Scientific justification of the need to increase the remuneration of medical workers in the Russian Federation
On June 18, 2022, Russian President Vladimir Putin emphasized fundamental role of healthcare in solving national goals and set the task of its further development. However, despite the heroic efforts of medical workers during the COVID-19 pandemic, led by the headquarters of the industry, in 2020 and 2021 there was a significant increase in mortality rate of the Russian population compared to 2019 (by 19 and 36%, respectively). The most important reason for increase in mortality is decrease in medical care availability for general population due to a shortage of medical personnel. Adoption of measures to increase the remuneration of medical workers, started in 2013 (according to Presidential Decree No. 597 of 07.05.2012), did not allow raising it to a level that would eliminate their deficit.
The aim of the study was to analyze the security and remuneration of medical workers in the Russian Federation and the subjects of the Russian Federation, as well as the main factors that affect the level of these indicators. As a result of the analysis, it was revealed that from 2013 to 2021, the average salary of doctors increased by only 20% in constant prices (2013 = 100%), and for average medical personnel - by 6%. At the same time, the availability of doctors remained at the same level, while for nurses it decreased by 11%. In 2021, in the Russian Federation, the guaranteed salary (tariff rate for one position) for half of doctors was less than 23 thousand rubles, and for average medical workers - less than 12.6 thousand rubles. Excluding Moscow and St. Petersburg, these indicators are less than 22 thousand rubles for doctors, and less than 12 thousand rubles for average medical staff. In 2021, in the Russian Federation, the ratio of the average annual income of a doctor to GDP per capita (that is, to what the country "earns" per capita per year) was 3 times lower than in Germany and 1.5 times lower than in Poland (1.2, 3.6 and 1.8 respectively). As a result of low wages and overwork in 2020, the provision of doctors in the Russian Federation was 5% lower than in the "old" EU countries (3.8 and 4.0 per 1 thousand population, respectively). A particularly pronounced shortage of personnel has developed in the primary health care sector: there are 1.5 times fewer district service doctors than established by the standards, and 2 times fewer paramedics. The difference in salaries of doctors and average medical staff in federal districts was 2 times, in regions - 5 times or more, which leads to labor migration of specialists. To solve the problem of shortage of personnel in the Russian healthcare system, it is required to increase the remuneration of medical workers to the level of military salaries, according to which the wage fund for doctors and secondary medical workers should grow by 2 times in 4 years, which will require an increase in state financing of healthcare, taking into account junior medical and non-medical personnel, annually by at least 300 billion rubles.
Keywords:national development goals of the Russian Federation; remuneration of medical workers; shortage of medical personnel; state financing of healthcare of the Russian Federation
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Ulumbekova G.E., Vlasov Ya.V., Domnikov A.I., Gaponova E.A. Scientific justification of the need to increase the remuneration of medical workers in the Russian Federation. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ [HEALTHCARE MANAGEMENT: News, Views, Education. Bulletin of VSHOUZ]. 2023; 9 (1): 4-25. DOI: https://doi.org/10.33029/2411-8621-2023-9-1-4-25 (in Russian)
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