S.A. Leonov¹, V.I. Perkhov¹, I.A. Titova², Ed.N. Matveev¹, Yu.A. Mirskov¹, M.N. Banteva^1
1Federal Research Institute for Public Health Organization and Information Promotion of Ministry of Health and Social Welfare of the Russian Federation, Moscow, RUSSIA
²Institute of supplemental vocational training of Ministry of education of the Russian Federation, Moscow, RUSSIA

Summary. Out techniques envisaged that principal directions and fully developed proportions between components of public health were to be extrapolated from Federal to Regional level - with regard to local demographic situation and medical organizational underlying structures. This procedure was meant to detect and then implement locally the main structural regularity of basic Federal standards of medical care level.

In calculating state funding needed to provide the realization of standards of medical care level under regional programs of state guarantees, it proved indispensable to implement normalized values of coefficient of transport accessibility of delivered medical care that were really related to local density of population settlement. These locally varying, yet case-to-case fixed coefficients were - when similar in magnitude – unitized in a modular adjusting coefficient for network standards of medical care. This coefficient was in turn derived in part from coefficient for the density of population settlement. The latter was used for 5-chain classification of 82 constituent territories of the Russian Federation, where 17 constituent territories presented high density, 28 constituent territories elevated density, 17 constituent territories – moderate, and 11 – diminished, 9 constituent territories - low density of population settlement.

It is considered inexpedient - when thus classifying the constituent territories - to confine to this adjusting coefficient, which had been directly related to transport accessibility of delivered medical care. Nevertheless, another three-chain classification of constituent territories was created to include 46 constituent territories with low value of adjusting coefficient, 25 constituent territories with moderate one, and 11 constituent territories with high value of adjusting coefficient.

This classification was developed with regard to “regionally adjusted units of cost of medical services” delivered to the population. The purpose of rated equivalent units was purely for calculation and estimation, and the aim of their very introduction was comparative account of budget funding for the realization of standards of medical care level allocated to a set of medical establishments in a given region. Equivalent units do reflect regional distinctions as concerns financial expenses for an entry of one medical service, say, outpatient visit, hospitalization, or anything else of that kind.

Key words. Differential standards of medical care capacities, transport accessibility coefficients, population density coefficients, adjusting coefficient of net standards, equivalent units of medical care capacities. 

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