Kalininskaya A. A., Malikova L.M.
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation

Contacts: Aleftina Kalininskaya, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Abstract. Rural population accounts for 26% of the Russian population or 37.2 million. In a quarter of subjects of the Russian Federation the rural population accounts for 40% of the population. Over the past 13 years (2000-2012) the Russian rural areas have lost 2241’8 thousand human resources. The process of depopulation continues and rural settlements shrink in size. During the inter-census period between 1989 and 2010, the rural areas have lost 9.2 thousand rural settlements. Problems of the rural healthcare include the following: low population density, poor roads and transport connections.

Sociological survey showed that medical care is geographically accessible only to 49% of rural dwellers, while for 40% the access to care is complicated, and for 9% - it is almost inaccessible. 2% of the respondents were undecided with their answer. Many studies indicate low health status of rural population with a sustainable trend towards further deterioration.

The study purpose was to develop proposals to reform rural healthcare based on the analysis of the resources and performance indicators of rural medical facilities with regard to morbidity and accessibility of medical care to rural dwellers.

The study objectives included a review of demographic and health indicators of the rural population in the Russian Federation; comparative analysis of performance indicators of rural medical facilities of different levels in the Russian Federation; analysis of resources and performance indicators of facilities providing medical care on the outpatient and inpatient basis in rural areas, in dynamics for 8 years (2005-2013); comparative analysis of performance indicators of medical facilities in rural areas with the Russian general indexes. The article presents demographic and health indicators of the rural population.

Based on the reporting data of the Ministry of Health of the Russian Federation the authors analyzed major performance indicators of rural medical facilities, and disease incidence in the rural population in Russia as a whole and with a breakdown on the Federal districts. Based on the results, the authors developed proposals for reforming rural healthcare.

Key words: rural healthcare; health care facilities; number of beds, hospitalization rate, rural health centers, municipal district, outpatient health care facilities; inpatient health care facilities.

References

1. Maksimova T.M. Sovremennye problemy i perspektivnye otsenki zdorov'ya naseleniya kak osnova reformirovaniya zdravookhraneniya. [Contemporary issues and future population health assessment as the basis of health care reform]. Problemy sotsial'noy gigieny, zdravookhraneniya i istorii meditsiny 2000; (5): 9-15. (In Russian).
2. Paskal' A.B. Innovatsionnye podkhody k probleme formirovaniya sistemy mediko-sotsial'noy pomoshchi zhitelyam sela [Innovative approaches to the problem of formation of the system of health and social care to rural residents]. Problemy sotsial'noy gigieny, zdravookhraneniya i istorii meditsiny. 2006; (5): 38-39. (In Russian).
3. Sostoyanie sotsial'no-trudovoy sfery sela i predlozheniya po ee regulirovaniyu. Ezhegodnyy doklad po rezul'tatam monitoringa 2013 g.[ The state of social and labor sphere in rural regions and proposals for its regulation. An annual report on the monitoring results]. Moscow: 2014. (15). 268p. (In Russian).
4. Starodubov V.I., Ivanova A.E. Analiz izmeneniy i prognoz smertnosti naseleniya v svyazi s merami demograficheskoy politiki. [Analysis of changes and prediction of population mortality in relation to the measures of demographic policy[. Sotsial'nye aspekty zdorov'ya naseleniya [serial online] 2009; 1(9). Available from: http//vestnik.mednet.ru/content/view/101/30/ (In Russian).
5. Starodubov V.I., Kalininskaya A.A., Dzugaev A.K., Stryuchkov V.V. Problemy zdravookhraneniya sela [Health problems in rural regions]. Moscow: Izdatel'skiy dom Akademii Estestvoznaniya; 2012. 208p. (In Russian).
6. Shchepin V.O., Rastorgueva T.I., Karpova O.B. Sovremennye demograficheskie tendentsii v Rossiyskoy Federatsii [Current demographic trends in the Russian Federation]. Byulleten' Natsional'nogo nauchno-issledovatel'skogo instituta obshchestvennogo zdorov'ya 2013; (2): 10-13 (In Russian).
7. Shchepin O.P., Medik V.A. Obshchestvennoe zdorov'e i zdravookhranenie. Uchebnik dlya sistemy poslevuzovskogo professional'nogo obrazovaniya vrachey po spetsial'nosti "Obshchestvennoe zdorov'e i zdravookhranenie"[Public health and health care. Textbook for postgraduate education in “public health and health care” specialty]. Moscow: GEOTAR-Media; 2012. 592p. (In Russian).

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