Some Aspects of the Patient’s Rights Protection in the Public Procurement System for Medical Care

The article provides a comprehensive theoretical and legal analysis of patient rights protection mechanisms in the context of a three-pronged model of legal relations in the healthcare system of the Russian Federation, where the state as a customer of medical services, a medical organization as a performer and the patient as the ultimate beneficiary of medical care interact. The article examines the specifics of the legal status of a patient who, while not formally a party to contractual obligations between the state and a medical organization, is a central element of the entire healthcare system. Using the example of the legal regulation of palliative care in Moscow, institutional mechanisms for protecting patients' rights are considered, including the creation of specialized coordination structures, the formation of patient registers, the standardization of medical care processes and ensuring transport accessibility. The objective conflict of interests between the desire to optimize budget expenditures and the need to provide high-quality medical care is analyzed. The main problematic aspects of the implementation of patient rights have been identified, including information asymmetry, the practice of unjustifiably imposing paid medical services, the limited exercise of the right to choose, and the problem of ensuring the proper quality of medical care. Priority areas for improving the institutional system for protecting patient rights have been identified: strengthening patient subjectivity, ensuring transparency in funding, developing the institute of medical ombudsmen, and digitalizing the healthcare system. The necessity of maintaining a balance of interests of all subjects of legal relations while maintaining the priority of ensuring the rights of the patient as a key goal of the functioning of the healthcare system is substantiated. The authors conclude that ensuring effective protection of patient rights in the institutional system of the state order for medical care requires constant maintenance of a balance of interests of all three subjects of legal relations, with mandatory consideration of both medical data and budgetary opportunities.

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