On the main problems of healthcare in the Russian Federation and measures to eliminate them

• Vladimir M. Chernyshev
• Oksana V. Strelchenko
• Ildar F. Mingazov

Abstract

In recent years, quite a lot of problems have accumulated in the health care of the Russian Federation, requiring measures to eliminate them.

Аim is to analyze the factors that have had a significant impact on the activity of the modern health care system of the country and to consider measures to eliminate them and improve the structure and functioning of the industry.

Material and methods. Statistical data of the Ministry of Health of Russia and regional health care management bodies, literature devoted to the problems of health care organization in Russia and abroad were used. The following methods were used: analytical, historical, statistical.

Results and discussion. Many problems existing in public health care of the Russian Federation are caused by a number of factors, the main of which are: provision of the branch with medical personnel and deficit financing remaining for many years. All this leads to the non-fulfillment of the Presidential Decree on increasing the salaries of medical workers in some territories. In the country as a whole for the period from 2000 to 2021, the number of doctors per 10,000 population decreased by 10.4%, and the number of specialists with secondary medical education by 17.4%. From 2005 to 2020, in the age structure, the share of doctors under 30 years of age in public medical organizations (MOs) decreased by 1.5 times, and over 50 years of age increased by more than 1.7 times. The number of medical workers in the public health sector decreased by 6.7% over the period, while in the private sector it increased almost threefold. All of the above did not contribute to the improvement of accessibility and quality of medical care. According to the survey data, citizens’ trust in state and municipal MOs at their place of residence amounted to only 16%, while in Malaysia – 75%, in Australia – 74%. Only 11% of Russians consider the quality of medical services in our country to be very good and good.

To improve the quality and availability of medical care to the population it is necessary to: 1) to bring financing up to the level recommended by WHO, i.e. not less than 5% of GDP at the expense of budget funds; 2) to ensure the implementation of the Presidential Decree on raising salaries of medical workers; 3) to create a system of work with personnel, which would allow the state to use trained specialists taking into account the real need for them. In order to ensure more rational and efficient use of the bed fund, its restructuring should be completed. The measures taken should be scientifically justified and financially secured. The heads of the RF subjects should be responsible for the provision of the regions with medical personnel.

Conclusion. The analysis of the state of health care in the country shows the problems, the main of which is the shortage of personnel and insufficient financing. It is necessary to take scientifically grounded measures for their elimination.

Keywords:health care system; health care financing; quality of medical care; accessibility of medical care; medical care, medical personnel; medical personnel deficit

References

1. Sleptsova E.V., Gapeeva V.O. Modern problems of personnel policy in the field of health care. Ekonomika i biznes: teoriya i praktika [Economics and Business: Theory and Practice]. 2018: (5-2). URL: https://cyberleninka.ru/article/n/sovremennye-problemy-kadrovoy-politiki-v-sfere-zdravoohraneniya (date of access 11.05.2023) (in Russian)

2. Resources and activities of medical health care organizations, 1 part. Medical personnel. Statistical materials. In: E.G. Kotova, O.S. Kobyakova, V.I. Starodubov, G.A. Aleksandrova, N.A. Golubev, A.A. Latyshova, et al. Moscow: TsNIIOIZ Minzdrava Rossii, 2022: 285 p. (in Russian)

3. Main indicators of public health and health care of the Siberian Federal District in 2021. Collection of statistical and analytical materials. Issue 21. In: O.V. Strel’chenko (ed.). Novosibirsk: Sibirskoe universitetskoe izdatel’stvo, 2022: 264 р. (in Russian)

4. Ayrapetyan L. Scientists: the number of therapists affects the mortality rate of the population. URL: https://medvestnik.ru/content/news/Uchenye-kolichestvo-terapevtov-vliyaet-na-uroven-smertnosti-naseleniya.html (in Russian).

5. State personnel policy in the sphere of health care. Scientific edition. In: A.A. Kostin, B.T. Ponomarenko (eds). Moscow: Etnosotsium, 2015: 96 р. (in Russian)

6. Health care in Russia 2021. Statistical compendium [Electronic resource]. In: Rosstat. Мoscow, 2021: 171 р. URL: https://rosstat.gov.ru/folder/210/document/13218 (in Russian)

7. Public health and public health care. National guide. In: G.E. Ulumbekova, V.A. Medik (eds). 2^nd ed. Moscow: GEOTAR-Media, 2022: 1144 p. (in Russian)

8. Aksenova E.I., Besschetnova O.V. Indicators of accessibility and quality of medical care, providing satisfaction of the population with medical care in different countries of the world. Expert review. Moscow: GBU «NIIOZMM DZM», 2021: 40 p. (in Russian)

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