The problems of rural health care and prospects of development

Abstract

Further reforming of the rural health care should be proceeded with special attention to availability of medical care in countryside.The purpose of the study is to develop on the basis of analysis of accounting data and research results recommendations for improving organizational forms of medical care to country dwellers. The exploration of peopleware and main performance indicators of medical organizations in rural areas was implemented.The statistical, analytical and sociological methods were applied. The reporting forms 47, 30, 12 of Federal statistical monitoring are analyzed.Results. The provision of population with medical personnel in rural municipalities in 2010-2018 increased from 12.5 to 14.5 per 10 thousand of rural population. The provision with paramedical personnel made up to 52.3%oo and during the same years indicator decreased from 55.4 to 52.3%oo. During the analysis period, 4241 feldsher obstetric posts were reduced and in 2018 their number made up to 33,350. The number of feldshers in rural areas decreased on 18.5%. In 2005-2018 number of central district hospitals and district hospitals decreased in 2.5 times. At that, provision of beds in municipalities of rural areas decreased from 49.6 to 38.8%oo. There significant winding up of district hospitals and their restructuring into branches of central district hospitals occurred. In 2018, remained only 47 out of them equipped with 1549 beds. Unfortunately, the reporting forms of the Ministry of Health of the Russian Federation do not account branches of central district hospitals. This information is to be included in accountability of the Ministry of Health.It is necessary to expand scope of authority of local government bodies in resolving medical and social problems in rural territories.

Health and Demographic Indicators in Population Over Working Age

“…Низкая медицинская активность и склонность к самолечению, в первую очередь среди жителей сельских территорий, требуют улучшения доступности медицинской помощи, а также усиления просветительской работы со стороны медицинских работников и представителей органов власти [13,14]. Ряд авторов указывают на региональные различия заболеваемости и медико-демографической ситуации в стране, что свидетельствует о необходимости анализа этой ситуации с целью разработки управленческих решений с использованием давно известных ресурсосберегающих технологий и современных информационных систем на региональном уровне [15][16][17][18][19].…”