SCIENTIFIC SUBSTANTIATION OF THE ORGANIZATIONAL MODEL OF THE ACADEMIC MEDICAL CLUSTER

Abstract

Aim. To develop and substantiate an organizational model of an academic medical cluster built around a multidisciplinary medical university, defining its component composition, the structure of intra-cluster interactions and the managerial mechanisms that integrate teaching, research and clinical care. Materials and methods. The study combined organizational modelling, systems analysis and expert appraisal. A systematic review of Russian and international publications issued between 2005 and 2025 was performed, followed by a comparative analysis of 28 academic medical centers. The model was then appraised by 42 experts across two Delphi rounds run from October 2025 to April 2026. Agreement was quantified with Kendall's coefficient of concordance, and the model was formalized in the IDEF0 and BPMN 2.0 notations. Results. The substantiated model comprises five functional components centered on a multidisciplinary medical university. It rests on translational orientation, horizontal coordination and orientation toward an integral outcome, all of which drew strong expert support (W = 0.78; p<0.001). The components are linked by informational, personnel, resource and process relationships, while governance follows a three-tier scheme spanning strategic, tactical and operational levels and supported by a balanced scorecard of performance indicators. Conclusion. The model is tailored to Russian healthcare and higher medical education. Its implementation appears feasible where an adequate regulatory framework, a receptive organizational culture and financial sustainability are in place, and stepwise cluster formation is preferable to a single-stage transition.