid medicine clinic has prospects for developing and expanding the base of consumers of services. To date, private medical centers are not yet fully able to compete with insurance medicine. Among the consumers of this type of services are very few people of the older generation, and in fact they are the main patients of medical institutions due to objective reasons. Do not perform private paid centers and the most important function of medical institutions, namely, preventive. The range of services provided is not wide either, mostly they prefer paid dentistry and various kinds of diagnostics. Practically, the same treatment of diseases in such centers is practically not carried out.

It should be noted that paid medicine in Khabarovsk has several advantages, among them, the availability of highly qualified personnel, technological modern medical equipment. Also, private medical centers are characterized by attentive attitude towards patients, lack of queues and high level of service.

We believe that paid medicine in Khabarovsk is necessary to strengthen its competitive position:

- to expand the target audience of consumers of their services,

- to expand the range of services provided, while maintaining their quality and level,

- to form a flexible and more reasonable pricing policy,

- to regularly conduct marketing research of different target orientation.

Conclusions made in the framework of this study can be used in practice of medicine development in the region, can identify some of its "pain points", as well as indicate the direction of further development.

Aristova, E.V. (2012). Specific features of medical services as an economic category. Bulletin of Kostroma State University, 2 (18), 224-228.

Federal Service for Supervision in Health Care. Retrieved from: http://www.roszdravnadzor.ru/feedback/faq (accessed November 15, 2017)

Federal State Statistics Service. Retrieved from: http://www.gks.ru (accessed June 30, 2017).

Kosolapova, N.V. Medical service: legal aspects. Electronic scientific journal "Social aspects of public health, 2 (36), 2014. Retrieved from: http://vestnik.mednet.ru/content/category/5/72/30/lang,en/ (accessed November 12, 2017)

Nagapetyan, N.A. (2015). Marketing in the sectors and spheres of activity: Proc. Allowance. Moscow: University textbook.

Pozdnyakova, T.N. Research of the market of paid medical services of the city of Penza. Retrieved from: http://www.penzgtu.ru/fileadmin/filemounts/itmmbs/staff/publish/pozdnyakova/3.pdf (accessed 10.11.2017)

Preconditions for the emergence of marketing in health. Retrieved from: http: //dado.msk.ru/medicine/doc2/zxrZsY.html (accessed November 14, 2017)

Vyalkov, A.I. (2013). Management and economics of health. Textbook for high schools. Moscow: GEOTAR-Media.

1. Associate Professor, Candidate of Economic Sciences, Department of Business of Technologies and Management, Moscow Technological University; Russian Federation, E-mail: grigorenko@mirea.ru

2. Candidate of Economic Sciences, Department of Business of Technologies and Management, Moscow Technological University; Russian Federation, E-mail: gavrilenko@mirea.ru

3. Assistant, Department of Business of Technologies and Management, Moscow Technological University; Russian Federation, E-mail: belousova@mirea.ru

4. Assistant, Department of Business of Technologies and Management, Moscow Technological University; Russian Federation, E-mail: terpugov@mirea.ru

5. Associate Professor, Candidate of Economic Sciences, Department of Business of Technologies and Management, Moscow Technological University; Russian Federation, E-mail: sadovnichaya@mirea.ru

6. Student, Northeastern University; USA, E-mail: turukina.v@husky.neu.edu