2022 № 9 Issues related to the powers of state (municipal) healthcare institutions in the field of labor rationing
The presented material concerns the rights and obligations of state (municipal) healthcare institutions in matters of labor rationing. It examines the scope of authority of the heads of these institutions as employers for the organization of rationing.
With reference to the Labor Code of the Russian Federation and other normative legal acts devoted to this topic, various aspects of labor rationing are analyzed. In particular, the degree of completeness of the coverage of labor standards of all employees of medical organizations, the identity of load indicators and labor standards, etc.
2023 № 5 Provision of the medical statistics service with qualified personnel.
The implementation of the tasks of the medical statistics service is an integral part of the health care management process, as well as methodological support of the management vertical in the system [2, 3]. The quality of medical statistical and analytical data depends primarily on the personnel component of the medical statistics service. Currently, medical statistics are developing in the context of significant organizational changes in the healthcare system , which determines the priority of providing the service with qualified personnel .
The purpose of the study: to study the availability of qualified personnel engaged in professional activities in medical statistics.
Materials and methods. The data of the Federal statistical observation form No. 30 “Information about a medical organization” were used for the study.
Statistical and analytical methods were used in the study.
Results. The Medical Statistics Service performs one of the key roles in the management of a medical organization and the healthcare industry as a whole. In medical organizations, statistical document management is carried out by specialists of departments (offices) of medical statistics, which make up the medical statistics service as a whole. The key specialists of the service are statisticians and medical statisticians.
The analysis of the indicator of the availability of qualified personnel of the medical statistics service shows its stable decline. Thus, in the dynamics of the total indicator of the provision of statisticians and medical statisticians per 10 000 population in the Russian Federation from 2015 to 2021, there is a decrease in its level by 18,6% or from 0,86 0/000 to 0,700/000, including in outpatient settings by 24,4% or from 0,450/000 to 0,34 0/000, in stationary by 11,8% or from 0,34 0/000 to 0,30 0/000. By the end of 2021, the shortage of qualified specialists of the medical statistics service amounted to 44,3% of their total needs. A similar situation is observed in medical organizations for outpatient and inpatient medical care (45% and 42,6%, respectively). Simultaneously with the decrease in the staffing of the medical statistics service, an increase in the load on the specialist was revealed. Thus, in medical organizations providing medical care in outpatient and inpatient settings, the average load on a statistician and medical statistician is almost 1,5–2 times higher than the average standard.
Conclusions. The analysis of personnel changes in the medical statistics service indicates the need to improve approaches to the training and use of qualified personnel engaged in professional activities in medical statistics.
2018 № 1 Availability and staffing by phthisiatricians in the Udmurt republic, 2011-2015
Provision of human resources represents one of the main problems in the organization of health care. The purpose of the study was to determine the main trends in the provision and staffing of phthisiatricians. The purpose of the study is determination of the main trends in the provision and staffing by phthisiatricians. Material and meth¬ods: official statistics of Udmurt Republic from 2006 to 2015. Mathematical, analytical and descriptive methods were used. Analysis of the availability of outpatient clinics by the phthisiatricians of the Udmurt Republic in the dynamics for 2011-2015 (per 10 000 population) showed the stability of the situation in the provision of specialists with a slight decrease in staffing. A positive trend was noted in the desire of young specialists to work in phthisiatric services. The results of the study of the level of provision and staffing of the phthisiatrics services in Udmurt Republic demonstrate the stability of the situation as a whole across the Republic, although in some administrative regions of the country the data are highly unequal. The arrival of young specialists in the phthisiatric service is encouraging growth in the supply of specialists in the near future
2020 № 5 Availability and staffing of gastroenterologists in the Russian Federation and in pilot regions, 2013–2017
Human resource issues are of high relevance for accessibility of the quality of health care. The aim of the study was to conduct analyses of actual staffing of health care facilities for provision of gastroenterological care on an outpatient basis in the Russian Federation and its subjects. Materials and methods: calculation of occupied positions and physicians-gastroenterologists rate, extensive indicators, method of descriptive statistics. Results. Multidirectional levels and trends in physicians-gastroenterologists coverage rates in the constituent entities of the Russian Federation have been established. In a number of federal districts there is an increase in the studied indicators, in some – levelling. Conclusions. An analysis of the availability of gastroenterologists roviding health care an outpatient basis showed that the supply of gastroenterologists in the federal districts increased or levelled. Moreover, in six of them there was a decrease in the staffing rate by these specialists. The results of the study could be used for the human resources planning and for decision-making.
2021 № 8 Regional features of the provision of medical personnel in Russia
The article analyzes the regional features of the provision of medical personnel in Russia in the context of various subjects and federal districts.
P u r p o s e of the study is to analyze the features of staffing of medical organizations in the constituent entities of the Russian Federation in modern conditions and the main directions of policy to improve the staffing situation at the regional level.
M a t e r i a l s a n d m e t h o d s . According to the official statistics, an analysis of the staffing of medical and paramedical personnel was carried out in the context of the constituent entities of the Russian Federation; in the course of the study, methods were used such as: analytical, statistical, study and generalization of experience.
R e s u l t s . The analysis showed that the provision of doctors and the provision of emergency medical services for different regions of the Russian Federation is different. The lowest values of the indicator of the provision of doctors in 2019 were recorded in the Ural FD, the Southern FD and the North Caucasian FD, while in the constituent entities of the Russian Federation the most pronounced tendency towards a decrease in the level of provision nursing staff was noted in Moscow, Tyumen region, Chukotka Autonomous Okrug, Republic of Kalmykia, Udmurt Republic, as well as in Yaroslavl, Murmansk, Novgorod and Kirov regions, which emphasizes the need to take appropriate management measures, both at the local and federal levels.
F i n d i n g s . The existing imbalance in the country between the provision of the population with doctors and nurses in various regions (the difference between low and high rates is more than 2.3 times), as well as between the provision of medical workers in the city and rural areas is the main problem of staffing the system. To overcome this situation, further implementation of new measures of social support and moral incentives for medical personnel in Russia is required.
2022 № 7 Analysis of morbidity and staffing of the population of rural areas in the Russian Federation
Rural health care is the most important socio-economic resource in the system of the agrarian economy.
Purpose of the study. Based on medical and demographic indicators and analysis of morbidity and staffing of the rural population, develop proposals for improving the organization of medical care for rural residents.
M a t e r i a l s a n d m e t h o d s : analytical, statistical, direct observation. The article used the forms of federal statistical observation of the Ministry of Health of the Russian Federation.
R e s u l t s . The mortality rate of the rural population over the 20 years of analysis for all the years has been and remains higher than that of the urban population. In 2020, there was a sharp increase in the mortality of the population: urban – from 11,9 to 14,3‰, rural – from 13,3 to 15,4‰, which is associated with the COVID‑19 pandemic. The indicators of the general and newly diagnosed morbidity of the rural population are lower than those of the urban population, which is associated with the low availability of medical care to the rural population.
The ranking of indicators of the general incidence of the rural population in the federal districts of the Russian Federation (2020) showed that the difference in indicators was 1,5 times. The highest indicator was noted in the Volga Federal District – 142220,6‰00, the lowest in the Far Eastern Federal District – 96922,8‰00. In the subjects of the Russian Federation, the difference in indicators is 8 times. Lower rates of primary morbidity in the rural population than in the urban population were noted for all classes of diseases. The incidence of COVID‑19 among rural residents was 2151,9‰00, lower than in urban areas – 4539,5‰00, in the Russian Federation the figure was 3384,5‰00. In 2020, the primary morbidity rate of the rural population decreased for all classes of diseases, except for respiratory diseases. In dynamics (2014–2020), the provision of medical organizations located in rural areas increased with doctors from 12,1 to 14,0‰0, with nurses from 44,4 to 50,3‰0, the number of physical EMS persons decreased by 14,8%, paramedics – by 11,6%, the number of FAPs and AFs decreased by 8,9%. The analysis shows that the Decree of the Government of the Russian Federation dated 02.02.2015 No. 151-r “Target indicators of the strategy for sustainable development of rural areas of the Russian Federation for the period up to 2030” is not being implemented.
C o n c l u s i o n . Proposals for providing medical care to the population of rural areas are presented
2014 № 10 Russian and regional parameters of activity of general practitioners (Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia)
Annotation. The total number of general practitioner's visits within the studied period has increased in Russia and other federal regions, and in some states — significantly. There is noticed a trend of decrease in the number of preventative visits at home, relative share of visits among country side residents. There is a considerable increase in coefficient of double job holding against a general trend for decrease of practitioner's staffing. There is demonstrated a high demand in general practitioners, in their ability to provide first medical aid and high accessibility of their services to the public. Therefore, development of the institute of general practice should be considered as a perspective path for managing medical-sanitary aid.
2019 № 10 The main contours of the next reform of sectoral wage system in public health
The special attention paid to staffing is not accidental – it is a natural reaction of the state to the deterioration of the situation with the number of medical workers in state (municipal) institutions. In turn, the personnel deficit has increased due to the fact that in difficult economic conditions, many institutions have taken the path of reducing workers in order to increase the wages of the remaining. These steps directly contradicted the logic of the "May" presidential Decrees of 2012, but simplified the task of achieving the salaries of medical workers at the level stipulated by these Decrees. Therefore, a number of documents reflecting the strategy of development of health care, as well as the Instructions of the President contain measures aimed at correcting the situation, including by reforming the system of remuneration of employees of state (municipal) health care institutions. At the same time, it is important not just to implement the measures provided for in these documents, but also a specific implementation mechanism. Therefore, the article analyzes the possible positive and negative consequences of various options for the implementation of measures provided for by the Instructions and other documents.
2015 № 4 Supply of general practitioners and their activity in different federal districts of the country in the period from 2007 to 2013 biennium
In the Russian Federation from 2007 to 2013 biennium. indicator of the availability of general practitioners has steadily increased. The most pronounced positive trend registered in the southern federal district (53,9%), the lowest-in the Siberian federal district (2,6%), along with the indicators of the medical and the coefficients of its rejection had considerable variability (maximum in the North Caucasus federal district: +40,6%, minimum-VLS: +14,6%) Also decreased the number of specialists, particularly in the Northwest and Vls, which contributed to the growth in health care ISSUES for the country as a whole, over the period from 2007 to 2013 biennium. was +31,4%. Increased proportion of patients and GPS at home, especially rural people. The overwhelming number of visits to doctors in that specialty was about diseases. This situation requires re-evaluation of the primary health care for the population in order to increase the availability of care provided by general practitioners, and the basis of the positive experience of a number of constituent entities of the Russian Federation.
2020 № 4 Risks that need to be taken into account in the implementation of a new model of a medical organization providing primary health care help
The article analyzes documents (guidelines, drafts of Federal legal acts) that present issues related to criteria and the introduction of a new model of a medical organization that provides primary health care. As a result, it was noted that the analyzed documents lack clear characteristics of the new model, the principles of its organization and functioning, and there is no clear description of the content and structure of the new model. The article draws attention to the fact that the financial and economic justification of the draft Law on the implementation of the new model does not contain any information about the financial and human resources required for the implementation of the new model. The authors emphasize that one of the main criteria for allowing medical organizations to implement the new model should be at least
2016 № 5 Overview of the implementation of a policy to provide neurosurgery medical care for adult population in Ryasan region
The quality and accessibility of medical care affect improving health, social and economic efficiency and directly dependent on the optimal organization of medical care on the basis of developed and approved procedures of medical care. The number of beds and neuro-surgical profile doctors-neuro-surgeons in the Ryazan region, are lower than the national average. In General, in the Ryazan region observed the procedure of rendering of medical aid to adult population the profile of «neurosurgery». To improve the quality and efficiency of neurosurgical care is necessary to conduct a number of organizational measures.